Atrial Fibrillation and Hyperthyroidism

Atrial fibrillation occurs in 10 – 15% of patients with hyperthyroidism. Low serum thyrotropin concentration is an independent risk factor for atrial fibrillation. Thyroid hormone contributes to arrythmogenic activity by altering the electrophysiological characteristics of atrial myocytes by shortening the action potential duration, enhancing automaticity and triggered activity in the pulmonary vein cardio myocytes. Hyperthyroidism results in excess mortality from increased incidence of circulatory diseases and dysrhythmias. Incidence of cerebral embolism is more in hyperthyroid patients with atrial fibrillation, especially in the elderly and anti-coagulation is indicated in them. Treatment of hyperthyroidism results in conversion to sinus rhythm in up to two-third of patients. Beta-blockers reduce left ventricular hypertrophy and atrial and ventricular arrhythmias in patients with hyperthyroidism. Treatment of sub clinical hyperthyroidism is controversial. Optimizing dose of thyroxine treatment in those with replacement therapy and beta-blockers is useful in exogenous subclinical hyperthyroidism

Are interventions for improving the quality of services provided by specialized drug shops effective in sub-Saharan Africa? A systematic review of the literature.

PURPOSE: We set out to determine effectiveness of interventions for improving the quality of services provided by specialized drug shops in sub-Saharan Africa. DATA SOURCES: We searched PubMed, CAB Abstracts, Web of Science, PsycINFO and Eldis databases and websites for organizations such as WHO and Management Sciences for Health. Finally, we searched manually through the references of retrieved articles. STUDY SELECTION: Our search strategy included randomized trials, time-series studies and before and after studies evaluating six interventions; education, peer review, reorganizing administrative structures, incentives, regulation and legislation. DATA EXTRACTION: We extracted information on design features, participants, interventions and outcomes assessed studies for methodological quality, and extracted results, all using uniform checklists. RESULTS OF DATA SYNTHESIS: We obtained 10 studies, all implementing educational interventions. Outcome measures were heterogeneous and included knowledge, communication and dispensing practices. Education improved knowledge across studies, but gave mixed results on communication between sellers and clients, dispensing of appropriate treatments and referring of patients to health facilities. Profit incentives appeared to constrain behaviour change in certain instances, although cases of shops adopting practices at the expense of sales revenue were also reported. CONCLUSION: Evidence suggests that knowledge and practices of pharmacies and drug shops can be improved across a range of diseases and countries/regions, although variations were reported across studies. Profit incentives appear to bear some influence on the level of success of interventions. More work is required to extend the geographical base of evidence, investigate cost-effectiveness and evaluate sustainability of interventions over periods longer than 1 year

Quasi-Degenerate Neutrino Masses with Normal and Inverted Hierarchy

The effects of CP-phases on the three absolute quasi-degenerate Majorana neutrino (QDN) masses are stud-ied with neutrino mass matrices obeying {\mu} - {\tau} symmetry for normal as well as inverted hierarchical mass patterns. We have made further investigations on 1) the prediction of solar mixing angle which lies below tri-bimaximal mixing value in consistent with neutrino oscillation observational data, 2) the prediction on absolute neutrino mass parameter (mee) in 0{\nu}{\beta}{\beta} decay, and 3) cosmological bound on the sum of the three absolute neutrino masses. The numerical analysis is carried out through the parameterization of neu- trino mass matrices using only two unknown parameters ({\epsilon}, {\eta}) within {\mu} - {\tau} symmetry. The results show the validity of QDN mass models in both normal and inverted hierarchical patterns. These models are far from discrimination and hence not yet ruled out. The results presented in this article are new and have subtle ef- fects in the discrimination of neutrino mass models.Comment: 8 pages, gave a contributory Talk at Ist IAS-CERN Singpore, Jan 2012; Journal of Modern Physics (JMP), Vol 2. No.11, November 2011 US

Quantum quenches in the Dicke model: statistics of the work done and of other observables

We study the statistics of the work done in a zero temperature quench of the coupling constant in the Dicke model describing the interaction between a gas of two level atoms and a single electromagnetic cavity mode. When either the final or the initial coupling constants approach the critical coupling $\lambda_c$ that separates the normal and superradiant phases of the system, the probability distribution of the work done displays singular behavior. The average work tends to diverge as the initial coupling parameter is brought closer to the critical value $\lambda_c$. In contrast, for quenches ending close to criticality, the distribution of work has finite moments but displays a sequence of edge singularities. This contrasting behavior is related to the difference between the processes of compression and expansion of a particle subject to a sudden change of its confining potential. We confirm this by studying in detail the time dependent statistics of other observables, such as the quadratures of the photons and the total occupation of the bosonic modes.Comment: 8 pages, 2 figure

Peak into the Past - An Archaeo-Astronomy Summer School

Our landscape has been shaped by man throughout the millennia. It still contains many clues to how it was used in the past giving us insights into ancient cultures and their everyday life. Our summer school uses archaeology and astronomy as a focus for effective out-of-classroom learning experiences. It demonstrates how a field trip can be used to its full potential by utilising ancient monuments as outdoor classrooms. This article shows how such a summer school can be embedded into the secondary curriculum; giving advice, example activities, locations to visit, and outlines the impact this work has had.Comment: 11 pages, 10 figures, accepted for School Science Revie

Linear recurrences and asymptotic behavior of exponential sums of symmetric boolean functions

In this paper we give an improvement of the degree of the homogeneous linear recurrence with integer coefficients that exponential sums of symmetric Boolean functions satisfy. This improvement is tight. We also compute the asymptotic behavior of symmetric Boolean functions and provide a formula that allows us to determine if a symmetric boolean function is asymptotically not balanced. In particular, when the degree of the symmetric function is a power of two, then the exponential sum is much smaller than $2^n$.Comment: 18 pages, 3 figure

Police use of force: a contextual study of 'suicide by cop' within the British Police paradigm

The phenomenon of ‘Suicide by Cop’ (SbC) may be described as a ‘high impact low probability’ type of event occurring where a vulnerable individual, with ‘lethality of means’, initiates self-destructive violent conduct. Necessary to sustain public confidence and police legitimacy, research to understand the police response to SbC is deficient in England & Wales (E&W). By understanding the theories, challenges and operational reality of mitigating a vulnerable individual’s SbC ideation, this research seeks to develop a fuller comprehension of the use of force (UoF) paradigm within an E&W policing context. Using a mixed method approach, a survey questionnaire (n=315) and published UoF Metropolitan Police Service (MPS) dataset (n=132,410) was statistically analysed. Comparing MPS TASER and authorised firearms officer’s UoF, this research analyses the response, effectiveness and limitations of policing high-risk persons. The findings indicate the sample response to a ‘high-risk’ person is statistically similar, implying a minimal difference in decision making or application of force. The influence of training appears a factor in mitigating threat or risk and the proficiency of any response. This research indicates that firearms officers enhanced training conditions a ‘primed’ response, reducing cognitive burden and enabling the use of other de-escalation tactics. This thesis argues the occurrence of SbC or similar averted ‘near miss’ type incidents is not measured and is reliant on post-incident investigations to improve operational practise. This research concludes implying the mode of arming and use of force paradigm within an E&W context may innately restrain police use of fatal force