Optical read out and feedback cooling of a nanostring optomechanical cavity

Optical measurement of the motion of a 940 kHz mechanical resonance of a silicon nitride nanostring resonator is demonstrated with a read out noise imprecision reaching 37 dB below that of the resonator's zero-point fluctuations. Via intensity modulation of the optical probe laser, radiation pressure feedback is used to cool and damp the mechanical mode from an initial room temperature occupancy of $\bar{n}_{b} = 6.5 \times 10^6$ ($T_{b}=295$K) down to a phonon occupation of $\langle n \rangle = 66 \pm 10$, representing a mode temperature of $T_{m} \approx 3$mK. The five decades of cooling is enabled by the system's large single-photon cooperativity $(C_{1} = 4)$ and high quantum efficiency of optical motion detection ($\eta_{t} = 0.27$).Comment: 13 pages, 13 figure

Challenging the Perceived Value of Alumni by Developing a Peer-Mentoring Scheme to Support Student Learning.

While peer-assisted learning and peer mentoring schemes are commonplace in HEIs, the use of alumni in supporting postgraduate students is a new and innovative development. This article describes a recent initiative at a post-92 university involving the use of alumni from the MBA programme to act as mentors for incoming part-time MBA students

Development of CMX001 for the Treatment of Poxvirus Infections

CMX001 (phosphonic acid, [[(S)-2-(4-amino-2-oxo-1(2H)-pyrimidinyl)-1-(hydroxymethyl)ethoxy]methyl]mono[3-(hexadecyloxy)propyl] ester) is a lipid conjugate of the acyclic nucleotide phosphonate, cidofovir (CDV). CMX001 is currently in Phase II clinical trials for the prophylaxis of human cytomegalovirus infection and under development using the Animal Rule for smallpox infection. It has proven effective in reduction of morbidity and mortality in animal models of human smallpox, even after the onset of lesions and other clinical signs of disease. CMX001 and CDV are active against all five families of double-stranded DNA (dsDNA) viruses that cause human morbidity and mortality, including orthopoxviruses such as variola virus, the cause of human smallpox. However, the clinical utility of CDV is limited by the requirement for intravenous dosing and a high incidence of acute kidney toxicity. The risk of nephrotoxicity necessitates pre-hydration and probenecid administration in a health care facility, further complicating high volume CDV use in an emergency situation. Compared with CDV, CMX001 has a number of advantages for treatment of smallpox in an emergency including greater potency in vitro against all dsDNA viruses that cause human disease, a high genetic barrier to resistance, convenient oral administration as a tablet or liquid, and no evidence to date of nephrotoxicity in either animals or humans. The apparent lack of nephrotoxicity observed with CMX001 in vivo is because it is not a substrate for the human organic anion transporters that actively secrete CDV into kidney cells. The ability to test the safety and efficacy of CMX001 in patients with life-threatening dsDNA virus infections which share many basic traits with variola is a major advantage in the development of this antiviral for a smallpox indication

The development of responsible & sustainable business practice: value, mind-sets, business-models

The main goal of this Special Issue (SI) of the Journal of Business Ethics is to explore the changes in values and mind-sets that are required for new, sustainable and ethical business models and consumption practices to flourish. Notable manifestations of efforts to embody an ethical perspective within business practices are seen in recent attempts to rethink business models (Bocken, Short, Rana and Evans, 2014, Linder and Williander, 2015) and to develop hybrid organisations (e.g., social enterprises) and collaborations (Defourney and Nissens, 2006) more likely to balance economic, social and environmental needs. Changes in consumption range from selecting more ethical and sustainable options, e.g., fair trade, renewable energy etc. (De Pelsmacker and Janssens, 2007; Bang, Ellinger, Hadjimarcou and Traichal, 2000) and slowing the acquisition and replacement of goods (Cooper, 2005, 2010) to more radical shifts in lifestyles such as voluntary simplicity (Marchand, Walker and Cooper, 2010; Shaw and Riach, 2011). It is widely recognised that embedded practices and beliefs constrain change, but there is a keenness to investigate the emergence of business and consumption practices that shift away from traditional resource-depleting forms of capitalism. We are delighted to guest edit this special issue and present a set of papers that illustrates the appetite to generate this insight by examining diverse forms of enterprise and consumption, evidencing efforts to embed more ethical and sustainable approaches. Though the papers vary in the conceptual lenses that they adopt, the trend towards a process-based perspective of valuation is evident among them. Hence we start our editorial by articulating some of the changing conceptions of value and the potential to explore how evolving mind-sets and mental models can influence responsible and sustainable business

Sequential simulation (SqS) of clinical pathways: a tool for public and patient engagement in point-of-care diagnostics

Objectives: Public and patient engagement (PPE) is fundamental to healthcare research. To facilitate effective engagement in novel point-of-care tests (POCTs), the test and downstream consequences of the result need to be considered. Sequential simulation (SqS) is a tool to represent patient journeys and the effects of intervention at each and subsequent stages. This case study presents a process evaluation of SqS as a tool for PPE in the development of a volatile organic compound-based breath test POCT for the diagnosis of oesophagogastric (OG) cancer. Setting: Three 3-hour workshops in central London. Participants: 38 members of public attended a workshop, 26 (68%) had no prior experience of the OG cancer diagnostic pathway. Interventions: Clinical pathway SqS was developed from a storyboard of a patient, played by an actor, noticing symptoms of oesophageal cancer and following a typical diagnostic pathway. The proposed breath testing strategy was then introduced and incorporated into a second SqS to demonstrate pathway impact. Facilitated group discussions followed each SqS. Primary and secondary outcome measures: Evaluation was conducted through pre-event and postevent questionnaires, field notes and analysis of audiovisual recordings. Results: 38 participants attended a workshop. All participants agreed they were able to contribute to discussions and like the idea of an OG cancer breath test. Five themes emerged related to the proposed new breath test including awareness of OG cancer, barriers to testing and diagnosis, design of new test device, new clinical pathway and placement of test device. 3 themes emerged related to the use of SqS: participatory engagement, simulation and empathetic engagement, and why participants attended. Conclusions: SqS facilitated a shared immersive experience for participants and researchers that led to the coconstruction of knowledge that will guide future research activities and be of value to stakeholders concerned with the invention and adoption of POCT

Comparison of high and low intensity contact between secondary and primary care to detect people at ultra-high risk for psychosis: study protocol for a theory-based, cluster randomized controlled trial.

BACKGROUND: The early detection and referral to specialized services of young people at ultra-high risk (UHR) for psychosis may reduce the duration of untreated psychosis and, therefore, improve prognosis. General practitioners (GPs) are usually the healthcare professionals contacted first on the help-seeking pathway of these individuals. METHODS/DESIGN: This is a cluster randomized controlled trial (cRCT) of primary care practices in Cambridgeshire and Peterborough, UK. Practices are randomly allocated into two groups in order to establish which is the most effective and cost-effective way to identify people at UHR for psychosis. One group will receive postal information about the local early intervention in psychosis service, including how to identify young people who may be in the early stages of a psychotic illness. The second group will receive the same information plus an additional, ongoing theory-based educational intervention with dedicated liaison practitioners to train clinical staff at each site. The primary outcome of this trial is count data over a 2-year period: the yield - number of UHR for psychosis referrals to a specialist early intervention in psychosis service - per primary care practice. DISCUSSION: There is little guidance on the essential components of effective and cost-effective educational interventions in primary mental health care. Furthermore, no study has demonstrated an effect of a theory-based intervention to help GPs identify young people at UHR for psychosis. This study protocol is underpinned by a robust scientific rationale that intends to address these limitations. TRIAL REGISTRATION: Current Controlled Trials ISRCTN70185866.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

A microchip optomechanical accelerometer

The monitoring of accelerations is essential for a variety of applications ranging from inertial navigation to consumer electronics. The basic operation principle of an accelerometer is to measure the displacement of a flexibly mounted test mass; sensitive displacement measurement can be realized using capacitive, piezo-electric, tunnel-current, or optical methods. While optical readout provides superior displacement resolution and resilience to electromagnetic interference, current optical accelerometers either do not allow for chip-scale integration or require bulky test masses. Here we demonstrate an optomechanical accelerometer that employs ultra-sensitive all-optical displacement read-out using a planar photonic crystal cavity monolithically integrated with a nano-tethered test mass of high mechanical Q-factor. This device architecture allows for full on-chip integration and achieves a broadband acceleration resolution of 10 \mu g/rt-Hz, a bandwidth greater than 20 kHz, and a dynamic range of 50 dB with sub-milliwatt optical power requirements. Moreover, the nano-gram test masses used here allow for optomechanical back-action in the form of cooling or the optical spring effect, setting the stage for a new class of motional sensors.Comment: 16 pages, 9 figure

Assessing the content validity of the revised Health of the Nation Outcome Scales 65+: the HoNOS Older Adults

Aims and method: Recently, the Health of the Nation Outcome Scales (HoNOS) 65+ was revised. Twenty-five experts from Australia and New Zealand completed an anonymous web-based survey about the content validity of the revised measure, the HoNOS Older Adults (HoNOS OA). Results: All 12 HoNOS OA scales were rated by most (≥75%) experts as ‘important’ or ‘very important’ for determining overall clinical severity among older adults. Ratings of sensitivity to change, comprehensibility and comprehensiveness were more variable, but mostly positive. Experts’ comments provided possible explanations. For example, some experts suggested that additional older adult-specific examples be included in the glossary (e.g., for scales measuring depressed mood, problems with relationships, and problems with activities of daily living). Clinical implications: Experts agreed that the HoNOS OA measures important constructs. Training may be needed to orient experienced raters to the rationale for some revisions. Further psychometric testing of the HoNOS OA is recommended

Assessing the content validity of the revised Health of the Nation Outcome Scales (HoNOS 2018)

The Health of the Nation Outcome Scales (HoNOS) comprises 12 scales that cover the kinds of problems that may be experienced by working-age adults in contact with specialised mental health services. Drawing on 20 years’ experience in clinical practice, a collaborative, international review of the HoNOS was undertaken and a revised measure (known as the HoNOS 2018) was published. In this study, 32 experts from Australia, England and New Zealand completed an anonymous web-based survey to assess the relevance, comprehensiveness and comprehensibility (aspects of content validity) of the HoNOS 2018. The experts rated 11 of the 12 HoNOS 2018 scales as ‘important’ or ‘very important’ for determining the overall clinical severity (item-level content validity index or I-CVI ≥ 0.75). Evaluations of the scales’ ability to capture change, comprehensiveness and comprehensibility were more variable, but generally positive. Experts’ comments provided further insights into this variability; for example, they noted that some scales combine multiple phenomena, which can result in ambiguity in item wording and assessment challenges. Results from this study suggest that the revisions have not altered the importance of the scales. Given the measure’s breadth of content, training remains important for ensuring rating fidelity. Inter-rater reliability and utility testing are indicated

Exercise training in pediatric patients with end-stage renal disease

The objective of this study was to determine the feasibility and efficacy of an exercise training program to improve exercise capacity and fatigue level in pediatric patients with end-stage renal disease (ESRD). Twenty children on dialysis intended to perform a 12-week graded community-based exercise program. Exercise capacity and fatigue level were studied; muscle force and health-related quality of life were secondary outcomes. All outcomes were measured at baseline (T = 0) and after intervention (T = 1). Fourteen of the 20 patients (70%) either did not start the program or did not complete the program. Of these patients, seven did not complete or even start the exercise program because of a combination of lack of time and motivational problems. Six patients were not able to continue the program or were unable to do the follow-up measurements because of medical problems. Exercise capacity and muscle strength was higher after the exercise program in the children who completed the training. In conclusion, exercise training is difficult to perform in children with ESRD and is not always feasible in real-life situations for many children with ESRD