2,185 research outputs found
Anderson localisation in tight-binding models with flat bands
We consider the effect of weak disorder on eigenstates in a special class of
tight-binding models. Models in this class have short-range hopping on periodic
lattices; their defining feature is that the clean systems have some energy
bands that are dispersionless throughout the Brillouin zone. We show that
states derived from these flat bands are generically critical in the presence
of weak disorder, being neither Anderson localised nor spatially extended.
Further, we establish a mapping between this localisation problem and the one
of resonances in random impedance networks, which previous work has suggested
are also critical. Our conclusions are illustrated using numerical results for
a two-dimensional lattice, known as the square lattice with crossings or the
planar pyrochlore lattice.Comment: 5 pages, 3 figures, as published (this version includes minor
corrections
Doctors’ approaches to PSA testing and overdiagnosis in primary healthcare: a qualitative study.
Objectives: (1) To explain general practitioners’ (GPs’) approaches to prostate-specific antigen (PSA) testing and overdiagnosis; (2) to explain how GPs reason about their PSA testing routines and (3) to explain how these routines influence GPs’ personal experience as clinicians. Setting: Primary care practices in Australia including men’s health clinics and rural practices with variable access to urology services. Partic ipants: 32 urban and rural GPs within Australia. We included GPs of varying ages, gender (11 female), clinical experience and patient populations. All GPs interested in participating in the study were included. Primary and secondary outcome measure(s): Data were analysed using grounded theory methods to determine how and why GPs provide (or do not provide) PSA testing to their asymptomatic male patients. Results: We observed patterned variation in GP practice, and identified four heuristics to describe GP preference for, and approaches to, PSA testing and overdiagnosis: (1) GPs who prioritised avoiding underdiagnosis, (2) GPs who weighed underdiagnosis and overdiagnosis case by case, (3) GPs who prioritised avoiding overdiagnosis and (4) GPs who did not engage with overdiagnosis at all. The heuristics guided GPs’ Routine Practice (usual testing, communication and responses to patient request). The heuristics also reflected GPs’ different Practice Rationales (drawing on experience, medicolegal obligations, guidelines and evidence) and produced different Practice Outcomes (GPs’ experiences of the consequences of their PSA testing decisions). Some of these heuristics were more responsive to patient preferences than others. Conclus ions: Variation in GPs’ PSA testing practices is strongly related to their approach to overdiagnosis and underdiagnosis of prostate cancer. Men receive very different care depending on their GP’s reasoning and practice preferences. Future policy to address overdiagnosis will be more likely to succeed if it responds to these patterned variationsThe project was funded by NHMRC grant 1023197. Stacy Carter is supported by NHMRC Career Development Fellowship 1032963
Doctors\u27 perspectives on PSA testing illuminate established differences in prostate cancer screening rates between Australia and the UK: A qualitative study
Objectives: To examine how general practitioners (GPs) in the UK and GPs in Australia explain their prostate-specific antigen (PSA) testing practices and to illuminate how these explanations are similar and how they are different.
Design: A grounded theory study.
Setting: Primary care practices in Australia and the UK.
Participants: 69 GPs in Australia (n=40) and the UK (n=29). We included GPs of varying ages, sex, clinical experience and patient populations. All GPs interested in participating in the study were included.
Results: GPs’ accounts revealed fundamental differences in whether and how prostate cancer screening occurred in their practice and in the broader context within which they operate. The history of prostate screening policy, organisational structures and funding models appeared to drive more prostate screening in Australia and less in the UK. In Australia, screening processes and decisions were mostly at the discretion of individual clinicians, and varied considerably, whereas the accounts of UK GPs clearly reflected a consistent, organisationally embedded approach based on local evidence-based recommendations to discourage screening.
Conclusions: The GP accounts suggested that healthcare systems, including historical and current organisational and funding structures and rules, collectively contribute to how and why clinicians use the PSA test and play a significant role in creating the mindlines that GPs employ in their clinic. Australia’s recently released consensus guidelines may support more streamlined and consistent care. However, if GP mindlines and thus routine practice in Australia are to shift, to ultimately reduce unnecessary or harmful prostate screening, it is likely that other important drivers at all levels of the screening process will need to be addressed
Managing the Remains of Foetuses and Abandoned Infants – A Call to Urgently Review South African Law and Medico-legal Practice
This article reviews South African (SA) law and its impact on the medicolegal management of fetal remains emanating from elective and therapeutic termination of pregnancies, stillbirths and miscarriages and the remains of abandoned or exposed infants. It was found that remains are treated differently, some constituting medical waste while others have sufficient status in law to allow for burial. This approach results in some women or couples being denied a choice with regard to disposal via culturally relevant practices, and is insensitive to the fact that all remains ultimately constitute human remains. The article argues that SA law is in urgent need of reform, and turns to foreign law and forensic practice to shed light on possible alternative approaches that could assist with developing the SA position and thereby improve the practical management of fetal and infant remains in SA
Spatial modeling of individual-level infectious disease transmission: Tuberculosis data in Manitoba, Canada
Geographically dependent individual level models (GD-ILMs) are a class of statistical models that can be used to study the spread of infectious disease through a population in discrete-time in which covariates can be measured both at individual and area levels. The typical ILMs to illustrate spatial data are based on the distance between susceptible and infectious individuals. A key feature of GD-ILMs is that they take into account the spatial location of the individuals in addition to the distance between susceptible and infectious individuals. As a motivation of this article, we consider tuberculosis (TB) data which is an infectious disease which can be transmitted through individuals. It is also known that certain areas/demographics/communities have higher prevalent of TB (see Section 4 for more details). It is also of interest of policy makers to identify those areas with higher infectivity rate of TB for possible preventions. Therefore, we need to analyze this data properly to address those concerns. In this article, the expectation conditional maximization algorithm is proposed for estimating the parameters of GD-ILMs to be able to predict the areas with the highest average infectivity rates of TB. We also evaluate the performance of our proposed approach through some simulations. Our simulation results indicate that the proposed method provides reliable estimates of parameters which confirms accuracy of the infectivity rates
The effects of inhomogeneities on the cosmology of type IIB conifold transitions
In this paper we examine the evolution of the effective field theory
describing a conifold transition in type IIB string theory. Previous studies
have considered such dynamics starting from the cosmological approximation of
homogeneous fields, here we include the effects of inhomogeneities by using a
real-time lattice field theory simulation. By including spatial variations we
are able to simulate the effect of currents and the gauge fields which they
source. We identify two different regimes where the inhomogeneities have
opposite effects, one where they aid the system to complete the conifold
transition and another where they hinder it. The existence of quantized fluxes
in related systems has lead to the speculation that (unstable) string solutions
could exist, using our simulations we give strong evidence that these
string-like defects do not form.Comment: 11 pages, 2 figures. Published versio
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Measles vaccination and antibody response in autism spectrum disorder
OBJECTIVE: To test the hypothesis that measles vaccination was involved in the pathogenesis of autism spectrum disorders (ASD) as evidenced by signs of a persistent measles infection or abnormally persistent immune response shown by circulating measles virus or raised antibody titres in children with ASD who had been vaccinated against measles, mumps and rubella (MMR) compared with controls. DESIGN: Case-control study, community based. METHODS: A community sample of vaccinated children aged 10-12 years in the UK with ASD (n = 98) and two control groups of similar age, one with special educational needs but no ASD (n = 52) and one typically developing group (n = 90), were tested for measles virus and antibody response to measles in the serum. RESULTS: No difference was found between cases and controls for measles antibody response. There was no dose-response relationship between autism symptoms and antibody concentrations. Measles virus nucleic acid was amplified by reverse transcriptase-PCR in peripheral blood mononuclear cells from one patient with autism and two typically developing children. There was no evidence of a differential response to measles virus or the measles component of the MMR in children with ASD, with or without regression, and controls who had either one or two doses of MMR. Only one child from the control group had clinical symptoms of possible enterocolitis. CONCLUSION: No association between measles vaccination and ASD was shown
The strong coupling constant from lattice QCD with N_f=2 dynamical quarks
We compute for two flavors of light dynamical quarks
using non-perturbatively improved Wilson fermions. We improve on a
recent calculation by employing Pad\'e-improved two-loop and three-loop
perturbation theory to convert the lattice numbers to the scheme.Comment: Contribution to Lattice 2001 (matrix elements), typo correcte
The costs of scaling up HIV prevention for high risk groups: lessons learned from the Avahan Programme in India.
OBJECTIVE: The study objective is to measure, analyse costs of scaling up HIV prevention for high-risk groups in India, in order to assist the design of future HIV prevention programmes in South Asia and beyond. DESIGN: Prospective costing study. METHODS: This study is one of the most comprehensive studies of the costs of HIV prevention for high-risk groups to date in both its scope and size. HIV prevention included outreach, sexually transmitted infections (STI) services, condom provision, expertise enhancement, community mobilisation and enabling environment activities. Economic costs were collected from 138 non-government organisations (NGOs) in 64 districts, four state level lead implementing partners (SLPs), and the national programme level (Bill and Melinda Gates Foundation (BMGF)) office over four years using a top down costing approach, presented in US 235(56-1864) and US 477 per person reached in 2004 to US 68 to US$ 64 per person reached. CONCLUSIONS: Scaling up HIV prevention for high risk groups requires significant investment in expertise enhancement and programme administration. However, unit costs decreased with programme expansion in spite of an increase in the scope of activities
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