Optimizing patient risk stratification for colonoscopy screening and surveillance of colorectal cancer: The role for linked data

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Noise activated nonlinear dynamic sensors.

We introduce a novel dynamical description for a wide class of nonlinear physical sensors operating in a noisy environment. The presence of unknown physical signals is assessed via the monitoring of the residence times in the metastable attractors of the system. We show that the presence of ambient noise, far from degrading the sensor operation, can actually improve its sensitivity and provide a greatly simplified readout scheme, as well as significantly reduce processing procedures for this new class of devices that we propose to call noise activated nonlinear dynamic sensors. Such devices can also show interesting dynamical features such as the resonant trapping effect

Supernarrow spectral peaks near a kinetic phase transition in a driven, nonlinear micromechanical oscillator

We measure the spectral densities of fluctuations of an underdamped nonlinear micromechanical oscillator. By applying a sufficiently large periodic excitation, two stable dynamical states are obtained within a particular range of driving frequency. White noise is injected into the excitation, allowing the system to overcome the activation barrier and switch between the two states. While the oscillator predominately resides in one of the two states for most excitation frequencies, a narrow range of frequencies exist where the occupations of the two states are approximately equal. At these frequencies, the oscillator undergoes a kinetic phase transition that resembles the phase transition of thermal equilibrium systems. We observe a supernarrow peak in the power spectral densities of fluctuations of the oscillator. This peak is centered at the excitation frequency and arises as a result of noise-induced transitions between the two dynamical states.Comment: 4 pages, 4 figure

The Evolving Paradigm in the Management of Intracranial Atherosclerotic Disease

Intracranial atherosclerotic disease (ICAD) is a major cause of ischemic stroke worldwide and represents a significant health problem. The pathogenesis and natural history of ICAD are poorly understood, and rigorous treatment paradigms do not exist as they do for extracranial atherosclerosis. Currently, the best treatment for ICAD remains aspirin therapy, but many patients who are placed on aspirin continue to experience recurrent strokes. As microsurgical and endovascular techniques continue to evolve, the role of extracranial to intracranial bypass operations and stenting are increasingly being reconsidered. We performed a PubMed review of the English literature with a particular focus on treatment options for ICAD and present evidence-based data for the role of surgery and stenting in ICAD against medical therapy alone

Models for community based day care for older people: A narrative review

Objectives: Older Australians are choosing to live within the community and there are a number of initiatives to enable this sector of the population to do so for longer. In an effort to ensure that they remain both physically and psychologically engaged, one initiative has been to provide community based day care (CBDC). Method: A narrative review was undertaken through searching MEDLINE, CINAHL Plus, Scopus and AgeInfo using keywords related to facility related, target group related and purpose/program of CBDC services. Results: Results indicated that there is a much research investigating different approaches but little consensus regarding the optimal delivery model thereby rendering it difficult to make a direct correlation as to the most effective CBDC. Discussion: The review presents an overview of the array of models providing centre based day care for older people. The challenge for future service delivery is to determine which of CBDC services are most successful in catering for the needs of older community dwelling adult or are new innovative models of CBDC require

Giant Relaxation Oscillations in a Very Strongly Hysteretic SQUID ring-Tank Circuit System

In this paper we show that the radio frequency (rf) dynamical characteristics of a very strongly hysteretic SQUID ring, coupled to an rf tank circuit resonator, display relaxation oscillations. We demonstrate that the the overall form of these characteristics, together with the relaxation oscillations, can be modelled accurately by solving the quasi-classical non-linear equations of motion for the system. We suggest that in these very strongly hysteretic regimes SQUID ring-resonator systems may find application in novel logic and memory devices.Comment: 7 pages, 5 figures. Uploaded as implementing a policy of arXiving old paper

Morbidity after surgical management of cervical cancer in low and middle income countries: A systematic review and meta-analysis

Objective: To investigate morbidity for patients after the primary surgical management of cervical cancer in low and middle-income countries (LMIC). Methods: The Pubmed, Cochrane, the Cochrane Central Register of Controlled Trials, Embase, LILACS and CINAHL were searched for published studies from 1st Jan 2000 to 30th June 2017 reporting outcomes of surgical management of cervical cancer in LMIC. Randomeffects meta-analytical models were used to calculate pooled estimates of surgical complications including blood transfusions, ureteric, bladder, bowel, vascular and nerve injury, fistulae and thromboembolic events. Secondary outcomes included five-year progression free (PFS) and overall survival (OS). Findings: Data were available for 46 studies, including 10,847 patients from 11 middle income countries. Pooled estimates were: blood transfusion 29% (95%CI 0.19–0.41, P = 0.00, I 2 = 97.81), nerve injury 1% (95%CI 0.00–0.03, I 2 77.80, P = 0.00), bowel injury, 0.5% (95%CI 0.01–0.01, I 2 = 0.00, P = 0.77), bladder injury 1% (95%CI 0.01–0.02, P = 0.10, I 2 = 32.2), ureteric injury 1% (95%CI 0.01–0.01, I 2 0.00, P = 0.64), vascular injury 2% (95% CI 0.01– 0.03, I 2 60.22, P = 0.00), fistula 2% (95%CI 0.01–0.03, I 2 = 77.32, P = 0.00,), pulmonary embolism 0.4% (95%CI 0.00–0.01, I 2 26.69, P = 0.25), and infection 8% (95%CI 0.04–0.12, 2 95.72, P = 0.00). 5-year PFS was 83% for laparotomy, 84% for laparoscopy and OS was 85% for laparotomy cases and 80% for laparoscopy. Conclusion: This is the first systematic review and meta-analysis of surgical morbidity in cervical cancer in LMIC, which highlights the limitations of the current data and provides a benchmark for future health services research and policy implementation

The relationship between destination proximity, destination mix and physical activity behaviors

Background. The presence and mix of destinations is an important aspect of the built environment that may encourage or discourage physical activity. This study examined the association between the proximity and mix of neighbourhood destinations and physical activity. Methods. Secondary analysis was undertaken on physical activity data from Western Australian adults (n=1394). These data were linked with geographical information systems (GIS) data including the presence and the mix of destinations located within 400 and 1500 m from respondents' homes. Associations with walking for transport and recreation and vigorous physical activity were examined. Results. Access to post boxes, bus stops, convenience stores, newsagencies, shopping malls, and transit stations within 400 m (OR 1.63–5.00) and schools, transit stations, newsagencies, convenience stores and shopping malls within 1500 m (OR 1.75–2.38) was associated with participation in regular transport-related walking. A dose–response relationship between the mix of destinations and walking for transport was also found. Each additional destination within 400 and 1500 m resulted in an additional 12 and 11 min/fortnight spent walking for transport, respectively. Conclusion. Proximity and mix of destinations appears strongly associated with walking for transport, but not walking for recreation or vigorous activity. Increasing the diversity of destinations may contribute to adults doing more transport-related walking and achieving recommended levels of physical activity

Patient attitudes towards analgesia and their openness to non-pharmacological methods such as acupuncture in the emergency department

Aims: To investigate patient attitudes to analgesia, opioids and non-pharmacological analgesia including acupuncture, in the ED. Methods: ED patients with pain were surveyed regarding: pain scores, satisfaction, addiction concern, non-pharmacological methods of pain relief, and acupuncture. Data were analysed using logistic regression. Results: Of 196 adult patients, 52.8% were ‘very satisfied’ with analgesia. Most patients (84.7%) would accept non-pharmacological methods including acupuncture (68.9%) and 78.6% were not concerned about addiction. Satisfaction was associated with male gender, and ‘adequate analgesia’ but not with opioids. Conclusion: Most patients were generally satisfied with ED analgesia and were open to non-pharmacologic analgesia including acupuncture