147 research outputs found
Hawking radiation of scalar particles from accelerating and rotating black holes
Hawking radiation of uncharged and charged scalars from accelerating and
rotating black holes is studied. We calculate the tunneling probabilities of
these particles from the rotation and acceleration horizons of these black
holes. Using the tunneling method we recover the correct Hawking temperature as
well
An evaluation of the impact of a data driven, individualised, diabetes specific, structured information delivered by mail to people with diabetes : the WICKED (Wolverhampton Interface Care-Knowledge Empowered Diabetes) Project
Background
Does promoting patient activation improve outcomes? We tested the hypothesis that provision of structured and personalised information can activate patients, promote selfcare, and improve outcomes.
Methods
We recruited all eligible people with diabetes in Wolverhampton CCG (n= 14,559), randomizing them into two groups. The active group was mailed their “My diabetes, My information, My plan” report at baseline, 3 and 6 months; the control group received standard care for first 3 months, then a single mailing. We compared a Failed Process Score (FPS = completion of nine processes; zero = full attainment) and HbA1c. A patient feedback survey was sent to 1000 randomly selected patients from the active cohort to assess the qualitative impact of this individualised report.
Results
At three months, the FPS score (1.25 ± 1.87 vs. 1.35 ± 1.97, P < 0.01) and the change in FPS score (0.48 ± 1.55 vs. 0.42 ± 1.49, P < 0.02) were significantly better in the active group. At 12 months FPS score between group differences just failed overall significance (F=3.459, p=0.06). However, in those with lower baseline activation (FPS of ≥2), FPS was significantly better (F=4.369, p=0.037, 3 month (p<0.01), 12 month (p=0.01)) in the multi mailed and their likelihood of achieving the good attainment category (12 month FPS ≤1) with mailing was 1.15 (95% CI 1.02 – 1.29, p=0.022). Considering baseline HbA1c% categories as ≤7.5, 7.6-8.4 and ≥8.5, and adjusting for variables in univariate analysis (r2=0.39, p<0.001; age p<0.001, gender (ns), ethnicity (ns), IMD score (ns), type of diabetes (ns)), the impact of being mailed multiple times was significant (F= 6.2, p=0.013).In the patient feedback survey, patients found this report useful (89%), a source of knowledge (78%) and confidence (74%) and it helped them in understanding their diabetes (78%).
Conclusion
The provision of structured and individualized information to people with diabetes can positively influence the level of patient activation, promote better engagement and open the potential to improve other crucial diabetes outcomes
Barriers to colorectal cancer screening in Asia: A systematic review
Purpose: Colorectal cancer (CRC) is among the top five cancers afflicting both men and women globally. Once predominantly a Western disease, it has begun to rise in Asian countries as well. This systematic review aims to compile and analyze the various barriers towards colorectal cancer screening in Asia, and to determine if the barriers are consistent throughout the continent.Methods: Article Inclusion criteria for based on year of publication from year 2008 till 2015, has been conducted in Asia, and written in English language. A total of 23 studies were included in this review, chosen via primary search of journal websites and databases, and a secondary search through the reference lists of eligible articles.Results: It was found that major barriers of colorectal cancer screening are; poor education/knowledge, negative perceptions towards screening, aversion to test results, financial constraints, time constraints, lack of physicians’ recommendation, limited/difficult access to screening locations, fatalistic beliefs, low perceived risks, language barriers, confidence in traditional medicine/distrust in Western medicine,ignorance and old age.Conclusion: Lack of knowledge/education is the most critical barrier that is linked to a majority of other barriers that can hinder a person from undergoing CRC screening for early prevention, detection and treatment. Majority of these barriers encountered regarding the poor rates of CRC screening are similar across countries in Asia.Keywords: Colorectal cancer screening, Barrier, Knowledge, Criteria for eligibilit
Assessment of hospital pharmacists' clinical knowledge and practical skill levels for pharmaceutical care in Madinah, Saudi Arabia
Purpose: To evaluate hospital pharmacists’ clinical knowledge and practical skill levels for pharmaceutical care.Methods: A quasi-experimental prospective longitudinal study design was used to evaluate the level of clinical skills with problem-based learning (PBL) sessions. Pharmacists’ in three different government hospitals in Madinah, Saudi Arabia recorded their responses or assessments in their work manuals for preparing reports. Instructors encouraged interactive learning by presenting case studies, in which pharmacists had to interpret medical history and clinical assessments of various body systems. Course learning design also focused on drug use evaluation, monitoring plans, and reaching clinical evidencebased decision-making.Results: A total of two hundred and fifty-five (255) hospital pharmacists participated in the study. The study sample was comprised of 128 (50.9 %) males and 127 (49.1 %) females. A significant (p < 0.01) difference was noticed between genders (male: 47.91 ± 7.15, female: 50.31 ± 4.88) for total mean scores of clinical skills. Cronbach’s alpha reliability coefficient for case data recitation was 0.91, while clinical assessment skills coefficient was 0.89. Overall, pharmacists reported that they “agree” (4.01 ± 0.67) that they acquired the ability to use case data recitation taught in the PBL; they also reported a positive evaluation (4.48 ± 0.58) of their ability to perform clinical data assessment.Conclusion: The findings indicate that pharmacist’s self-confidence to perform clinical assessment activities is low. Lack of confidence remains a critical education issue among pharmacists in the study setting.Keywords: Clinical pharmacy, Problem-based learning, Clinical skills, Pharmacist focus group, Therapeutics, Pharmaceutical car
A randomised controlled trial in diabetes demonstrating the positive impact of a patient activation strategy on diabetes processes and HbA1c: The WICKED project
Background: Patient activation is a demonstration of people participating effectively in their own care as measurable in objective outcomes. Techniques of activating patients are various. Aims: We developed a structured information booklet to promote patient activation and report the 1-year outcomes of a randomised controlled trial assessing its impact on diabetes care processes and on glycaemic control. Design and setting: It is an open label cluster randomised trial involving all people with diabetes aged more than 18 years within Wolverhampton Clinical Commissioning Group. Methods: All people with diabetes were cluster randomised into a group who were multiply mailed (MM) at 0, 3 and 6 months whilst a control group was mailed once at 3 months. Comparison of a Failed Process Score (FPS) between active and control groups was performed at 0, 3 and 12 months and of HbA1c at baseline and 12 months. Results: FPS improved significantly with multiple mailing (p=0.013), with particular impact on those with poor baseline FPS (≥2) (achieved FPS ≤1 at 12 months 49.2% vs. 46.0%, χ2=6.09, p<0.05). Overall HbA1c% across the year (adjusted) was significantly better with MM (p=0.021), with specific impact in those with a baseline HbA1c ≤7.5 (MM HbA1c% 6.7±0.07 (mean±SEM) vs. 7.0±0.09; mean±SEM difference 0.3±0.1, F=11.1, p=0.009). Conclusion: The direct provision of structured information to people with diabetes activates them to engage in their care delivery as reflected in care process and glycaemic control outcomes
Comparative Evaluation of Efficacy, Safety and Haemostatic Parameters of Enoxaparin and Fondaparinux in Unstable Coronary Artery Disease Pharmacology Section
ABSTRACT Aim: To compare the safety and efficacy of Enoxaparin (EX) and Fondaparinux (FD) in patients with Unstable Coronary Artery Disease (UCAD). Materials and Methods: A prospective, open label, randomized comparative study was designed to study the comparative efficacy and safety of EX and FD in UCAD patients. Recovery, recurrence, major and minor bleeding and biochemical investigations were evaluated and compared among two arms. Results: The baseline demographic characteristics were similar in both groups, with mean age of 56.05 and 56.05 years in EX and FD group respectively. Recovery was equal in two arms. Recurrent MI or angina was seen numerically more in EX group, but it did not statistically vary from that in the FD group. Incidence of haemorrhage was similar in both groups at 9 days, but at 30 days, EX showed a higher incidence (p<0.05). Deaths were prevented in both the treatment arms. Bleeding parameters such as BT, CT and platelet count were not altered in both groups. Conclusion: FD appeared to be better than EX in efficacy, as was indicated by a numerically more decrease in recurrence of angina or MI. FD regimen group also had better safety profile, as there was no incidence of haemorrhage at 30 days Therefore, we conclude that FD is an attractive option than EX in UCAD patients
Voltage-based Covert Channels using FPGAs
FPGAs are increasingly used in cloud applications and being integrated into Systems-on-Chip (SoCs).
For these systems, various side-channel attacks on cryptographic implementations have been reported, motivating to apply proper countermeasures.
Beyond cryptographic implementations, maliciously introduced covert channel receivers and transmitters can allow to exfiltrate other secret information from the FPGA.
In this paper, we present a fast covert channel on FPGAs, which exploits the on-chip power distribution network.
This can be achieved without any logical connection between the transmitter and receiver blocks.
Compared to a recently published covert channel with an estimated 4.8 Mbit/s transmission speed, we show 8 Mbit/s transmission and reduced errors from around 3% to less than 0.003%.
Furthermore, we demonstrate proper transmissions of word-size messages and test the channel in the presence of noise generated from other residing tenants\u27 modules in the FPGA. When we place and operate other co-tenant modules that require 85% of the total FPGA area, the error rate increases to 0.02%, depending on the platform and setup.
This error rate is still reasonably low for a covert channel.
Overall, the transmitter and receiver work with less than 3-5% FPGA LUT resources together.
We also show the feasibility of other types of covert channel transmitters, in the form of synchronous circuits within the FPGA
Tunnelling Methods and Hawking's radiation: achievements and prospects
The aim of this work is to review the tunnelling method as an alternative
description of the quantum radiation from black holes and cosmological
horizons. The method is first formulated and discussed for the case of
stationary black holes, then a foundation is provided in terms of analytic
continuation throughout complex space-time. The two principal implementations
of the tunnelling approach, which are the null geodesic method and the
Hamilton-Jacobi method, are shown to be equivalent in the stationary case. The
Hamilton-Jacobi method is then extended to cover spherically symmetric
dynamical black holes, cosmological horizons and naked singularities. Prospects
and achievements are discussed in the conclusions.Comment: Topical Review commissioned and accepted for publication by
"Classical and Quantum Gravity". 101 pages; 6 figure
Effect of temperature anisotropy on various modes and instabilities for a magnetized non-relativistic bi-Maxwellian plasma
Using kinetic theory for homogeneous collisionless magnetized plasmas, we
present an extended review of the plasma waves and instabilities and discuss
the anisotropic response of generalized relativistic dielectric tensor and
Onsager symmetry properties for arbitrary distribution functions. In general,
we observe that for such plasmas only those electromagnetic modes whose
magnetic field perturbations are perpendicular to the ambient magneticeld,
i.e.,B1 \perp B0, are effected by the anisotropy. However, in oblique
propagation all modes do show such anisotropic effects. Considering the
non-relativistic bi-Maxwellian distribution and studying the relevant
components of the general dielectric tensor under appropriate conditions, we
derive the dispersion relations for various modes and instabilities. We show
that only the electromagnetic R- and L- waves, those derived from them and the
O-mode are affected by thermal anisotropies, since they satisfy the required
condition B1\perpB0. By contrast, the perpendicularly propagating X-mode and
the modes derived from it (the pure transverse X-mode and Bernstein mode) show
no such effect. In general, we note that the thermal anisotropy modifies the
parallel propagating modes via the parallel acoustic effect, while it modifies
the perpendicular propagating modes via the Larmor-radius effect. In oblique
propagation for kinetic Alfven waves, the thermal anisotropy affects the
kinetic regime more than it affects the inertial regime. The generalized fast
mode exhibits two distinct acoustic effects, one in the direction parallel to
the ambient magnetic field and the other in the direction perpendicular to it.
In the fast-mode instability, the magneto-sonic wave causes suppression of the
firehose instability. We discuss all these propagation characteristics and
present graphic illustrations
Effectiveness of the Administrative Performance of Directly Selected Executive District Officers in Elementary and Secondary Education of KHYBER PUKHTUNKHWA PAKISTAN
Abstrac
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