Delay in diabetic retinopathy screening increases the rate of detection of referable diabetic retinopathy

Aims - To assess whether there is a relationship between delay in retinopathy screening after diagnosis of Type 2 diabetes and level of retinopathy detected. Methods - Patients were referred from 88 primary care practices to an English National Health Service diabetic eye screening programme. Data for screened patients were extracted from the primary care databases using semi-automated data collection algorithms supplemented by validation processes. The programme uses two-field mydriatic digital photographs graded by a quality assured team. Results - Data were available for 8183 screened patients with diabetes newly diagnosed in 2005, 2006 or 2007. Only 163 with Type 1 diabetes were identified and were insufficient for analysis. Data were available for 8020 with newly diagnosed Type 2 diabetes. Of these, 3569 were screened within 6 months, 2361 between 6 and 11 months, 1058 between 12 and 17 months, 366 between 18 and 23 months, 428 between 24 and 35 months, and 238 at 3 years or more after diagnosis. There were 5416 (67.5%) graded with no retinopathy, 1629 (20.3%) with background retinopathy in one eye, 753 (9.4%) with background retinopathy in both eyes and 222 (2.8%) had referable diabetic retinopathy. There was a significant trend (P = 0.0004) relating time from diagnosis to screening detecting worsening retinopathy. Of those screened within 6 months of diagnosis, 2.3% had referable retinopathy and, 3 years or more after diagnosis, 4.2% had referable retinopathy. Conclusions - The rate of detection of referable diabetic retinopathy is elevated in those who were not screened promptly after diagnosis of Type 2 diabetes

Indoor radio channel characterization and modeling for a 5.2-GHz bodyworn receiver

[Abstract]: Wireless local area network applications may include the use of bodyworn or handportable terminals. For the first time, this paper compares measurements and simulations of a narrowband 5.2-GHz radio channel incorporating a fixed transmitter and a mobile bodyworn receiver. Two indoor environments were considered, an 18-m long corridor and a 42-m2 office. The modeling technique was a site-specific ray-tracing simulator incorporating the radiation pattern of the bodyworn receiver. In the corridor, the measured body-shadowing effect was 5.4 dB, while it was 15.7 dB in the office. First- and second-order small-scale fading statistics for the measured and simulated results are presented and compared with theoretical Rayleigh and lognormal distributions. The root mean square error in the cumulative distributions for the simulated results was less than 0.74% for line-of-sight conditions and less than 1.4% for nonline-of-sight conditions

Propagation modelling and measurements in a populated indoor environment at 5.2 GHz

There are a number of significant radiowave propagation phenomena present in the populated indoor environment, including multipath fading and human body effects. The latter can be divided into shadowing and scattering caused by pedestrian movement, and antenna-body interaction with bodyworn or hand portable terminals [1]. Human occupants within indoor environments are not always stationary and their movement will lead to temporal channel variations that can strongly affect the quality of indoor wireless communication systems. Hence, populated environments remain a major challenge for wireless local area networks (WLAN) and other indoor communication systems. Therefore, it is important to develop an understanding of the potential and limitations of indoor radiowave propagation at key frequencies of interest, such as the 5.2 GHz band employed by commercial wireless LAN standards such as IEEE 802.11a and HiperLAN 2. Although several indoor wireless models have been proposed in the literature, these temporal variations have not yet been thoroughly investigated. Therefore, we have made an important contribution to the area by conducting a systematic study of the problem, including a propagation measurement campaign and statistical channel characterization of human body effects on line-of-sight indoor propagation at 5.2 GHz. Measurements were performed in the everyday environment of a 7.2 m wide University hallway to determine the statistical characteristics of the 5.2 GHz channel for a fixed, transverse line-of-sight (LOS) link perturbed by pedestrian movement. Data were acquired at hours of relatively high pedestrian activity, between 12.00 and 14.00. The location was chosen as a typical indoor wireless system environment that had sufficient channel variability to permit a valid statistical analysis. The paper compares the first and second order statistics of the empirical signals with the Gaussian-derived distributions commonly used in wireless communications. The analysis shows that, as the number of pedestrians within the measurement location increases, the Ricean K-factor that best fits the Cumulative Distribution Function (CDF) of the empirical data tends to decrease proportionally, ranging from K=7 with 1 pedestrian to K=0 with 4 pedestrians. These results are consistent with previous results obtained for controlled measurement scenarios using a fixed link at 5.2 GHz in [2], where the K factor reduced as the number of pedestrians within a controlled measurement area increased. Level crossing rate results were Rice distributed, considering a maximum Doppler frequency of 8.67 Hz. While average fade duration results were significantly higher than theoretically computed Rice and Rayleigh, due to the fades caused by pedestrians. A novel statistical model that accurately describes the 5.2 GHz channel in the considered indoor environment is proposed. For the first time, the received envelope CDF is explicitly described in terms of a quantitative measurement of pedestrian traffic within the indoor environment. The model provides an insight into the prediction of human body shadowing effects for indoor channels at 5.2 GHz

Identifying the ground state structures of point defects in solids

Point defects are a universal feature of crystals. Their identification is addressed by combining experimental measurements with theoretical models. The standard modelling approach is, however, prone to missing the ground state atomic configurations associated with energy-lowering reconstructions from the idealised crystallographic environment. Missed ground states compromise the accuracy of calculated properties. To address this issue, we report an approach to navigate the defect configurational landscape using targeted bond distortions and rattling. Application of our workflow to eight materials (CdTe, GaAs, Sb2S3, Sb2Se3, CeO2, In2O3, ZnO, anatase-TiO2) reveals symmetry breaking in each host crystal that is not found via conventional local minimisation techniques. The point defect distortions are classified by the associated physico-chemical factors. We demonstrate the impact of these defect distortions on derived properties, including formation energies, concentrations and charge transition levels. Our work presents a step forward for quantitative modelling of imperfect solids

Antiferromagnetism at T > 500 K in the Layered Hexagonal Ruthenate SrRu2O6

We report an experimental and computational study of magnetic and electronic properties of the layered Ru(V) oxide SrRu2O6 (hexagonal, P-3 1m), which shows antiferromagnetic order with a N\'eel temperature of 563(2) K, among the highest for 4d oxides. Magnetic order occurs both within edge-shared octahedral sheets and between layers and is accompanied by anisotropic thermal expansivity that implies strong magnetoelastic coupling of Ru(V) centers. Electrical transport measurements using focused ion beam induced deposited contacts on a micron-scale crystallite as a function of temperature show p-type semiconductivity. The calculated electronic structure using hybrid density functional theory successfully accounts for the experimentally observed magnetic and electronic structure and Monte Carlo simulations reveals how strong intralayer as well as weaker interlayer interactions are a defining feature of the high temperature magnetic order in the material.Comment: Physical Review B 2015 accepted for publicatio

Book Reviews

Book reviews by Felix Morley, Aaron I. Abell, Thomas M. Scanlon, Anton-Hermann Chroust, and Richard O\u27Sullivan

Tablet PCs in schools: Case study report: A report for Becta by the Open University

The publication provides an analysis of twelve case studies involving schools in England that were using Tablet PCs. The analysis is complemented by brief individual reports describing aspects of how each of these schools was using Tablet PCs

An investigation into the mechanical damping characteristics of catenary contact wires and their effect on aerodynamic galloping instability

Measurement of the damped oscillation of a section of the UK East Coast Main Line (ECML) catenary/contact wire system was undertaken, and the natural frequency and mechanical damping were found to be 1.4Hz and 0.05 respectively. This information was used to assess the effect of increasing the mechanical damping ratio on the susceptibility of the system to an aerodynamic galloping instability. The section of line tested was known to gallop at wind speeds of approximately 40 mile/h, and theoretical and experimental work verified this. A friction damper arm was designed and three units were fitted to the section of line affected. The introduction of increased mechanical damping was found to raise the mechanical damping coefficient of the line to between 0.095 and 0.18, and the mathematical analysis produced a theoretical wind speed for galloping oscillation of between 75 and 141 mile/h respectively. For over a year since the units were fitted, no problems with galloping instability have been observed

Characteristics of HIV-infected adolescents enrolled in a disclosure intervention trial in western Kenya

Knowledge of one's own HIV status is essential for long-term disease management, but there are few data on how disclosure of HIV status to infected children and adolescents in sub-Saharan Africa is associated with clinical and psychosocial health outcomes. We conducted a detailed baseline assessment of the disclosure status, medication adherence, HIV stigma, depression, emotional and behavioral difficulties, and quality of life among a cohort of Kenyan children enrolled in an intervention study to promote disclosure of HIV status. Among 285 caregiver-child dyads enrolled in the study, children's mean age was 12.3 years. Caregivers were more likely to report that the child knew his/her diagnosis (41%) compared to self-reported disclosure by children (31%). Caregivers of disclosed children reported significantly more positive views about disclosure compared to caregivers of non-disclosed children, who expressed fears of disclosure related to the child being too young to understand (75%), potential psychological trauma for the child (64%), and stigma and discrimination if the child told others (56%). Overall, the vast majority of children scored within normal ranges on screenings for behavioral and emotional difficulties, depression, and quality of life, and did not differ by whether or not the child knew his/her HIV status. A number of factors were associated with a child's knowledge of his/her HIV diagnosis in multivariate regression, including older age (OR 1.8, 95% CI 1.5-2.1), better WHO disease stage (OR 2.5, 95% CI 1.4-4.4), and fewer reported caregiver-level adherence barriers (OR 1.9, 95% CI 1.1-3.4). While a minority of children in this cohort knew their HIV status and caregivers reported significant barriers to disclosure including fears about negative emotional impacts, we found that disclosure was not associated with worse psychosocial outcomes

Legal coercion, respect & reason-responsive agency

Legal coercion seems morally problematic because it is susceptible to the Hegelian objection that it fails to respect individuals in a way that is ‘due to them as men’. But in what sense does legal coercion fail to do so? And what are the grounds for this requirement to respect? This paper is an attempt to answer these questions. It argues that (a) legal coercion fails to respect individuals as reason-responsive agents; and (b) individuals ought to be respected as such in virtue of the fact that they are human beings. Thus it is in this sense that legal coercion fails to treat individuals with the kind of respect ‘due to them as men’.The Leverhulme Trust (ECF-2012-032); AHRC (AH/H015655/1