Impact on maternity professionals of novel approaches to clinical audit feedback

We compared three approaches to feedback of clinical audit findings relating to miscarriage in 15 Scottish maternity services (printed report alone; report plus Action Planning Letter; report plus face-to-face Facilitated Action Planning). We surveyed clinicians to measure Theory of Planned Behaviour constructs (in the context of two audit criteria) before and after feedback (n=253) and assessed perceptions of the audit through in-depth interviews (n=17). Pre-feedback, clinicians had positive attitudes and strong subjective norms and intentions to comply, although perceived behavioural control was lower. Generally, positive attitudes, subjective norms and intentions increased after feedback but for one of the two criteria (providing a 7-day miscarriage service), perceived behavioural control decreased. No changes over time reached statistical significance and analysis of covariance (adjusting for pre-feedback scores) showed no consistent relationships between method of feedback and post-feedback construct scores. Interviews revealed positive perceptions of audit but frustration at lack of capacity to implement changes. While interventions which increased intensity of feedback proved feasible and acceptable to clinicians, we were unable to demonstrate that they increased intention to comply with audit criteria.This study was funded by NHS Quality Improvement Scotland

Supporting security-oriented, collaborative nanoCMOS electronics research

Grid technologies support collaborative e-Research typified by multiple institutions and resources seamlessly shared to tackle common research problems. The rules for collaboration and resource sharing are commonly achieved through establishment and management of virtual organizations (VOs) where policies on access and usage of resources by collaborators are defined and enforced by sites involved in the collaboration. The expression and enforcement of these rules is made through access control systems where roles/privileges are defined and associated with individuals as digitally signed attribute certificates which collaborating sites then use to authorize access to resources. Key to this approach is that the roles are assigned to the right individuals in the VO; the attribute certificates are only presented to the appropriate resources in the VO; it is transparent to the end user researchers, and finally that it is manageable for resource providers and administrators in the collaboration. In this paper, we present a security model and implementation improving the overall usability and security of resources used in Grid-based e-Research collaborations through exploitation of the Internet2 Shibboleth technology. This is explored in the context of a major new security focused project at the National e-Science Centre (NeSC) at the University of Glasgow in the nanoCMOS electronics domain

FEA simulation studies of accelerated aging of power cables in water tanks

IEEE Standard 1407 provides guidance on accelerated insulation aging experiments on multiple medium voltage (MV) power cables using water-filled tanks. An applied cable current increases the temperature within the water tank and thus provides the accelerated aging conditions for the cables. Understanding the precise nature of the temperature distribution within the water tank and within the cable insulation is important to quantify and calculate the effective aging of the cables. This paper presents initial finite element analysis (FEA) simulation studies that evaluate the temperature distribution within a water filled tank and across submerged power cables when multiple cables are supplied with current. Two scenarios are evaluated and compared, namely the temperature profiles of cables when the water in the tank is treated (a) as a solid material, and (b) as a fluid with natural convection. The importance of applying effective water circulation mechanisms are also highlighted

Lymphatic expression of CLEVER-1 in breast cancer and its relationship with lymph node metastasis

BACKGROUND Mechanisms regulating breast cancer lymph node metastasis are unclear. Staining of CLEVER-1 (common lymphatic endothelial and vascular endothelial receptor-1) in human breast tumors was used, along with in vitro techniques, to assess involvement in the metastatic process. METHODS 148 sections of primary invasive breast cancers, with 10 yr follow-up, were stained with anti-CLEVER-1. Leukocyte infiltration was assessed, along with involvement of specific subpopulations by staining with CD83 (mature dendritic cells, mDC), CD209 (immature DC, iDC) and CD68 (macrophage, Mϕ). In vitro expression of CLEVER-1 on lymphatic (LEC) and blood endothelial cells (BEC) was examined by flow cytometry. RESULTS In vitro results showed that although both endothelial cell types express CLEVER-1, surface expression was only evident on LEC. In tumour sections CLEVER-1 was expressed in blood vessels (BV, 61.4% of samples), lymphatic vessels (LV, 18.2% of samples) and in Mϕ/DCs (82.4% of samples). However, only CLEVER-1 expression in LV was associated with LN metastasis (p = 0.027) and with Mϕ indices (p = 0.021). Although LV CLEVER-1 was associated with LN positivity there was no significant correlation with recurrence or overall survival, BV CLEVER-1 expression was, however, associated with increased risk of recurrence (p = 0.049). The density of inflammatory infiltrate correlated with CLEVER-1 expression in BV (p < 0.001) and LV (p = 0.004). CONCLUSIONS The associations between CLEVER-1 expression on endothelial vessels and macrophage/leukocyte infiltration is suggestive of its regulation by inflammatory conditions in breast cancer, most likely by macrophage-associated cytokines. Its upregulation on LV, related surface expression, and association with LN metastasis suggest that it may be an important mediator of tumor cell metastasis to LN

An artificially generated atmosphere near a lunar base

We discuss the formation of an artificial atmosphere generated by vigorous lunar base activity in this paper. We developed an analytical, steady-state model for a lunar atmosphere based upon previous investigations of the Moon's atmosphere from Apollo. Constant gas-injection rates, ballistic trajectories, and a Maxwellian particle distribution for an oxygen-like gas are assumed. Even for the extreme case of continuous He-3 mining of the lunar regolith, we find that the lunar atmosphere would not significantly degrade astronomical observations beyond about 10 km from the mining operation

Time dependent simulation of PD electromagnetic wave propagation in GIS systems

UHF methods have been widely used in PD detection and localization in GIS systems. Modeling of electromagnetic wave propagation inside a GIS structure can be helpful for understanding and improvement in sensitivity of PD detection by providing information to help determine more optimal positions for UHF PD sensors. This paper studies the effect of L-type and T-type GIS structures on electromagnetic wave propagation by simulating the time dependent wave propagation behavior for these arrangements of the GIS busbar. The effects of L-type and T-type structures for PD electromagnetic wave propagation behavior are presented. It is noted that if the location of the electric field detected by a UHF sensor is chosen reasonably based on knowledge of the physical structures, the measurement result obtained can reduce the attenuation affects introduced by the L-type and T-type structure

Construction of a transformer DGA health index based on DGA screening processes

An automated transformer dissolved gas analysis evaluation system based on the recently released IEEE Standard C57.104-2019 for mineral oil-immersed transformers is implemented and its outputs demonstrated. The system includes diagnostic capabilities using the Duval Triangles 1-4-5 and Rogers Ratio method. In addition, a Health Index derived from the above Standards is proposed as a compact, yet informative metric for tracking transformer health. Finally, some of the challenges in developing such an implementation are highlighted

Integrating security solutions to support nanoCMOS electronics research

The UK Engineering and Physical Sciences Research Council (EPSRC) funded Meeting the Design Challenges of nanoCMOS Electronics (nanoCMOS) is developing a research infrastructure for collaborative electronics research across multiple institutions in the UK with especially strong industrial and commercial involvement. Unlike other domains, the electronics industry is driven by the necessity of protecting the intellectual property of the data, designs and software associated with next generation electronics devices and therefore requires fine-grained security. Similarly, the project also demands seamless access to large scale high performance compute resources for atomic scale device simulations and the capability to manage the hundreds of thousands of files and the metadata associated with these simulations. Within this context, the project has explored a wide range of authentication and authorization infrastructures facilitating compute resource access and providing fine-grained security over numerous distributed file stores and files. We conclude that no single security solution meets the needs of the project. This paper describes the experiences of applying X.509-based certificates and public key infrastructures, VOMS, PERMIS, Kerberos and the Internet2 Shibboleth technologies for nanoCMOS security. We outline how we are integrating these solutions to provide a complete end-end security framework meeting the demands of the nanoCMOS electronics domain

Inflationary Cosmological Perturbations of Quantum-Mechanical Origin

This review article aims at presenting the theory of inflation. We first describe the background spacetime behavior during the slow-roll phase and analyze how inflation ends and the Universe reheats. Then, we present the theory of cosmological perturbations with special emphasis on their behavior during inflation. In particular, we discuss the quantum-mechanical nature of the fluctuations and show how the uncertainty principle fixes the amplitude of the perturbations. In a next step, we calculate the inflationary power spectra in the slow-roll approximation and compare these theoretical predictions to the recent high accuracy measurements of the Cosmic Microwave Background radiation (CMBR) anisotropy. We show how these data already constrain the underlying inflationary high energy physics. Finally, we conclude with some speculations about the trans-Planckian problem, arguing that this issue could allow us to open a window on physical phenomena which have never been probed so far.Comment: Review Article, 47 pages, 3 figures. Lectures given at the 40th Karpacz Winter School on Theoretical Physics (Poland, Feb. 2004), submitted to Lecture Notes in Physic

High prevalence of scrapie in a dairy goat herd: tissue distribution of disease-associated PrP and effect of PRNP genotype and age

Following a severe outbreak of clinical scrapie in 2006–2007, a large dairy goat herd was culled and 200 animals were selected for post-mortem examinations in order to ascertain the prevalence of infection, the effect of age, breed and PRNP genotype on the susceptibility to scrapie, the tissue distribution of diseaseassociated PrP (PrP$^{\rm d}$), and the comparative efficiency of different diagnostic methods. As determined by immunohistochemical (IHC) examinations with Bar224 PrP antibody, the prevalence of preclinical infection was very high (72/200; 36.0%), with most infected animals being positive for PrP$^{\rm d}$ in lymphoreticular system (LRS) tissues (68/72; 94.4%) compared to those that were positive in brain samples (38/72; 52.8%). The retropharyngeal lymph node and the palatine tonsil showed the highest frequency of PrP$^{\rm d}$ accumulation (87.3% and 84.5%, respectively), while the recto-anal mucosa-associated lymphoid tissue (RAMALT) was positive in only 30 (41.7%) of the infected goats. However, the efficiency of rectal and palatine tonsil biopsies taken shortly before necropsy was similar. The probability of brain and RAMALT being positive directly correlated with the spread of PrP$^{\rm d}$ within the LRS. The prevalence of infection was influenced by PRNP genetics at codon 142 and by the age of the goats: methionine carriers older than 60 months showed a much lower prevalence of infection (12/78; 15.4%) than those younger than 60 months (20/42; 47.6%); these last showed prevalence values similar to isoleucine homozygotes of any age (40/80; 50.0%). Two of seven goats with definite signs of scrapie were negative for PrP$^{\rm d}$ in brain but positive in LRS tissues, and one goat showed biochemical and IHC features of PrP$^{\rm d}$ different from all other infected goats. The results of this study have implications for surveillance and control policies for scrapie in goats