Making co-enrolment feasible for randomised controlled trials in paediatric intensive care.

Enrolling children into several trials could increase recruitment and lead to quicker delivery of optimal care in paediatric intensive care units (PICU). We evaluated decisions taken by clinicians and parents in PICU on co-enrolment for two large pragmatic trials: the CATCH trial (CATheters in CHildren) comparing impregnated with standard central venous catheters (CVCs) for reducing bloodstream infection in PICU and the CHIP trial comparing tight versus standard control of hyperglycaemia

UV solar irradiance in observations and the NRLSSI and SATIRE-S models

Total solar irradiance and UV spectral solar irradiance have been monitored since 1978 through a succession of space missions. This is accompanied by the development of models aimed at replicating solar irradiance by relating the variability to solar magnetic activity. The NRLSSI and SATIRE-S models provide the most comprehensive reconstructions of total and spectral solar irradiance over the period of satellite observation currently available. There is persistent controversy between the various measurements and models in terms of the wavelength dependence of the variation over the solar cycle, with repercussions on our understanding of the influence of UV solar irradiance variability on the stratosphere. We review the measurement and modelling of UV solar irradiance variability over the period of satellite observation. The SATIRE-S reconstruction is consistent with spectral solar irradiance observations where they are reliable. It is also supported by an independent, empirical reconstruction of UV spectral solar irradiance based on UARS/SUSIM measurements from an earlier study. The weaker solar cycle variability produced by NRLSSI between 300 and 400 nm is not evident in any available record. We show that although the method employed to construct NRLSSI is principally sound, reconstructed solar cycle variability is detrimentally affected by the uncertainty in the SSI observations it draws upon in the derivation. Based on our findings, we recommend, when choosing between the two models, the use of SATIRE-S for climate studies

Heavy-to-light transition form factors and their relations in light-cone QCD sum rules

The improved light-cone QCD sum rules by using chiral current correlator is systematically reviewed and applied to the calculation of all the heavy-to-light form factors, including all the semileptonic and penguin ones. By choosing suitable chiral currents, the light-cone sum rules for all the form factors are greatly simplified and depend mainly on one leading twist distribution amplitude of the light meson. As a result, relations between these form factors arise naturally. At the considered accuracy these relations reproduce the results obtained in the literature. Moreover, since the explicit dependence on the leading twist distribution amplitudes is preserved, these relations may be more useful to simulate the experimental data and extract the information on the distribution amplitude.Comment: 1+16 pages, no figure

A new SATIRE-S spectral solar irradiance reconstruction for solar cycles 21--23 and its implications for stratospheric ozone

We present a revised and extended total and spectral solar irradiance (SSI) reconstruction, which includes a wavelength-dependent uncertainty estimate, spanning the last three solar cycles using the SATIRE-S model. The SSI reconstruction covers wavelengths between 115 and 160,000 nm and all dates between August 1974 and October 2009. This represents the first full-wavelength SATIRE-S reconstruction to cover the last three solar cycles without data gaps and with an uncertainty estimate. SATIRE-S is compared with the NRLSSI model and SORCE/SOLSTICE ultraviolet (UV) observations. SATIRE-S displays similar cycle behaviour to NRLSSI for wavelengths below 242 nm and almost twice the variability between 242 and 310 nm. During the decline of last solar cycle, between 2003 and 2008, SSI from SORCE/SOLSTICE version 12 and 10 typically displays more than three times the variability of SATIRE-S between 200 and 300 nm. All three datasets are used to model changes in stratospheric ozone within a 2D atmospheric model for a decline from high solar activity to solar minimum. The different flux changes result in different modelled ozone trends. Using NRLSSI leads to a decline in mesospheric ozone, while SATIRE-S and SORCE/SOLSTICE result in an increase. Recent publications have highlighted increases in mesospheric ozone when considering version 10 SORCE/SOLSTICE irradiances. The recalibrated SORCE/SOLSTICE version 12 irradiances result in a much smaller mesospheric ozone response than when using version 10 and now similar in magnitude to SATIRE-S. This shows that current knowledge of variations in spectral irradiance is not sufficient to warrant robust conclusions concerning the impact of solar variability on the atmosphere and climate.Comment: 25 pages (18 pages in main article with 6 figures; 7 pages in supplementary materials with 6 figures) in draft mode using the American Meteorological Society package. Submitted to Journal of Atmospheric Sciences for publicatio

The predictability of wind and virtual temperature profiles for flight and static test operations Final report, Jul. 1, 1965 - Mar. 31, 1966

Predictability of wind and virtual temperature profiles for flight and static test operation

Effectiveness of group-based self-management education for individuals with Type 2 diabetes:A systematic review with meta-analyses and meta-regression

Aims: Patient education for the management of Type 2 diabetes can be delivered in various forms, with the goal of promoting and supporting positive self-management behaviours. This systematic review aimed to determine the effectiveness of group-based interventions compared with individual interventions or usual care for improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes. Methods: Six electronic databases were searched. Group-based education programmes for adults with Type 2 diabetes that measured glycated haemoglobin (HbA1c) and followed participants for ≥ 6 months were included. The primary outcome was HbA1c, and secondary outcomes included fasting blood glucose, weight, body mass index, waist circumference, blood pressure, blood lipid profiles, diabetes knowledge and self-efficacy. Results: Fifty-three publications describing 47 studies were included (n = 8533 participants). Greater reductions in HbA1c occurred in group-based education compared with controls at 6–10 months [n = 30 studies; mean difference (MD) = 3 mmol/mol (0.3%); 95% confidence interval (CI): −0.48, −0.15; P = 0.0002], 12–14 months [n = 27 studies; MD = 4 mmol/mol (0.3%); 95% CI: −0.49, −0.17; P < 0.0001], 18 months [n = 3 studies; MD = 8 mmol/mol (0.7%); 95% CI: −1.26, −0.18; P = 0.009] and 36–48 months [n = 5 studies; MD = 10 mmol/mol (0.9%); 95% CI: −1.52, −0.34; P = 0.002], but not at 24 months. Outcomes also favoured group-based education for fasting blood glucose, body weight, waist circumference, triglyceride levels and diabetes knowledge, but not at all time points. Interventions facilitated by a single discipline, multidisciplinary teams or health professionals with peer supporters resulted in improved outcomes in HbA1c when compared with peer-led interventions. Conclusions: Group-based education interventions are more effective than usual care, waiting list control and individual education at improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes.No Full Tex

Social networks : the future for health care delivery

With the rapid growth of online social networking for health, health care systems are experiencing an inescapable increase in complexity. This is not necessarily a drawback; self-organising, adaptive networks could become central to future health care delivery. This paper considers whether social networks composed of patients and their social circles can compete with, or complement, professional networks in assembling health-related information of value for improving health and health care. Using the framework of analysis of a two-sided network – patients and providers – with multiple platforms for interaction, we argue that the structure and dynamics of such a network has implications for future health care. Patients are using social networking to access and contribute health information. Among those living with chronic illness and disability and engaging with social networks, there is considerable expertise in assessing, combining and exploiting information. Social networking is providing a new landscape for patients to assemble health information, relatively free from the constraints of traditional health care. However, health information from social networks currently complements traditional sources rather than substituting for them. Networking among health care provider organisations is enabling greater exploitation of health information for health care planning. The platforms of interaction are also changing. Patient-doctor encounters are now more permeable to influence from social networks and professional networks. Diffuse and temporary platforms of interaction enable discourse between patients and professionals, and include platforms controlled by patients. We argue that social networking has the potential to change patterns of health inequalities and access to health care, alter the stability of health care provision and lead to a reformulation of the role of health professionals. Further research is needed to understand how network structure combined with its dynamics will affect the flow of information and potentially the allocation of health care resources

Mappings of least Dirichlet energy and their Hopf differentials

The paper is concerned with mappings between planar domains having least Dirichlet energy. The existence and uniqueness (up to a conformal change of variables in the domain) of the energy-minimal mappings is established within the class $\bar{\mathscr H}_2(X, Y)$ of strong limits of homeomorphisms in the Sobolev space $W^{1,2}(X, Y)$, a result of considerable interest in the mathematical models of Nonlinear Elasticity. The inner variation leads to the Hopf differential $h_z \bar{h_{\bar{z}}} dz \otimes dz$ and its trajectories. For a pair of doubly connected domains, in which $X$ has finite conformal modulus, we establish the following principle: A mapping $h \in \bar{\mathscr H}_2(X, Y)$ is energy-minimal if and only if its Hopf-differential is analytic in $X$ and real along the boundary of $X$. In general, the energy-minimal mappings may not be injective, in which case one observes the occurrence of cracks in $X$. Nevertheless, cracks are triggered only by the points in the boundary of $Y$ where $Y$ fails to be convex. The general law of formation of cracks reads as follows: Cracks propagate along vertical trajectories of the Hopf differential from the boundary of $X$ toward the interior of $X$ where they eventually terminate before making a crosscut.Comment: 51 pages, 4 figure

Object-based attentional facilitation and inhibition are neuropsychologically dissociated

Salient peripheral cues produce a transient shift of attention which is superseded by a sustained inhibitory effect. Cueing part of an object produces an inhibitory cueing effect (ICE) that spreads throughout the object. In dynamic scenes the ICE stays with objects as they move. We examined object-centred attentional facilitation and inhibition in a patient with visual form agnosia. There was no evidence of object-centred attentional facilitation. In contrast, object-centred ICE was observed in 3 out of 4 tasks. These inhibitory effects were strongest where cues to objecthood were highly salient. These data are evidence of a neuropsychological dissociation between the facilitatory and inhibitory effects of attentional cueing. From a theoretical perspective the findings suggest that ‘grouped arrays’ are sufficient for object-based inhibition, but insufficient to generate object-centred attentional facilitation