Health-care sector and complementary medicine: practitioners’ experiences of delivering acupuncture in the public and private sectors

AIM: The aim was to identify similarities and differences between private practice and the National Health Service (NHS) in practitioners' experiences of delivering acupuncture to treat pain. We wished to identify differences that could affect patients' experiences and inform our understanding of how trials conducted in private clinics relate to NHS clinical practice. BACKGROUND: Acupuncture is commonly used in primary care for lower back pain and is recommended in the National Institute for Health and Clinical Excellence's guidelines. Previous studies have identified differences in patients' accounts of receiving acupuncture in the NHS and in the private sector. The major recent UK trial of acupuncture for back pain was conducted in the private sector. METHODS: Semi-structured qualitative interviews were conducted with 16 acupuncturists who had experience of working in the private sector (n = 7), in the NHS (n =3), and in both the sectors (n = 6). The interviews lasted between 24 and 77 min (median=49 min) and explored acupuncturists' experiences of treating patients in pain. Inductive thematic analysis was used to identify similarities and differences across private practice and the NHS.FINDINGS: The perceived effectiveness of acupuncture was described consistently and participants felt they did (or would) deliver acupuncture similarly in NHS and in private practice. In both the sectors, patients sought acupuncture as a last resort and acupuncturist-patient relationships were deemed important. Acupuncture availability differed across sectors: in the NHS it was constrained by Trust policies and in the private sector by patients' financial resources. There were greater opportunities for autonomous practice in the private sector and regulation was important for different reasons in each sector. In general, NHS practitioners had Western-focussed training and also used conventional medical techniques, whereas private practitioners were more likely to have Traditional Chinese training and to practise other complementary therapies in addition to acupuncture. Future studies should examine the impact of these differences on patients' clinical outcomes

Electrical activation and electron spin resonance measurements of implanted bismuth in isotopically enriched silicon-28

We have performed continuous wave and pulsed electron spin resonance measurements of implanted bismuth donors in isotopically enriched silicon-28. Donors are electrically activated via thermal annealing with minimal diffusion. Damage from bismuth ion implantation is repaired during thermal annealing as evidenced by narrow spin resonance linewidths (B_pp=12uT and long spin coherence times T_2=0.7ms, at temperature T=8K). The results qualify ion implanted bismuth as a promising candidate for spin qubit integration in silicon.Comment: 4 pages, 4 figure

Low temperature ordering and high (001) orientation of [Fe/Pt/Cu]\u3csub\u3e18\u3c/sub\u3e multilayer films

[Fe/Pt/Cu]18 multilayer films with different Cu thicknesses were prepared on thermally oxidized Si (111) substrates at room temperature using dc- and rf-magnetron sputtering. The magnetic proper-ties and microstructure of [Fe/Pt/Cu]18 multilayer films annealed at various temperatures have been investigated. Compared with pure [Fe/Pt]18 multilayer films low-temperature ordering and (001) ori-entation in the annealed films with Cu volume concentration below 20% can be obtained. During annealing process Cu atoms diffused into FePt lattice which enhanced the diffusion of Fe and Pt atoms and the grain growth of the films. The perpendicular anisotropy and hard magnetic properties of the films deteriorated with increasing Cu volume concentration due to the formation of L10 Fe-CuPt2 phase

Low temperature ordering and high (001) orientation of [Fe/Pt/Cu]\u3csub\u3e18\u3c/sub\u3e multilayer films

[Fe/Pt/Cu]18 multilayer films with different Cu thicknesses were prepared on thermally oxidized Si (111) substrates at room temperature using dc- and rf-magnetron sputtering. The magnetic proper-ties and microstructure of [Fe/Pt/Cu]18 multilayer films annealed at various temperatures have been investigated. Compared with pure [Fe/Pt]18 multilayer films low-temperature ordering and (001) ori-entation in the annealed films with Cu volume concentration below 20% can be obtained. During annealing process Cu atoms diffused into FePt lattice which enhanced the diffusion of Fe and Pt atoms and the grain growth of the films. The perpendicular anisotropy and hard magnetic properties of the films deteriorated with increasing Cu volume concentration due to the formation of L10 Fe-CuPt2 phase

Fracture in Three-Dimensional Fuse Networks

We report on large scale numerical simulations of fracture surfaces using random fuse networks for two very different disorders. There are some properties and exponents that are different for the two distributions, but others, notably the roughness exponents, seem universal. For the universal roughness exponent we found a value of zeta = 0.62 +/- 0.05. In contrast to what is observed in two dimensions, this value is lower than that reported in experimental studies of brittle fractures, and rules out the minimal energy surface exponent, 0.41 +/- 0.01.Comment: 4 pages, RevTeX, 5 figures, Postscrip

Experimenting Liver Fibrosis Diagnostic by Two Photon Excitation Microscopy and Bag-of-Features Image Classification

The accurate staging of liver fibrosis is of paramount importance to determine the state of disease progression, therapy responses, and to optimize disease treatment strategies. Non-linear optical microscopy techniques such as two-photon excitation fluorescence (TPEF) and second harmonic generation (SHG) can image the endogenous signals of tissue structures and can be used for fibrosis assessment on non-stained tissue samples. While image analysis of collagen in SHG images was consistently addressed until now, cellular and tissue information included in TPEF images, such as inflammatory and hepatic cell damage, equally important as collagen deposition imaged by SHG, remain poorly exploited to date. We address this situation by experimenting liver fibrosis quantification and scoring using a combined approach based on TPEF liver surface imaging on a Thioacetamide-induced rat model and a gradient based Bag-of-Features (BoF) image classification strategy. We report the assessed performance results and discuss the influence of specific BoF parameters to the performance of the fibrosis scoring framework.Romania. Executive Agency for Higher Education, Research, Development and Innovation Funding (research grant PN-II-PT-PCCA-2011-3.2-1162)Rectors' Conference of the Swiss Universities (SCIEX NMS-CH research fellowship nr. 12.135)Singapore. Agency for Science, Technology and Research (R-185-000-182-592)Singapore. Biomedical Research CouncilInstitute of Bioengineering and Nanotechnology (Singapore)Singapore-MIT Alliance (Computational and Systems Biology Flagship Project funding (C-382-641-001-091))Singapore-MIT Alliance for Research and Technology (SMART BioSyM and Mechanobiology Institute of Singapore (R-714-001-003-271)

Extracranial head and neck schwannomas: a study of the nerve of origin

Schwannoma is a type of benign nerve sheath tumour arising from the Schwann cell. Because of the close relationship between the tumour and the nerve of origin (NOO), the operation of extracranial head and neck schwannoma may lead to palsy of major nerve. For this reason, an accurate diagnosis of schwannoma with the identification of the NOO is crucial to the management. The aim of this review was to find out the distribution of the NOO and the usefulness of the investigations in the diagnosis of schwannoma. Medical records of the patients who underwent operation of the extracranial head and neck schwannoma in our division were reviewed. Between January 2000 and December 2009, 30 cases of extracranial head and neck schwannoma were operated. Sympathetic trunk (10, 33%) and vagus nerve (6, 20%) were the two most common NOOs. In five (17%) cases, the NOO was not found to be arising from any major nerve. For these 30 patients, 20 received fine needle aspiration cytology (FNAC) and 26 underwent imaging studies (computed tomography or magnetic resonance imaging) before operation. The specificity of FNAC and imaging studies in making the diagnosis of schwannoma was 20 and 38%, respectively. For the patients who had nerve palsies on presentation, their deficits remained after operation. The rate of nerve palsy after tumour excision with division of NOO and intracapsular enucleation was 100 and 67%, respectively. The diagnosis of schwannoma is suggested by clinical features and supported by investigations. Most of the time, the diagnosis can only be confirmed on the histological study of the surgical specimen. Sympathetic trunk and vagus nerve are the two common NOOs. MRI is the investigation of choice in the diagnosis of schwannoma and the identification of NOO

Determination of the Michel Parameters rho, xi, and delta in tau-Lepton Decays with tau --> rho nu Tags

Using the ARGUS detector at the $e^+ e^-$ storage ring DORIS II, we have measured the Michel parameters $\rho$, $\xi$, and $\xi\delta$ for $\tau^{\pm}\to l^{\pm} \nu\bar\nu$ decays in $\tau$-pair events produced at center of mass energies in the region of the $\Upsilon$ resonances. Using $\tau^\mp \to \rho^\mp \nu$ as spin analyzing tags, we find $\rho_{e}=0.68\pm 0.04 \pm 0.08$, $\xi_{e}= 1.12 \pm 0.20 \pm 0.09$, $\xi\delta_{e}= 0.57 \pm 0.14 \pm 0.07$, $\rho_{\mu}= 0.69 \pm 0.06 \pm 0.08$, $\xi_{\mu}= 1.25 \pm 0.27 \pm 0.14$ and $\xi\delta_{\mu}= 0.72 \pm 0.18 \pm 0.10$. In addition, we report the combined ARGUS results on $\rho$, $\xi$, and $\xi\delta$ using this work und previous measurements.Comment: 10 pages, well formatted postscript can be found at http://pktw06.phy.tu-dresden.de/iktp/pub/desy97-194.p

Szeg\"o kernel asymptotics and Morse inequalities on CR manifolds

We consider an abstract compact orientable Cauchy-Riemann manifold endowed with a Cauchy-Riemann complex line bundle. We assume that the manifold satisfies condition Y(q) everywhere. In this paper we obtain a scaling upper-bound for the Szeg\"o kernel on (0, q)-forms with values in the high tensor powers of the line bundle. This gives after integration weak Morse inequalities, analogues of the holomorphic Morse inequalities of Demailly. By a refined spectral analysis we obtain also strong Morse inequalities which we apply to the embedding of some convex-concave manifolds.Comment: 40 pages, the constants in Theorems 1.1-1.8 have been modified by a multiplicative constant 1/2 ; v.2 is a final updat