Achieving change in the NHS: a feasibility study to introduce a home-based cancer chemotherapy service

A major focus of current health policyin the United Kingdom is the development of services that meet the public’s expectations. To achieve this there is a need to evaluate current provision to ensure that the best use is made of finite resources. The studyreported here adopted an interview approach to examine an existing outpatient chemotherapy service, and to consider the feasibilityof introducing a home based model. Following a review of literature on this topic data were obtained from in-depth interviews with patients and professionals regarding the present service. These were then combined with an analysis of service contracts and financial estimates. The poor quality of much of the costrelated information limited the conclusions which could be drawn, and emphasised the need for access to more accessible and robust financial information upon which to base change. The studyalso illustrated the benefits of feasibility studies; especially when cost-effectiveness and patient satisfaction are the driving forces behind proposed changes to clinical services

Parker and Usery: Portended Constitutional Limits on the Federal Interdiction of Anticompetitive State Action

This Article examines in detail the policies underlying these recent Supreme Court decisions interpreting the Sherman Act and shows that they have equal applicability to FTC enforcement of the Clayton and FTC Acts. The Article identifies the factual criteria used by the courts for distinguishing state and private conduct that is subject to the antitrust laws, and to congressional commerce dictates, from sovereign state regulatory conduct that is immune from antitrust sanction. The Article then focuses on the impact of Usery, which provides constitutional support for the so-called state action doctrine that was originated in Parker v. Brown. Finally, we conclude that the state action doctrine is not limited to the confines of the Sherman, Clayton, or FTC Acts but may well stand as a constitutional limitation on the substantive, economic powers of Congress and its regulatory agencies

Exploring Effects of Information Filtering With a VR Interface for Multi-Robot Supervision

Supervising and controlling remote robot systems currently requires many specialised operators to have knowledge of the internal state of the system in addition to the environment. For applications such as remote maintenance of future nuclear fusion reactors, the number of robots (and hence supervisors) required to maintain or decommission a facility is too large to be financially feasible. To address this issue, this work explores the idea of intelligently filtering information so that a single user can supervise multiple robots safely. We gathered feedback from participants using five methods for teleoperating a semi-autonomous multi-robot system via Virtual Reality (VR). We present a novel 3D interaction method to filter the displayed information to allow the user to read information from the environment without being overwhelmed. The novelty of the interface design is the link between Semantic and Spatial filtering and the hierarchical information contained within the multi robot system. We conducted a user study including a cohort of expert robot teleoperators comparing these methods; highlighting the significant effects of 3D interface design on the performance and perceived workload of a user teleoperating many robot agents in complex environments. The results from this experiment and subjective user feedback will inform future investigations that build upon this initial work

Harnessing Marine Renewable Energy from Poole Harbour: Case Study

Global warming and its impact on our environment, society, economies and security is one of the fundamental concerns of our time. In response, the United Kingdom government has put in place a legally binding target of an 80% reduction in greenhouse gas emissions on 1990 levels by 2050. The United Kingdom will need to achieve a tenfold expansion of energy supply from renewable sources by 2020 to meet its share of the European Union renewable energy target. The marine and coastal environment’s renewable energy potential in Britain is high. It is estimated that it has 50% of the tidal energy, 35% of wave and 40% of wind resources in the European Union. Use of geothermal resources using heat pump technology is the least evolved sector, but in 2010 contributed to 0.7 TWh of energy and it is believed that non domestic heat pumps could contribute up to 22 TWh by 2020. In the Southwest of England, Poole Harbour has been recognised as a potential, highly predictable source of tidal and heat energy. Local groups are embarking on a feasibility study for harnessing this energy for the benefit of the community. The purpose of this article is to examine the potential conflict of interest between the laudable aims of promoting the use of renewable energy and of safeguarding ecosystems and their biodiversity. Using Poole Harbour as a case study, it will consider the environmental and economic costs and benefits of a Community Renewable Energy project (the Poole Tidal Energy Partnership) in the context of an area subject to a number of statutory and non-statutory designations to protect nationally and internationally important habitats and species. The paper identifies key environmental legislation, including spatial planning law and policy, which will facilitate exploring whether there is potential for reconciling what may be perceived as competing objectives for sustainable development

Efficient Environment Guided Approach for Exploration of Complex Environments

Remote inspection of a complex environment is a difficult, time consuming task for human operators to perform. The need to manually avoid obstacles whilst considering other performance factors i.e. time taken, joint effort and information gained represents significant challenges to continuous operation. This paper proposes an autonomous robotic solution for exploration of an unknown, complex environment using a high DoF robot arm with an eye in hand depth sensor. The main contribution of this work is a new strategy to find the next best view by evaluating frontier regions of the map to maximise coverage, in contrast to many current approaches which densely sample joint or workspace configurations of the robot. Multiple utility functions were evaluated that showed different behaviours. Our results indicated that the presented algorithm can explore an arbitrary environment efficiently while optimising various performance criteria based on the utility function chosen, application constraints and the desires of the user

A new algorithm to diagnose atrial ectopic origin from multi lead ECG systems - insights from 3D virtual human atria and torso

Rapid atrial arrhythmias such as atrial fibrillation (AF) predispose to ventricular arrhythmias, sudden cardiac death and stroke. Identifying the origin of atrial ectopic activity from the electrocardiogram (ECG) can help to diagnose the early onset of AF in a cost-effective manner. The complex and rapid atrial electrical activity during AF makes it difficult to obtain detailed information on atrial activation using the standard 12-lead ECG alone. Compared to conventional 12-lead ECG, more detailed ECG lead configurations may provide further information about spatio-temporal dynamics of the body surface potential (BSP) during atrial excitation. We apply a recently developed 3D human atrial model to simulate electrical activity during normal sinus rhythm and ectopic pacing. The atrial model is placed into a newly developed torso model which considers the presence of the lungs, liver and spinal cord. A boundary element method is used to compute the BSP resulting from atrial excitation. Elements of the torso mesh corresponding to the locations of the placement of the electrodes in the standard 12-lead and a more detailed 64-lead ECG configuration were selected. The ectopic focal activity was simulated at various origins across all the different regions of the atria. Simulated BSP maps during normal atrial excitation (i.e. sinoatrial node excitation) were compared to those observed experimentally (obtained from the 64-lead ECG system), showing a strong agreement between the evolution in time of the simulated and experimental data in the P-wave morphology of the ECG and dipole evolution. An algorithm to obtain the location of the stimulus from a 64-lead ECG system was developed. The algorithm presented had a success rate of 93%, meaning that it correctly identified the origin of atrial focus in 75/80 simulations, and involved a general approach relevant to any multi-lead ECG system. This represents a significant improvement over previously developed algorithms

Chromatographic profiles of blood plasma free oligosaccharides in patients with cardiovascular disease

Free oligosaccharides (FOS) are unbound structural analogs of glycans of glycoconjugates. There are several sources of them inside the cell: 1) multistep pathways of N-glycosylation, 2) the cell quality control and endoplastic reticulum-associated degradation of mis-glycosylated and/or misfolded glycoproteins, 3) lysosomal degradation of mature glycoconjugates. Some of these FOS are the earliest indicators of potential glycosylation alterations that would be revealed in the course of the cell quality control and the endoplastic reticulum-associated degradation. Ischemia and hypertension cause stress of intracellular organelles leading to disruption of their functions. The main objective of the work was the characterization of free oligosaccharides (FOS) in plasma obtained from patients with cardiovascular diseases compared to those from healthy subjects to evaluate the potential of these compounds for diagnostics. Chromatographic profiles of FOS composed of 4–12 monosaccharides were obtained and analyzed for quantitative and qualitative differences between the samples. After plasma deproteinization and FOS purification the oligosaccharides were labelled with anthranilic acid (2-AA), separated into the neutral and charged with QAE Sephadex (Q25-120) chromatography and analysed using high-performance liquid chromatography (HPLC). Glucose unit values were determined following comparison with a 2-AA-labelled glucose oligomer ladder derived from a partial hydrolysate of dextran as an external standard. The data were collected and processed using Empower software. The charged FOS were digested with the sialidase from Arthrobacter ureafaciens. 2-AA – labelled free oligosaccharides from transferrin were used as an external standard for the structure decoding. The profiles obtained were compared with intracellular free oligosaccharides of known structures and with the glycan structures and their descriptions in the databases GlycoBase and EUROCarbDB. These approaches allowed predicting a range of glycan structures for each of the main peaks of HPLC profiles of plasma free oligosaccharides and managing ways for their future experimental analysis. In the case of cardiovascular disorders, HPLC profiles of FOS revealed a changing pattern of heterogeneity, depending on the severity of the disease. Three main enlarged glycan species in the netral fraction and one peak in the charged fraction distinguished the FOS of the patients from those of the healthy volunteers. It has been revealed that the neutral marker peaks were represented by polimannose glycans with 5–7 mannose residues and 1–2 residues of N-acetylglucosamine, and one of the major peaks of the charged fraction – by two-antennary complex N-glycan with two sialic acid residues. The study of free oligosaccharides of blood plasma is a new field of glycobiology allowing an evaluation of an organism state at the level of the cell organelle functional status and openning up broad prospects for finding early diagnostic and prognostic markers of cardiac insufficiency

Single-Photon Single-Flux Coupled Detectors

In this work, we present a novel device that is a combination of a superconducting nanowire single-photon detector and a superconducting multi-level memory. We show that these devices can be used to count the number of detections through single-photon to single-flux conversion. Electrical characterization of the memory properties demonstrates single-flux quantum (SFQ) separated states. Optical measurements using attenuated laser pulses with different mean photon number, pulse energies and repetition rates are shown to differentiate single-photon detection from other possible phenomena, such as multi-photon detection and thermal activation. Finally, different geometries and material stacks to improve device performance, as well as arraying methods are discussed