Thyroxine treatment in patients with symptoms of hypothyroidism but thyroid function tests within the reference range: randomised double blind placebo controlled crossover trial

OBJECTIVES: To determine whether thyroxine treatment is effective in patients with symptoms of hypothyroidism but with thyroid function tests within the reference range, and to investigate the effect of thyroxine treatment on psychological and physical wellbeing in healthy participants. DESIGN: Randomised double blind placebo controlled crossover trial. SETTING: Outpatient clinic in a general hospital. Participants: 25 patients with symptoms of hypothyroidism who had thyroid function tests within the reference range, and 19 controls. Methods: Participants were given thyroxine 100 microgram or placebo to take once a day for 12 weeks. Washout period was six weeks. They were then given the other to take once a day for 12 weeks. All participants were assessed physiologically and psychologically at baseline and on completion of each phase. MAIN OUTCOME MEASURES: Thyroid function tests, measures of cognitive function and of psychological and physical wellbeing. RESULTS: 22 patients and 19 healthy controls completed the study. At baseline, patients' scores on 9 out of 15 psychological measures were impaired when compared with controls. Patients showed a significantly greater response to placebo than controls in 3 out of 15 psychological measures. Healthy participants had significantly lower scores for vitality when taking thyroxine compared to placebo (mean (SD) 60 (17) v 73 (16), P<0.01). However, patients' scores from psychological tests when taking thyroxine were no different from those when taking placebo except for a poorer performance on one visual reproduction test when taking thyroxine. Serum concentrations of free thyroxine increased and those of thyroid stimulating hormone decreased in patients and controls while they were taking thyroxine, confirming compliance with treatment. Although serum concentrations of free triiodothyronine increased in patients and controls taking thyroxine, the difference between the response to placebo and to thyroxine was significant only in the controls. CONCLUSIONS: Thyroxine was no more effective than placebo in improving cognitive function and psychological wellbeing in patients with symptoms of hypothyroidism but thyroid function tests within the reference range. Thyroxine did not improve cognitive function and psychological wellbeing in healthy participants

Building Full-Service Schools: Lessons Learned in the Development of Interagency Collaboratives

Although the history of clinical-school-eommunity collaboration can be traced back to the end of the 19th century, the full-service school movement represents a new era in the quest for more effective ways to deliver human services to children. As awareness that school systems alone cannot address the social problems affecting millions of children, the concept of full-service schools has been embraced as a potential solution to service delivery problems affecting children living in high-risk environments. Built on shared commitment to positive child development, full-service schools represent an effort to make human service systems partners in the educational process, while simultaneously making school systems partners in the delivery of human services (Adelman & Taylor, 1999; Dryfoos, 1994a, 1995/1997/1998; Morrill, 1992)

Direct numerical solution of Poisson`s equation in cylindrical (r, z) coordinates

A direct solver method is developed for solving Poisson`s equation numerically for the electrostatic potential {phi}(r,z) in a cylindrical region (r < R{sub wall}, 0 < z < L). The method assumes the charge density {rho}(r,z) and wall potential {phi}(r = R{sub wall}, z) are specified, and {partial_derivative}{phi}/{partial_derivative}z = 0 at the axial boundaries (z = 0, L)

Decoupling of the S=1/2 antiferromagnetic zig-zag ladder with anisotropy

The spin-1/2 antiferromagnetic zig-zag ladder is studied by exact diagonalization of small systems in the regime of weak inter-chain coupling. A gapless phase with quasi long-range spiral correlations has been predicted to occur in this regime if easy-plane (XY) anisotropy is present. We find in general that the finite zig-zag ladder shows three phases: a gapless collinear phase, a dimer phase and a spiral phase. We study the level crossings of the spectrum,the dimer correlation function, the structure factor and the spin stiffness within these phases, as well as at the transition points. As the inter-chain coupling decreases we observe a transition in the anisotropic XY case from a phase with a gap to a gapless phase that is best described by two decoupled antiferromagnetic chains. The isotropic and the anisotropic XY cases are found to be qualitatively the same, however, in the regime of weak inter-chain coupling for the small systems studied here. We attribute this to a finite-size effect in the isotropic zig-zag case that results from exponentially diverging antiferromagnetic correlations in the weak-coupling limit.Comment: to appear in Physical Review

Personal identity (de)formation among lifestyle travellers: A double-edged sword?

This article explores the personal identity work of lifestyle travellers – individuals for whom extended leisure travel is a preferred lifestyle that they return to repeatedly. Qualitative findings from in-depth semi-structured interviews with lifestyle travellers in northern India and southern Thailand are interpreted in light of theories on identity formation in late modernity that position identity as problematic. It is suggested that extended leisure travel can provide exposure to varied cultural praxes that may contribute to a sense of social saturation. Whilst a minority of the respondents embraced a saturation of personal identity in the subjective formation of a cosmopolitan cultural identity, several of the respondents were paradoxically left with more identity questions than answers as the result of their travels

User-friendly tail bounds for sums of random matrices

This paper presents new probability inequalities for sums of independent, random, self-adjoint matrices. These results place simple and easily verifiable hypotheses on the summands, and they deliver strong conclusions about the large-deviation behavior of the maximum eigenvalue of the sum. Tail bounds for the norm of a sum of random rectangular matrices follow as an immediate corollary. The proof techniques also yield some information about matrix-valued martingales. In other words, this paper provides noncommutative generalizations of the classical bounds associated with the names Azuma, Bennett, Bernstein, Chernoff, Hoeffding, and McDiarmid. The matrix inequalities promise the same diversity of application, ease of use, and strength of conclusion that have made the scalar inequalities so valuable.Comment: Current paper is the version of record. The material on Freedman's inequality has been moved to a separate note; other martingale bounds are described in Caltech ACM Report 2011-0

Making Almost Commuting Matrices Commute

Suppose two Hermitian matrices $A,B$ almost commute ($\Vert [A,B] \Vert \leq \delta$). Are they close to a commuting pair of Hermitian matrices, $A',B'$, with $\Vert A-A' \Vert,\Vert B-B'\Vert \leq \epsilon$? A theorem of H. Lin shows that this is uniformly true, in that for every $\epsilon>0$ there exists a $\delta>0$, independent of the size $N$ of the matrices, for which almost commuting implies being close to a commuting pair. However, this theorem does not specify how $\delta$ depends on $\epsilon$. We give uniform bounds relating $\delta$ and $\epsilon$. We provide tighter bounds in the case of block tridiagonal and tridiagonal matrices and a fully constructive method in that case. Within the context of quantum measurement, this implies an algorithm to construct a basis in which we can make a {\it projective} measurement that approximately measures two approximately commuting operators simultaneously. Finally, we comment briefly on the case of approximately measuring three or more approximately commuting operators using POVMs (positive operator-valued measures) instead of projective measurements.Comment: 22 pages; tighter bounds; Note: fixed mistake in proof pointed out by Filonov and Kachkovski

From Coherent Modes to Turbulence and Granulation of Trapped Gases

The process of exciting the gas of trapped bosons from an equilibrium initial state to strongly nonequilibrium states is described as a procedure of symmetry restoration caused by external perturbations. Initially, the trapped gas is cooled down to such low temperatures, when practically all atoms are in Bose-Einstein condensed state, which implies the broken global gauge symmetry. Excitations are realized either by imposing external alternating fields, modulating the trapping potential and shaking the cloud of trapped atoms, or it can be done by varying atomic interactions by means of Feshbach resonance techniques. Gradually increasing the amount of energy pumped into the system, which is realized either by strengthening the modulation amplitude or by increasing the excitation time, produces a series of nonequilibrium states, with the growing fraction of atoms for which the gauge symmetry is restored. In this way, the initial equilibrium system, with the broken gauge symmetry and all atoms condensed, can be excited to the state, where all atoms are in the normal state, with completely restored gauge symmetry. In this process, the system, starting from the regular superfluid state, passes through the states of vortex superfluid, turbulent superfluid, heterophase granular fluid, to the state of normal chaotic fluid in turbulent regime. Both theoretical and experimental studies are presented.Comment: Latex file, 25 pages, 4 figure

Caste development and reproduction: a genome-wide analysis of hallmarks of insect eusociality

The honey bee queen and worker castes are a model system for developmental plasticity. We used established expressed sequence tag information for a Gene Ontology based annotation of genes that are differentially expressed during caste development. Metabolic regulation emerged as a major theme, with a caste-specific difference in the expression of oxidoreductases vs. hydrolases. Motif searches in upstream regions revealed group-specific motifs, providing an entry point to cis-regulatory network studies on caste genes. For genes putatively involved in reproduction, meiosis-associated factors came out as highly conserved, whereas some determinants of embryonic axes either do not have clear orthologs (bag of marbles, gurken, torso), or appear to be lacking (trunk) in the bee genome. Our results are the outcome of a first genome-based initiative to provide an annotated framework for trends in gene regulation during female caste differentiation (representing developmental plasticity) and reproduction