A Systematic Review of the Uptake and Adherence Rates to Supervised Exercise Programs in Patients with Intermittent Claudication

Background Intermittent claudication (IC) is a common and debilitating symptom of peripheral arterial disease and is associated with a significant reduction in a sufferer's quality of life. Guidelines recommend a supervised exercise program (SEP) as the primary treatment option; however, anecdotally there is a low participation rate for exercise in this group of patients. We undertook a systematic review of the uptake and adherence rates to SEPs for individuals with IC. Methods The MEDLINE, Embase, and PubMed databases were searched up to January 2015 for terms related to supervised exercise in peripheral arterial disease. The review had 3 aims: first, to establish the rates of uptake to SEPs, second, the rates of adherence to programs, and finally to determine the reasons reported for poor uptake and adherence. Separate inclusion and/or exclusion criteria were applied in selecting reports for each aim of the review. Results Only 23 of the 53 potentially eligible articles for uptake analysis identified on literature searches reported any details of screened patients (n = 7,517) with only 24.2% of patients subsequently recruited to SEPs. Forty-five percent of screen failures had no reason for exclusion reported. Sixty-seven articles with 4,012 patients were included for analysis of SEP adherence. Overall, 75.1% of patients reportedly completed an SEP; however, only one article defined a minimal attendance required for SEP completion. Overall, 54.1% of incomplete adherence was due to patient withdrawal and no reason for incomplete adherence was reported for 16% of cases. Conclusions Reporting of SEP trials was poor with regard to the numbers of subjects screened and reasons for exclusions. Only approximately 1 in 3 screened IC patients was suitable for and willing to undertake SEP. Levels of adherence to SEPs and definitions of satisfactory adherence were also lacking in most the current literature. Current clinical guidelines based on this evidence base may not be applicable to most IC patients and changes to SEPs may be needed to encourage and/or retain participants

Rho meson form factors in a confining Nambu--Jona-Lasinio model

Elastic electromagnetic form factors for the $\rho^+$ meson are calculated in a Nambu--Jona-Lasinio model which incorporates quark confinement through the use of the proper-time regularization scheme. A comparison is made with recent lattice QCD results and previous quark model calculations for static quantities and the Sachs form factors. The results are qualitatively in good agreement with the lattice QCD calculations, with the exception of the quadrupole moment and corresponding form factor, which may be related to a lack of spherical symmetry on the lattice.Comment: 8 pages, 11 figure

Understanding Heisenberg's 'Magical' Paper of July 1925: a New Look at the Calculational Details

In July 1925 Heisenberg published a paper [Z. Phys. 33, 879-893 (1925)] which ended the period of `the Old Quantum Theory' and ushered in the new era of Quantum Mechanics. This epoch-making paper is generally regarded as being difficult to follow, perhaps partly because Heisenberg provided few clues as to how he arrived at the results which he reported. Here we give details of calculations of the type which, we suggest, Heisenberg may have performed. We take as a specific example one of the anharmonic oscillator problems considered by Heisenberg, and use our reconstruction of his approach to solve it up to second order in perturbation theory. We emphasize that the results are precisely those obtained in standard quantum mechanics, and suggest that some discussion of the approach - based on the direct computation of transition amplitudes - could usefully be included in undergraduate courses in quantum mechanics.Comment: 24 pages, no figures, Latex, submitted to Am. J. Phy

Baryon Octet Electromagnetic Form Factors in a confining NJL model

Electromagnetic form factors of the baryon octet are studied using a Nambu--Jona-Lasinio model which utilizes the proper-time regularization scheme to simulate aspects of colour confinement. In addition, the model also incorporates corrections to the dressed quarks from vector meson correlations in the t-channel and the pion cloud. Comparison with recent chiral extrapolations of lattice QCD results shows a remarkable level of consistency. For the charge radii we find the surprising result $r_{E}^p < r_{E}^{\Sigma^+}$ and $|r_{E}^n| < |r_{E}^{\Xi^0}|$, whereas the magnetic radii have a pattern largely consistent with a naive expectation based on the dressed quark masses.Comment: 7 pages, 4 figure

A systematic review and meta-analysis of systemic intraoperative anticoagulation during arteriovenous access formation for dialysis

Purpose: Surgical arteriovenous fistula (AVF) or graft (AVG) is preferred to a central venous catheter for dialysis access. Surgical access may suffer thrombosis early after placement and systemic anticoagulation during surgical access formation may increase patency rates but would be expected to increase bleeding-related complications. A systematic review and meta-analysis of randomised controlled trials was conducted to examine the impact of systemic anticoagulation on access surgery perioperative bleeding and patency rates. Methods: We included randomised controlled trials testing systemic anticoagulation during access formation versus a control group without systemic anticoagulation reporting bleeding complications and access patency. Medline, Embase, CENTRAL and CINAHL were searched up to March 2015. Risk of bias was assessed using the Cochrane risk of bias tool and the Jadad score. Meta-analysis was performed using Cochrane Revman ® software. Results: Searches identified 445 reports of which four randomised studies involving 411 participants were included. Three studies pertained to AVF only and one included both AVF and AVG. Systemic anticoagulation led to increased bleeding events in all access [four trials; risk ratio (RR) 7.18; confidence interval (CI), 2.41 to 21.38; p < 0.001]. Patency was not improved for all access (four trials; RR, 0.64; CI, 0.37 to 1.09; p = 0.10) but was improved when AVF analysed alone (three trials; RR, 0.57; CI, 0.33 to 0.97; p = 0.04). Conclusions: The use of intraoperative systemic anticoagulation during access formation is associated with a highly significant increased risk of bleeding-related complications. A significant improvement in AVF patency was seen, though not when AVF and AVG were analysed together

Raman Quantum Memory with Built-In Suppression of Four-wave Mixing Noise

Quantum memories are essential for large-scale quantum information networks. Along with high efficiency, storage lifetime and optical bandwidth, it is critical that the memory add negligible noise to the recalled signal. A common source of noise in optical quantum memories is spontaneous four-wave mixing. We develop and implement a technically simple scheme to suppress this noise mechanism by means of quantum interference. Using this scheme with a Raman memory in warm atomic vapour we demonstrate over an order of magnitude improvement in noise performance. Furthermore we demonstrate a method to quantify the remaining noise contributions and present a route to enable further noise suppression. Our scheme opens the way to quantum demonstrations using a broadband memory, significantly advancing the search for scalable quantum photonic networks.Comment: 6 pages, 5 figures plus Supplementary Materia