Contamination in complex healthcare trials:the falls in care homes (FinCH) study experience

BACKGROUND: Trials are at risk of contamination bias which can occur when participants in the control group are inadvertently exposed to the intervention. This is a particular risk in rehabilitation studies where it is easy for trial interventions to be either intentionally or inadvertently adopted in control settings. The Falls in Care Homes (FinCH) trial is used in this paper as an example of a large randomised controlled trial of a complex intervention to explore the potential risks of contamination bias. We outline the FinCH trial design, present the potential risks from contamination bias, and the strategies used in the design of the trial to minimise or mitigate against this. The FinCH trial was a multi-centre randomised controlled trial, with embedded process evaluation, which evaluated whether systematic training in the use of the Guide to Action Tool for Care Homes reduced falls in care home residents. Data were collected from a number of sources to explore contamination in the FinCH trial. Where specific procedures were adopted to reduce risk of, or mitigate against, contamination, this was recorded. Data were collected from study e-mails, meetings with clinicians, research assistant and clinician network communications, and an embedded process evaluation in six intervention care homes. During the FinCH trial, there were six new falls prevention initiatives implemented outside the study which could have contaminated our intervention and findings. Methods used to minimise contamination were: cluster randomisation at the level of care home; engagement with the clinical community to highlight the risks of early adoption; establishing local collaborators in each site familiar with the local context; signing agreements with NHS falls specialists that they would maintain confidentiality regarding details of the intervention; opening additional research sites; and by raising awareness about the importance of contamination in research among participants. CONCLUSION: Complex rehabilitation trials are at risk of contamination bias. The potential for contamination bias in studies can be minimized by strengthening collaboration and dialogue with the clinical community. Researchers should recognise that clinicians may contaminate a study through lack of research expertise

Secondary organic aerosol formation from in-use motor vehicle emissions using a potential aerosol mass reactor.

Secondary organic aerosol (SOA) formation from in-use vehicle emissions was investigated using a potential aerosol mass (PAM) flow reactor deployed in a highway tunnel in Pittsburgh, Pennsylvania. Experiments consisted of passing exhaust-dominated tunnel air through a PAM reactor over integrated hydroxyl radical (OH) exposures ranging from ∼ 0.3 to 9.3 days of equivalent atmospheric oxidation. Experiments were performed during heavy traffic periods when the fleet was at least 80% light-duty gasoline vehicles on a fuel-consumption basis. The peak SOA production occurred after 2-3 days of equivalent atmospheric oxidation. Additional OH exposure decreased the SOA production presumably due to a shift from functionalization to fragmentation dominated reaction mechanisms. Photo-oxidation also produced substantial ammonium nitrate, often exceeding the mass of SOA. Analysis with an SOA model highlight that unspeciated organics (i.e., unresolved complex mixture) are a very important class of precursors and that multigenerational processing of both gases and particles is important at longer time scales. The chemical evolution of the organic aerosol inside the PAM reactor appears to be similar to that observed in the atmosphere. The mass spectrum of the unoxidized primary organic aerosol closely resembles ambient hydrocarbon-like organic aerosol (HOA). After aging the exhaust equivalent to a few hours of atmospheric oxidation, the organic aerosol most closely resembles semivolatile oxygenated organic aerosol (SV-OOA) and then low-volatility organic aerosol (LV-OOA) at higher OH exposures. Scaling the data suggests that mobile sources contribute ∼ 2.9 ± 1.6 Tg SOA yr(-1) in the United States, which is a factor of 6 greater than all mobile source particulate matter emissions reported by the National Emissions Inventory. This highlights the important contribution of SOA formation from vehicle exhaust to ambient particulate matter concentrations in urban areas

Strongly absorbed quiescent X-ray emission from the X-ray transient XTE J0421+56 (CI Cam) observed with XMM-Newton

We have observed the X-ray transient XTE J0421+56 in quiescence with XMM-Newton. The observed spectrum is highly unusual being dominated by an emission feature at ~6.5 keV. The spectrum can be fit using a partially covered power-law and Gaussian line model, in which the emission is almost completely covered (covering fraction of 0.98_{-0.06}^{+0.02}) by neutral material and is strongly absorbed with an N_H of (5_{-2}^{+3}) x 10^{23} atom cm^{-2}. This absorption is local and not interstellar. The Gaussian has a centroid energy of 6.4 +/- 0.1 keV, a width < 0.28 keV and an equivalent width of 940 ^{+650}_{-460} eV. It can be interpreted as fluorescent emission line from iron. Using this model and assuming XTE J0421+56 is at a distance of 5 kpc, its 0.5-10 keV luminosity is 3.5 x 10^{33} erg s^{-1}. The Optical Monitor onboard XMM-Newton indicates a V magnitude of 11.86 +/- 0.03. The spectra of X-ray transients in quiescence are normally modeled using advection dominated accretion flows, power-laws, or by the thermal emission from a neutron star surface. The strongly locally absorbed X-ray emission from XTE J0421+56 is therefore highly unusual and could result from the compact object being embedded within a dense circumstellar wind emitted from the supergiant B[e] companion star. The uncovered and unabsorbed component observed below 5 keV could be due either to X-ray emission from the supergiant B[e] star itself, or to the scattering of high-energy X-ray photons in a wind or ionized corona, such as observed in some low-mass X-ray binary systems.Comment: 8 pages, 4 postscript figures, accepted for publication in Astronomy and Astrophysic

Structure formation by cosmic strings with a cosmological constant

Final published version.Comment: 4 Page

On the conveyance of angular momentum in electronic energy transfer

When electronic excitation transfer occurs, it is of considerable interest to establish whether angular momentum can also be conveyed in the process. The question is prompted by a consideration that when the participating chromophores are atoms, ions, or molecular systems having high local symmetry, the electronic excited states that are involved are generally characterized not only by energy, but by angular momentum properties. Moreover, it is known that electron spin can be communicated between quantum dot exciton states. Resolving the general issue entails an electrodynamic representation exploiting irreducible tensor methods, the analysis being illustrated by application to energy transfer associated with a variety of multipolar transitions. The results exhibit novel connections between an angular momentum content of the electromagnetic coupling and a strongly varying distance dependence. It is concluded that the communication of angular momentum does not in general map unambiguously between a donor and energy acceptor

Neighborhoods of trees in circular orderings

In phylogenetics, a common strategy used to construct an evolutionary tree for a set of species X is to search in the space of all such trees for one that optimizes some given score function (such as the minimum evolution, parsimony or likelihood score). As this can be computationally intensive, it was recently proposed to restrict such searches to the set of all those trees that are compatible with some circular ordering of the set X. To inform the design of efficient algorithms to perform such searches, it is therefore of interest to find bounds for the number of trees compatible with a fixed ordering in the neighborhood of a tree that is determined by certain tree operations commonly used to search for trees: the nearest neighbor interchange (nni), the subtree prune and regraft (spr) and the tree bisection and reconnection (tbr) operations. We show that the size of such a neighborhood of a binary tree associated with the nni operation is independent of the tree’s topology, but that this is not the case for the spr and tbr operations. We also give tight upper and lower bounds for the size of the neighborhood of a binary tree for the spr and tbr operations and characterize those trees for which these bounds are attained

Parenting ‘gifted and talented’ children in urban areas: Parents' voices

This is the author's accepted manuscript. The final published article is available from the link below. Copyright © 2014 by SAGE Publications.International evidence demonstrates the importance of engaging parents in the education of their ‘high-potential’ children, yet limited research has focused on the involvement of parents from differing economic strata/backgrounds. The current study explored the dilemmas of parenting academically high-ability children from economically deprived urban areas in the UK. Data were gathered from a sample of parents whose children attended a university-based sustained intervention programme for designated ‘gifted’ pupils aged 12–16. Parental perceptions were sought in relation to (a) the usefulness/impact of the intervention programme, (b) parents’ aspirations for their children growing up in economically deprived urban areas and (c) parents’ views on the support provided by the extended family, peer groups and the wider community. The findings have significant implications for both policy and practice and, more specifically, for engaging parents in intervention programmes offered by universities and schools to children in order to increase their access to higher education and for enhancing their life chances

Planetary Nebulae as standard candles XI. Application to Spiral Galaxies

We report the results of an [O III] lambda 5007 survey for planetary nebulae (PN) in three spiral galaxies: M101 (NGC 5457), M51 (NGC 5194/5195) and M96 (NGC 3368). By comparing on-band/off-band [O III] lambda 5007 images with images taken in H-alpha and broadband R, we identify 65, 64 and 74 PN candidates in each galaxy, respectively. From these data, an adopted M31 distance of 770 kpc, and the empirical planetary nebula luminosity function (PNLF), we derive distances to M101, M51, and M96 of 7.7 +/- 0.5, 8.4 +/- 0.6, and 9.6 +/- 0.6 Mpc. These observations demonstrate that the PNLF technique can be successfully applied to late-type galaxies, and provide an important overlap between the Population I and Population II distance scales. We also discuss some special problems associated with using the PNLF in spiral galaxies, including the effects of dust and the possible presence of [O III] bright supernova remnants.Comment: 38 pages, TeX, with tables included but not figures. Uses epsf.tex and kpnobasic.tex. To be published in the Astophysical Journal. Full paper is available at http://www.astro.psu.edu/users/johnf/Text/research.htm

Liquid-Liquid Phase Transitions for Soft-Core Attractive Potentials

Using event driven molecular dynamics simulations, we study a three dimensional one-component system of spherical particles interacting via a discontinuous potential combining a repulsive square soft core and an attractive square well. In the case of a narrow attractive well, it has been shown that this potential has two metastable gas-liquid critical points. Here we systematically investigate how the changes of the parameters of this potential affect the phase diagram of the system. We find a broad range of potential parameters for which the system has both a gas-liquid critical point and a liquid-liquid critical point. For the liquid-gas critical point we find that the derivatives of the critical temperature and pressure, with respect to the parameters of the potential, have the same signs: they are positive for increasing width of the attractive well and negative for increasing width and repulsive energy of the soft core. This result resembles the behavior of the liquid-gas critical point for standard liquids. In contrast, for the liquid-liquid critical point the critical pressure decreases as the critical temperature increases. As a consequence, the liquid-liquid critical point exists at positive pressures only in a finite range of parameters. We present a modified van der Waals equation which qualitatively reproduces the behavior of both critical points within some range of parameters, and give us insight on the mechanisms ruling the dependence of the two critical points on the potential's parameters. The soft core potential studied here resembles model potentials used for colloids, proteins, and potentials that have been related to liquid metals, raising an interesting possibility that a liquid-liquid phase transition may be present in some systems where it has not yet been observed.Comment: 29 pages, 15 figure

Joint Elastic Side-Scattering Lidar and Raman Lidar Measurements of Aerosol Optical Properties in South East Colorado

We describe an experiment, located in south-east Colorado, USA, that measured aerosol optical depth profiles using two Lidar techniques. Two independent detectors measured scattered light from a vertical UV laser beam. One detector, located at the laser site, measured light via the inelastic Raman backscattering process. This is a common method used in atmospheric science for measuring aerosol optical depth profiles. The other detector, located approximately 40km distant, viewed the laser beam from the side. This detector featured a 3.5m2 mirror and measured elastically scattered light in a bistatic Lidar configuration following the method used at the Pierre Auger cosmic ray observatory. The goal of this experiment was to assess and improve methods to measure atmospheric clarity, specifically aerosol optical depth profiles, for cosmic ray UV fluorescence detectors that use the atmosphere as a giant calorimeter. The experiment collected data from September 2010 to July 2011 under varying conditions of aerosol loading. We describe the instruments and techniques and compare the aerosol optical depth profiles measured by the Raman and bistatic Lidar detectors.Comment: 34 pages, 16 figure