A research protocol for developing a Point-Of-Care Key Evidence Tool 'POCKET': a checklist for multidimensional evidence reporting on point-of-care in vitro diagnostics.

INTRODUCTION: Point-of-care in vitro diagnostics (POC-IVD) are increasingly becoming widespread as an acceptable means of providing rapid diagnostic results to facilitate decision-making in many clinical pathways. Evidence in utility, usability and cost-effectiveness is currently provided in a fragmented and detached manner that is fraught with methodological challenges given the disruptive nature these tests have on the clinical pathway. The Point-of-care Key Evidence Tool (POCKET) checklist aims to provide an integrated evidence-based framework that incorporates all required evidence to guide the evaluation of POC-IVD to meet the needs of policy and decisionmakers in the National Health Service (NHS). METHODS AND ANALYSIS: A multimethod approach will be applied in order to develop the POCKET. A thorough literature review has formed the basis of a robust Delphi process and validation study. Semistructured interviews are being undertaken with POC-IVD stakeholders, including industry, regulators, commissioners, clinicians and patients to understand what evidence is required to facilitate decision-making. Emergent themes will be translated into a series of statements to form a survey questionnaire that aims to reach a consensus in each stakeholder group to what needs to be included in the tool. Results will be presented to a workshop to discuss the statements brought forward and the optimal format for the tool. Once assembled, the tool will be field-tested through case studies to ensure validity and usability and inform refinement, if required. The final version will be published online with a call for comments. Limitations include unpredictable sample representation, development of compromise position rather than consensus, and absence of blinding in validation exercise. ETHICS AND DISSEMINATION: The Imperial College Joint Research Compliance Office and the Imperial College Hospitals NHS Trust R&D department have approved the protocol. The checklist tool will be disseminated through a PhD thesis, a website, peer-reviewed publication, academic conferences and formal presentations

Fluctuations of Quantum Radiation Pressure in Dissipative Fluid

Using the generalized Langevin equations involving the stress tensor approach, we study the dynamics of a perfectly reflecting mirror which is exposed to the electromagnetic radiation pressure by a laser beam in a fluid at finite temperature. Based on the fluctuation-dissipation theorem, the minimum uncertainty of the mirror's position measurement from both quantum and thermal noises effects including the photon counting error in the laser interferometer is obtained in the small time limit as compared with the "standard quantum limit". The result of the large time behavior of fluctuations of the mirror's velocity in a dissipative environment can be applied to the laser interferometer of the ground-based gravitational wave detector.Comment: 8 pages. Version published in Physics Letters

Literature Survey on Interaction Techniques for Large Displays

When designing for large screen displays, designers are forced to deal with cursor tracking issues, interacting over distances, and space management issues. Because of the large visual angle of the user that the screen can cover, it may be hard for users to begin and complete search tasks for basic items such as cursors or icons. In addition, maneuvering over long distances and acquiring small targets understandably takes more time than the same interactions on normally sized screen systems. To deal with these issues, large display researchers have developed more and more unconventional devices, methods and widgets for interaction, and systems for space and task management. For tracking cursors there are techniques that deal with the size and shape of the cursor, as well as the “density” of the cursor. There are other techniques that help direct the attention of the user to the cursor. For target acquisition on large screens, many researchers saw fit to try to augment existing 2D GUI metaphors. They try to optimize Fitts’ law to accomplish this. Some techniques sought to enlarge targets while others sought to enlarge the cursor itself. Even other techniques developed ways of closing the distances on large screen displays. However, many researchers feel that existing 2D metaphors do not and will not work for large screens. They feel that the community should move to more unconventional devices and metaphors. These unconventional means include use of eye-tracking, laser-pointing, hand-tracking, two-handed touchscreen techniques, and other high-DOF devices. In the end, many of these developed techniques do provide effective means for interaction on large displays. However, we need to quantify the benefits of these methods and understand them better. The more we understand the advantages and disadvantages of these techniques, the easier it will be to employ them in working large screen systems. We also need to put into place a kind of interaction standard for these large screen systems. This could mean simply supporting desktop events such as pointing and clicking. It may also mean that we need to identify the needs of each domain that large screens are used for and tailor the interaction techniques for the domain

Comparative assessment of onabotulinumtoxinA and mirabegron for overactive bladder: an indirect treatment comparison

CONTEXT: OnabotulinumtoxinA and mirabegron have recently gained marketing authorisation to treat symptoms of overactive bladder (OAB). OBJECTIVE: To evaluate the relative efficacy of mirabegron and onabotulinumtoxinA in patients with idiopathic OAB. DESIGN: Network meta-analysis. DATA SOURCES: A search of 9 electronic databases, review documents, guidelines and websites. METHODS: Randomised trials comparing any licensed dose of onabotulinumtoxinA or mirabegron with each other, anticholinergic drugs or placebo were eligible (19 randomised trials were identified). 1 reviewer extracted data from the studies and a second reviewer checked the data. Candidate trials were assessed for similarity and networks were developed for each outcome. Bayesian network meta-analysis was conducted using both fixed-effects and random-effects models. When there were differences in mean baseline values between mirabegron and onabotulinumtoxinA trials they were adjusted for using network meta-regression (NMR). RESULTS: No studies directly comparing onabotulinumtoxinA to mirabegron were identified. A network was created for each of the 7 outcomes, with 3-9 studies included in each individual network. The trials included in the networks were broadly similar. Patients in the onabotulinumtoxinA trials had more urinary incontinence and urgency episodes at baseline than patients in the mirabegron trials and these differences were adjusted for using NMR. Both onabotulinumtoxinA and mirabegron were more efficacious than placebo at reducing the frequency of urinary incontinence, urgency, urination and nocturia. OnabotulinumtoxinA was more efficacious than mirabegron (50 and 25 mg) in completely resolving daily episodes of urinary incontinence and urgency and in reducing the frequency of urinary incontinence, urgency and urination. NMR supported the results of the network meta-analysis. CONCLUSIONS: In the absence of head-to-head trials comparing onabotulinumtoxinA to mirabegron, this indirect comparison indicates that onabotulinumtoxinA may be superior to mirabegron in improving symptoms of urinary incontinence, urgency and urinary frequency in patients with idiopathic OAB

Nonlinear Localization in Metamaterials

Metamaterials, i.e., artificially structured ("synthetic") media comprising weakly coupled discrete elements, exhibit extraordinary properties and they hold a great promise for novel applications including super-resolution imaging, cloaking, hyperlensing, and optical transformation. Nonlinearity adds a new degree of freedom for metamaterial design that allows for tuneability and multistability, properties that may offer altogether new functionalities and electromagnetic characteristics. The combination of discreteness and nonlinearity may lead to intrinsic localization of the type of discrete breather in metallic, SQUID-based, and ${\cal PT}-$symmetric metamaterials. We review recent results demonstrating the generic appearance of breather excitations in these systems resulting from power-balance between intrinsic losses and input power, either by proper initialization or by purely dynamical procedures. Breather properties peculiar to each particular system are identified and discussed. Recent progress in the fabrication of low-loss, active and superconducting metamaterials, makes the experimental observation of breathers in principle possible with the proposed dynamical procedures.Comment: 19 pages, 14 figures, Invited (Review) Chapte

The magnetic nature of disk accretion onto black holes

Although disk accretion onto compact objects - white dwarfs, neutron stars, and black holes - is central to much of high energy astrophysics, the mechanisms which enable this process have remained observationally elusive. Accretion disks must transfer angular momentum for matter to travel radially inward onto the compact object. Internal viscosity from magnetic processes and disk winds can in principle both transfer angular momentum, but hitherto we lacked evidence that either occurs. Here we report that an X-ray-absorbing wind discovered in an observation of the stellar-mass black hole binary GRO J1655-40 must be powered by a magnetic process that can also drive accretion through the disk. Detailed spectral analysis and modeling of the wind shows that it can only be powered by pressure generated by magnetic viscosity internal to the disk or magnetocentrifugal forces. This result demonstrates that disk accretion onto black holes is a fundamentally magnetic process.Comment: 15 pages, 2 color figures, accepted for publication in Nature. Supplemental materials may be obtained by clicking http://www.astro.lsa.umich.edu/~jonmm/nature1655.p

Effect of Dietary Components on Larval Life History Characteristics in the Medfly (Ceratitis capitata: Diptera, Tephritidae)

Background: The ability to respond to heterogenous nutritional resources is an important factor in the adaptive radiation of insects such as the highly polyphagous Medfly. Here we examined the breadth of the Medfly’s capacity to respond to different developmental conditions, by experimentally altering diet components as a proxy for host quality and novelty. Methodology/Principal Findings: We tested responses of larval life history to diets containing protein and carbohydrate components found in and outside the natural host range of this species. A 40% reduction in the quantity of protein caused a significant increase in egg to adult mortality by 26.5%±6% in comparison to the standard baseline diet. Proteins and carbohydrates had differential effects on larval versus pupal development and survival. Addition of a novel protein source, casein (i.e. milk protein), to the diet increased larval mortality by 19.4%±3% and also lengthened the duration of larval development by 1.93±0.5 days in comparison to the standard diet. Alteration of dietary carbohydrate, by replacing the baseline starch with simple sugars, increased mortality specifically within the pupal stage (by 28.2%±8% and 26.2%±9% for glucose and maltose diets, respectively). Development in the presence of the novel carbohydrate lactose (milk sugar) was successful, though on this diet there was a decrease of 29.8±1.6 µg in mean pupal weight in comparison to pupae reared on the baseline diet. Conclusions: The results confirm that laboratory reared Medfly retain the ability to survive development through a wide range of fluctuations in the nutritional environment. We highlight new facets of the responses of different stages of holometabolous life histories to key dietary components. The results are relevant to colonisation scenarios and key to the biology of this highly invasive species

Curie Temperatures for Three-Dimensional Binary Ising Ferromagnets

Using the Swendsen and Wang algorithm, high accuracy Monte Carlo simulations were performed to study the concentration dependence of the Curie temperature in binary, ferromagnetic Ising systems on the simple-cubic lattice. Our results are in good agreement with known mean-field like approaches. Based on former theoretical formulas we propose a new way of estimating the Curie temperature of these systems.Comment: nr. of pages:13, LATEX. Version 2.09, Scientific Report :02/1994 (Univ. of Bergen, Norway), 7 figures upon reques

ANALISIS PERHITUNGAN TEBAL LAPIS TAMBAHAN PADA JALAN PANGERAN SURYANATA – PATUNG LEMBUSWANA KOTA SAMARINDA

Technical planning of the program carried out in East Kalimantan province are still using Component Analysis Method ISO 1732-1989-F with manual calculation. Along with the development of technology, Technical Directorate of the Directorate General of Highways, Ministry of Public Works introduced a new method using software such as Flexible Pavement Design Software (SDPJL) in 2011. The purpose of this study was to compare the additional overlay on flexible pavement using Component Analysis Method ISO 1732-1989-F and Flexible Pavement Design Software (SDPJL). Location of the study was conducted on roads Santan-Bontang in East Kalimantan province. Primary data used is the Land Capability (CBR value), Road Condition Index (RCI), and the geometric path which was held on 14 and 15 February 2013. Secondary data traffic Daily Average (LHR), Deflection (Benkelman beam), climate and temperature data obtained from the Planning and Monitoring Unit of National Roads (P2JN) East Kalimantan. From these data, overlay is calculated using Component Analysis Method SNI 1732-1989-F and Flexible Pavement Design Software (SDPJL). Overlay of additional analysis calculations using the obtained thick Component Analysis Method AC-WC 4 cm and AC-BC 2.35 cm, while the overlay of additional calculations using the method of Flexible Pavement Design Software (SDPJL) obtained thick AC-WC 4 cm and AC-BC 13 cm. Differences the calculation caused of parameters the data used

ANALISIS PERHITUNGAN TEBAL LAPIS TAMBAHAN PADA JALAN PANGERAN SURYANATA – PATUNG LEMBUSWANA KOTA SAMARINDA

Technical planning of the program carried out in East Kalimantan province are still using Component Analysis Method ISO 1732-1989-F with manual calculation. Along with the development of technology, Technical Directorate of the Directorate General of Highways, Ministry of Public Works introduced a new method using software such as Flexible Pavement Design Software (SDPJL) in 2011. The purpose of this study was to compare the additional overlay on flexible pavement using Component Analysis Method ISO 1732-1989-F and Flexible Pavement Design Software (SDPJL). Location of the study was conducted on roads Santan-Bontang in East Kalimantan province. Primary data used is the Land Capability (CBR value), Road Condition Index (RCI), and the geometric path which was held on 14 and 15 February 2013. Secondary data traffic Daily Average (LHR), Deflection (Benkelman beam), climate and temperature data obtained from the Planning and Monitoring Unit of National Roads (P2JN) East Kalimantan. From these data, overlay is calculated using Component Analysis Method SNI 1732-1989-F and Flexible Pavement Design Software (SDPJL). Overlay of additional analysis calculations using the obtained thick Component Analysis Method AC-WC 4 cm and AC-BC 2.35 cm, while the overlay of additional calculations using the method of Flexible Pavement Design Software (SDPJL) obtained thick AC-WC 4 cm and AC-BC 13 cm. Differences the calculation caused of parameters the data used