Emergency management in health: key issues and challenges in the UK

Background Emergency planning in the UK has grown considerably in recent years, galvanised by the threat of terrorism. However, deficiencies in NHS emergency planning were identified and the evidence-base that underpins it is questionable. Inconsistencies in terminologies and concepts also exist. Different models of emergency management exist internationally but the optimal system is unknown. This study examines the evidence-base and evidence requirements for emergency planning in the UK health context. Methods The study involved semi-structured interviews with key stakeholders and opinion leaders. Purposive sampling was used to obtain a breadth of views from various agencies involved in emergency planning and response. Interviews were then analysed using a grounded approach using standard framework analysis techniques. Results We conducted 17 key informant interviews. Interviewees identified greater gaps in operational than technical aspects of emergency planning. Social and behavioural knowledge gaps were highlighted with regards to how individuals and organisations deal with risk and behave in emergencies. Evidence-based approaches to public engagement and for developing community resilience to disasters are lacking. Other gaps included how knowledge was developed and used. Conflicting views with regards to the optimal configuration and operation of the emergency management system were voiced. Conclusions Four thematic categories for future research emerged: (i) Knowledge-base for emergency management: Further exploration is needed of how knowledge is acquired, valued, disseminated, adopted and retained. (ii) Social and behavioural issues: Greater understanding of how individuals approach risk and behave in emergencies is required. (iii) Organisational issues in emergencies: Several conflicting organisational issues were identified; value of planning versus plans, flexible versus standardized procedures, top-down versus bottom-up engagement, generic versus specific planning, and reactive versus proactive approaches to emergencies. (iv) Emergency management system: More study is required of system-wide issues relating to system configuration and operation, public engagement, and how emergency planning is assessed

Search for Anomalous Production of Events with a Photon, Jet, b-quark Jet, and Missing Transverse Energy

Submitted to Phys. Rev. DWe present a signature-based search for anomalous production of events containing a photon, two jets, of which at least one is identified as originating from a b quark, and missing transverse energy. The search uses data corresponding to 2.0/fb of integrated luminosity from p-pbar collisions at a center-of-mass energy of sqrt(s)=1.96 TeV, collected with the CDF II detector at the Fermilab Tevatron. From 6,697,466 events with a photon candidate with transverse energy ET> 25 GeV, we find 617 events with missing transverse energy > 25 GeV and two or more jets with ET> 15 GeV, at least one identified as originating from a b quark, versus an expectation of 607+- 113 events. Increasing the requirement on missing transverse energy to 50 GeV, we find 28 events versus an expectation of 30+-11 events. We find no indications of non-standard-model phenomena.We present a signature-based search for the anomalous production of events containing a photon, two jets, of which at least one is identified as originating from a b quark, and missing transverse energy (E̸T). The search uses data corresponding to 2.0  fb-1 of integrated luminosity from pp̅ collisions at a center-of-mass energy of √s=1.96  TeV, collected with the CDF II detector at the Fermilab Tevatron. From 6.697 47×106 events with a photon candidate with transverse energy ET>25  GeV, we find 617 events with E̸T>25  GeV and two or more jets with ET>15  GeV, at least one identified as originating from a b quark, versus an expectation of 607±113 events. Increasing the requirement on E̸T to 50 GeV, we find 28 events versus an expectation of 30±11 events. We find no indications of non-standard-model phenomena.Peer reviewe

Vortex dynamics study on an uniaxially textured YBCO/MgO superconducting film from magnetic measurements

The vortex dynamics of an undoped uniaxially textured YBa2Cu3O7-δ (YBCO) superconducting film grown onto a MgO (100) substrate was inspected by applying the vortex glass and collective-pinning models. The texture and structural characterization studied by XRD revealed a uniaxially (00l) YBCO layer, which coexists with minor Y2BaCuO5 and CuO phases. The temperature dependence of the magnetization in the superconducting state reveals a critical temperature TC = 88 K. By measuring the hysteresis loops (M(H)) at 10 - 70 K, the critical fields HC1, HC2, HP and Hirr were estimated and a vortex matter diagram is sketched. By using the Bean model, the critical current density values JC(T,H) are obtained and the typical peak effect is observed. The vortex dynamics mechanism is discussed taking into account four vortex feature regimes in the double-logarithmical JC(H) curves. The vortex pinning mechanism is discussed by obtaining the pining force, FP, its normalization, f(h), and magnetic relaxation M(t) measurements taken in field cooling (FC) mode at 10 – 60 K. The glassy exponent μ and the characteristic energy U(J, T) in the vortex glass model were estimated following the Maley method. The collective-pinning model is used to discuss the possible vortex regimes mechanism (individual flux lines, small bundles and large bundles of pinned flux). Eventually, the E(J) curves, expressed from the swept field and creep measurements, show a power-law behaviour, in agreement with the vortex matter.&#xD

Search for new physics in the multijet and missing transverse momentum final state in proton-proton collisions at √s=8 Tev

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Intracranial injection of dengue virus induces interferon stimulated genes and CD8(+) T cell infiltration by sphingosine kinase 1 independent pathways

We have previously reported that the absence of sphingosine kinase 1 (SK1) affects both dengue virus (DENV) infection and innate immune responses in vitro. Here we aimed to define SK1-dependancy of DENV-induced disease and the associated innate responses in vivo. The lack of a reliable mouse model with a fully competent interferon response for DENV infection is a challenge, and here we use an experimental model of DENV infection in the brain of immunocompetent mice. Intracranial injection of DENV-2 into C57BL/6 mice induced body weight loss and neurological symptoms which was associated with a high level of DENV RNA in the brain. Body weight loss and DENV RNA level tended to be greater in SK1-/- compared with wildtype (WT) mice. Brain infection with DENV-2 is associated with the induction of interferon-β (IFN-β) and IFN-stimulated gene (ISG) expression including viperin, Ifi27l2a, IRF7, and CXCL10 without any significant differences between WT and SK1-/- mice. The SK2 and sphingosine-1-phosphate (S1P) levels in the brain were unchanged by DENV infection or the lack of SK1. Histological analysis demonstrated the presence of a cellular infiltrate in DENV-infected brain with a significant increase in mRNA for CD8 but not CD4 suggesting this infiltrate is likely CD8+ but not CD4+ T-lymphocytes. This increase in T-cell infiltration was not affected by the lack of SK1. Overall, DENV-infection in the brain induces IFN and T-cell responses but does not influence the SK/S1P axis. In contrast to our observations in vitro, SK1 has no major influence on these responses following DENV-infection in the mouse brain.Wisam H. Al-Shujairi, Jennifer N. Clarke, Lorena T. Davies, Mohammed Alsharifi, Stuart M. Pitson, Jillian M. Car

Measurement of Higgs boson production and properties in the WW decay channel with leptonic final states

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A low-temperature Kerr effect microscope for the simultaneous magneto-optic and magneto-transport study of magnetic topological insulators

Magneto-optic Kerr effect (MOKE) microscopy involves the surface-sensitive probing of magnetisation at micron-sized lateral resolution. Here, we present a low-temperature, focused polar MOKE microscope for simultaneous magneto-optic and magneto-transport measurements which has a temperature range of 1.6–300 K and is equipped with a magnet capable of delivering a field of up to 9 T. In this microscope, all optical components are integrated in a free-standing probe, allowing for straightforward incorporation into many non-optical cryostat systems. Two-dimensional magnetisation scans on patterned ferromagnetic [CoFeB/Pt]n films demonstrate a magnetisation sensitivity of 10 µrad (Kerr angle) and a spatial resolution of 2.2 µm. The combination of optical and electrical measurements provides complementary temperature-dependent information, as demonstrated by the study of magnetic topological insulator thin films with out-of-plane magnetic anisotropy. Using this complementary approach, we study the effects of a secondary phase in Cr and V co-doped Sb2Te3 thin films, which show a combination of weak antilocalisation and anisotropic magnetoresistance effects above 70 K. Our results highlight the virtue of MOKE and electrical transport to optimise exotic topological magnetic materials, paving the way for energy-efficient spintronic devices

Prediction of overall survival for patients with metastatic castration-resistant prostate cancer : development of a prognostic model through a crowdsourced challenge with open clinical trial data

Background Improvements to prognostic models in metastatic castration-resistant prostate cancer have the potential to augment clinical trial design and guide treatment strategies. In partnership with Project Data Sphere, a not-for-profit initiative allowing data from cancer clinical trials to be shared broadly with researchers, we designed an open-data, crowdsourced, DREAM (Dialogue for Reverse Engineering Assessments and Methods) challenge to not only identify a better prognostic model for prediction of survival in patients with metastatic castration-resistant prostate cancer but also engage a community of international data scientists to study this disease. Methods Data from the comparator arms of four phase 3 clinical trials in first-line metastatic castration-resistant prostate cancer were obtained from Project Data Sphere, comprising 476 patients treated with docetaxel and prednisone from the ASCENT2 trial, 526 patients treated with docetaxel, prednisone, and placebo in the MAINSAIL trial, 598 patients treated with docetaxel, prednisone or prednisolone, and placebo in the VENICE trial, and 470 patients treated with docetaxel and placebo in the ENTHUSE 33 trial. Datasets consisting of more than 150 clinical variables were curated centrally, including demographics, laboratory values, medical history, lesion sites, and previous treatments. Data from ASCENT2, MAINSAIL, and VENICE were released publicly to be used as training data to predict the outcome of interest-namely, overall survival. Clinical data were also released for ENTHUSE 33, but data for outcome variables (overall survival and event status) were hidden from the challenge participants so that ENTHUSE 33 could be used for independent validation. Methods were evaluated using the integrated time-dependent area under the curve (iAUC). The reference model, based on eight clinical variables and a penalised Cox proportional-hazards model, was used to compare method performance. Further validation was done using data from a fifth trial-ENTHUSE M1-in which 266 patients with metastatic castration-resistant prostate cancer were treated with placebo alone. Findings 50 independent methods were developed to predict overall survival and were evaluated through the DREAM challenge. The top performer was based on an ensemble of penalised Cox regression models (ePCR), which uniquely identified predictive interaction effects with immune biomarkers and markers of hepatic and renal function. Overall, ePCR outperformed all other methods (iAUC 0.791; Bayes factor >5) and surpassed the reference model (iAUC 0.743; Bayes factor >20). Both the ePCR model and reference models stratified patients in the ENTHUSE 33 trial into high-risk and low-risk groups with significantly different overall survival (ePCR: hazard ratio 3.32, 95% CI 2.39-4.62, p Interpretation Novel prognostic factors were delineated, and the assessment of 50 methods developed by independent international teams establishes a benchmark for development of methods in the future. The results of this effort show that data-sharing, when combined with a crowdsourced challenge, is a robust and powerful framework to develop new prognostic models in advanced prostate cancer.Peer reviewe

Study of double parton scattering using W+2-jet events in proton-proton collisions at √s=7 TeV

Peer reviewe

Search for Dark Matter and Supersymmetry with a Compressed Mass Spectrum in the Vector Boson Fusion Topology in Proton-Proton Collisions at root s=8 TeV

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