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This article analyzes the nature of clinical decision-making in order to clarify some of the impediments to the direct regulation of medical work. It develops the familiar idea of medicine as an art, showing that this includes the notion that each clinical case is unique, that clinical medical knowledge is unavoidably segmented, that clinicians commonly reason from exemplary cases, and that in this process the fine judgment of each practitioner is indispensable. Taken together this means that outside attempts to regulate medicine directly are doomed to fail. A more promising strategy would be to adopt forms of reflexive regulation which mobilize the self-regulatory capacities of medical professionals themselves. [ABSTRACT FROM AUTHOR]

Abstract Background Health behaviours do not occur in isolation. Rather they cluster together. It is important to examine patterns of health behaviours to inform a more holistic approach to health in both health promotion and illness prevention strategies. Examination of patterns is also important because of the increased risk of mortality, morbidity and synergistic effects of health behaviours. This study examines the clustering of health behaviours in a nationally representative sample of Irish adults and explores the association of these clusters with mental health, self-rated health and quality of life. Methods TwoStep Cluster analysis using SPSS was carried out on the SLÁN 2007 data (national Survey of Lifestyle, Attitudes and Nutrition, n = 10,364; response rate =62%; food frequency n = 9,223; cluster analysis n = 7,350). Patterns of smoking, drinking alcohol, physical activity and diet were considered. Associations with positive and negative mental health, quality of life and self-rated health were assessed. Results Six health behaviour clusters were identified: Former Smokers, 21.3% (n = 1,564), Temperate, 14.6% (n = 1,075), Physically Inactive, 17.8% (n = 1,310), Healthy Lifestyle, 9.3% (n = 681), Multiple Risk Factor, 17% (n = 1248), and Mixed Lifestyle, 20% (n = 1,472). Cluster profiles varied with men aged 18-29 years, in the lower social classes most likely to adopt unhealthy behaviour patterns. In contrast, women from the higher social classes and aged 65 years and over were most likely to be in the Healthy Lifestyle cluster. Having healthier patterns of behaviour was associated with positive lower levels of psychological distress and higher levels of energy vitality. Conclusion The current study identifies discernible patterns of lifestyle behaviours in the Irish population which are similar to those of our European counterparts. Healthier clusters (Former Smokers, Temperate and Healthy Lifestyle) reported higher levels of energy vitality, lower levels of psychological distress, better self-rated health and better quality of life. In contrast, those in the Multiple Risk Factor cluster had the lowest levels of energy and vitality and the highest levels of psychological distress. Identification of these discernible patterns because of their relationship with mortality, morbidity and longevity is important for identifying national and international health behaviour patterns.

Abstract Background As the use of self-reported data to classify obesity continues, the temporal change in the accuracy of self-report measurement when compared to clinical measurement remains unclear. The objective of this study was to examine temporal trends in misclassification patterns, as well as sensitivity and specificity, of clinically measured versus self-report based body mass index (BMI) from three national lifestyle surveys over a 10-year period. Methods The Surveys of Lifestyle Attitudes and Nutrition (SLÁN) were interview based cross-sectional survey/measurements involving nationally representative samples in 1998, 2002 and 2007. Data from a subsample of both self-reported and measured height and weight were available from 66 men and 142 women in 1998, 147 men and 184 women in 2002 and 909 men and 1128 women in 2007. Respondents were classified into the BMI categories normal (< 25 kg m-2), overweight (25- < 30 kg m-2) and obese (≥ 30 kg m-2). Results Underreporting of BMI increased across the three surveys (14%→21%→24%; p = 0.002). Sensitivity scores for the normal category exceeded 94% in all three surveys but decreased for the overweight (75%→68%→66%) and obese categories (80%→64%→53%). Simultaneously, specificity levels remained high. Conclusions BMI values based on self-reported determinations of height and weight in population samples are underestimating the true prevalence of the obesity epidemic and this underestimation is increasing with time. The decreased sensitivity and consistently high specificity scores in the obese category across time, highlights the limitation of self-report based BMI classifications and the need for simple, readily comprehensible indicators of obesity.

Abstract Background Childhood obesity is emerging as a major public health problem in developed and developing countries worldwide. The aim of this survey was to establish baseline data on the prevalence and correlates of overweight and obesity among children and adolescents in the Republic of Ireland (RoI) and Northern Ireland (NI). Methods The heights and weights of 19,617 school-going children and adolescents aged between 4 and 16 years in NI and RoI were measured using standardised and calibrated scales and measures. The participants were a representative cross-sectional sample of children randomly selected on the basis of age, gender and geographical location of the school attended. Overweight and obesity were classified according to standard IOTF criteria. Results Males were taller than females, children in RoI were taller than those in NI and the more affluent were taller than the less well off. The overall prevalence of overweight and obesity was higher among females than males in both jurisdictions. Overall, almost one in four boys (23% RoI and NI) and over one in four girls (28% RoI, 25% NI) were either overweight or obese. In RoI, the highest prevalence of overweight was among 13 year old girls (32%) and obesity among 7 year old girls (11%). In NI the highest prevalence of overweight and obesity were found among 11 and 8 year old girls respectively (33% and 13%). Conclusion These figures confirm the emergence of the obesity epidemic among children in Ireland, a wealthy country with the European Union. The results serve to underpin the urgency of implementing broad intersectoral measures to reduce calorie intake and increase levels of physical activity, particularly among children.

The purpose of this study was to determine climatologically suitable places to raise feedlot cattle in Türkiye. The Comprehensive Climate Index (CCI), a model that enables one to quantify beef cattle performance based on environmental conditions (temperature, relative humidity, wind speed, solar radiation) at any time in the year, was used to predict dry matter intake (DMI), average daily gain (ADG), and feed efficiency (FE) of feedlot cattle. Thirty years of daily average temperature, relative humidity, and wind speed values were obtained for 15 cities, namely, Antalya, Balikesir, Çorum, Diyarbakir, Edirne, Elazig, Erzincan, Erzurum, Eskisehir, Isparta, Izmir, Kayseri, Konya, Sivas, and Van. Measured daily solar radiation values were not available and values were calculated based on a formula that takes hemisphere, latitude, and day of the year into account. Since mostly dairy breed calves are placed into a feedlot in Türkiye, the Holstein option in the CCI model was chosen to calculate the maintenance energy requirement. Based on previous feedlot feeding studies conducted in Türkiye, it was assumed that calves would be placed on feed at 250 kg and be marketed at 520 kg, that the diet would have 2600 kcal/kg metabolic energy, and that DMI would be 2.31% of the body weight. Results indicate that cattle raised in Antalya (the hottest place) and Erzurum (the coldest place) had the lowest and highest DMI, respectively (P<0.05). Summer months depressed the DMI of cattle in hotter cities and winter months increased the DMI of cattle in colder cities (P<0.05). Feedlot cattle raised in hotter and colder regions of Türkiye had lower ADG than other places having a more temperate climate (P<0.05). In general, cattle raised in a hotter climate had better FE than those raised in a cold climate (P<0.05)., (© 2023. The Author(s) under exclusive licence to International Society of Biometeorology.)

The standard model of particle physics is both incredibly successful and glaringly incomplete. Among the questions left open is the striking imbalance of matter and antimatter in the observable universe 1 , which inspires experiments to compare the fundamental properties of matter/antimatter conjugates with high precision 2-5 . Our experiments deal with direct investigations of the fundamental properties of protons and antiprotons, performing spectroscopy in advanced cryogenic Penning trap systems 6 . For instance, we previously compared the proton/antiproton magnetic moments with 1.5 parts per billion fractional precision 7,8 , which improved upon previous best measurements 9 by a factor of greater than 3,000. Here we report on a new comparison of the proton/antiproton charge-to-mass ratios with a fractional uncertainty of 16 parts per trillion. Our result is based on the combination of four independent long-term studies, recorded in a total time span of 1.5 years. We use different measurement methods and experimental set-ups incorporating different systematic effects. The final result, [Formula: see text], is consistent with the fundamental charge-parity-time reversal invariance, and improves the precision of our previous best measurement 6 by a factor of 4.3. The measurement tests the standard model at an energy scale of 1.96 × 10 -27 gigaelectronvolts (confidence level 0.68), and improves ten coefficients of the standard model extension 10 . Our cyclotron clock study also constrains hypothetical interactions mediating violations of the clock weak equivalence principle (WEP cc ) for antimatter to less than 1.8 × 10 -7 , and enables the first differential test of the WEP cc using antiprotons 11 . From this interpretation we constrain the differential WEP cc -violating coefficient to less than 0.030., (© 2022. The Author(s), under exclusive licence to Springer Nature Limited.)

We constrain the coupling between axionlike particles (ALPs) and photons, measured with the superconducting resonant detection circuit of a cryogenic Penning trap. By searching the noise spectrum of our fixed-frequency resonant circuit for peaks caused by dark matter ALPs converting into photons in the strong magnetic field of the Penning-trap magnet, we are able to constrain the coupling of ALPs with masses around 2.7906-2.7914  neV/c^{2} to g&#95;{aγ}<1×10^{-11}  GeV^{-1}. This is more than one order of magnitude lower than the best laboratory haloscope and approximately 5 times lower than the CERN axion solar telescope (CAST), setting limits in a mass and coupling range which is not constrained by astrophysical observations. Our approach can be extended to many other Penning-trap experiments and has the potential to provide broad limits in the low ALP mass range.

Astrophysical observations indicate that there is roughly five times more dark matter in the Universe than ordinary baryonic matter 1 , and an even larger amount of the Universe's energy content is attributed to dark energy 2 . However, the microscopic properties of these dark components remain unknown. Moreover, even ordinary matter-which accounts for five per cent of the energy density of the Universe-has yet to be understood, given that the standard model of particle physics lacks any consistent explanation for the predominance of matter over antimatter 3 . Here we present a direct search for interactions of antimatter with dark matter and place direct constraints on the interaction of ultralight axion-like particles (dark-matter candidates) with antiprotons. If antiprotons have a stronger coupling to these particles than protons do, such a matter-antimatter asymmetric coupling could provide a link between dark matter and the baryon asymmetry in the Universe. We analyse spin-flip resonance data in the frequency domain acquired with a single antiproton in a Penning trap 4 to search for spin-precession effects from ultralight axions, which have a characteristic frequency governed by the mass of the underlying particle. Our analysis constrains the axion-antiproton interaction parameter to values greater than 0.1 to 0.6 gigaelectronvolts in the mass range from 2 × 10 -23 to 4 × 10 -17 electronvolts, improving the sensitivity by up to five orders of magnitude compared with astrophysical antiproton bounds. In addition, we derive limits on six combinations of previously unconstrained Lorentz- and CPT-violating terms of the non-minimal standard model extension 5 .

We report on the first detailed study of motional heating in a cryogenic Penning trap using a single antiproton. Employing the continuous Stern-Gerlach effect we observe cyclotron quantum transition rates of 6(1)  quanta/h and an electric-field noise spectral density below 7.5(3.4)×10^{-20}  V^{2} m^{-2} Hz^{-1}, which corresponds to a scaled noise spectral density below 8.8(4.0)×10^{-12}  V^{2} m^{-2}, results which are more than 2 orders of magnitude smaller than those reported by other ion-trap experiments.

Erbium-doped yttrium aluminum garnet (Er 3+ :YAG) rods were inserted inside undoped tubes and grown into single-crystal fibers of a diameter of 300 μm using the laser-heated pedestal growth technique. Growth at various rates resulted in radially graded distributions of Er 3+ dopant ions, as observed using laser-induced fluorescence imaging. Profiles of the refractive index were measured using cross-sectional reflectometry in a microscope. Dopant distributions and the corresponding index profiles were compared with thermal diffusion theory to determine the inter-diffusion coefficient of Y 3+ and Er 3+ ions at 2000°C, yielding an estimated value of D=(9.10±0.8)×10 -11   m 2 /s. This work constitutes a step toward controlled growth of fibers with high thermal conductivities, low Brillouin gain, and waveguiding properties required for high-power optical amplifier and laser applications.

Manifestation of Čerenkov radiation as a contaminating signal is a significant issue in radiation therapy dose measurement by fiber-coupled scintillator dosimeters. To enhance the scintillation signal transmission while minimizing Čerenkov radiation contamination, we designed a fiber probe using a silver-only coated hollow waveguide (HWG). The HWG with scintillator inserted in its tip, embedded in tissue-mimicking phantoms, was irradiated with clinical electron and photon beams generated by a medical linear accelerator. Optical spectra of the irradiated tip were taken using a fiber spectrometer, and the signal was deconvolved with a linear fitting algorithm. The resultant decomposed spectra of the scintillator with and without Čerenkov correction were in agreement with measurements performed by a standard electron diode and ion chamber for electron and photon beam dosimetry, respectively, indicating the minimal effect of Čerenkov contamination in the HWG-based dosimeter. Furthermore, compared with a silver/dielectric-coated HWG fiber dosimeter design, we observed higher signal transmission in the design based on the use of silver-only HWG., ((2018) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE).)

The effect of misalignments of different optical components in the laser heated pedestal growth apparatus have been modeled using Zemax optical design software. By isolating the misalignments causing the non-uniformity in the melt zone, the alignment of the components was fine-tuned. Using this optimized alignment, low-loss YAG single crystal fibers of 120 μm diameter were grown, with total attenuation loss as low as 0.5 dB/m at 1064 nm.

The process of anti-cancer drug development is complex, with high attrition rates. Factors that may optimise this process include well-constructed and relevant pre-clinical testing and use of biomarkers for patient selection. However, the design of early phase clinical trials will probably play a vital role in both the robust clinical investigation of new targeted therapies and in streamlining drug development. In this overview, we assess current concepts in phase I clinical trials, highlighting issues and opportunities to improve their meaningfulness. The particular challenge of how to design combination trials is addressed, with focus on the potential of new adaptive and model-based designs., (Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.)

Precise comparisons of the fundamental properties of matter-antimatter conjugates provide sensitive tests of charge-parity-time (CPT) invariance, which is an important symmetry that rests on basic assumptions of the standard model of particle physics. Experiments on mesons, leptons and baryons have compared different properties of matter-antimatter conjugates with fractional uncertainties at the parts-per-billion level or better. One specific quantity, however, has so far only been known to a fractional uncertainty at the parts-per-million level: the magnetic moment of the antiproton, . The extraordinary difficulty in measuring with high precision is caused by its intrinsic smallness; for example, it is 660 times smaller than the magnetic moment of the positron. Here we report a high-precision measurement of in units of the nuclear magneton μ N with a fractional precision of 1.5 parts per billion (68% confidence level). We use a two-particle spectroscopy method in an advanced cryogenic multi-Penning trap system. Our result  = -2.7928473441(42)μ N (where the number in parentheses represents the 68% confidence interval on the last digits of the value) improves the precision of the previous best measurement by a factor of approximately 350. The measured value is consistent with the proton magnetic moment, μ p  = 2.792847350(9)μ N , and is in agreement with CPT invariance. Consequently, this measurement constrains the magnitude of certain CPT-violating effects to below 1.8 × 10 -24 gigaelectronvolts, and a possible splitting of the proton-antiproton magnetic moments by CPT-odd dimension-five interactions to below 6 × 10 -12 Bohr magnetons.

In this paper we propose a workflow to detect and track mitotic cells in time-lapse microscopy image sequences. In order to avoid the requirement for cell lines expressing fluorescent markers and the associated phototoxicity, phase contrast microscopy is often preferred over fluorescence microscopy in live-cell imaging. However, common specific image characteristics complicate image processing and impede use of standard methods. Nevertheless, automated analysis is desirable due to manual analysis being subjective, biased and extremely time-consuming for large data sets. Here, we present the following workflow based on mathematical imaging methods. In the first step, mitosis detection is performed by means of the circular Hough transform. The obtained circular contour subsequently serves as an initialisation for the tracking algorithm based on variational methods. It is sub-divided into two parts: in order to determine the beginning of the whole mitosis cycle, a backwards tracking procedure is performed. After that, the cell is tracked forwards in time until the end of mitosis. As a result, the average of mitosis duration and ratios of different cell fates (cell death, no division, division into two or more daughter cells) can be measured and statistics on cell morphologies can be obtained. All of the tools are featured in the user-friendly MATLAB®Graphical User Interface MitosisAnalyser., (Copyright © 2017. Published by Elsevier Inc.)

The field of terahertz (THz) waveguides continues to grow rapidly, with many being tailored to suit the specific demands of a particular final application. Here, we explore waveguides capable of enabling efficient and accurate power delivery within cryogenic environments (< 4 K). The performance of extruded hollow cylindrical metal waveguides made of un-annealed and annealed copper, as well as stainless steel, have been investigated for bore diameters between 1.75 - 4.6 mm, and at frequencies of 2.0, 2.85 and 3.4 THz, provided by a suitable selection of THz quantum cascade lasers. The annealed copper resulted in the lowest transmission losses, < 3 dB/m for a 4.6 mm diameter waveguide, along with 90° bending losses as low as ~2 dB for a bend radius of 15.9 mm. The observed trends in losses were subsequently analyzed and related to measured inner surface roughness parameters. These results provide a foundation for the development of a wide array of demanding low-temperature THz applications, and enabling the study of fundamental physics.

Background: Insertable cardiac monitors (ICMs) are increasingly utilized for diagnosis of unexplained syncope and arrhythmia monitoring. The Reveal LINQ is a novel miniaturized ICM with improved algorithms. The feasibility and safety of insertion outside the traditional electrophysiology laboratory is unknown. Here we compare outcomes of Reveal LINQ insertion in different environments., Methods: We report on a prospective, single-centre, non-randomized, observational experience of consecutive Reveal LINQ implantation in the electrophysiology laboratory or a procedure room between October 2013 and October 2015., Results: Of 178 consecutive patients who underwent LINQ device insertion, 80 were implanted in the electrophysiology laboratory and 98 in a procedure room. There were no significant differences in baseline patient characteristics. All implants were performed in the recommended manufacturer method with the exception of 1 which required suture closure. Only a minority received peri-procedural antibiotics with a greater number in the electrophysiology laboratory group (11 [14%] versus 1 [1%], p=0.007). Overall, there were 3 (1.7%) complications with no significant difference between the electrophysiology laboratory and the procedure room groups (2 [3%] versus 1 [1%], p=0.45). There was 1 superficial infection in the procedure room group and 1 superficial infection with device extrusion and 1 traumatic extrusion in the electrophysiology laboratory group. Procedure room implantation subjectively improved laboratory efficiency and patient flow., Conclusion: Reveal LINQ insertion can be safely performed outside of the cardiac laboratory provided a sterile technique is followed by the operator using manufacturer recommendations for insertion. These findings have significant resource implications for hospitals undertaking such procedures., (Crown Copyright © 2016. Published by Elsevier Ireland Ltd. All rights reserved.)

Single-crystal YAG (Y 3 Al 5 O 12 ) fibers have been grown by the laser heated pedestal growth technique with losses as low as 0.3 dB/m at 1.06 μm. These YAG fibers are as long as about 60 cm with diameters around 330 μm. The early fibers were grown from unoriented YAG seed fibers and these fibers exhibited facet steps or ridges on the surface of the fiber. However, recently we have grown fibers using an oriented seed to grow step-free fibers. Scattering losses made on the fibers indicate that the scattering losses are equal to about 30% of the total loss.

Lasing was demonstrated for the first time at 2.09 μm in 0.5% Holmium (Ho) doped YAG single crystal fiber (SCF) fabricated using the Laser Heated Pedestal Growth (LHPG) method. Output power of 23.5 W with 67.5% optical-to-optical slope efficiency is, to the best of our knowledge, the highest output power achieved at 2 µm from a SCF fabricated using LHPG. With continued improvement in the quality of the SCF and better thermal management, output power of few 100s W and higher, especially in the 2 µm spectral region, is realizable in the very near future.

Patterns of biodiversity are changing rapidly. "Legacy studies" use historical data to document changes between past and present communities, revealing long-term trends that can often be linked to particular drivers of ecological change. However, a single pair of historical samples cannot ascertain whether rates of change are consistent or whether the impact and identity of drivers have shifted. Using data from a second resurvey of 47 Wisconsin prairie remnants, we show that the pace of community change has increased with shifts in the strength of particular drivers. Annual rates of local colonization and extinction accelerated by 129 and 214%, respectively, between 1950 and 1987 and between 1987 and 2012. Two anthropogenic drivers-patch area and fire history-increased in importance between these periods. As the strength and number of anthropogenic forces increase, rates of biodiversity change are likely to accelerate in other ecosystems as well.

Metal/dielectric-coated hollow glass waveguides (HGWs) have been studied extensively for the efficient transmission of radiation over a broad spectral range. In this study, a low-absorption optical polymer, cyclic olefin copolymer (COC), is investigated as a dielectric material for HGWs designed for the delivery of various IR lasers. Using established silver (Ag) plating techniques and a newly optimized polymer-coating procedure, Ag/COC HGWs with low attenuation coefficients are fabricated for operation at the following three wavelengths: 808 nm, 1.064 μm, and 2.94 μm. The spectral responses of the HGW designs are used to develop a film thickness dependency of the COC layer formation based on the concentration of the solution used in the polymer deposition procedure. Further, the attenuation coefficients of the HGWs are measured using the cutback method at the three wavelengths as a function of the curvature of the waveguide. In order of increasing operation, the attenuation coefficients are measured to be 0.549, 0.095, and 0.298  dB/m for the HGWs in the straight configuration. These experimental values for the straight attenuation coefficients are compared to theoretical values calculated using a ray transfer matrix approach and are found to be in good agreement.

The growth in terahertz frequency applications utilising the quantum cascade laser is hampered by a lack of targeted power delivery solutions over large distances (>100 mm). Here we demonstrate the efficient coupling of double-metal quantum cascade lasers into flexible polystyrene lined hollow metallic waveguides via the use of a hollow copper waveguide integrated into the laser mounting block. Our approach exhibits low divergence, Gaussian-like emission, which is robust to misalignment error, at distances > 550 mm, with a coupling efficiency from the hollow copper waveguide into the flexible waveguide > 90%. We also demonstrate the ability to nitrogen purge the flexible waveguide, increasing the power transmission by up to 20% at 2.85 THz, which paves the way for future fibre based terahertz sensing and spectroscopy applications.

Background: Feline cytauxzoonosis is a highly fatal tick-borne disease caused by a hemoparasitic protozoan, Cytauxzoon felis. This disease is a leading cause of mortality for cats in the Midwestern United States, and no vaccine or effective treatment options exist. Prevention based on knowledge of risk factors is therefore vital. Associations of different environmental factors, including recent climate were evaluated as potential risk factors for cytauxzoonosis using Geographic Information Systems (GIS)., Methods: There were 69 cases determined to be positive for cytauxzoonosis based upon positive identification of C. felis within blood film examinations, tissue impression smears, or histopathologic examination of tissues. Negative controls totaling 123 were selected from feline cases that had a history of fever, malaise, icterus, and anorexia but lack of C. felis within blood films, impression smears, or histopathologic examination of tissues. Additional criteria to rule out C. felis among controls were the presence of regenerative anemia, cytologic examination of blood marrow or lymph node aspirate, other causative agent diagnosed, or survival of 25 days or greater after testing. Potential environmental determinants were derived from publicly available sources, viz., US Department of Agriculture (soil attributes), US Geological Survey (land-cover/landscape, landscape metrics), and NASA (climate). Candidate variables were screened using univariate logistic models with a liberal p value (0.2), and associations with cytauxzoonosis were modeled using a global multivariate logistic model (p<0.05). Spatial heterogeneity among significant variables in the study region was modeled using a geographically weighted regression (GWR) approach., Results: Total Edge Contrast Index (TECI), grassland-coverage, humidity conditions recorded during the 9(th) week prior to case arrival, and an interaction variable, "diurnal temperature range × percent mixed forest area" were significant risk factors for cytauxzoonosis in the study region. TECI and grassland areas exhibited significant regional differences in their effects on cytauxzoonosis outcome, whereas others were uniform., Conclusions: Land-cover areas favorable for tick habitats and climatic conditions that favor the tick life cycle are strong risk factors for feline cytauxzoonosis. Spatial heterogeneity and interaction effects between land-cover and climatic variables may reveal new information when evaluating risk factors for vector-borne diseases.

0.5% Holmium (Ho) doped YAG single crystal fiber (SCF) was fabricated using Laser Heated Pedestal Growth (LHPG) method and characterized for its optical absorption and emission properties involving transitions between the 5I8 and 5I7 energy levels. The results verified the absorption peaks suitable for in-band direct pumping at 1908 nm and 1932 nm with the emission occurring between 2050 and 2150 nm. Small signal gain measurements were also performed for demonstrating the fiber like characteristics of the SCF.

This analysis explores the theory and design of dielectric multilayer reflection-enhancing thin film stacks based on high and low refractive index alternating layers of cadmium sulfide (CdS) and lead sulfide (PbS) on silver (Ag)-coated hollow glass waveguides (HGWs) for low loss transmission at midinfrared wavelengths. The fundamentals for determining propagation losses in such multilayer thin-film-coated Ag hollow waveguides is thoroughly discussed, and forms the basis for further theoretical analysis presented in this study. The effects on propagation loss resulting from several key parameters of these multilayer thin film stacks is further explored in order to bridge the gap between results predicted through calculation under ideal conditions and deviations from such ideal models that often arise in practice. In particular, the effects on loss due to the number of dielectric thin film layers deposited, deviation from ideal individual layer thicknesses, and surface roughness related scattering losses are presented and thoroughly investigated. Through such extensive theoretical analysis the level of understanding of the underlying loss mechanisms of multilayer thin-film Ag-coated HGWs is greatly advanced, considerably increasing the potential practical development of next-generation ultralow-loss mid-IR Ag/multilayer dielectric-coated HGWs.

A low-loss and low-dispersive optical-fiber-like hybrid HE₁₁ mode is developed within a wide band in metallic hollow waveguides if their inner walls are coated with a thin dielectric layer. We investigate terahertz (THz) transmission losses from 0.5 to 5.5 THz and bending losses at 2.85 THz in a polystyrene-lined silver waveguides with core diameters small enough (1 mm) to minimize the number of undesired modes and to make the waveguide flexible, while keeping the transmission loss of the HE₁₁ mode low. The experimentally measured loss is below 10 dB/m for 2 < ν < 2.85 THz (~4-4.5 dB/m at 2.85 THz) and it is estimated to be below 3 dB/m for 3 < ν < 5 THz according to the numerical calculations. At ~1.25 THz, the waveguide shows an absorption peak of ~75 dB/m related to the transition between the TM₁₁-like mode and the HE₁₁ mode. Numerical modeling reproduces the measured absorption spectrum but underestimates the losses at the absorption peak, suggesting imperfections in the waveguide walls and that the losses can be reduced further.

This study involves the fabrication and characterization of improved quality silver (Ag)/polystyrene (PS) thin-film-coated hollow-glass waveguides for the low-loss transmission of terahertz radiation via modified dynamic liquid phase deposition techniques. High-quality PS thin films were deposited from aqueous PS solutions, and the spectral response of fabricated samples was measured from λ=1-100 μm. Fabricated samples exhibited highly defined spectral responses throughout this entire range indicative of PS films of excellent quality. The spectra of experimental samples were compared to the theoretical and bulk PS spectra in the near-IR and far-IR regions. The thickness of deposited PS thin films was found to depend on total sample length and to vary from approximately 10-16 μm for sample lengths ranging from 115 to 140 cm. Such PS film thicknesses are adequate for low-loss delivery from approximately 2-4 THz. Furthermore, film thickness was found to vary minimally along the waveguide length regardless of total sample length.

Silver/silver halide-coated hollow-glass waveguides (HGWs) are capable of low-loss, broadband transmission at infrared wavelengths with the advantage of optical response tunability through alteration of a number of key design parameters. Generally, the design of circular HGWs has primarily involved optimization of the waveguide bore size and deposited film structure in order to obtain the desired optical response, with the waveguide bore size being held constant as a function of length. In this study, the effects of HGW structures consisting of linearly tapered inner diameters on the optical response at infrared wavelengths are theoretically and experimentally investigated. Theoretical analysis involving numerical ray optics methods accounting for the dynamic nature of bore size, and consequently light propagation, along the waveguide length is presented and compared to experimental results in order to gain a deeper understanding of these atypical HGW structures.

Studies attempting to identify environmental risk factors for diseases can be seen to extract candidate variables from remotely sensed datasets, using a single buffer-zone surrounding locations from where disease status are recorded. A retrospective case-control study using canine leptospirosis data was conducted to verify the effects of changing buffer-zones (spatial extents) on the risk factors derived. The case-control study included 94 case dogs predominantly selected based on positive polymerase chain reaction (PCR) test for leptospires in urine, and 185 control dogs based on negative PCR. Land cover features from National Land Cover Dataset (NLCD) and Kansas Gap Analysis Program (KS GAP) around geocoded addresses of cases/controls were extracted using multiple buffers at every 500 m up to 5,000 m, and multivariable logistic models were used to estimate the risk of different land cover variables to dogs. The types and statistical significance of risk factors identified changed with an increase in spatial extent in both datasets. Leptospirosis status in dogs was significantly associated with developed high-intensity areas in models that used variables extracted from spatial extents of 500-2000 m, developed medium-intensity areas beyond 2,000 m and up to 3,000 m, and evergreen forests beyond 3,500 m and up to 5,000 m in individual models in the NLCD. Significant associations were seen in urban areas in models that used variables extracted from spatial extents of 500-2,500 m and forest/woodland areas beyond 2,500 m and up to 5,000 m in individual models in Kansas gap analysis programme datasets. The use of ad hoc spatial extents can be misleading or wrong, and the determination of an appropriate spatial extent is critical when extracting environmental variables for studies. Potential work-arounds for this problem are discussed.

Anticancer agents used in combination are fundamental to successful cancer treatment, particularly in a curative setting. For dual-agent phase I trials, the goal is to identify drug doses and schedules for further clinical testing. However, current methods for establishing the recommended phase II dose for agents in combination can fail to fully explore drug interactions. With increasing numbers of anticancer drugs requiring testing, new adaptive model-based trial designs that improve on current practice have been proposed, although uptake has been minimal. We describe the methods available and discuss some of the opportunities and challenges faced in dual-agent phase I trials, as well as giving examples of trials in which adaptive designs have been implemented successfully. Improving the design and execution of phase I trials of drug combinations critically relies on collaboration between the statistical and clinical communities to facilitate the implementation of adaptive, model-based designs.

We report on single mode optical transmission of hollow core glass waveguides (HWG) coupled with an external cavity mid-IR quantum cascade lasers (QCLs). The QCL mode results perfectly matched to the hybrid HE(11) waveguide mode and the higher losses TE-like modes have efficiently suppressed by the deposited inner dielectric coating. Optical losses down to 0.44 dB/m and output beam divergence of ~5 mrad were measured. Using a HGW fiber with internal core size of 300 µm we obtained single mode laser transmission at 10.54 µm and successful employed it in a quartz enhanced photoacoustic gas sensor setup.

Background: Amplification of aurora kinase A (AK-A) overrides the mitotic spindle assembly checkpoint, inducing resistance to taxanes. RNA interference targeting AK-A in human pancreatic cancer cell lines enhanced taxane chemosensitivity. In this study, a novel AK-A inhibitor, CYC3, was investigated in pancreatic cancer cell lines, in combination with paclitaxel., Methods: Western blot, flow cytometry and immunostaining were used to investigate the specificity of CYC3. Sulforhodamine B staining, time-lapse microscopy and colony-formation assays were employed to evaluate the cytotoxic effect of CYC3 and paclitaxel. Human colony-forming unit of granulocyte and macrophage (CFU-GM) cells were used to compare the effect in tumour and normal tissue., Results: CYC3 was shown to be a specific AK-A inhibitor. Three nanomolar paclitaxel (growth inhibition 50% (GI(50)) 3 nM in PANC-1, 5.1 nM in MIA PaCa-2) in combination with 1 μM CYC3 (GI(50) 1.1 μM in MIA PaCa2 and 2 μM in PANC-1) was synergistic in inhibiting pancreatic cell growth and causing mitotic arrest, achieving similar effects to 10-fold higher concentrations of paclitaxel (30 nM). In CFU-GM cells, the effect of the combination was simply additive, displaying significantly less myelotoxicity compared with high concentrations of paclitaxel (30 nM; 60-70% vs 100% inhibition)., Conclusion: The combination of lower doses of paclitaxel and CYC3 merits further investigation with the potential for an improved therapeutic index in vivo.

Hollow glass waveguides, composed of Ag/AgI coatings, have been studied at 10.6 µm. The losses for different bore sizes equal the theoretical loss, which for the 700 µm bore guide was about 0.15  dB/m. The losses for the guides increase upon bending, varying linearly with increasing curvature. These hollow guides propagate a single mode when the bore size of the guide is approximately 30λ. In addition, the best single-mode transmission is obtained when the thickness of the glass wall is large. These smaller bores, thick wall hollow guides, can also be used to filter higher order modes from poor quality input laser beams.

Upconversion photochemistry occurring between palladium(II) octaethylporphyrin (PdOEP, 1) and 9,10-diphenylanthracene (DPA, 2) in toluene successfully sensitizes nanostructured WO(3) photoanodes (E(g) = 2.7 eV) to sub-bandgap non-coherent green photons at low power density., (This journal is © The Royal Society of Chemistry 2012)

Although chemotherapy, based on docetaxel, is now established in the management of metastatic castration-resistant prostate cancer (mCRPC), until recently, there has been no treatment licensed for use in the second line in men whose disease progresses during or after docetaxel therapy. This article reviews the classes of agents that have shown potential in this setting, notably chemotherapy drugs, hormonal therapies, immunotherapies, anti-angiogenic drugs, and clusterin-targeted therapy., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

This study's objective is to validate a method for the measurement of two compound phantoms as a proof of concept for oxygen saturation level measurement via a thermal imaging bundle. The method consists of a thermal imaging system and an algorithm which estimates the compound concentration according to temperature rise. A temperature rise is obtained by illuminating the tissue with a laser with different wavelengths in the NIR range and measured using a thermal camera. A coherent thermal imaging bundle was used for image transmittance for minimal invasive transendoscopic use. The algorithm's estimation ability was evaluated using agar phantoms of varying Methylene Blue and ICG ratios as well as blood samples The Methylene Blue ratio in each phantom was estimated and the calculated average RMS of the error was 9.38%, a satisfying value for this stage, verifying the algorithm's and bundle's suitability for the use in a minimal invasive system., (Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Thin dielectric layers deposited on the inner surface of hollow cylindrical metallic waveguides for Terahertz (THz) waves reduce transmission losses below 1 dB/m. Impact of the dielectric layer on the waveguide dispersion is experimentally investigated by near-field mapping of guided short THz pulses at the input and the output of the waveguide. We obtain dispersion characteristics for the low-loss waveguide modes, the linearly-polarized HE(11) mode and the TE(01) mode, and compare the experimental results to the metallic waveguide dispersion. The additional dispersion due to the dielectric layer is found to be small for the HE(11) mode and the phase velocity is primarily determined by the waveguide radius.

West Nile virus infection can result in prolonged subjective complaints of cognitive and functional decline even in the absence of a neuroinvasive form of infection. Persistent cognitive and functional complaints could be a result of general somatic symptoms, emotional distress, or residual central nervous system damage or dysfunction. Most studies of cognition in postacute West Nile virus infection rely on self-report. This descriptive study aimed to document cognitive deficits in a sample of the 2003 infected population reported in New Mexico. Patients with clinically defined neuroinvasive disease or who were impaired on brief mental status screening were seen for comprehensive neuropsychological assessment. We found that one year after symptom onset, more than half of the sample had objectively measurable neuropsychological impairment in at least two cognitive domains. Impairment was not related to subjective complaints of physical or emotional distress, or premorbid intellectual abilities. Persistent cognitive impairment in West Nile virus infection may be due to prolonged or permanent damage to the central nervous system.

Low- and high-refractive-index chalcogenide glasses are studied for their potential use in the fabrication of one-dimensional hollow Bragg fibers. The low-index glasses are based on the GeSe-glass systems with indices varying from 2.0 to 2.5, while the high-index glasses are formed from the AgAsSe glasses with indices ranging from 2.8 to 3.8. High-purity elemental starting materials are distilled and the surface oxides removed prior to mixing in a rocking furnace. The refractive indices of the AgAsSe glasses, measured using a CO2 laser reflectometer, were near 3.10 for the compositions most compatible with the low-index Ge20Se80 glass (n = 2.46). Spectral measurements show impurity absorption bands between 12 and 16 microm. The loss at 10.6 microm for the Ag25As40Se35 glass measured using CO2 laser calorimetry was 1.16 x 10(-3) cm(-1).

We have applied techniques developed for IR waveguides to fabricate Ag/polystyrene (PS) -coated hollow glass waveguides (HGWs) for transmission of terahertz radiation. A loss of 0.95 dB/m at 119 microm (2.5 THz) was obtained for a 2 mm bore, 90 cm long Ag/PS HGW. We found that TE modes are supported in HGWs with thin PS films, while hybrid (HE) modes dominate when PS film thickness increases. The lowest losses are obtained for the thicker PS films and the propagation of the HE modes.