The quality of reporting of diagnostic accuracy studies published in ophthalmic journals

Aim: To evaluate the quality of reporting of all diagnostic studies published in five major ophthalmic journals in the year 2002 using the Standards for Reporting of Diagnostic Accuracy (STARD) initiative parameters. Methods: Manual searching was used to identify diagnostic studies published in 2002 in five leading ophthalmic journals, the American Journal of Ophthalmology (AJO), Archives of Ophthalmology (Archives), British Journal of Ophthalmology (BJO), Investigative Ophthalmology and Visual Science (IOVS), and Ophthalmology. The STARD checklist of 25 items and flow chart was used to evaluate the quality of each publication. Results: A total of 16 publications were included (AJO = 5, Archives = 1, BJO = 2, IOVS = 2, and Ophthalmology = 6). More than half of the studies (n = 9) were related to glaucoma diagnosis. Other specialties included retina (n = 4) cornea (n = 2), and neuro-ophthalmology (n = 1). The most common description of diagnostic accuracy was sensitivity and specificity values, published in 13 articles. The number of fully reported items in evaluated studies ranged from eight to 19. Seven studies reported more than 50% of the STARD items. Conclusions: The current standards of reporting of diagnostic accuracy tests are highly variable. The STARD initiative may be a useful tool for appraising the strengths and weaknesses of diagnostic accuracy studies.

Parametric study of non-relativistic electrostatic shocks and the structure of their transition layer

Nonrelativistic electrostatic unmagnetized shocks are frequently observed in laboratory plasmas and they are likely to exist in astrophysical plasmas. Their maximum speed, expressed in units of the ion acoustic speed far upstream of the shock, depends only on the electron-to-ion temperature ratio if binary collisions are absent. The formation and evolution of such shocks is examined here for a wide range of shock speeds with particle-in-cell simulations. The initial temperatures of the electrons and the 400 times heavier ions are equal. Shocks form on electron time scales at Mach numbers between 1.7 and 2.2. Shocks with Mach numbers up to 2.5 form after tens of inverse ion plasma frequencies. The density of the shock-reflected ion beam increases and the number of ions crossing the shock thus decreases with an increasing Mach number, causing a slower expansion of the downstream region in its rest frame. The interval occupied by this ion beam is on a positive potential relative to the far upstream. This potential pre-heats the electrons ahead of the shock even in the absence of beam instabilities and decouples the electron temperature in the foreshock ahead of the shock from the one in the far upstream plasma. The effective Mach number of the shock is reduced by this electron heating. This effect can potentially stabilize nonrelativistic electrostatic shocks moving as fast as supernova remnant shocks. 

Two-Ray Modeling of Recombination Effects in the Presence of a Phase Conjugation Array

This article describes by means of a simple model how signal recombination effects behave under the influence of phase conjugating retrodirective array (RDA) technology. A two-ray ground reflection model is used to predict the operational advantages of RDA technology in multipath rich environments. The simulation results show that advantageous signal recombination occurs due to automatic self-phasing. As the number of elements in the RDA increases, the fading effect normally observed due to out of phase multipath signal is mitigated to the extent that the system approaches that of one operating in a free space environment. © 2013 Wiley Periodicals, Inc. Microwave Opt Technol Lett 55:1987–1989, 2013

On the Complexity of Universal Leader Election

Electing a leader is a fundamental task in distributed computing. In its implicit version, only the leader must know who is the elected leader. This paper focuses on studying the message and time complexity of randomized implicit leader election in synchronous distributed networks. Surprisingly, the most "obvious" complexity bounds have not been proven for randomized algorithms. The "obvious" lower bounds of O(m) messages (m is the number of edges in the network) and O(D) time (D is the network diameter) are non-trivial to show for randomized (Monte Carlo) algorithms. (Recent results that show that even O(n) (n is the number of nodes in the network) is not a lower bound on the messages in complete networks, make the above bounds somewhat less obvious). To the best of our knowledge, these basic lower bounds have not been established even for deterministic algorithms (except for the limited case of comparison algorithms, where it was also required that some nodes may not wake up spontaneously, and that D and n were not known).

We establish these fundamental lower bounds in this paper for the general case, even for randomized Monte Carlo algorithms. Our lower bounds are universal in the sense that they hold for all universal algorithms (such algorithms should work for all graphs), apply to every D, m, and n, and hold even if D, m, and n are known, all the nodes wake up simultaneously, and the algorithms can make anyuse of node's identities. To show that these bounds are tight, we present an O(m) messages algorithm. An O(D) time algorithm is known. A slight adaptation of our lower bound technique gives rise to an O(m) message lower bound for randomized broadcast algorithms.

An interesting fundamental problem is whether both upper bounds (messages and time) can be reached simultaneously in the randomized setting for all graphs. (The answer is known to be negative in the deterministic setting). We answer this problem partially by presenting a randomized algorithm that matches both complexities in some cases. This already separates (for some cases) randomized algorithms from deterministic ones. As first steps towards the general case, we present several universal leader election algorithms with bounds that trade-off messages versus time. We view our results as a step towards understanding the complexity of universal leader election in distributed networks.

The role of semantic interference in limiting memory for the details of visual scenes

Many studies suggest a large capacity memory for briefly presented pictures of whole scenes. At the same time, visual working memory (WM) of scene elements is limited to only a few items. We examined the role of retroactive interference in limiting memory for visual details. Participants viewed a scene for 5?s and then, after a short delay containing either a blank screen or 10 distracter scenes, answered questions about the location, color, and identity of objects in the scene. We found that the influence of the distracters depended on whether they were from a similar semantic domain, such as "kitchen" or "airport." Increasing the number of similar scenes reduced, and eventually eliminated, memory for scene details. Although scene memory was firmly established over the initial study period, this memory was fragile and susceptible to interference. This may help to explain the discrepancy in the literature between studies showing limited visual WM and those showing a large capacity memory for scenes.

Intermediate Care: The Role of Medicines Management

Healthcare systems worldwide are facing an unprecedented demographic change as globally, the number of older people will triple to 2 billion by the year 2050. The resulting pressures on acute services have been instrumental in the development of intermediate care (IC) as a new healthcare model, which has its origins in the National Health Service in the UK. IC is an umbrella term for patient services that do not require the resources of a general hospital but are beyond the scope of a traditional primary care team. IC aims to promote timely discharge from hospital, prevent unnecessary hospital admissions and reduce the need for long-term residential care by optimizing functional independence. Various healthcare providers around the world have adopted similar models of care to manage changing healthcare needs. Polypharmacy, along with age-related changes, places older people at an increased risk of adverse drug events, including inappropriate prescribing, which has been shown to be prevalent in this population in other healthcare settings. Medicines management (the practice of maximizing health through optimal use of medicines) of older people has been discussed in the literature in a variety of settings; however, its place within IC is largely unknown. Despite IC being a multidisciplinary healthcare model, there is a lack of evidence to suggest that enhanced pharmaceutical involvement is core to the service provided within IC. This review article highlights the gap in the literature surrounding medicines management within IC and identifies potential solutions aimed at improving patient outcomes in this setting.

Women Speaking of National Security: The Case of Checkpoint Watch

The production of reports and the distribution of information have become integral to the operation of many non-governmental organizations. In this regard, the fact that the all-women organization of Checkpoint Watch publishes reports about the Israeli checkpoints in the occupied West Bank seems to comply with current trends. However, the reports—most of which are short repetitive descriptions of the banality and everydayness of the military checkpoints, counting the number of people and cars waiting, commenting on the manner in which the checks are performed and meticulously documenting what mostly amounts to minor incidents of humiliation and distress—do not seem to abide by any convention of reporting. This work analyzes the reporting praxis of the organization and claims that it should be understood as a form of activism in and of itself. Tracking the ways in which the reports address the Israeli public through the concept of parrhesia, the work suggests that this form of reporting enables the women activists to use their gendered marginality to make their way into the highly masculinized and militarized Israeli security discourse.

The role of private care in the interval between diagnosis and treatment of breast cancer in Northern Ireland: an analysis of Registry data

Objective: To examine the differences in the interval between diagnosis and initiation of treatment among women with breast cancer in Northern Ireland.

Design: A cross-sectional observational study.
Setting: All breast cancer care patients in the Northern Ireland Cancer Registry in 2006.
Participants: All women diagnosed and treated for breast cancer in Northern Ireland in 2006.
Main outcome measure: The number of days between diagnosis and initiation of treatment for breast cancer.

Results: The mean (median) interval between diagnosis and initiation of treatment among public patients was 19 (15) compared with 14 (12) among those whose care involved private providers. The differences between individual public providers were as marked as those between the public and private sector - the mean (median) ranging between 14 (12) and 25 (22) days. Multivariate models revealed that the differences were evident when a range of patient characteristics were controlled for including cancer stage.

Conclusions: A relatively small number of women received care privately in Northern Ireland but experienced shorter intervals between diagnosis and initiation of treatment than those who received care wholly in the public system. The variation among public providers was as great as that between the public and private providers. The impact of such differences on survival and in light of waiting time targets introduced in Northern Ireland warrants investigation.

Modelling lay-up automation and production rate interaction on the cost of large stiffened panel components

This paper presents an integrated design and costing method for large stiffened panels for the purpose of investigating the influence and interaction of lay-up technology and production rate on manufacturing cost. A series of wing cover panels (≈586kg, 19·9m2) have been sized with realistic requirements considering manual and automated lay-up routes. The integrated method has enabled the quantification of component unit cost sensitivity to changes in annual production rate and employed equipment maximum deposition rate. Moreover the results demonstrate the interconnected relationship between lay-up process and panel design, and unit cost. The optimum unit cost solution when using automated lay-up is a combination of the minimum deposition rate and minimum number of lay-up machines to meet the required production rate. However, the location of the optimum unit cost, at the boundaries between the number of lay-up machines required, can make unit cost very sensitive to small changes in component design, production rate, and equipment maximum deposition rate. - See more at: http://aerosociety.com/News/Publications/Aero-Journal/Online/1941/Modelling-layup-automation-and-production-rate-interaction-on-the-cost-of-large-stiffened-panel-components#sthash.0fLuu9iG.dpuf

Green Media: The Future of Wireless Multimedia Networks:Guest Editorial

By 2015, with the proliferation of wireless multimedia applications and services (e.g., mobile TV, video on demand, online video repositories, immersive video interaction, peer to peer video streaming, and interactive video gaming), and any-time anywhere communication, the number of smartphones and tablets will exceed 6.5 billion as the most common web access devices. Data volumes in wireless multimedia data-intensive applications and mobile web services are projected to increase by a factor of 10 every five years, associated with a 20 percent increase in energy consumption, 80 percent of which is multimedia traffic related. In turn, multimedia energy consumption is rising at 16 percent per year, doubling every six years. It is estimated that energy costs alone account for as much as half of the annual operating expenditure. This has prompted concerted efforts by major operators to drastically reduce carbon emissions by up to 50 percent over the next 10 years. Clearly, there is an urgent need for new disruptive paradigms of green media to bridge the gap between wireless technologies and multimedia applications.

Explaining the multiparty systems of Western Europe prior to the adoption of proportional representation

The literature has difficulty explaining why the number of parties in majoritarian electoral systems often exceeds the two-party predictions associated with Duverger’s Law. To understand why this is the case, I examine several party systems in Western Europe before the adoption of proportional representation. Drawing from the social cleavage approach, I argue that the emergence of multiparty systems was because of the development of the class cleavage, which provided a base of voters sizeable enough to support third parties. However, in countries where the class cleavage became the largest cleavage, the class divide displaced other cleavages and the number of parties began to converge on two. The results show that the effect of the class cleavage was nonlinear, producing the greatest party system fragmentation in countries where class cleavages were present – but not dominant – and smaller in countries where class cleavages were either dominant or non-existent.

Targeted Impersonation As A Tool For The Detection Of Biometric System Vulnerabilities

This paper argues that biometric verification evaluations can obscure vulnerabilities that increase the chances that an attacker could be falsely accepted. This can occur because existing evaluations implicitly assume that an imposter claiming a false identity would claim a random identity rather than consciously selecting a target to impersonate. This paper shows how an attacker can select a target with a similar biometric signature in order to increase their chances of false acceptance. It demonstrates this effect using a publicly available iris recognition algorithm. The evaluation shows that the system can be vulnerable to attackers targeting subjects who are enrolled with a smaller section of iris due to occlusion. The evaluation shows how the traditional DET curve analysis conceals this vulnerability. As a result, traditional analysis underestimates the importance of an existing score normalisation method for addressing occlusion. The paper concludes by evaluating how the targeted false acceptance rate increases with the number of available targets. Consistent with a previous investigation of targeted face verification performance, the experiment shows that the false acceptance rate can be modelled using the traditional FAR measure with an additional term that is proportional to the logarithm of the number of available targets.

The Development of the Contextual Analysis of Human Remains in Ireland

The colonial experience has been a dominant factor in the production of culture in Ireland, including narratives of the past. In the context of nineteenth century British imperialism, physical anthropology and archaeology were just two of a number of scientific discourses recruited to rationalise and justify colonialist policies. Legitimation was in part provided by racialised and sectarian conceptualisations of local populations in both past and present. After the partition of the island in the early twentieth century, racialised notions of the Irish population were embraced by both nationalist movements (green and orange) on the island. Changes came with the impact of processual archaeology and the appearance of bioarchaeology in the early 1980s, the latter directly influenced by the North American tradition. The last two decades have seen considerable achievements in bioarchaeology in Ireland. The profile of the discipline has been raised, and despite the impact of the recent economic downturn, the number of archaeologists gaining the necessary specialist skills has finally reached critical mass. The focus in Irish bioarchaeology is now on synthetic and thematic projects, and a number of initiatives are currently underway which will go some way towards furthering understanding of the past populations of Ireland.

The effect of warfarin therapy on breast, colorectal, lung, and prostate cancer survival: a population-based cohort study using the Clinical Practice Research Datalink

PURPOSE: Pre-clinical studies suggest that oral anticoagulant agents, such as warfarin, may inhibit metastases and potentially prolong survival in cancer patients. However, few population-based studies have examined the association between warfarin use and cancer-specific mortality.

METHODS: Using prescribing, cause of death, and cancer registration data from the UK Clinical Practice Research Datalink, four population-based cohorts were constructed, comprising breast, colorectal, lung, and prostate cancer patients diagnosed between 1 January 1998, and the 31 December 2010. Comparing pre-diagnostic warfarin users to non-users, multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for cancer-specific mortality.

RESULTS: Overall, 16,525 breast, 12,902 colorectal, 12,296 lung, and 12,772 prostate cancers were included. Pre-diagnostic warfarin use ranged from 2.4 to 4.7 %. There was little evidence of any strong association between warfarin use pre-diagnosis and cancer-specific mortality in prostate (adjusted HR 1.03, 95 % CI 0.84-1.26), lung (adjusted HR 1.06, 95 % CI 0.96-1.16), breast (adjusted HR 0.81, 95 % CI 0.62-1.07), or colorectal (adjusted HR 0.88, 95 % CI 0.77-1.01) cancer patients. Dose-response analyses did not reveal consistent evidence of reductions in users of warfarin defined by the number of prescriptions used and daily defined doses.

CONCLUSIONS: There was little evidence of associations between pre-diagnostic use of warfarin and cancer-specific mortality in lung, prostate, breast, or colorectal cancer patients.

Rifampicin and sodium fusidate reduces the frequency of methicillin-resistant Staphylococcus aureus (MRSA) isolation in adults with cystic fibrosis and chronic MRSA infection

Nosocomial transmission of methicillin-resistant Staphylococcus aureus (MRSA) to patients with cystic fibrosis (CF) frequently results in chronic respiratory tract carriage. This is an increasing problem, adds to the burden of glycopeptide antibiotic use in hospitals, and represents a relative contraindication to lung transplantation. The aim of this study was to determine whether it is possible to eradicate MRSA with prolonged oral combination antibiotics, and whether this treatment is associated with improved clinical status. Adult CF patients (six male, one female) with chronic MRSA infection were treated for six months with rifampicin and sodium fusidate. Outcome data were examined for six months before treatment, on treatment and after treatment. The patients had a mean age of 29.3 (standard deviation=6.3) years and FEV(1) of 36.1% (standard deviation=12.7) predicted. The mean duration of MRSA isolation was 31 months. MRSA isolates identified in these patients was of the same lineage as the known endemic strain at the hospital when assessed by pulsed-field gel electrophoresis. Five of the seven had no evidence of MRSA during and for at least six months after rifampicin and sodium fusidate. The proportion of sputum samples positive for MRSA was lower during the six months of treatment (0.13) and after treatment (0.19) compared with before treatment (0.85) (P<0.0001). There was a reduction in the number of days of intravenous antibiotics per six months with 20.3+/-17.6 on treatment compared with 50.7 before treatment and 33.0 after treatment (P=0.02). There was no change in lung function. Gastrointestinal side effects occurred in three, but led to therapy cessation in only one patient. Despite the use of antibiotics with anti-staphylococcal activity for treatment of respiratory exacerbation, MRSA infection persists. MRSA can be eradicated from the sputum of patients with CF and chronic MRSA carriage by using rifampicin and sodium fusidate for six months. This finding was associated with a significant reduction in the duration of intravenous antibiotic treatment during therapy.