Lumbar epidural steroids are not cost effective in sciatica

Background Lumbar Epidural Steroids Injections (ESI’s) have previously been shown to provide some degree of pain relief in sciatica. Number Needed To Treat (NNT) to achieve 50% pain relief has been estimated at 7 from the results of randomised controlled trials. Pain relief is temporary. They remain one of the most commonly provided procedures in the UK. It is unknown whether this pain relief represents good value for money. Methods 228 patients were randomised into a multi-centre Double Blind Randomised Controlled Trial. Subjects received up to 3 ESI’s or intra-spinous saline depending on response and fall off with the first injection. All other treatments were permitted. All received a review of analgesia, education and physical therapy. Quality of life was assessed using the SF36 at 6 points and compared using independent sample t-tests. Follow up was up to 1 yr. Missing data was imputed using last observation carried forward (LOCF). QALY’s (Quality of Life Years) were derived from preference based heath values (summary health utility score). SF-6D health state classification was derived from SF-36 raw score data. Standard gambles (SG) were calculated using Model 10. SG scores were calculated on trial results. LOCF was not used for this. Instead average SG were derived for a subset of patients with observations for all visits up to week 12. Incremental QALY’s were derived as the difference in the area between the SG curve for the active group and placebo group. Results SF36 domains showed a significant improvement in pain at week 3 but this was not sustained (mean 54 Active vs 61 Placebo P<0.05). Other domains did not show any significant gains compared with placebo. For derivation of SG the number in the sample in each period differed. In week 12, average SG scores for active and placebo converged. In other words, the health gain for the active group as measured by SG was achieved by the placebo group by week 12. The incremental QALY gained for a patient under the trial protocol compared with the standard care package was 0.0059350. This is equivalent to an additional 2.2 days of full health. The cost per QALY gained to the provider from a patient management strategy administering one epidural as suggested by results was £25 745.68. This result was derived assuming that the gain in QALY data calculated for patients under the trial protocol would approximate that under a patient management strategy based on the trial results (one ESI). This is above the threshold suggested by some as a cost effective treatment. Conclusions The transient benefit in pain relief afforded by ESI’s does not appear to be cost-effective. Further work is needed to develop more cost-effective conservative treatments for sciatica.

Coherence and Localization in 2D Luttinger Liquids

Recent measurements on the resistivity of (La-Sr)(2)CuO4 are shown to tit within the general framework of Luttinger liquid transport theory. They exhibit a crossover from the spin-charge separated ''holon nondrag regime'' usually observed, with rho(ab) similar to T, to a ''localizing'' regime dominated by impurity scattering at low temperature. The proportionality of rho(c) and rho(ab) and the giant anisotropy follow directly from the theory.

Atomically resolved scanning tunneling microscopy on perovskite manganite single crystals

Atomically resolved scanning tunneling microscopy was conducted on cleaved single crystals of the cubic perovskite Pr0.68Pb0.32MnO3.Several different surface configurations could be resolved including a frequent square arrangement with atomic distances in excellent agreement to the bulk lattice constant of the cubic structure. We also observed stripe formation and a surface reconstruction. The latter is likely related to a polar rare earth-oxygen terminated surface. (C) 2010 American Institute of Physics.

Reduction in magnetic field induced broadening of the resistive transition in laser‐deposited YBa2Cu3O7−x thin films on MgO

The magnetic field induced broadening of the normal to superconducting resistive transition of YBa2Cu3O7−x thin films laser deposited on (100) MgO substrates for field oriented parallel to the c axis is found to be significantly reduced in comparison with that found previously in single crystals and in films deposited on SrTiO3. This reduction in broadening is associated with a high density of defects which, while causing a slight decrease in Tc and an increase in the zero‐field transition width, seems to provide strong vortex pinning centers that reduce flux creep

Temperature dependent transport behavior of n-InN nanodot/p-Si heterojunction structures

The present work explores the temperature dependent transport behavior of n-InN nanodot/p-Si(100) heterojunction diodes. InN nanodot (ND) structures were grown on a 20 nm InN buffer layer on p-Si(100) substrates. These dots were found to be single crystalline and grown along 001] direction. The junction between these two materials exhibits a strong rectifying behavior at low temperatures. The average barrier height (BH) was determined to be 0.7 eV from current-voltage-temperature, capacitance-voltage, and flat band considerations. The band offsets derived from built-in potential were found to be Delta E-C=1.8 eV and Delta E-V=1.3 eV and are in close agreement with Anderson's model. (C) 2010 American Institute of Physics. doi:10.1063/1.3517489]

Electronic structure of La1-xSrxFeO3

We have investigated the electronic structure of well-characterized samples of La1-xSrxFeO3 (x=0.0�0.4) by x-ray photoelectron spectroscopy (XPS), ultraviolet photoelectron spectroscopy, bremsstrahlung isochromat (BI) spectroscopy, and Auger electron spectroscopy. We find systematic behavior in the occupied and unoccupied density of states reflecting changes in the electronic structure on hole doping via Sr substitution as well as providing estimates for different interaction strengths. The spectral features, particularly of the unoccupied states obtained from BI spectra, indicate the probable reason for the absence of an insulator-metal transition in this series. Analysis of the Auger spectra provides the estimates of the on-site effective Coulomb interaction strengths in Fe 3d and O 2p states. The parameter values for the bare charge-transfer energy ? and the Fe 3d�O 2p hybridization strength t? for LaFeO3 are obtained from an analysis of the Fe 2p core-level XPS in terms of a model many-body calculation. We discuss the character of the ground state in LaFeO3 as well as the nature of the doped hole states in La1-xSrxFeO3, based on these parameter values.

Length-scale-dependent ensemble-averaged conductance of a 1D disordered conductor: Conductance minimum

An exact numerical calculation of ensemble-averaged length-scale-dependent conductance for the one-dimensional Anderson model is shown to support an earlier conjecture for a conductance minimum. The numerical results can be understood in terms of the Thouless expression for the conductance and the Wigner level-spacing statistics.

Dielectric function and optical conductivity of TiOx (0.8

Reflection electron energy-loss spectra are reported for the family of compounds TiOx over the entire homogeneity range (0.8 < a: < 1.3). The spectra exhibit a plasmon feature on the low-energy side, while several interband transitions are prominent at higher energies. The real and imaginary parts of dielectric functions and optical conductivity for these compounds are determined using the Kramers-Kronig analysis. The results exhibit systematic behavior with varying oxygen stoichiometry.

Enhanced charge and spin currents in the one-dimensional disordered mesoscopic Hubbard ring

We consider a one-dimensional mesoscopic Hubbard ring with and without disorder and compute charge and spin stiffness as a measure of the permanent currents. For finite disorder we identify critical disorder strength beyond which the charge currents in a system with repulsive interactions are larger than those for a free system. The spin currents in the disordered repulsive Hubbard model are enhanced only for small U, where the magnetic state of the system corresponds to a charge-density wave pinned to the impurities. For large U, the state of the system corresponds to localized isolated spins and the spin currents are found to be suppressed. For the attractive Hubbard model we find that the charge currents are always suppressed compared to the free system at all length scales.

Thomas-Fermi Method For Particles Obeying Generalized Exclusion Statistics

We use the Thomas-Fermi method to examine the thermodynamics of particles obeying Haldane exclusion statistics. Specifically, we study Calogero-Sutherland particles placed in a given external potential in one dimension. For the case of a simple harmonic potential (constant density of states), we obtain the exact one-particle spatial density and a {\it closed} form for the equation of state at finite temperature, which are both new results. We then solve the problem of particles in a $x^{2/3} ~$ potential (linear density of states) and show that Bose-Einstein condensation does not occur for any statistics other than bosons.

Photoinduced transparency of effective three-photon absorption coefficient for femtosecond laser pulses in Ge16As29Se55 thin films

We report a dramatic change in effective three-photon absorption coefficient of amorphous Ge16As29Se55 thin films, when its optical band gap decreases by 10 meV with 532 nm light illumination. This large change provides valuable information on the higher excited states, which are otherwise inaccessible via normal optical absorption. The results also indicate that photodarkening in chalcogenide glasses can serve as an effective tool to tune the multiphoton absorption in a rather simple way. (C) 2011 American Institute of Physics.

Translational and rotational motion in molecular liquids: A computer simulation study of Lennard-Jones ellipsoids

In order to understand the translational and rotational motion in dense molecular liquids, detailed molecular dynamics simulations of Lennard-Jones ellipsoids have been carried out for three different values of the aspect ratio kappa. For ellipsoids with an aspect ratio equal to 2, the product of the translational diffusion coefficient (D-T) and the average orientational correlation time of the l-th rank harmonics (tau(lR)), converges to a nearly constant value at high density. Surprisingly, this density independent value of D-T tau(lR) is within 5% of the hydrodynamic prediction with the slip boundary condition. This is despite the fact that both D-T and tau(lR) themselves change nearly by an order of magnitude in the density range considered, and the rotational correlation function itself is strongly nonexponential. For small aspect ratios (kappa less than or equal to 1.5), the rotational correlation function remains largely Gaussian even at a very large density, while for a large aspect ratio (kappa greater than or equal to 3), the transition to the nematic liquid-crystalline phase precludes the hydrodynamic regime. Thus, the rotational dynamics of ellipsoids show great sensitivity to the aspect ratio. At low density, tau(lR) goes through a minimum value, indicating the role of interactions in enhancing the rate of orientational relaxation. (C) 1997 American Institute of Physics. [S0021-9606(97)50142-5].

Structural and electrical properties of low pressure metalorganic chemical vapor deposition grown Eu2O3 films on Si(100)

Structural and electrical properties of Eu2O3 films grown on Si(100) in 500–600 °C temperature range by low pressure metalorganic chemical vapor deposition are reported. As-grown films also possess the impurity Eu1−xO phase, which has been removed upon annealing in O2 ambient. Film’s morphology comprises uniform spherical mounds (40–60 nm). Electrical properties of the films, as examined by capacitance-voltage measurements, exhibit fixed oxide charges in the range of −1.5×1011 to −6.0×1010 cm−2 and dielectric constant in the range of 8–23. Annealing has resulted in drastic improvement of their electrical properties. Effect of oxygen nonstoichiometry on the film’s property is briefly discussed.

Determination of the secondary structure of the king cobra neurotoxin CM-11

The king cobra neuotoxin CM-11 is a small protein with 72 amino acid residues. After its complete assignments of H-1-NMR resonance's were obtained using various 2D-NMR technologies, including of DQF-COSY, clean-TOCSY AND NOESY, the secondary structure was analysed by studying the various NOEs extracted from the NOESY spectra and the distribution of chemical shifts. The secondary structure was finally determined by MCD as follows: a triple-strand antiparallel beta sheet with I20-W36, R37-A43 and V53--S59 as its beta strands, a short alpha helix formed by W30-G35 and four turns formed by P7-K10, C14-G17, K50-V53 and D61-N64.