156 research outputs found
Cosmology = topology/geometry: mathematical evidence for the Holographic Principle
In August 2015 NORDITA (Nordic Institute for Theoretical Physics) hosted a conference where Hawking strongly supported the conjectured relationship between string theory and quantum fields that was initiated with the holographic principle some 20 years ago by ’t Hooft, Maldacena, Susskind and Witten. We bring together results of several papers showing how mathematics can come to the party: the fundamentals of flat (even higher-dimensional) space can be derived very simply from topological properties on a surface. Specifically, Desargues, Pappus or other configurations do not have to be assumed a priori or as self-evident (a fundamental weakness of Hilbert’s work in 1899) to develop the foundations of geometry. Are black holes places where non-commutative (quantum) behaviour reigns while Euclidean (flat) space is where commutativity holds sway? So, we cannot hope to look inside a black hole unless we know how “deformable” topology is related to “flat” geometry
Towards Eliminating Bias in Cluster Analysis of TB Genotyped Data
The relative contributions of transmission and reactivation of latent infection to TB cases observed clinically has been reported in many situations, but always with some uncertainty. Genotyped data from TB organisms obtained from patients have been used as the basis for heuristic distinctions between circulating (clustered strains) and reactivated infections (unclustered strains). Naïve methods previously applied to the analysis of such data are known to provide biased estimates of the proportion of unclustered cases. The hypergeometric distribution, which generates probabilities of observing clusters of a given size as realized clusters of all possible sizes, is analyzed in this paper to yield a formal estimator for genotype cluster sizes. Subtle aspects of numerical stability, bias, and variance are explored. This formal estimator is seen to be stable with respect to the epidemiologically interesting properties of the cluster size distribution (the number of clusters and the number of singletons) though it does not yield satisfactory estimates of the number of clusters of larger sizes. The problem that even complete coverage of genotyping, in a practical sampling frame, will only provide a partial view of the actual transmission network remains to be explored
Implementation of a Family Intervention for Individuals with Schizophrenia
Families are rarely included in clinical care despite research showing that family involvement has a positive effect on individuals with schizophrenia by reducing relapse, improving work functioning, and social adjustment.
The VA QUERI study, EQUIP (Enhancing QUality of care In Psychosis), implemented family services for this population.
At two VA medical centers, veterans with schizophrenia and their clinicians were interviewed separately at baseline and 15 months. A family intervention was implemented, and a process evaluation of the implementation was conducted.
Veterans with schizophrenia (n = 173) and their clinicians (n = 29).
Consent to contact family was obtained, mailers to engage families were sent, families were prioritized as high need for family services, and staff volunteers were trained in a brief three-session family intervention.
Of those enrolled, 100 provided consent for family involvement. Seventy-three of the 100 were sent a mailer to engage them in care; none became involved. Clinicians were provided assessment data on their patients and notified of 50 patients needing family services. Of those 50, 6 families were already involved, 34 were never contacted, and 10 were contacted; 7 new families became involved in care. No families were referred to the family psychoeducational program.
Uptake of the family intervention failed due to barriers from all stakeholders. Families did not respond to the mailer, patients were concerned about privacy and burdening family, clinicians had misperceptions of family-patient contact, and organizations did not free up time or offer incentives to provide the service. If a full partnership with patients and families is to be achieved, these barriers will need to be addressed, and a family-friendly environment will need to be supported by clinicians and their organizations. Applicability to family involvement in other disorders is discussed
No more 'business as usual' with audit and feedback interventions: towards an agenda for a reinvigorated intervention
Background: Audit and feedback interventions in healthcare have been found to be effective, but there has been little progress with respect to understanding their mechanisms of action or identifying their key ‘active ingredients.’
Discussion: Given the increasing use of audit and feedback to improve quality of care, it is imperative to focus further research on understanding how and when it works best. In this paper, we argue that continuing the ‘business as usual’ approach to evaluating two-arm trials of audit and feedback interventions against usual care for common problems and settings is unlikely to contribute new generalizable findings. Future audit and feedback trials should incorporate evidence- and theory-based best practices, and address known gaps in the literature.
Summary: We offer an agenda for high-priority research topics for implementation researchers that focuses on reviewing best practices for designing audit and feedback interventions to optimize effectiveness
Accounting for Centennial Scale Variability when Detecting Changes in ENSO: a study of the Pliocene
The El Niño Southern Oscillation (ENSO) is the dominant mode of interannual climate variability. However, climate models are inconsistent in future predictions of ENSO, and long term variations in ENSO cannot be quantified from the short instrumental records available. Here we analyse ENSO behaviour in millennial-scale climate simulations of a warm climate of the past, the mid-Pliocene Warm Period (mPWP; ∼3.3 − 3.0Ma). We consider centennial-scale variability in ENSO for both the mPWP and the preindustrial, and consider which changes between the two climates are detectable above this variability. We find that El Niño typically occurred 12% less frequently in the mPWP but with a 20% longer duration, and with stronger amplitude in precipitation and temperature. However low frequency variability in ENSO meant that Pliocene-preindustrial changes in El Niño temperature amplitude in the NINO3.4 region (5° N-5° S, 170° W-120° W) were not always detectable. The Pliocene-preindustrial El Niño temperature signal in the NINO4 region (5° N-5° S, 160° E-150° W) and the El Niño precipitation signal are usually larger than centennial scale variations of El Niño amplitude, and provide consistent indications of ENSO amplitude change. The enhanced mPWP temperature signal in the NINO4 region is associated with an increase in Central Pacific El Niño events similar to those observed in recent decades and predicted for the future. This study highlights the importance of considering centennial scale variability when comparing ENSO changes between two climate states. If centennial scale variability in ENSO has not first been established, results suggesting changes in ENSO behaviour may not be robust
Genetic variation of Mycobacterium tuberculosis circulating in Kharkiv Oblast, Ukraine
<p>Abstract</p> <p>Background</p> <p>A persistent increase of tuberculosis cases has recently been noted in the Ukraine. The reported incidence of drug-resistant isolates of <it>M. tuberculosis </it>is growing steadily; however, data on the genetic variation of isolates of <it>M. tuberculosis </it>circulating in northern Ukraine and on the spectrum and frequency of occurrence of mutations determining resistance to the principal anti-tuberculosis drugs isoniazid and rifampicin have not yet been reported.</p> <p>Methods</p> <p>Isolates of <it>M. tuberculosis </it>from 98 tuberculosis patients living in Kharkiv Oblast (Ukraine) were analyzed using VNTR- and RFLP-IS6110-typing methods. Mutations associated with resistance to rifampicin and isoniazid were detected by RFLP-PCR methods, and also confirmed by sequencing.</p> <p>Results</p> <p>We identified 75 different genetic profiles. Thirty four (34%) isolates belonged to the Beijing genotype and 23 (23%) isolates belonged to the LAM family. A cluster of isolates belonging to the LAM family had significant genetic heterogeneity, indicating that this family had an ancient distribution and circulation in this geographical region. Moreover, we found a significant percentage of the isolates (36%) belonged to as yet unidentified families of <it>M. tuberculosis </it>or had individual non-clustering genotypes. Mutations conferring rifampicin and isoniazid resistance were detected in 49% and 54% isolates, respectively. Mutations in codon 531 of the <it>rpoB </it>gene and codon 315 of the <it>katG </it>gene were predominant among drug-resistant isolates. An association was found for belonging to the LAM strain family and having multiple drug resistance (R = 0.27, p = 0.0059) and also for the presence of a mutation in codon 531 of the <it>rpoB </it>gene and belonging to the Beijing strain family (R = 0.2, p = 0.04).</p> <p>Conclusions</p> <p>Transmission of drug-resistant isolates seems to contribute to the spread of resistant TB in this oblast. The Beijing genotype and LAM genotype should be seen as a major cause of drug resistant TB in this region.</p
Multimorbidity and comorbidity in the Dutch population - data from general practices
<p>Abstract</p> <p>Background</p> <p>Multimorbidity is increasingly recognized as a major public health challenge of modern societies. However, knowledge about the size of the population suffering from multimorbidity and the type of multimorbidity is scarce. The objective of this study was to present an overview of the prevalence of multimorbidity and comorbidity of chronic diseases in the Dutch population and to explore disease clustering and common comorbidities.</p> <p>Methods</p> <p>We used 7 years data (2002–2008) of a large Dutch representative network of general practices (212,902 patients). Multimorbidity was defined as having two or more out of 29 chronic diseases. The prevalence of multimorbidity was calculated for the total population and by sex and age group. For 10 prevalent diseases among patients of 55 years and older (N = 52,014) logistic regressions analyses were used to study disease clustering and descriptive analyses to explore common comorbid diseases.</p> <p>Results</p> <p>Multimorbidity of chronic diseases was found among 13% of the Dutch population and in 37% of those older than 55 years. Among patients over 55 years with a specific chronic disease more than two-thirds also had one or more other chronic diseases. Most disease pairs occurred more frequently than would be expected if diseases had been independent. Comorbidity was not limited to specific combinations of diseases; about 70% of those with a disease had one or more extra chronic diseases recorded which were not included in the top five of most common diseases.</p> <p>Conclusion</p> <p>Multimorbidity is common at all ages though increasing with age, with over two-thirds of those with chronic diseases and aged 55 years and older being recorded with multimorbidity. Comorbidity encompassed many different combinations of chronic diseases. Given the ageing population, multimorbidity and its consequences should be taken into account in the organization of care in order to avoid fragmented care, in medical research and healthcare policy.</p
Multispacer Sequence Typing for Mycobacterium tuberculosis Genotyping
Background: Genotyping methods developed to survey the transmission dynamics of Mycobacterium tuberculosis currently rely on the interpretation of restriction and amplification profiles. Multispacer sequence typing (MST) genotyping is based on the sequencing of several intergenic regions selected after complete genome sequence analysis. It has been applied to various pathogens, but not to M. tuberculosis. Methods and Findings: In M. tuberculosis, the MST approach yielded eight variable intergenic spacers which included four previously described variable number tandem repeat loci, one single nucleotide polymorphism locus and three newly evaluated spacers. Spacer sequence stability was evaluated by serial subculture. The eight spacers were sequenced in a collection of 101 M. tuberculosis strains from five phylogeographical lineages, and yielded 29 genetic events including 13 tandem repeat number variations (44.82%), 11 single nucleotide mutations (37.93%) and 5 deletions (17.24%). These 29 genetic events yielded 32 spacer alleles or spacer-types (ST) with an index of discrimination of 0.95. The distribution of M. tuberculosis isolates into ST profiles correlated with their assignment into phylogeographical lineages. Blind comparison of a further 93 M. tuberculosis strains by MST and restriction fragment length polymorphism-IS6110 fingerprinting and mycobacterial interspersed repetitive units typing, yielded an index of discrimination of 0.961 and 0.992, respectively. MST yielded 41 different profiles delineating 16 related groups and proved to be more discriminatory than IS6110-based typing for isolates containing M<8 IS6110 copies (P<0.0003). MST was successfully applied to 7/10 clinical specimens exhibiting a Cts <= 42 cycles in internal transcribed spacer-real time PCR. Conclusions: These results support MST as an alternative, sequencing-based method for genotyping low IS6110 copy-number M. tuberculosis strains. The M. tuberculosis MST database is freely available (http://ifr48.timone.univ-mrs.fr/MST_MTuberculosis/mst)
Diurnally Entrained Anticipatory Behavior in Archaea
By sensing changes in one or few environmental factors biological systems can anticipate future changes in multiple factors over a wide range of time scales (daily to seasonal). This anticipatory behavior is important to the fitness of diverse species, and in context of the diurnal cycle it is overall typical of eukaryotes and some photoautotrophic bacteria but is yet to be observed in archaea. Here, we report the first observation of light-dark (LD)-entrained diurnal oscillatory transcription in up to 12% of all genes of a halophilic archaeon Halobacterium salinarum NRC-1. Significantly, the diurnally entrained transcription was observed under constant darkness after removal of the LD stimulus (free-running rhythms). The memory of diurnal entrainment was also associated with the synchronization of oxic and anoxic physiologies to the LD cycle. Our results suggest that under nutrient limited conditions halophilic archaea take advantage of the causal influence of sunlight (via temperature) on O2 diffusivity in a closed hypersaline environment to streamline their physiology and operate oxically during nighttime and anoxically during daytime
Advances in estimation by the item sum technique using auxiliary information in complex surveys
To collect sensitive data, survey statisticians have designed many strategies to reduce
nonresponse rates and social desirability response bias. In recent years, the item count
technique (ICT) has gained considerable popularity and credibility as an alternative mode
of indirect questioning survey, and several variants of this technique have been proposed as
new needs and challenges arise. The item sum technique (IST), which was introduced by
Chaudhuri and Christofides (2013) and Trappmann et al. (2014), is one such variant, used
to estimate the mean of a sensitive quantitative variable. In this approach, sampled units are
asked to respond to a two-list of items containing a sensitive question related to the study
variable and various innocuous, nonsensitive, questions. To the best of our knowledge,
very few theoretical and applied papers have addressed the IST. In this article, therefore,
we present certain methodological advances as a contribution to appraising the use of the
IST in real-world surveys. In particular, we employ a generic sampling design to examine
the problem of how to improve the estimates of the sensitive mean when auxiliary information on the population under study is available and is used at the design and estimation
stages. A Horvitz-Thompson type estimator and a calibration type estimator are proposed
and their efficiency is evaluated by means of an extensive simulation study. Using simulation experiments, we show that estimates obtained by the IST are nearly equivalent to those
obtained using “true data” and that in general they outperform the estimates provided by a
competitive randomized response method. Moreover, the variance estimation may be considered satisfactory. These results open up new perspectives for academics, researchers and
survey practitioners, and could justify the use of the IST as a valid alternative to traditional
direct questioning survey modes.Ministerio de Economía y Competitividad of SpainMinisterio de Educacion, Cultura y Deporteproject PRIN-SURWE
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