1,350 research outputs found
Impaired Right, Left, or Biventricular Function and Resting Oxygen Saturation Are Associated With Mortality in Eisenmenger Syndrome: A Clinical and Cardiovascular Magnetic Resonance Study.
Solitary neurofibroma in the male breast
BACKGROUND: Neurofibroma of the male breast outside of neurofibromatosis is extremely rare with only one previous case having been reported. CASE PRESENTATION: A 48 year old male patient with a neurofibroma in the breast presenting with gynaecomastia is reported. Clinical and mammogram findings with fine needle aspiration cytology and full histology are presented. CONCLUSION: To our knowledge this is only the second case of a neurofibroma in a male breast in the English literature and the first report to include the mammographic findings
Presymptomatic risk assessment for chronic non-communicable diseases
The prevalence of common chronic non-communicable diseases (CNCDs) far
overshadows the prevalence of both monogenic and infectious diseases combined.
All CNCDs, also called complex genetic diseases, have a heritable genetic
component that can be used for pre-symptomatic risk assessment. Common single
nucleotide polymorphisms (SNPs) that tag risk haplotypes across the genome
currently account for a non-trivial portion of the germ-line genetic risk and
we will likely continue to identify the remaining missing heritability in the
form of rare variants, copy number variants and epigenetic modifications. Here,
we describe a novel measure for calculating the lifetime risk of a disease,
called the genetic composite index (GCI), and demonstrate its predictive value
as a clinical classifier. The GCI only considers summary statistics of the
effects of genetic variation and hence does not require the results of
large-scale studies simultaneously assessing multiple risk factors. Combining
GCI scores with environmental risk information provides an additional tool for
clinical decision-making. The GCI can be populated with heritable risk
information of any type, and thus represents a framework for CNCD
pre-symptomatic risk assessment that can be populated as additional risk
information is identified through next-generation technologies.Comment: Plos ONE paper. Previous version was withdrawn to be updated by the
journal's pdf versio
Potential of optimized NOvA for large theta(13) & combined performance with a LArTPC & T2K
NOvA experiment has reoptimized its event selection criteria in light of the
recently measured moderately large value of theta(13). We study the improvement
in the sensitivity to the neutrino mass hierarchy and to leptonic CP violation
due to these new features. For favourable values of deltacp, NOvA sensitivity
to mass hierarchy and leptonic CP violation is increased by 20%. Addition of 5
years of neutrino data from T2K to NOvA more than doubles the range of deltacp
for which the leptonic CP violation can be discovered, compared to stand alone
NOvA. But for unfavourable values of deltacp, the combination of NOvA and T2K
are not enough to provide even a 90% C.L. hint of hierarchy discovery.
Therefore, we further explore the improvement in the hierarchy and CP violation
sensitivities due to the addition of a 10 kt liquid argon detector placed close
to NOvA site. The capabilities of such a detector are equivalent to those of
NOvA in all respects. We find that combined data from 10 kt liquid argon
detector (3 years of nu + 3 years of nubar run), NOvA (6 years of nu + 6 years
of nubar run) and T2K (5 years of nu run) can give a close to 2 sigma hint of
hierarchy discovery for all values of deltacp. With this combined data, we can
achieve CP violation discovery at 95% C.L. for roughly 60% values of deltacp.Comment: 22 pages, 24 pdf figures, 5 tables. In the appendix, new results are
presented with conservative choices of central values of oscillation
parameters. New references are added. Accepted in JHE
Src Dependent Pancreatic Acinar Injury Can Be Initiated Independent of an Increase in Cytosolic Calcium
Several deleterious intra-acinar phenomena are simultaneously triggered on initiating acute pancreatitis. These culminate in acinar injury or inflammatory mediator generation in vitro and parenchymal damage in vivo. Supraphysiologic caerulein is one such initiator which simultaneously activates numerous signaling pathways including non-receptor tyrosine kinases such as of the Src family. It also causes a sustained increase in cytosolic calcium- a player thought to be crucial in regulating deleterious phenomena. We have shown Src to be involved in caerulein induced actin remodeling, and caerulein induced changes in the Golgi and post-Golgi trafficking to be involved in trypsinogen activation, which initiates acinar cell injury. However, it remains unclear whether an increase in cytosolic calcium is necessary to initiate acinar injury or if injury can be initiated at basal cytosolic calcium levels by an alternate pathway. To study the interplay between tyrosine kinase signaling and calcium, we treated mouse pancreatic acinar cells with the tyrosine phosphatase inhibitor pervanadate. We studied the effect of the clinically used Src inhibitor Dasatinib (BMS-354825) on pervanadate or caerulein induced changes in Src activation, trypsinogen activation, cell injury, upstream cytosolic calcium, actin and Golgi morphology. Pervanadate, like supraphysiologic caerulein, induced Src activation, redistribution of the F-actin from its normal location in the sub-apical area to the basolateral areas, and caused antegrade fragmentation of the Golgi. These changes, like those induced by supraphysiologic caerulein, were associated with trypsinogen activation and acinar injury, all of which were prevented by Dasatinib. Interestingly, however, pervanadate did not cause an increase in cytosolic calcium, and the caerulein induced increase in cytosolic calcium was not affected by Dasatinib. These findings suggest that intra-acinar deleterious phenomena may be initiated independent of an increase in cytosolic calcium. Other players resulting in acinar injury along with the Src family of tyrosine kinases remain to be explored. © 2013 Mishra et al
Theory of disk accretion onto supermassive black holes
Accretion onto supermassive black holes produces both the dramatic phenomena
associated with active galactic nuclei and the underwhelming displays seen in
the Galactic Center and most other nearby galaxies. I review selected aspects
of the current theoretical understanding of black hole accretion, emphasizing
the role of magnetohydrodynamic turbulence and gravitational instabilities in
driving the actual accretion and the importance of the efficacy of cooling in
determining the structure and observational appearance of the accretion flow.
Ongoing investigations into the dynamics of the plunging region, the origin of
variability in the accretion process, and the evolution of warped, twisted, or
eccentric disks are summarized.Comment: Mostly introductory review, to appear in "Supermassive black holes in
the distant Universe", ed. A.J. Barger, Kluwer Academic Publishers, in pres
Unlocking Community Capabilities Across Health Systems in Low- and Middle-Income Countries: Lessons Learned from Research and Reflective Practice
The right and responsibility of communities to participate
in health service delivery was enshrined in the 1978
Alma Ata declaration and continues to feature centrally
in health systems debates today. Communities are
a vital part of people-centred health systems and
their engagement is critical to realizing the diverse
health targets prioritised by the Sustainable Development
Goals and the commitments made to Universal
Health Coverage. Community members' intimate
knowledge of local needs and adaptive capacities are essential
in constructively harnessing global transformations
related to epidemiological and demographic transitions,
urbanization, migration, technological innovation and
climate change. Effective community partnerships and
governance processes that underpin community capability
also strengthen local resilience, enabling communities to
better manage shocks, sustain gains, and advocate for
their needs through linkages to authorities and services.
This is particularly important given how power relations
mark broader contexts of resource scarcity and concentration,
struggles related to social liberties and other types of
ongoing conflicts.IS
What is the Role of Community Capabilities for Maternal Health? An Exploration of Community Capabilities as Determinants to Institutional Deliveries in Bangladesh, India, and Uganda
Background:
While community capabilities are recognized as important factors in developing resilient health systems and communities, appropriate metrics for these have not yet been developed. Furthermore, the role of community capabilities on access to maternal health services has been underexplored. In this paper, we summarize the development of a community capability score based on the Future Health System (FHS) project’s experience in Bangladesh, India, and Uganda, and, examine the role of community capabilities as determinants of institutional delivery in these three contexts.
Methods:
We developed a community capability score using a pooled dataset containing cross-sectional household survey data from Bangladesh, India, and Uganda. Our main outcome of interest was whether the woman delivered in an institution. Our predictor variables included the community capability score, as well as a series of previously identified determinants of maternal health. We calculate both population-averaged effects (using GEE logistic regression), as well as sub-national level effects (using a mixed effects model).
Results:
Our final sample for analysis included 2775 women, of which 1238 were from Bangladesh, 1199 from India, and 338 from Uganda. We found that individual-level determinants of institutional deliveries, such as maternal education, parity, and ante-natal care access were significant in our analysis and had a strong impact on a woman’s odds of delivering in an institution. We also found that, in addition to individual-level determinants, greater community capability was significantly associated with higher odds of institutional delivery. For every additional capability, the odds of institutional delivery would increase by up to almost 6 %.
Conclusion:
Individual-level characteristics are strong determinants of whether a woman delivered in an institution. However, we found that community capability also plays an important role, and should be taken into account when designing programs and interventions to support institutional deliveries. Consideration of individual factors and the capabilities of the communities in which people live would contribute to the vision of supporting people-centered approaches to health
Obtaining Statistics of Turbulent Velocity from Astrophysical Spectral Line Data
Turbulence is a crucial component of dynamics of astrophysical fluids
dynamics, including those of ISM, clusters of galaxies and circumstellar
regions. Doppler shifted spectral lines provide a unique source of information
on turbulent velocities. We discuss Velocity-Channel Analysis (VCA) and its
offspring Velocity Coordinate Spectrum (VCS) that are based on the analytical
description of the spectral line statistics. Those techniques are well suited
for studies of supersonic turbulence. We stress that a great advantage of VCS
is that it does not necessary require good spatial resolution. Addressing the
studies of mildly supersonic and subsonic turbulence we discuss the criterion
that allows to determine whether a traditional tool for such a research,
namely, Velocity Centroids are dominated by density or velocity. We briefly
discuss the use of higher order correlations as the means to study
intermittency of turbulence. We discuss observational data available and
prospects of the field.Comment: 12 pages, Invited Talk, Penetrating Bars Through Masks of Cosmic
Dust, Pilanesberg National Park, South Afrika, 7 June-12 June 200
Surgery and postoperative radiotherapy a valid treatment for advanced oropharyngeal carcinoma
Since 1992 we have prospectively included all head and neck cancer patients in our health region in a departmental based register. Our hospital takes care of all head and neck cancer patients in our health region consisting of approximately 1 million people. In 1997, we evaluated the results of the treatment of oropharyngeal cancer in the 1992–1997 period. On the basis of this evaluation, we changed our treatment policy for tonsillar and base of tongue carcinoma. We first changed the treatment for the lesions with worst prognosis, i.e., those with T3–T4 carcinomas, from radiotherapy only, to radical surgery and postoperative radiotherapy. We have since that time increasingly also operated the smaller oropharyngeal carcinomas. The 2 years’ overall survival and disease-specific survival for all patients diagnosed in the 1992–1997 period was 56 and 63%, respectively. The results from a similar group of patients in the 6 years’ period from 2000 to 2005, after the change in treatment, have increased to 83 and 88%. When we looked at the subgroup of patients in the 2000–2005 period treated with surgery and postoperative radiotherapy, 45 out of 69 patients (65%) presenting with an oropharyngeal cancer were fit for operation. With radical surgery and postoperative radiation therapy, the 2 years overall survival is now 91%. The 2-year disease-specific survival is 96% and the locoregional control is 98%. This is a marked improvement as compared to radiotherapy alone and definitely competitive with modern radiochemotherapy
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