Excess direct hospital cost of treating adult patients with ventilator associated respiratory infection (VARI) in Vietnam

INTRODUCTION: Ventilator associated respiratory infections (VARIs) are the most common hospital acquired infections in critical care worldwide. This work aims to estimate the total annual direct hospital cost of treating VARI throughout Vietnam. METHODS: A costing model was constructed to evaluate the excess cost of diagnostics and treatment of VARI in Vietnam. Model inputs included costs for extra lengths of stay, diagnostics, VARI incidence, utilisation of ventilators and antibiotic therapy. RESULTS: With the current VARI incidence rate of 21.7 episodes per 1000 ventilation-days, we estimated 34,428 VARI episodes in the 577 critical care units in Vietnam per year. The extra cost per VARI episode was $1,174.90 and the total annual excess cost was US$40.4 million. A 1% absolute reduction in VARI incidence density would save US$1.86 million annually. For each episode of VARI, the share of excess cost components was 45.1$117 per capita, VARI represents a substantial cost to the health service in Vietnam. Enhanced infection prevention and control and antimicrobial stewardship programmes should be implemented to reduce this

The non-Abelian gauge theory of matrix big bangs

We study at the classical and quantum mechanical level the time-dependent Yang-Mills theory that one obtains via the generalisation of discrete light-cone quantisation to singular homogeneous plane waves. The non-Abelian nature of this theory is known to be important for physics near the singularity, at least as far as the number of degrees of freedom is concerned. We will show that the quartic interaction is always subleading as one approaches the singularity and that close enough to t=0 the evolution is driven by the diverging tachyonic mass term. The evolution towards asymptotically flat space-time also reveals some surprising features.Comment: 29 pages, 8 eps figures, v2: minor changes, references added: v3 small typographical changes

Bovine virus diarrhea and the vector-borne diseases Anaplasmosis and Bluetongue: a sero-surveillance in free-ranging red deer (Cervus elaphus) in selected areas of Switzerland

Due to climate changes, diseases emerging from southerly adjacent areas (Mediterranean countries) are likely to spread northward. Expanded migration of red deer harbors the risk of introducing new pathogens into a naive population of either wild or domestic animals. Little is known about the importance of red deer as a potential reservoir for diseases of domestic ruminants in Switzerland. Deer is susceptible for all three agents that were selected in this study: bovine virus diarrhea virus (BVDV), Anaplasma marginale (AM), and Bluetongue virus (BTV). The goal of this project was to establish the serological status of red deer in Switzerland concerning BVDV, AM, and BTV, and to assess the possible impact of disease dynamics with a focus on potential transmission of these diseases from red deer to cattle or vice versa. Sampling areas were selected according the following criteria: abundance of red deer, potential insect vector distribution due to climatic conditions, and traditional alpine pasture husbandry along with known migration routes of red deer. Blood samples were collected during the regular hunting season 2004 and 2005 by hunters and gamekeepers. There was no serological evidence for the presence of the vector-borne diseases AM and BT in red deer in Switzerland. Four out of 234 sera showed a positive result for BVD, corresponding to a sero-prevalence of 1.7% (95% CI 0.46–4.38). Facing the fact of the high sero-prevalence for BVD in Swiss cattle (60–80%) disease transmission from red deer to cattle in these areas under investigation is rather unlikely

The true cost of hidden waiting times for cataract surgery in Australia

Cataract surgery is a safe, effective and common elective procedure in Australia but access is inequitable. True waiting times for cataract care are undisclosed or inconsistently reported by governments. Estimates of true waiting times range from 4 to 30 months and have been extended during the coronavirus disease 2019 (COVID-19) pandemic. Comparative analysis revealed that reducing waiting periods from 12 to 3 months would result in estimated public health system cost savings of $6.6 million by preventing 50 679 falls. Investment in public cataract services to address current unmet needs would prevent avoidable vision impairment and associated negative consequences

Irreversible reorganization in a supercooled liquid originates from localised soft modes

The transition of a fluid to a rigid glass upon cooling is a common route of transformation from liquid to solid that embodies the most poorly understood features of both phases1,2,3. From the liquid perspective, the puzzle is to understand stress relaxation in the disordered state. From the perspective of solids, the challenge is to extend our description of structure and its mechanical consequences to materials without long range order. Using computer simulations, we show that the localized low frequency normal modes of a configuration in a supercooled liquid are causally correlated to the irreversible structural reorganization of the particles within that configuration. We also demonstrate that the spatial distribution of these soft local modes can persist in spite of significant particle reorganization. The consequence of these two results is that it is now feasible to construct a theory of relaxation length scales in glass-forming liquids without recourse to dynamics and to explicitly relate molecular properties to their collective relaxation.Comment: Published online: 20 July 2008 | doi:10.1038/nphys1025 Available from http://www.nature.com/nphys/journal/v4/n9/abs/nphys1025.htm

Cell proliferation and differentiation kinetics during spermatogenesis in Hydra carnea

Spermatogenesis inHydra carnea was investigated. The cell proliferation and differentiation kinetics of intermediates in the spermatogenesis pathway were determined, using quantitative determinations of cell abundance, pulse and continuous labelling with3H-thymidine and nuclear DNA measurements. Testes develop in the ectoderm of male hydra as a result of interstitial cell proliferation. Gonial stem cells and proliferating spermatogonia have cell cycles of 28 h and 22 h, respectively. Stem cells undergo four, five or six cell divisions prior to meiosis which includes a premeiotic S+G2 phase of 20 h followed by a long meiotic prophase (22 h). Spermatid differentiation requires 12–29 h. When they first appear, testes contain only proliferating spermatogonia; meiotic and postmeiotic cells appear after 2 and 3 days, respectively and release of mature sperm begins after 4 days. Mature testes produce about 27,000 sperm per day over a period of 4–6 days: about 220 gonial stem cells per testis are required to support this level of sperm differentiation. Further results indicate that somatic (e.g. nematocyte) differentiation does not occur in testes although it continues normally in ectodermal tissue outside testes. Our results support the hypothesis that spermatogenesis is controlled locally in regions of the ectoderm where testes develop

A semiparametric joint model for terminal trend of quality of life and survival in palliative care research

Copyright © 2017 John Wiley & Sons, Ltd. Palliative medicine is an interdisciplinary specialty focusing on improving quality of life (QOL) for patients with serious illness and their families. Palliative care programs are available or under development at over 80% of large US hospitals (300+ beds). Palliative care clinical trials present unique analytic challenges relative to evaluating the palliative care treatment efficacy which is to improve patients’ diminishing QOL as disease progresses towards end of life (EOL). A unique feature of palliative care clinical trials is that patients will experience decreasing QOL during the trial despite potentially beneficial treatment. Often longitudinal QOL and survival data are highly correlated which, in the face of censoring, makes it challenging to properly analyze and interpret terminal QOL trend. To address these issues, we propose a novel semiparametric statistical approach to jointly model the terminal trend of QOL and survival data. There are two sub-models in our approach: a semiparametric mixed effects model for longitudinal QOL and a Cox model for survival. We use regression splines method to estimate the nonparametric curves and AIC to select knots. We assess the model performance through simulation to establish a novel modeling approach that could be used in future palliative care research trials. Application of our approach in a recently completed palliative care clinical trial is also presented

Time Reversal Violation from the entangled B0-antiB0 system

We discuss the concepts and methodology to implement an experiment probing directly Time Reversal (T) non-invariance, without any experimental connection to CP violation, by the exchange of "in" and "out" states. The idea relies on the B0-antiB0 entanglement and decay time information available at B factories. The flavor or CP tag of the state of the still living neutral meson by the first decay of its orthogonal partner overcomes the problem of irreversibility for unstable systems, which prevents direct tests of T with incoherent particle states. T violation in the time evolution between the two decays means experimentally a difference between the intensities for the time-ordered (l^+ X, J/psi K_S) and (J/psi K_L, l^- X) decays, and three other independent asymmetries. The proposed strategy has been applied to simulated data samples of similar size and features to those currently available, from which we estimate the significance of the expected discovery to reach many standard deviations.Comment: 17 pages, 2 figures, 6 table

"Meaning" as a sociological concept: A review of the modeling, mapping, and simulation of the communication of knowledge and meaning

The development of discursive knowledge presumes the communication of meaning as analytically different from the communication of information. Knowledge can then be considered as a meaning which makes a difference. Whereas the communication of information is studied in the information sciences and scientometrics, the communication of meaning has been central to Luhmann's attempts to make the theory of autopoiesis relevant for sociology. Analytical techniques such as semantic maps and the simulation of anticipatory systems enable us to operationalize the distinctions which Luhmann proposed as relevant to the elaboration of Husserl's "horizons of meaning" in empirical research: interactions among communications, the organization of meaning in instantiations, and the self-organization of interhuman communication in terms of symbolically generalized media such as truth, love, and power. Horizons of meaning, however, remain uncertain orders of expectations, and one should caution against reification from the meta-biological perspective of systems theory