1,124 research outputs found

    A tale of two studies: Study design and our understanding of SARS-CoV-2 seroprevalence

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    The COVID-19 pandemic is arguably the most important public health crisis of the last century. To date, infections with the SARS-CoV-2 virus have caused nearly 300,000 deaths in the United States alone [1], while also contributing to substantial excess morbidity and mortality from delayed and deferred care [2]. In addition to the direct and indirect health impacts, policies intended to limit the spread of the disease have resulted in large-scale disruptions to education systems, economic activity, and social networks. Put simply, the COVID-19 pandemic has impacted the daily lives of nearly all Americans in a way that no other health crisis has in our lifetimes

    Algebraic charge liquids

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    High temperature superconductivity emerges in the cuprate compounds upon changing the electron density of an insulator in which the electron spins are antiferromagnetically ordered. A key characteristic of the superconductor is that electrons can be extracted from them at zero energy only if their momenta take one of four specific values (the `nodal points'). A central enigma has been the evolution of the zero energy electrons in the metallic state between the antiferromagnet and the superconductor, and recent experiments yield apparently contradictory results. The oscillation of the resistance in this metal as a function of magnetic field indicate that the zero energy electrons carry momenta which lie on elliptical `Fermi pockets', while ejection of electrons by high intensity light indicates that the zero energy electrons have momenta only along arc-like regions. We present a theory of new states of matter, which we call `algebraic charge liquids', which arise naturally between the antiferromagnet and the superconductor, and reconcile these observations. Our theory also explains a puzzling dependence of the density of superconducting electrons on the total electron density, and makes a number of unique predictions for future experiments.Comment: 6+8 pages, 2 figures; (v2) Rewritten for broader accessibility; (v3) corrected numerical error in Eq. (5

    Family composition and age at menarche: findings from the international Health Behaviour in School-Aged Children Study

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    This research was funded by The University of St Andrews and NHS Health Scotland.Background Early menarche has been associated with father absence, stepfather presence and adverse health consequences in later life. This article assesses the association of different family compositions with the age at menarche. Pathways are explored which may explain any association between family characteristics and pubertal timing. Methods Cross-sectional, international data on the age at menarche, family structure and covariates (age, psychosomatic complaints, media consumption, physical activity) were collected from the 2009–2010 Health Behaviour in School-aged Children (HBSC) survey. The sample focuses on 15-year old girls comprising 36,175 individuals across 40 countries in Europe and North America (N = 21,075 for age at menarche). The study examined the association of different family characteristics with age at menarche. Regression and path analyses were applied incorporating multilevel techniques to adjust for the nested nature of data within countries. Results Living with mother (Cohen’s d = .12), father (d = .08), brothers (d = .04) and sisters (d = .06) are independently associated with later age at menarche. Living in a foster home (d = −.16), with ‘someone else’ (d = −.11), stepmother (d = −.10) or stepfather (d = −.06) was associated with earlier menarche. Path models show that up to 89% of these effects can be explained through lifestyle and psychological variables. Conclusions Earlier menarche is reported amongst those with living conditions other than a family consisting of two biological parents. This can partly be explained by girls’ higher Body Mass Index in these families which is a biological determinant of early menarche. Lower physical activity and elevated psychosomatic complaints were also more often found in girls in these family environments.Publisher PDFPeer reviewe

    Effectiveness of interventions to promote healthy diet in primary care: systematic review and meta-analysis of randomised controlled trials

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    Background A diet rich in fruit, vegetables and dietary fibre and low in fat is associated with reduced risk of chronic disease. This review aimed to estimate the effectiveness of interventions to promote healthy diet for primary prevention among participants attending primary care.<p></p> Methods A systematic review of trials using individual or cluster randomisation of interventions delivered in primary care to promote dietary change over 12 months in healthy participants free from chronic disease or defined high risk states. Outcomes were change in fruit and vegetable intake, consumption of total fat and fibre and changes in serum cholesterol concentration.<p></p> Results Ten studies were included with 12,414 participants. The design and delivery of interventions were diverse with respect to grounding in behavioural theory and intervention intensity. A meta-analysis of three studies showed an increase in fruit consumption of 0.25 (0.01 to 0.49) servings per day, with an increase in vegetable consumption of 0.25 (0.06 to 0.44) serving per day. A further three studies that reported on fruit and vegetable consumption together showed a pooled increment of 0.50 (0.13 to 0.87) servings per day. The pooled effect on consumption of dietary fibre, from four studies, was estimated to be 1.97 (0.43 to 3.52) gm fibre per day. Data from five studies showed a mean decrease in total fat intake of 5.2% of total energy (1.5 to 8.8%). Data from three studies showed a mean decrease in serum cholesterol of 0.10 (-0.19 to 0.00) mmol/L.<p></p> Conclusion Presently-reported interventions to promote healthy diet for primary prevention in primary care, which illustrate a diverse range of intervention methods, may yield small beneficial changes in consumption of fruit, vegetables, fibre and fat over 12 months. The present results do not exclude the possibility that more effective intervention strategies might be developed.<p></p&gt

    Permethrin-treated baby wraps for the prevention of malaria in children: Protocol for a double-blind, randomized placebo-controlled controlled trial in western Uganda

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    This article details the study protocol for a double-blind, randomized placebo-controlled trial to determine the effectiveness of permethrin-treated baby wraps to prevent Plasmodium falciparum malaria infection in children 6–24 months of age. Participating mother-infant dyads will be randomized to receive either a permethrin-treated or a sham-treated wrap, known locally as a “lesu.” After a baseline home visit, during which time all participants will receive new long-lasting insecticidal nets, participants will attend scheduled clinic visits every two weeks for a period of 24 weeks. In the event of an acute febrile illness or other symptoms that may be consistent with malaria (e.g., poor feeding, headache, malaise), participants will be instructed to present to their respective study clinic for evaluation. The primary outcome of interest is the incidence of laboratory-confirmed, symptomatic malaria in participating children. Secondary outcomes of interest include: (1) change in children’s hemoglobin levels; (2) change in children’s growth parameters; (3) prevalence of asymptomatic parasitemia in children; (4) hospitalization for malaria in children; (5) change in the mother’s hemoglobin level; and (6) clinical malaria in the mother. Analyses will be conducted using a modified intent-to-treat approach, with woman-infant dyads who attend one or more clinic visits analyzed according to the arm to which they were randomly assigned. This is the first use of an insecticide-treated baby wrap for prevention of malaria in children. The study began recruitment in June 2022 and is ongoing. ClinicalTrials.gov Identifier: NCT05391230, Registered 25 May 2022

    Stochastic population growth in spatially heterogeneous environments

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    Classical ecological theory predicts that environmental stochasticity increases extinction risk by reducing the average per-capita growth rate of populations. To understand the interactive effects of environmental stochasticity, spatial heterogeneity, and dispersal on population growth, we study the following model for population abundances in nn patches: the conditional law of Xt+dtX_{t+dt} given Xt=xX_t=x is such that when dtdt is small the conditional mean of Xt+dtiXtiX_{t+dt}^i-X_t^i is approximately [xiμi+j(xjDjixiDij)]dt[x^i\mu_i+\sum_j(x^j D_{ji}-x^i D_{ij})]dt, where XtiX_t^i and μi\mu_i are the abundance and per capita growth rate in the ii-th patch respectivly, and DijD_{ij} is the dispersal rate from the ii-th to the jj-th patch, and the conditional covariance of Xt+dtiXtiX_{t+dt}^i-X_t^i and Xt+dtjXtjX_{t+dt}^j-X_t^j is approximately xixjσijdtx^i x^j \sigma_{ij}dt. We show for such a spatially extended population that if St=(Xt1+...+Xtn)S_t=(X_t^1+...+X_t^n) is the total population abundance, then Yt=Xt/StY_t=X_t/S_t, the vector of patch proportions, converges in law to a random vector YY_\infty as tt\to\infty, and the stochastic growth rate limtt1logSt\lim_{t\to\infty}t^{-1}\log S_t equals the space-time average per-capita growth rate \sum_i\mu_i\E[Y_\infty^i] experienced by the population minus half of the space-time average temporal variation \E[\sum_{i,j}\sigma_{ij}Y_\infty^i Y_\infty^j] experienced by the population. We derive analytic results for the law of YY_\infty, find which choice of the dispersal mechanism DD produces an optimal stochastic growth rate for a freely dispersing population, and investigate the effect on the stochastic growth rate of constraints on dispersal rates. Our results provide fundamental insights into "ideal free" movement in the face of uncertainty, the persistence of coupled sink populations, the evolution of dispersal rates, and the single large or several small (SLOSS) debate in conservation biology.Comment: 47 pages, 4 figure

    Prioritisation by FIT to mitigate the impact of delays in the 2-week wait colorectal cancer referral pathway during the COVID-19 pandemic: a UK modelling study

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    OBJECTIVE: To evaluate the impact of faecal immunochemical testing (FIT) prioritisation to mitigate the impact of delays in the colorectal cancer (CRC) urgent diagnostic (2-week-wait (2WW)) pathway consequent from the COVID-19 pandemic. DESIGN: We modelled the reduction in CRC survival and life years lost resultant from per-patient delays of 2-6 months in the 2WW pathway. We stratified by age group, individual-level benefit in CRC survival versus age-specific nosocomial COVID-19-related fatality per referred patient undergoing colonoscopy. We modelled mitigation strategies using thresholds of FIT triage of 2, 10 and 150 µg Hb/g to prioritise 2WW referrals for colonoscopy. To construct the underlying models, we employed 10-year net CRC survival for England 2008-2017, 2WW pathway CRC case and referral volumes and per-day-delay HRs generated from observational studies of diagnosis-to-treatment interval. RESULTS: Delay of 2/4/6 months across all 11 266 patients with CRC diagnosed per typical year via the 2WW pathway were estimated to result in 653/1419/2250 attributable deaths and loss of 9214/20 315/32 799 life years. Risk-benefit from urgent investigatory referral is particularly sensitive to nosocomial COVID-19 rates for patients aged >60. Prioritisation out of delay for the 18% of symptomatic referrals with FIT >10 µg Hb/g would avoid 89% of these deaths attributable to presentational/diagnostic delay while reducing immediate requirement for colonoscopy by >80%. CONCLUSIONS: Delays in the pathway to CRC diagnosis and treatment have potential to cause significant mortality and loss of life years. FIT triage of symptomatic patients in primary care could streamline access to colonoscopy, reduce delays for true-positive CRC cases and reduce nosocomial COVID-19 mortality in older true-negative 2WW referrals. However, this strategy offers benefit only in short-term rationalisation of limited endoscopy services: the appreciable false-negative rate of FIT in symptomatic patients means most colonoscopies will still be required
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