1,229 research outputs found
Doctors and Drug Companies: Still Cozy after All These Years
David Henry discusses a research article by Geoffrey Spurling and colleagues that examined the relationship between exposure to promotional material from pharmaceutical companies and the quality, quantity, and cost of prescribing
Mid-infrared optical parametric amplifier using silicon nanophotonic waveguides
All-optical signal processing is envisioned as an approach to dramatically
decrease power consumption and speed up performance of next-generation optical
telecommunications networks. Nonlinear optical effects, such as four-wave
mixing (FWM) and parametric gain, have long been explored to realize
all-optical functions in glass fibers. An alternative approach is to employ
nanoscale engineering of silicon waveguides to enhance the optical
nonlinearities by up to five orders of magnitude, enabling integrated
chip-scale all-optical signal processing. Previously, strong two-photon
absorption (TPA) of the telecom-band pump has been a fundamental and
unavoidable obstacle, limiting parametric gain to values on the order of a few
dB. Here we demonstrate a silicon nanophotonic optical parametric amplifier
exhibiting gain as large as 25.4 dB, by operating the pump in the mid-IR near
one-half the band-gap energy (E~0.55eV, lambda~2200nm), at which parasitic
TPA-related absorption vanishes. This gain is high enough to compensate all
insertion losses, resulting in 13 dB net off-chip amplification. Furthermore,
dispersion engineering dramatically increases the gain bandwidth to more than
220 nm, all realized using an ultra-compact 4 mm silicon chip. Beyond its
significant relevance to all-optical signal processing, the broadband
parametric gain also facilitates the simultaneous generation of multiple
on-chip mid-IR sources through cascaded FWM, covering a 500 nm spectral range.
Together, these results provide a foundation for the construction of
silicon-based room-temperature mid-IR light sources including tunable
chip-scale parametric oscillators, optical frequency combs, and supercontinuum
generators
Fractionated 131I anti-CEA radioimmunotherapy: effects on xenograft tumour growth and haematological toxicity in mice
Dose fractionation has been proposed as a method to improve the therapeutic ratio of radioimmunotherapy (RIT). This study compared a single administration of 7.4 MBq 131I-anti-CEA antibody given on day 1 with the same total activity given as fractionated treatment: 3.7 MBq (days 1 and 3), 2.4 MBq (days 1, 3, and 5) or 1.8 MBq (days 1, 3, 5, and 8). Studies in nude mice, bearing the human colorectal xenograft LS174T, showed that increasing the fractionation significantly reduced the efficacy of therapy. Fractionation was associated with a decrease in systemic toxicity as assessed by weight, but did not lead to any significant decrease in acute haematological toxicity. Similarly, no significant decrease in marrow toxicity, as assessed by colony-forming unit assays for granulocytes and macrophages (CFUgm), was seen. However, there was a significant depression of CFUgm counts when all treated animals were compared with untreated controls, suggesting that treatment did suppress marrow function. In conclusion, in this tumour model system, fractionated RIT causes less systemic toxicity, but is also less effective at treating tumours
Ramified rectilinear polygons: coordinatization by dendrons
Simple rectilinear polygons (i.e. rectilinear polygons without holes or
cutpoints) can be regarded as finite rectangular cell complexes coordinatized
by two finite dendrons. The intrinsic -metric is thus inherited from the
product of the two finite dendrons via an isometric embedding. The rectangular
cell complexes that share this same embedding property are called ramified
rectilinear polygons. The links of vertices in these cell complexes may be
arbitrary bipartite graphs, in contrast to simple rectilinear polygons where
the links of points are either 4-cycles or paths of length at most 3. Ramified
rectilinear polygons are particular instances of rectangular complexes obtained
from cube-free median graphs, or equivalently simply connected rectangular
complexes with triangle-free links. The underlying graphs of finite ramified
rectilinear polygons can be recognized among graphs in linear time by a
Lexicographic Breadth-First-Search. Whereas the symmetry of a simple
rectilinear polygon is very restricted (with automorphism group being a
subgroup of the dihedral group ), ramified rectilinear polygons are
universal: every finite group is the automorphism group of some ramified
rectilinear polygon.Comment: 27 pages, 6 figure
Evaluating Active U: an Internet-mediated physical activity program.
Background:
Engaging in regular physical activity can be challenging, particularly during the winter months. To promote physical activity at the University of Michigan during the winter months, an eight-week Internet-mediated program (Active U) was developed providing participants with an online physical activity log, goal setting, motivational emails, and optional team participation and competition.
Methods:
This study is a program evaluation of Active U. Approximately 47,000 faculty, staff, and graduate students were invited to participate in the online Active U intervention in the winter of 2007. Participants were assigned a physical activity goal and were asked to record each physical activity episode into the activity log for eight weeks. Statistics for program reach, effectiveness, adoption, and implementation were calculated using the Re-Aim framework. Multilevel regression analyses were used to assess the decline in rates of data entry and goal attainment during the program, to assess the likelihood of joining a team by demographic characteristics, to test the association between various predictors and the number of weeks an individual met his or her goal, and to analyze server load.
Results:
Overall, 7,483 individuals registered with the Active U website (≈16% of eligible), and 79% participated in the program by logging valid data at least once. Staff members, older participants, and those with a BMI < 25 were more likely to meet their weekly physical activity goals, and average rate of meeting goals was higher among participants who joined a competitive team compared to those who participated individually (IRR = 1.28, P < .001).
Conclusion:
Internet-mediated physical activity interventions that focus on physical activity logging and goal setting while incorporating team competition may help a significant percentage of the target population maintain their physical activity during the winter months
Entangled-State Cycles of Atomic Collective-Spin States
We study quantum trajectories of collective atomic spin states of
effective two-level atoms driven with laser and cavity fields. We show that
interesting ``entangled-state cycles'' arise probabilistically when the (Raman)
transition rates between the two atomic levels are set equal. For odd (even)
, there are () possible cycles. During each cycle the
-qubit state switches, with each cavity photon emission, between the states
, where is a Dicke state in a rotated
collective basis. The quantum number (), which distinguishes the
particular cycle, is determined by the photon counting record and varies
randomly from one trajectory to the next. For even it is also possible,
under the same conditions, to prepare probabilistically (but in steady state)
the Dicke state , i.e., an -qubit state with excitations,
which is of particular interest in the context of multipartite entanglement.Comment: 10 pages, 9 figure
Mandatory Disclosure of Pharmaceutical Industry-Funded Events for Health Professionals
David Henry and colleagues examine compliance with new disclosure requirements of Medicines Australia, the pharmaceutical industry representative body, and argue that they fall short and instead more comprehensive reporting standards are needed
Evaluating the Sensitivity of Mycobacterium tuberculosis to Biotin Deprivation Using Regulated Gene Expression
In the search for new drug targets, we evaluated the biotin synthetic pathway of Mycobacterium tuberculosis (Mtb) and constructed an Mtb mutant lacking the biotin biosynthetic enzyme 7,8-diaminopelargonic acid synthase, BioA. In biotin-free synthetic media, ΔbioA did not produce wild-type levels of biotinylated proteins, and therefore did not grow and lost viability. ΔbioA was also unable to establish infection in mice. Conditionally-regulated knockdown strains of Mtb similarly exhibited impaired bacterial growth and viability in vitro and in mice, irrespective of the timing of transcriptional silencing. Biochemical studies further showed that BioA activity has to be reduced by approximately 99% to prevent growth. These studies thus establish that de novo biotin synthesis is essential for Mtb to establish and maintain a chronic infection in a murine model of TB. Moreover, these studies provide an experimental strategy to systematically rank the in vivo value of potential drug targets in Mtb and other pathogens
Population Physiology: Leveraging Electronic Health Record Data to Understand Human Endocrine Dynamics
Studying physiology and pathophysiology over a broad population for long periods of time is difficult primarily because collecting human physiologic data can be intrusive, dangerous, and expensive. One solution is to use data that have been collected for a different purpose. Electronic health record (EHR) data promise to support the development and testing of mechanistic physiologic models on diverse populations and allow correlation with clinical outcomes, but limitations in the data have thus far thwarted such use. For example, using uncontrolled population-scale EHR data to verify the outcome of time dependent behavior of mechanistic, constructive models can be difficult because: (i) aggregation of the population can obscure or generate a signal, (ii) there is often no control population with a well understood health state, and (iii) diversity in how the population is measured can make the data difficult to fit into conventional analysis techniques. This paper shows that it is possible to use EHR data to test a physiological model for a population and over long time scales. Specifically, a methodology is developed and demonstrated for testing a mechanistic, time-dependent, physiological model of serum glucose dynamics with uncontrolled, population-scale, physiological patient data extracted from an EHR repository. It is shown that there is no observable daily variation the normalized mean glucose for any EHR subpopulations. In contrast, a derived value, daily variation in nonlinear correlation quantified by the time-delayed mutual information (TDMI), did reveal the intuitively expected diurnal variation in glucose levels amongst a random population of humans. Moreover, in a population of continuously (tube) fed patients, there was no observable TDMI-based diurnal signal. These TDMI-based signals, via a glucose insulin model, were then connected with human feeding patterns. In particular, a constructive physiological model was shown to correctly predict the difference between the general uncontrolled population and a subpopulation whose feeding was controlled
Are Canadian General Internal Medicine training program graduates well prepared for their future careers?
BACKGROUND: At a time of increased need and demand for general internists in Canada, the attractiveness of generalist careers (including general internal medicine, GIM) has been falling as evidenced by the low number of residents choosing this specialty. One hypothesis for the lack of interest in a generalist career is lack of comfort with the skills needed to practice after training, and the mismatch between the tertiary care, inpatient training environment and "real life". This project was designed to determine perceived effectiveness of training for 10 years of graduates of Canadian GIM programs to assist in the development of curriculum and objectives for general internists that will meet the needs of graduates and ultimately society. METHODS: Mailed survey designed to explore perceived importance of training for and preparation for various aspects of Canadian GIM practice. After extensive piloting of the survey, including a pilot survey of two universities to improve the questionnaire, all graduates of the 16 universities over the previous ten years were surveyed. RESULTS: Gaps (difference between importance and preparation) were demonstrated in many of the CanMEDS 2000/2005(® )competencies. Medical problems of pregnancy, perioperative care, pain management, chronic care, ambulatory care and community GIM rotations were the medical expert areas with the largest gaps. Exposure to procedural skills was perceived to be lacking. Some procedural skills valued as important for current GIM trainees and performed frequently (example ambulatory ECG interpretation) had low preparation ratings by trainees. Other areas of perceived discrepancy between training and practice included: manager role (set up of an office), health advocate (counseling for prevention, for example smoking cessation), and professional (end of life issues, ethics). CONCLUSION: Graduates of Canadian GIM training programs over the last ten years have identified perceived gaps between training and important areas for practice. They have identified competencies that should be emphasized in Canadian GIM programs. Ongoing review of graduate's perceptions of training programs as it applies to their current practice is important to ensure ongoing appropriateness of training programs. This information will be used to strengthen GIM training programs in Canada
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