Factors Influencing Immunization Status in Primary Care Clinics

Background and Objectives: National standards and goals for childhood immunization rates are well established. Yet, despite clear standards and goals, physicians do not achieve the desired rate (90%) for immunization coverage. This study examined factors related to immunization status for 2-year-old children in pediatric and family practice settings. Methods: Specially trained personnel used computer software to audit 2,552 records from 42 practices in Northeast Florida throughout 1997–1999. Immunization records were judged as either complete or incomplete, and factors related to immunization status were studied. Clinic type and 18 immunization practice standards were reviewed for effect on immunization status. Results: The probability of complete immunization status for children in pediatric clinics was greater than for those in family practice clinics. Multivariate logistic regression revealed that use of semiannual audits (odds ratio [OR]=2.00, confidence interval [CI]=1.65–2.42) was the most important factor for immunization completion. This was followed by availability of discounted immunizations (OR=.44, CI=.27–.73) and the use of an immunization tracking system (OR=1.48, CI=1.18–1.70). Factors that were not found to contribute included clinic type and the remaining 15 practice standards. Conclusions: Considering the significant factors, immunization status was not affected by the type of clinic providing immunizations. Based on this analysis, family physicians should implement tracking systems and should perform semiannual audits to match the success of pediatricians in immunizing children. Neither group met nationally established goals for administration of immunizations for 2-year-old children

Complete Integrability of Geodesic Motion in General Kerr-NUT-AdS Spacetimes

We explicitly exhibit n-1 constants of motion for geodesics in the general D-dimensional Kerr-NUT-AdS rotating black hole spacetime, arising from contractions of even powers of the 2-form obtained by contracting the geodesic velocity with the dual of the contraction of the velocity with the (D-2)-dimensional Killing-Yano tensor. These constants of motion are functionally independent of each other and of the D-n+1 constants of motion that arise from the metric and the D-n = [(D+1)/2] Killing vectors, making a total of D independent constants of motion in all dimensions D. The Poisson brackets of all pairs of these D constants are zero, so geodesic motion in these spacetimes is completely integrable.Comment: 4 pages. We have now found that the geodesic motion is not just integrable, but completely integrabl

Constants of Geodesic Motion in Higher-Dimensional Black-Hole Spacetimes

In [arXiv:hep-th/0611083] we announced the complete integrability of geodesic motion in the general higher-dimensional rotating black-hole spacetimes. In the present paper we prove all the necessary steps leading to this conclusion. In particular, we demonstrate the independence of the constants of motion and the fact that they Poisson commute. The relation to a different set of constants of motion constructed in [arXiv:hep-th/0612029] is also briefly discussed.Comment: 8 pages, no figure

Separability of Hamilton-Jacobi and Klein-Gordon Equations in General Kerr-NUT-AdS Spacetimes

We demonstrate the separability of the Hamilton-Jacobi and scalar field equations in general higher dimensional Kerr-NUT-AdS spacetimes. No restriction on the parameters characterizing these metrics is imposed.Comment: 4 pages, no figure

Constraints on Cosmic Strings due to Black Holes Formed from Collapsed Cosmic String Loops

The cosmological features of primordial black holes formed from collapsed cosmic string loops are studied. Observational restrictions on a population of primordial black holes are used to restrict $f$, the fraction of cosmic string loops which collapse to form black holes, and $\mu$, the cosmic string mass-per-unit-length. Using a realistic model of cosmic strings, we find the strongest restriction on the parameters $f$ and $\mu$ is due to the energy density in $100 MeV$ photons radiated by the black holes. We also find that inert black hole remnants cannot serve as the dark matter. If earlier, crude estimates of $f$ are reliable, our results severely restrict $\mu$, and therefore limit the viability of the cosmic string large-scale structure scenario.Comment: (Plain Tex, uses tables.tex -- wrapped lines corrected), 11 pages, FERMILAB-Pub-93/137-

The targeted delivery of multicomponent cargos to cancer cells by nanoporous particle-supported lipid bilayers.

Encapsulation of drugs within nanocarriers that selectively target malignant cells promises to mitigate side effects of conventional chemotherapy and to enable delivery of the unique drug combinations needed for personalized medicine. To realize this potential, however, targeted nanocarriers must simultaneously overcome multiple challenges, including specificity, stability and a high capacity for disparate cargos. Here we report porous nanoparticle-supported lipid bilayers (protocells) that synergistically combine properties of liposomes and nanoporous particles. Protocells modified with a targeting peptide that binds to human hepatocellular carcinoma exhibit a 10,000-fold greater affinity for human hepatocellular carcinoma than for hepatocytes, endothelial cells or immune cells. Furthermore, protocells can be loaded with combinations of therapeutic (drugs, small interfering RNA and toxins) and diagnostic (quantum dots) agents and modified to promote endosomal escape and nuclear accumulation of selected cargos. The enormous capacity of the high-surface-area nanoporous core combined with the enhanced targeting efficacy enabled by the fluid supported lipid bilayer enable a single protocell loaded with a drug cocktail to kill a drug-resistant human hepatocellular carcinoma cell, representing a 10(6)-fold improvement over comparable liposomes

Dark Energy or Apparent Acceleration Due to a Relativistic Cosmological Model More Complex than FLRW?

We use the Szekeres inhomogeneous relativistic models in order to fit supernova combined data sets. We show that with a choice of the spatial curvature function that is guided by current observations, the models fit the supernova data almost as well as the LCDM model without requiring a dark energy component. The Szekeres models were originally derived as an exact solution to Einstein's equations with a general metric that has no symmetries and are regarded as good candidates to model the true lumpy universe that we observe. The null geodesics in these models are not radial. The best fit model found is also consistent with the requirement of spatial flatness at CMB scales. The first results presented here seem to encourage further investigations of apparent acceleration using various inhomogeneous models and other constraints from CMB and large structure need to be explored next.Comment: 6 pages, 1 figure, matches version published in PR

Positivity of Entropy in the Semi-Classical Theory of Black Holes and Radiation

Quantum stress-energy tensors of fields renormalized on a Schwarzschild background violate the classical energy conditions near the black hole. Nevertheless, the associated equilibrium thermodynamical entropy $\Delta S$ by which such fields augment the usual black hole entropy is found to be positive. More precisely, the derivative of $\Delta S$ with respect to radius, at fixed black hole mass, is found to vanish at the horizon for {\it all} regular renormalized stress-energy quantum tensors. For the cases of conformal scalar fields and U(1) gauge fields, the corresponding second derivative is positive, indicating that $\Delta S$ has a local minimum there. Explicit calculation shows that indeed $\Delta S$ increases monotonically for increasing radius and is positive. (The same conclusions hold for a massless spin 1/2 field, but the accuracy of the stress-energy tensor we employ has not been confirmed, in contrast to the scalar and vector cases). None of these results would hold if the back-reaction of the radiation on the spacetime geometry were ignored; consequently, one must regard $\Delta S$ as arising from both the radiation fields and their effects on the gravitational field. The back-reaction, no matter how "small",Comment: 19 pages, RevTe

Effective Field Theory, Black Holes, and the Cosmological Constant

Bekenstein has proposed the bound S < pi M_P^2 L^2 on the total entropy S in a volume L^3. This non-extensive scaling suggests that quantum field theory breaks down in large volume. To reconcile this breakdown with the success of local quantum field theory in describing observed particle phenomenology, we propose a relationship between UV and IR cutoffs such that an effective field theory should be a good description of Nature. We discuss implications for the cosmological constant problem. We find a limitation on the accuracy which can be achieved by conventional effective field theory: for example, the minimal correction to (g-2) for the electron from the constrained IR and UV cutoffs is larger than the contribution from the top quark.Comment: 5 pages, no figures minor clarifications, refs adde

Gauge Field Back-reaction on a Black Hole

The order $\hbar$ fluctuations of gauge fields in the vicinity of a blackhole can create a repulsive antigravity region extending out beyond the renormalized Schwarzschild horizon. If the strength of this repulsive force increases as higher orders in the back-reaction are included, the formation of a wormhole-like object could occur.Comment: 17 pages, three figures available on request, in RevTe