77 research outputs found
Estimating the cost-effectiveness of detecting cases of chronic hepatitis C infection on reception into prison
Background
In England and Wales where less than 1% of the population are Injecting drug users (IDUs), 97% of HCV reports are attributed to injecting drug use. As over 60% of the IDU population will have been imprisoned by the age of 30 years, prison may provide a good location in which to offer HCV screening and treatment. The aim of this work is to examine the cost effectiveness of a number of alternative HCV case-finding strategies on prison reception
Methods
A decision analysis model embedded in a model of the flow of IDUs through prison was used to estimate the cost effectiveness of a number of alternative case-finding strategies. The model estimates the average cost of identifying a new case of HCV from the perspective of the health care provider and how these estimates may evolve over time.
Results
The results suggest that administering verbal screening for a past positive HCV test and for ever having engaged in illicit drug use prior to the administering of ELISA and PCR tests can have a significant impact on the cost effectiveness of HCV case-finding strategies on prison reception; the discounted cost in 2017 being ÂŁ2,102 per new HCV case detected compared to ÂŁ3,107 when no verbal screening is employed.
Conclusion
The work here demonstrates the importance of targeting those individuals that have ever engaged in illicit drug use for HCV testing in prisons, these individuals can then be targeted for future intervention measures such as treatment or monitored to prevent future transmission
Fermi Large Area Telescope Gamma-Ray Detection of the Radio Galaxy M87
We report the Fermi-LAT discovery of high-energy (MeV/GeV) gamma-ray emission
positionally consistent with the center of the radio galaxy M87, at a source
significance of over 10 sigma in ten-months of all-sky survey data. Following
the detections of Cen A and Per A, this makes M87 the third radio galaxy seen
with the LAT. The faint point-like gamma-ray source has a >100 MeV flux of 2.45
(+/- 0.63) x 10^-8 ph cm^-2 s^-1 (photon index = 2.26 +/- 0.13) with no
significant variability detected within the LAT observation. This flux is
comparable with the previous EGRET upper limit (< 2.18 x 10^-8 ph cm^-2 s^-1, 2
sigma), thus there is no evidence for a significant MeV/GeV flare on decade
timescales. Contemporaneous Chandra and VLBA data indicate low activity in the
unresolved X-ray and radio core relative to previous observations, suggesting
M87 is in a quiescent overall level over the first year of Fermi-LAT
observations. The LAT gamma-ray spectrum is modeled as synchrotron self-Compton
(SSC) emission from the electron population producing the radio-to-X-ray
emission in the core. The resultant SSC spectrum extrapolates smoothly from the
LAT band to the historical-minimum TeV emission. Alternative models for the
core and possible contributions from the kiloparsec-scale jet in M87 are
considered, and can not be excluded.Comment: ApJ, accepted, 6 pages, 4 figures. Corresponding authors: C.C.
Cheung, W. McConvill
Coastal Upwelling Supplies Oxygen-Depleted Water to the Columbia River Estuary
Low dissolved oxygen (DO) is a common feature of many estuarine and shallow-water
environments, and is often attributed to anthropogenic nutrient enrichment from
terrestrial-fluvial pathways. However, recent events in the U.S. Pacific
Northwest have highlighted that wind-forced upwelling can cause naturally
occurring low DO water to move onto the continental shelf, leading to
mortalities of benthic fish and invertebrates. Coastal estuaries in the Pacific
Northwest are strongly linked to ocean forcings, and here we report observations
on the spatial and temporal patterns of oxygen concentration in the Columbia
River estuary. Hydrographic measurements were made from transect (spatial
survey) or anchor station (temporal survey) deployments over a variety of wind
stresses and tidal states during the upwelling seasons of 2006 through 2008.
During this period, biologically stressful levels of dissolved oxygen were
observed to enter the Columbia River estuary from oceanic sources, with minimum
values close to the hypoxic threshold of 2.0 mg Lâ1. Riverine
water was consistently normoxic. Upwelling wind stress controlled the timing and
magnitude of low DO events, while tidal-modulated estuarine circulation patterns
influenced the spatial extent and duration of exposure to low DO water. Strong
upwelling during neap tides produced the largest impact on the estuary. The
observed oxygen concentrations likely had deleterious behavioral and
physiological consequences for migrating juvenile salmon and benthic crabs.
Based on a wind-forced supply mechanism, low DO events are probably common to
the Columbia River and other regional estuaries and if conditions on the shelf
deteriorate further, as observations and models predict, Pacific Northwest
estuarine habitats could experience a decrease in environmental quality
Estimated GFR reporting is not sufficient to allow detection of chronic kidney disease in an Italian regional hospital
<p>Abstract</p> <p>Background</p> <p>Chronic kidney disease (CKD) is an emerging worldwide problem. The lack of attention paid to kidney disease is well known and has been described in previous publications. However, little is known about the magnitude of the problem in highly specialized hospitals where serum creatinine values are used to estimate GFR values.</p> <p>Methods</p> <p>We performed a cross-sectional evaluation of hospitalized adult patients who were admitted to the medical or surgical department of Santa Maria della Misericordia Hospital in 2007. Information regarding admissions was derived from a database. Our goal was to assess the prevalence of CKD (defined as an estimated glomerular filtration rate [eGFR] < 60 mL/min/1.73 m<sup>2</sup>) and detection of CKD using diagnostic codes (Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM]). To reduce the impact of acute renal failure on the study, the last eGFR obtained during hospitalization was the value used for analysis, and intensive care and nephrology unit admissions were excluded. We also excluded patients who had ICD-9-CM codes for renal replacement therapy, acute renal failure, and contrast administration listed as discharge diagnoses.</p> <p>Results</p> <p>Of the 18,412 patients included in the study, 4,748 (25.8%) had reduced eGFRs, falling into the category of Kidney Disease Outcomes Quality Initiative (KDOQI) stage 3 (or higher) CKD. However, the diagnosis of CKD was only reported in 19% of these patients (904/4,748). It is therefore evident that there was a "gray area" corresponding to stage 3 CKD (eGFR 30-59 ml/min), in which most CKD diagnoses are missed. The ICD-9 code sensitivity for detecting CKD was significantly higher in patients with diabetes, hypertension, and cardiovascular disease (26.8%, 22.2%, and 23.7%, respectively) than in subjects without diabetes, hypertension, or cardiovascular disease (p < 0.001), but these values are low when the widely described relationship between such comorbidities and CKD is considered.</p> <p>Conclusion</p> <p>Although CKD was common in this patient population at a large inpatient regional hospital, the low rates of CKD detection emphasize the primary role nephrologists must play in continued medical education, and the need for ongoing efforts to train physicians (particularly primary care providers) regarding eGFR interpretation and systematic screening for CKD in high-risk patients (i.e., the elderly, diabetics, hypertensives, and patients with CV disease).</p
Binary systems and their nuclear explosions
Peer ReviewedPreprin
The 2010 very high energy gamma-ray flare & 10 years of multi-wavelength observations of M 87
Abridged: The giant radio galaxy M 87 with its proximity, famous jet, and
very massive black hole provides a unique opportunity to investigate the origin
of very high energy (VHE; E>100 GeV) gamma-ray emission generated in
relativistic outflows and the surroundings of super-massive black holes. M 87
has been established as a VHE gamma-ray emitter since 2006. The VHE gamma-ray
emission displays strong variability on timescales as short as a day. In this
paper, results from a joint VHE monitoring campaign on M 87 by the MAGIC and
VERITAS instruments in 2010 are reported. During the campaign, a flare at VHE
was detected triggering further observations at VHE (H.E.S.S.), X-rays
(Chandra), and radio (43 GHz VLBA). The excellent sampling of the VHE gamma-ray
light curve enables one to derive a precise temporal characterization of the
flare: the single, isolated flare is well described by a two-sided exponential
function with significantly different flux rise and decay times. While the
overall variability pattern of the 2010 flare appears somewhat different from
that of previous VHE flares in 2005 and 2008, they share very similar
timescales (~day), peak fluxes (Phi(>0.35 TeV) ~= (1-3) x 10^-11 ph cm^-2
s^-1), and VHE spectra. 43 GHz VLBA radio observations of the inner jet regions
indicate no enhanced flux in 2010 in contrast to observations in 2008, where an
increase of the radio flux of the innermost core regions coincided with a VHE
flare. On the other hand, Chandra X-ray observations taken ~3 days after the
peak of the VHE gamma-ray emission reveal an enhanced flux from the core. The
long-term (2001-2010) multi-wavelength light curve of M 87, spanning from radio
to VHE and including data from HST, LT, VLA and EVN, is used to further
investigate the origin of the VHE gamma-ray emission. No unique, common MWL
signature of the three VHE flares has been identified.Comment: 19 pages, 5 figures; Corresponding authors: M. Raue, L. Stawarz, D.
Mazin, P. Colin, C. M. Hui, M. Beilicke; Fig. 1 lightcurve data available
online: http://www.desy.de/~mraue/m87
ATPase Na,K-dependent activity and water-matrix interactions in cerebella of aged mice
A new analytical approach to the chemical behaviour of mouse cerebella during ageing is described. The microcalorimetric determination of Na+/K+-ATPase activity and the thermogravimetric investigation of the water-matrix interactions were performed on cerebella of mice of 2, 10 and 22 months (young, adult and aged mice). The results are compared with a preceding work regarding the same determinations performed on cerebella of ouabain-treated mice (spongy-state induced in cerebella of mice as those affected by the Jacob-Creutzfeld disease) and also with similar studies on ageing of brain in mice reported in the literature. The results here obtained on cerebella of aged mice show a substantial difference with respect to those reported for analogous samples of mice affected by a spongy-state
Bound water is a quality discriminant of dried egg-pasta
Egg-pasta is a very popular food in Italy and its appreciation is growing in Europe and in the United States. In this work, the bound water has been demonstrated to be a quality discriminant parameter to distinguish the low-temperature dried egg-pasta with respect to the high-temperature dried egg-pasta. By the thermoanalytical profiles (TG and DTG), this systematic study scientifically proves the differences induced by the drying process on the egg-pasta samples: the low temperature dried egg-pasta (produced by the 'Entroterra' company, brand 'La Pasta di Camerino') shows the systematic lower amount of bound water when compared to other brand, high-temperature dried egg-pasta. The difference is constant either before or after the cooking process. Other physical parameters (thickness and width) confirmed the difference
- âŠ