Predicting risk of avian influenza a(H5N1) in Egypt: the creation of a community level metric

Abstract Background Efficient A(H5N1) control is unlikely to be based on epidemiological data alone. Such control depends on a thorough understanding and appreciation of the interconnectedness of epidemiological, social, and economic factors that contribute to A(H5N1) vulnerability. To date, the control of A(H5N1) in Egypt has been challenging. The disease has been endemic for more than 10 years with a dramatic increase in human cases between December 2014 and March 2015. Part of the problem has been a lack of understanding of the inter-play of drivers, conditions and motives that influence preventive behaviours at the household level. Methods To address this issue, the authors developed a Composite Risk Index (CRI) to inform decision-makers of critical epidemiological, livelihood, food security and risk perception factors that were found to contribute to A(H5N1) vulnerability at the community level. The CRI consists of seven constructs that were individually scored for each community. The seven constructs included poultry sales, previous flock exposure to A(H5N1), human risk probability, sense of control over the disease, preventative actions taken, level of household food insecurity and community norms toward certain handling and disposal practices. One hundred forty female poultry keepers across four governorates were interviewed in 2010 using a mix of random and purposive sampling techniques. A mixed method approach underpinned the analysis. The study used wealth ranking in order to help decision-makers in understanding the specific constraints of different wealth groups and aid better targeting of A(H5N1) control and prevention strategies. Results Poverty, widowhood and lack of education were among the factors associated with high risk scores. CRI scores in those villages where awareness raising had taken place were not significantly different compared to those villages where awareness raising had not taken place. Conclusions The aim of the tool is to enable targeting those communities that are likely to be highly vulnerable to A(H5N1) outbreaks and where control and awareness-raising efforts are expected to be most effective. In this manner, policy makers and practitioners will be able to better allocate limited resources to those communities most vulnerable to the negative impact of A(H5N1)

Design fabrication and characterization of an in-plane AFM probe with ultra-sharp silicon nitride tip

Scanning rates of the atomic force microscope (AFM) could be significantly \ud increased by integrating the force sensing probe with microelectromechanical systems (MEMS). We present a micromachining method for batch fabrication of in-plane AFM probes that consist of an ultra-sharp silicon nitride tip on a single \ud crystal silicon cantilever. Our fabrication method is fully compatible with the silicon-on-insulator (SOI) micromachining allowing a straightforward monolithic integration of the AFM probes with high-aspect-ratio monocrystalline silicon MEMS. Scanning probes with a sharp tip having diameter of less then 10 nm are successfully realized and tested in a commercial AFM set-up demonstrating \ud feasibility and the large innovation potential of this method

Prognostic factors for important clinical outcomes in patients with a severe infection

Patients who are admitted with a suspicion of a severe infection usually enter the hospital through the emergency department (ED). The recognition of prognostic factors in an early stage affects further treatment and might improve clinical outcomes. WE EXAMINED POSSIBLE PROGNOSTIC FACTORS FOR FOUR IMPORTANT OUTCOMES: intensive care unit (ICU) admission, positive blood cultures, mortality and re-admission. All adult patients arriving at the ED with a suspected infection for whom admittance and intravenous (iv) antibiotics were indicated were included between March and December 2006. Possible prognostic variables were obtained from medical history, physical examination and laboratory results during the ED presentation. Data were analysed using logistic regression analysis. A total of 295 ED patients were evaluated, of whom 27 were referred to the ICU, 62 had a positive blood culture, 16 died and 48 were re-admitted. In multivariate analysis, patients with a respiration rate of >25/min were at higher risk for ICU admission. Patients with a positive blood culture had a higher heart rate and a higher percentage of segmented neutrophils. Patients who died during admission were more likely to be older, confused and had lower blood pressure. Patients who were re-admitted within 30 days were more likely to be male, younger and less likely to have a positive blood culture. Routine clinical and biochemical information can be used to predict ICU admission, the presence of bacteraemia, mortality and re-admission (within 30 days) and should be taken into consideration for treatment decision

N-representability and stationarity in time-dependent density functional theory

To construct an N-representable time-dependent density-functional theory, a generalization to the time domain of the Levy-Lieb (LL) constrained search algorithm is required. That the action is only stationary in the Dirac-Frenkel variational principle eliminates the possibility of basing the search on the action itself. Instead, we use the norm of the partial functional derivative of the action in the Hilbert space of the wave functions in place of the energy of the LL search. The electron densities entering the formalism are $N$-representable, and the resulting universal action functional has a unique stationary point in the density at that corresponding to the solution of the Schr\"{o}dinger equation. The original Runge-Gross (RG) formulation is subsumed within the new formalism. Concerns in the literature about the meaning of the functional derivatives and the internal consistency of the RG formulation are allayed by clarifying the nature of the functional derivatives entering the formalism.Comment: 9 pages, 0 figures, Phys. Rev. A accepted. Introduction was expanded, subsections reorganized, appendix and new references adde

Escherichia coli bacteriuria in female adults is associated with the development of hypertension

AbstractObjectiveTo investigate whether Escherichia coli bacteriuria is associated with the development of hypertension during a long-term follow-up.MethodsA prospective cohort study was performed among the participants of two population-based studies. Between 1974 and 1986 all women aged 39 to 68 years old, who lived in Utrecht, the Netherlands, were invited to participate in a breast cancer screening program. The participants completed a questionnaire, underwent a medical examination, and collected a morning urine sample that remained stored. From 1993 to 1997 another population-based study was performed. We performed a full cohort analysis for 444 women who participated in both studies. E. coli bacteriuria was diagnosed by a real-time PCR. Hypertension was defined as the use of antihypertensive medication and/or a measured systolic blood pressure of at least 160 mmHg or a diastolic blood pressure of 95 mmHg or higher. The mean follow-up was 11.5±1.7 years.ResultsForty women (9%) had E. coli bacteriuria at baseline. Women who had bacteriuria at baseline had a mean blood pressure at study endpoint of 133±20 mmHg systolic and 78±11 mmHg diastolic, and women without bacteriuria had values of 129±20 and 78±11 mmHg, respectively (p-values for difference 0.33 and 0.88). Although E. coli bacteriuria was not associated with the blood pressure as a continuous variable, it was associated with the development of hypertension during follow-up (OR 2.8, 95% CI 1.4–5.5).ConclusionE. coli bacteriuria may increase the risk of future hypertension

Asymptotic tunneling conductance in Luttinger liquids

Conductance through weak constrictions in Luttinger liquids is shown to vanish with frequency $\omega$ as $c_1 \omega^2 + c_2 \omega^{2/g - 2}$, where $g$ is a dimensionless parameter characterizing the Luttinger liquid phase, and $c_1$ and $c_2$ are nonuniversal constants. The first term arises from the ^^ Coulomb blockade' effect and dominates for $g < 1/2$, whereas the second results from eliminating high-energy modes and dominates for $g > 1/2$.Comment: Latex file + one appended postcript figur

An exploratory study of healthcare professionals' perceptions of interprofessional communication and collaboration

Interprofessional communication and collaboration during hospitalisation is critically important to provide safe and effective care. Clinical rounds are an essential interprofessional process in which the clinical problems of patients are discussed on a daily basis. The objective of this exploratory study was to identify healthcare professionals' perspectives on the ideal interprofessional round for patients in a university teaching hospital. Three focus groups with medical residents, registered nurses, medical specialists, and quality improvement officers were held. We used a descriptive method of content analysis. The findings indicate that it is important for professionals to consider how team members and patients are involved in the decision-making process during the clinical round and how current social and spatial structures can affect communication and collaboration between the healthcare team and the patient. Specific aspects of communication and collaboration are identified for improving effective interprofessional communication and collaboration during rounds

Differences in the Pattern of Antibiotic Prescription Profile and Recurrence Rate for Possible Urinary Tract Infections in Women With and Without Diabetes

OBJECTIVE—Women with diabetes have a high incidence and complication rate of urinary tract infections (UTIs). Our aims were to compare current treatment strategies with respect to recurrence rates in women with diabetes with those without diabetes

Many Body Theory of Charge Transfer in Hyperthermal Atomic Scattering

We use the Newns-Anderson Hamiltonian to describe many-body electronic processes that occur when hyperthermal alkali atoms scatter off metallic surfaces. Following Brako and Newns, we expand the electronic many-body wavefunction in the number of particle-hole pairs (we keep terms up to and including a single particle-hole pair). We extend their earlier work by including level crossings, excited neutrals and negative ions. The full set of equations of motion are integrated numerically, without further approximations, to obtain the many-body amplitudes as a function of time. The velocity and work-function dependence of final state quantities such as the distribution of ion charges and excited atomic occupancies are compared with experiment. In particular, experiments that scatter alkali ions off clean Cu(001) surfaces in the energy range 5 to 1600 eV constrain the theory quantitatively. The neutralization probability of Na$^+$ ions shows a minimum at intermediate velocity in agreement with the theory. This behavior contrasts with that of K$^+$, which shows ... (7 figures, not included. Figure requests: [email protected])Comment: 43 pages, plain TeX, BUP-JBM-