Use of Hospitals, Physician Visits, and Hospice Care during Last Six Months of Life among Cohorts Loyal to Highly Respected Hospitals in the United States

Objective: To evaluate the use of healthcare resources during the last six months of life among patients of US hospitals with strong reputations for high quality care in managing chronic illness

Modelling the influence of RKIP on the ERK signalling pathway using the stochastic process algebra PEPA

This paper examines the influence of the Raf Kinase Inhibitor Protein (RKIP) on the Extracellular signal Regulated Kinase (ERK) signalling pathway [5] through modelling in a Markovian process algebra, PEPA [11]. Two models of the system are presented, a reagent-centric view and a pathway-centric view. The models capture functionality at the level of subpathway, rather than at a molecular level. Each model affords a different perspective of the pathway and analysis. We demonstrate the two models to be formally equivalent using the timing-aware bisimulation defined over PEPA models and discuss the biological significance

Acceptability of HIV self-sampling kits (TINY vial) among people of black African ethnicity in the UK: a qualitative study

Background: Increasing routine HIV testing among key populations is a public health imperative, so improving access to acceptable testing options for those in need is a priority. Despite increasing targeted distribution and uptake of HIV self-sampling kits (SSKs) among men who have sex with men in the UK, little is known about why targeted SSK interventions for black African users are not as wide-spread or well-used. This paper addresses this key gap, offering insight into why some groups may be less likely than others to adopt certain types of SSK interventions in particular contexts. These data were collected during the development phase of a larger study to explore the feasibility and acceptability of targeted distribution of SSKs to black African people. Methods: We undertook 6 focus groups with members of the public who self-identified as black African (n = 48), 6 groups with specialists providing HIV and social services to black African people (n = 53), and interviews with HIV specialist consultants and policy-makers (n = 9). Framework analysis was undertaken, using inductive and deductive analysis to develop and check themes. Results: We found three valuable components of targeted SSK interventions for this population: the use of settings and technologies that increase choice and autonomy; targeted offers of HIV testing that preserve privacy and do not exacerbate HIV stigma; and ensuring that the specific kit being used (in this case, the TINY vial) is perceived as simple and reliable. Conclusions: This unique and rigorous research offers insights into participants’ views on SSK interventions, offering key considerations when targeting this population.. Given the plethora of HIV testing options, our work demonstrates that those commissioning and delivering SSK interventions will need to clarify (for users and providers) how each kit type and intervention design adds value. Most significantly, these findings demonstrate that without a strong locus of control over their own circumstances and personal information, black African people are less likely to feel that they can pursue an HIV test that is safe and secure. Thus, where profound social inequalities persist, so will inequalities in HIV testing uptake – by any means

A Perturbative/Variational Approach to Quantum Lattice Hamiltonians

We propose a method to construct the ground state $\psi(\lambda)$ of local lattice hamiltonians with the generic form $H_0 + \lambda H_1$, where $\lambda$ is a coupling constant and $H_0$ is a hamiltonian with a non degenerate ground state $\psi_0$. The method is based on the choice of an exponential ansatz $\psi(\lambda) = {\rm exp}(U(\lambda)) \psi_0$, which is a sort of generalized lattice version of a Jastrow wave function. We combine perturbative and variational techniques to get succesive approximations of the operator $U(\lambda)$. Perturbation theory is used to set up a variational method which in turn produces non perturbative results. The computation with this kind of ansatzs leads to associate to the original quantum mechanical problem a statistical mechanical system defined in the same spatial dimension. In some cases these statistical mechanical systems turn out to be integrable, which allow us to obtain exact upper bounds to the energy. The general ideas of our method are illustrated in the example of the Ising model in a transverse field.Comment: 27 pages, three .ps figures appended, DFTUZ 94-2

Application of Information Theory in Nuclear Liquid Gas Phase Transition

Information entropy and Zipf's law in the field of information theory have been used for studying the disassembly of nuclei in the framework of the isospin dependent lattice gas model and molecular dynamical model. We found that the information entropy in the event space is maximum at the phase transition point and the mass of the cluster show exactly inversely to its rank, i.e. Zipf's law appears. Both novel criteria are useful in searching the nuclear liquid gas phase transition experimentally and theoretically.Comment: 5 pages, 5 figure

The preschool repetition test: An evaluation of performance in typically developing and clinically referred children

Purpose: To determine the psychometric properties of the Preschool Repetition Test (Roy & Chiat, 2004); to establish the range of performance in typically developing children and variables affecting this; and to compare the performance of clinically referred children. Method: The PSRep Test comprises 18 words and 18 phonologically matched nonwords systematically varied for length and prosodic structure. This test was administered to a ‘typical’ sample of children aged 2;0–4;0 (n=315) and a ‘clinic’ sample of children aged 2;6-4;0 (n=168), together with language assessments. Results: Performance in the typical sample was independent of gender and SES, but was affected by age, item length, and prosodic structure, and was moderately correlated with receptive vocabulary. Performance in the clinic sample was significantly poorer, but revealed similar effects of length and prosody, and similar relations to language measures overall, with some notable exceptions. Test-retest and interrater reliability were high. Conclusions: The PSRep Test is a viable and informative test. It differentiates within and between ‘typical’ and ‘clinic’ samples of children, and reveals some unusual profiles within the clinic sample. These findings lay the foundations for a follow-up study of the clinic sample to investigate the predictive value of the test

Cooling-rate effects in a model of (ideal?) glass

Using Monte Carlo simulations we study cooling-rate effects in a three-dimensional Ising model with four-spin interaction. During coarsening, this model develops growing energy barriers which at low temperature lead to very slow dynamics. We show that the characteristic zero-temperature length increases very slowly with the inverse cooling rate, similarly to the behaviour of ordinary glasses. For computationally accessible cooling rates the model undergoes an ideal glassy transition, i.e., the glassy transition for very small cooling rate coincides a thermodynamic singularity. We also study cooling of this model with a certain fraction of spins fixed. Due to such heterogeneous crystalization seeds the final state strongly depends on the cooling rate.Only for sufficiently fast cooling rate does the system end up in a glassy state while slow cooling inevitably leads to a crystal phase.Comment: 11 pages, 6 figure

Alignment between PIN1 Polarity and Microtubule Orientation in the Shoot Apical Meristem Reveals a Tight Coupling between Morphogenesis and Auxin Transport

Morphogenesis during multicellular development is regulated by intercellular signaling molecules as well as by the mechanical properties of individual cells. In particular, normal patterns of organogenesis in plants require coordination between growth direction and growth magnitude. How this is achieved remains unclear. Here we show that in Arabidopsis thaliana, auxin patterning and cellular growth are linked through a correlated pattern of auxin efflux carrier localization and cortical microtubule orientation. Our experiments reveal that both PIN1 localization and microtubule array orientation are likely to respond to a shared upstream regulator that appears to be biomechanical in nature. Lastly, through mathematical modeling we show that such a biophysical coupling could mediate the feedback loop between auxin and its transport that underlies plant phyllotaxis

Abstracts in high profile journals often fail to report harm

<p>Abstract</p> <p>Background</p> <p>To describe how frequently harm is reported in the abstract of high impact factor medical journals.</p> <p>Methods</p> <p><it>Design and population</it>: We carried out a blinded structured review of a random sample of 363 Randomised Controlled Trials (RCTs) carried out on human beings, and published in high impact factor medical journals in 2003. <it>Main endpoint</it>: 1) Proportion of articles reporting harm in the abstract; and 2) Proportion of articles that reported harm in the abstract when harm was reported in the main body of the article. <it>Analysis</it>: Corrected Prevalence Ratio (cPR) and its exact confidence interval were calculated. Non-conditional logistic regression was used.</p> <p>Results</p> <p>363 articles and 407 possible comparisons were studied. Overall, harm was reported in 135 abstracts [37.2% (CI95%:32.2 to 42.4)]. Harm was reported in the main text of 243 articles [66.9% (CI95%: 61.8 to 71.8)] and was statistically significant in 54 articles [14.9% (CI95%: 11.4 to 19.0)]. Among the 243 articles that mentioned harm in the text, 130 articles [53.5% (CI95% 47.0 to 59.9)] reported harm in the abstract; a figure that rose to 75.9% (CI95%: 62.4 to 86.5) when the harm reported in the text was statistically significant. Harm in the abstract was more likely to be reported when statistically significant harm was reported in the main body of the article [cPR = 1.70 (CI95% 1.47 to 1.92)] and when drug companies (not public institutions) funded the RCTs [cPR = 1.29 (CI95% 1.03 to 1.67)].</p> <p>Conclusion</p> <p>Abstracts published in high impact factor medical journals underreport harm, even when harm is reported in the main body of the article.</p

A high-risk study of bipolar disorder. Childhood clinical phenotypes as precursors of major mood disorders

CONTEXT: The childhood precursors of adult bipolar disorder (BP) are still a matter of controversy. OBJECTIVE: To report the lifetime prevalence and early clinical predictors of psychiatric disorders in offspring from families of probands with DSM-IV BP compared with offspring of control subjects. DESIGN: A longitudinal, prospective study of individuals at risk for BP and related disorders. We report initial (cross-sectional and retrospective) diagnostic and clinical characteristics following best-estimate procedures. SETTING: Assessment was performed at 4 university medical centers in the United States between June 1, 2006, and September 30, 2009. PARTICIPANTS: Offspring aged 12 to 21 years in families with a proband with BP (n = 141, designated as cases) and similarly aged offspring of control parents (n = 91). MAIN OUTCOME MEASURE: Lifetime DSM-IV diagnosis of a major affective disorder (BP type I; schizoaffective disorder, bipolar type; BP type II; or major depression). RESULTS: At a mean age of 17 years, cases showed a 23.4% lifetime prevalence of major affective disorders compared with 4.4% in controls (P = .002, adjusting for age, sex, ethnicity, and correlation between siblings). The prevalence of BP in cases was 8.5% vs 0% in controls (adjusted P = .007). No significant difference was seen in the prevalence of other affective, anxiety, disruptive behavior, or substance use disorders. Among case subjects manifesting major affective disorders (n = 33), there was an increased risk of anxiety and externalizing disorders compared with cases without mood disorder. In cases but not controls, a childhood diagnosis of an anxiety disorder (relative risk = 2.6; 95% CI, 1.1-6.3; P = .04) or an externalizing disorder (3.6; 1.4-9.0; P = .007) was predictive of later onset of major affective disorders. CONCLUSIONS: Childhood anxiety and externalizing diagnoses predict major affective illness in adolescent offspring in families with probands with BP