Stigma and mental health: The curious case of COVID-19

Introduction: This article considers the impact of COVID-19 on stigma and mental health across the life spectrum and the ways that people access services. Purpose: To explore the ways that a pandemic (COVID-19) has changed/shifted the relationship between mental illness or mental ill health and stigma across the life spectrum and call to re-focus resources on sustainable healthy societies, building cultures of peace. Methodology: A literature search was employed, combined with informal interviews and observation. Results and Discussion: On the one hand, the pandemic has opened public discussion of mental health challenges such as anxiety and depression, reducing some of the stigma attached as the experience is more common amongst people who have not previously declared mental health challenges. On the other hand, people previously experiencing mental ill health have mostly had that health challenge exacerbated by the pandemic. With fewer resources available, and changes in service delivery to largely on-line resources, the reduction in stigma has not meant better mental health care and services, but rather further marginalized some of the population. Cultures of peace are inclusive and provide space for full growth of all citizens, in contrast to reactive approaches now more readily applied. Mental health services are a basic right for all people and should be considered as such in all planned health strategies. Limitations: The article focuses on literature review, anecdotal and observation and is focused over a short term, in North America.  It is a preliminary study. Strengths: As a preliminary study, the article highlights an emergent and present dilemma. It also highlights the need for a much more holistic, global approach to mental health and wellbeing across the lifespan. Conclusion: While there are calls for national strategies for mental health services and services for people with dementia, in particular, there is still a need to take a more holistic approach to mental health as part of a whole health strategy to support human dignity and inclusion across the lifespa

An explanation of the Newman-Janis Algorithm

After the original discovery of the Kerr metric, Newman and Janis showed that this solution could be ``derived'' by making an elementary complex transformation to the Schwarzschild solution. The same method was then used to obtain a new stationary axisymmetric solution to Einstein's field equations now known as the Kerr-newman metric, representing a rotating massive charged black hole. However no clear reason has ever been given as to why the Newman-Janis algorithm works, many physicist considering it to be an ad hoc procedure or ``fluke'' and not worthy of further investigation. Contrary to this belief this paper shows why the Newman-Janis algorithm is successful in obtaining the Kerr-Newman metric by removing some of the ambiguities present in the original derivation. Finally we show that the only perfect fluid generated by the Newman-Janis algorithm is the (vacuum) Kerr metric and that the only Petrov typed D solution to the Einstein-Maxwell equations is the Kerr-Newman metric.Comment: 14 pages, no figures, submitted to Class. Quantum Gra

Volume preserving multidimensional integrable systems and Nambu--Poisson geometry

In this paper we study generalized classes of volume preserving multidimensional integrable systems via Nambu--Poisson mechanics. These integrable systems belong to the same class of dispersionless KP type equation. Hence they bear a close resemblance to the self dual Einstein equation. All these dispersionless KP and dToda type equations can be studied via twistor geometry, by using the method of Gindikin's pencil of two forms. Following this approach we study the twistor construction of our volume preserving systems

Radial Surface Density Profiles of Gas and Dust in the Debris Disk around 49 Ceti

We present ~0.4 resolution images of CO(3-2) and associated continuum emission from the gas-bearing debris disk around the nearby A star 49 Ceti, observed with the Atacama Large Millimeter/Submillimeter Array (ALMA). We analyze the ALMA visibilities in tandem with the broad-band spectral energy distribution to measure the radial surface density profiles of dust and gas emission from the system. The dust surface density decreases with radius between ~100 and 310 au, with a marginally significant enhancement of surface density at a radius of ~110 au. The SED requires an inner disk of small grains in addition to the outer disk of larger grains resolved by ALMA. The gas disk exhibits a surface density profile that increases with radius, contrary to most previous spatially resolved observations of circumstellar gas disks. While ~80% of the CO flux is well described by an axisymmetric power-law disk in Keplerian rotation about the central star, residuals at ~20% of the peak flux exhibit a departure from axisymmetry suggestive of spiral arms or a warp in the gas disk. The radial extent of the gas disk (~220 au) is smaller than that of the dust disk (~300 au), consistent with recent observations of other gas-bearing debris disks. While there are so far only three broad debris disks with well characterized radial dust profiles at millimeter wavelengths, 49 Ceti's disk shows a markedly different structure from two radially resolved gas-poor debris disks, implying that the physical processes generating and sculpting the gas and dust are fundamentally different.Comment: 20 pages, 8 figures, accepted for publication in ApJ March 31, 2017 (submitted Nov 2016

NCI-MATCH Arms N & P: Phase II study of PI3K beta inhibitor GSK2636771 in patients (pts) with cancers (ca) with PTEN mutation/deletion (mut/del) or PTEN protein loss

Background: The NCI-MATCH trial is the largest national study (1173 sites) for ptswith relapsed/ refractory solid tumors, lymphomas and myeloma, which assigns tar-geted therapies based on individual tumor molecular alterations detected using theadapted Oncomine AmpliSeq panel (143 genes) and immunohistochemistry (IHC).We hypothesized that patients with PTEN-deficient cancers enrolled to Arms N and Pmay benefit from treatment with the PI3K beta-selective inhibitor GSK2636771. Methods: Eligibility: relapsed/refractory ca, good end-organ function, and ECOG PS ≤ 1. Pts were screened for molecular alterations by centralized testing on fresh tumor biopsy and had deleterious PTEN mut/del without loss of expression (Arm N) or complete loss of cytoplasmic and nuclear PTEN staining on IHC (Arm P), and no other aberrations activating the PI3K/MTOR and MAPK pathways (mut in PIK3CA, PIK3R1, BRAF, KRAS, AKT1, TSC1/2, mTOR, RHEB, NF2, NRAS, HRAS). Pts received GSK2636771 400mg/day (28-days cycles). RECIST 1.1 overall response rate (ORR) was the primary endpoint. Results: Of 59 enrolled pts, 56 were eligible and received treatment. Of 22 pts with PTEN mut/del (Arm N: 6 uterine, 2 breast, 2 prostate, 2 head/neck ca, 10 other), all are off treatment as of analysis (14 disease progression, 4 for adverse events [AEs], 4 other). One pt (4.5%) with prostate ca (PTEN deletion, MPRSS2-ERG fusion) attained a partial response (-42%). Of 7 (32%) pts with stable disease (SD), 2 had SD \u3e 6 months (uterine leiomyosarcoma; endometrial carcinoma). Of 34 pts with loss of PTEN protein by IHC (Arm P: 7 prostate, 6 breast, 3 squamous anal ca, 2 cholangiocarcinoma, 16 other), all are off treatment as of analysis (26 disease progression, 4 for AE, 4 other). Of 9 (37.5%) pts with SD, 3 had SD \u3e 6 months (prostate cancer; squamous bladder cancer, squamous anal cancer). Median progression-free survival was 1.8 months for both arms. Gr ≥ 3 treatment-related (tr) reversible toxicities were experienced by 30% (7) and 20% (7) of pts in arms N and P, respectively. No tr Gr 5 toxicities were observed in either arm. Conclusions: Single agent GSK2636771 has very modest activity in ca with PTEN gene mutation/deletion and/or PTEN protein loss

Practice patterns for acute ischemic stroke workup: A longitudinal population‐based study

Background We examined practice patterns of inpatient testing to identify stroke etiologies and treatable risk factors for acute ischemic stroke recurrence. Methods and Results We identified stroke cases and related diagnostic testing from four 1‐year study periods (July 1993 to June 1994, 1999, 2005, and 2010) of the Greater Cincinnati/Northern Kentucky Stroke Study. Patients aged ≥18 years were included. We focused on evaluation of extracranial arteries for carotid stenosis and assessment of atrial fibrillation because randomized controlled trials supported treatment of these conditions for stroke prevention across all 4 study periods. In each study period, we also recorded stroke etiology, as determined by diagnostic testing and physician adjudication. An increasing proportion of stroke patients received assessment of both extracranial arteries and the heart over time (50%, 58%, 74%, and 78% in the 1993–1994, 1999, 2005, and 2010 periods, respectively; P &lt;0.0001 for trend), with the most dramatic individual increases in echocardiography (57%, 63%, 77%, and 83%, respectively). Concurrently, we observed a decrease in strokes of unknown etiology (47%, 48%, 41%, and 38%, respectively; P &lt;0.0001 for trend). We also found a significant increase in strokes of other known causes (32%, 25%, 45% and 59%, respectively; P &lt;0.0001 for trend). Conclusions Stroke workup for treatable causes of stroke are being used more frequently over time, and this is associated with a decrease in cryptogenic strokes. Future study of whether better determination of treatable stroke etiologies translates to a decrease in stroke recurrence at the population level will be essential. </jats:sec

Hypercomplex Integrable Systems

In this paper we study hypercomplex manifolds in four dimensions. Rather than using an approach based on differential forms, we develop a dual approach using vector fields. The condition on these vector fields may then be interpreted as Lax equations, exhibiting the integrability properties of such manifolds. A number of different field equations for such hypercomplex manifolds are derived, one of which is in Cauchy-Kovaleskaya form which enables a formal general solution to be given. Various other properties of the field equations and their solutions are studied, such as their symmetry properties and the associated hierarchy of conservation laws.Comment: Latex file, 19 page