3,363 research outputs found
The true cost of hidden waiting times for cataract surgery in Australia
Cataract surgery is a safe, effective and common elective procedure in Australia but access is inequitable. True waiting times for cataract care are undisclosed or inconsistently reported by governments. Estimates of true waiting times range from 4 to 30 months and have been extended during the coronavirus disease 2019 (COVID-19) pandemic. Comparative analysis revealed that reducing waiting periods from 12 to 3 months would result in estimated public health system cost savings of $6.6 million by preventing 50 679 falls. Investment in public cataract services to address current unmet needs would prevent avoidable vision impairment and associated negative consequences
Effect of sorption induced swelling on gas transport in coal
In this study, an investigation of carbon dioxide sorption induced coal swelling and its effects on gas transport in coal is shown. The model presented is based on an existing coupled thermal, hydraulic, chemical and mechanical (THCM) model. A series of numerical simulations dealing with high pressure carbon dioxide injection in coal sample is presented. In particular, the effect of carbon dioxide sorption induced swelling on permeability evolution and gas breakthrough is investigated. Different cases are considered accounting for the difference in coal seam properties and its sorption characteristics. Under the conditions considered, it is demonstrated that the permeability response of coal to gas is affected by the carbon dioxide sorption induced volumetric strain. The results suggest that medium and high porous coals that swell gradually over the range of pressures considered in this work would lose a smaller portion of injectivity during gas injection, compared to low porous coals that swell significantly at low pressures, allowing quick breakthrough of gas through the domain
The Age of the Galactic Disk
I review different methods devised to derive the age of the Galactic Disk,
namely the Radio-active Decay (RD), the Cool White Dwarf Luminosity Function
(CWDLF), old opne clusters (OOC) and the Color Magnitude Diagram (CMD) of the
stars in the solar vicinity. I argue that the disk is likely to be 8-10 Gyr
old. Since the bulk of globulars has an age around 13 Gyr, the possibility
emerges that the Galaxy experienced a minimum of Star Formation at the end of
the halo/bulge formation. This minimum might reflect the time at which the
Galaxy started to acquire material to form the disk inside-out.Comment: 10 pages, 4 figure, invited review, in "The chemical evolution of the
Milky Way : Stars vs Clusters, Vulcano (Italy), 20-24 September 199
Volume and functional outcome of intracerebral hemorrhage according to oral anticoagulant type
Objective: To compare intracerebral hemorrhage (ICH) volume and clinical outcome of non–vitamin K oral anticoagulants (NOAC)–associated ICH to warfarin-associated ICH.
Methods: In this multicenter cross-sectional observational study of patients with anticoagulant-associated ICH, consecutive patients with NOAC-ICH were compared to those with warfarin-ICH selected from a population of 344 patients with anticoagulant-associated ICH. ICH volume was measured by an observer blinded to clinical details. Outcome measures were ICH volume and clinical outcome adjusted for confounding factors.
Results: We compared 11 patients with NOAC-ICH to 52 patients with warfarin-ICH. The median ICH volume was 2.4 mL (interquartile range [IQR] 0.3–5.4 mL) for NOAC-ICH vs 8.9 mL (IQR 4.0–21.3 mL) for warfarin-ICH (p = 0.0028). In univariate linear regression, use of warfarin (difference in cube root volume 1.61; 95% confidence interval [CI] 0.69 to 2.53) and lobar ICH location (compared with nonlobar ICH; difference in cube root volume 1.52; 95% CI 2.20 to 0.85) were associated with larger ICH volumes. In multivariable linear regression adjusting for confounding factors (sex, hypertension, previous ischemic stroke, white matter disease burden, and premorbid modified Rankin Scale score [mRS]), warfarin use remained independently associated with larger ICH (cube root) volumes (coefficient 0.64; 95% CI 0.24 to 1.25; p = 0.042). Ordered logistic regression showed an increased odds of a worse clinical outcome (as measured by discharge mRS) in warfarin-ICH compared with NOAC-ICH: odds ratio 4.46 (95% CI 1.10 to 18.14; p = 0.037).
Conclusions: In this small prospective observational study, patients with NOAC-associated ICH had smaller ICH volumes and better clinical outcomes compared with warfarin-associated ICH
The tissue microarray data exchange specification: A community-based, open source tool for sharing tissue microarray data
BACKGROUND: Tissue Microarrays (TMAs) allow researchers to examine hundreds of small tissue samples on a single glass slide. The information held in a single TMA slide may easily involve Gigabytes of data. To benefit from TMA technology, the scientific community needs an open source TMA data exchange specification that will convey all of the data in a TMA experiment in a format that is understandable to both humans and computers. A data exchange specification for TMAs allows researchers to submit their data to journals and to public data repositories and to share or merge data from different laboratories. In May 2001, the Association of Pathology Informatics (API) hosted the first in a series of four workshops, co-sponsored by the National Cancer Institute, to develop an open, community-supported TMA data exchange specification. METHODS: A draft tissue microarray data exchange specification was developed through workshop meetings. The first workshop confirmed community support for the effort and urged the creation of an open XML-based specification. This was to evolve in steps with approval for each step coming from the stakeholders in the user community during open workshops. By the fourth workshop, held October, 2002, a set of Common Data Elements (CDEs) was established as well as a basic strategy for organizing TMA data in self-describing XML documents. RESULTS: The TMA data exchange specification is a well-formed XML document with four required sections: 1) Header, containing the specification Dublin Core identifiers, 2) Block, describing the paraffin-embedded array of tissues, 3)Slide, describing the glass slides produced from the Block, and 4) Core, containing all data related to the individual tissue samples contained in the array. Eighty CDEs, conforming to the ISO-11179 specification for data elements constitute XML tags used in the TMA data exchange specification. A set of six simple semantic rules describe the complete data exchange specification. Anyone using the data exchange specification can validate their TMA files using a software implementation written in Perl and distributed as a supplemental file with this publication. CONCLUSION: The TMA data exchange specification is now available in a draft form with community-approved Common Data Elements and a community-approved general file format and data structure. The specification can be freely used by the scientific community. Efforts sponsored by the Association for Pathology Informatics to refine the draft TMA data exchange specification are expected to continue for at least two more years. The interested public is invited to participate in these open efforts. Information on future workshops will be posted at (API we site)
A single nucleotide polymorphism in the Bax gene promoter affects transcription and influences retinal ganglion cell death
Pro-apoptotic Bax is essential for RGC (retinal ganglion cell)
death. Gene dosage experiments in mice, yielding a single wild-type
Bax allele, indicated that genetic background was able to
influence the cell death phenotype. DBA/2JBax+/− mice exhibited complete resistance to nerve damage after 2 weeks
(similar to Bax−/− mice), but 129B6Bax+/− mice exhibited significant cell loss (similar to wild-type mice). The
different cell death phenotype was associated with the level of
Bax expression, where 129B6 neurons had twice the level of
endogenous Bax mRNA and protein as DBA/2J neurons. Sequence
analysis of the Bax promoters between these strains revealed a
single nucleotide polymorphism (T129B6 to CDBA/2J) at
position −515. A 1.5- to 2.5-fold increase in transcriptional
activity was observed from the 129B6 promoter in transient transfection assays
in a variety of cell types, including RGC5 cells derived from rat RGCs. Since
this polymorphism occurred in a p53 half-site, we investigated the requirement
of p53 for the differential transcriptional activity. Differential
transcriptional activity from either 129B6 or DBA/2J Bax
promoters were unaffected in p53−/− cells, and
addition of exogenous p53 had no further effect on this difference, thus a role
for p53 was excluded. Competitive electrophoretic mobility-shift assays
identified two DNA–protein complexes that interacted with the
polymorphic region. Those forming Complex 1 bound with higher affinity to the
129B6 polymorphic site, suggesting that these proteins probably comprised a
transcriptional activator complex. These studies implicated quantitative
expression of the Bax gene as playing a possible role in
neuronal susceptibility to damaging stimuli
An open label, randomised controlled trial of rifapentine versus rifampicin based short course regimens for the treatment of latent tuberculosis in England: the HALT LTBI pilot study.
BACKGROUND: Ending the global tuberculosis (TB) epidemic requires a focus on treating individuals with latent TB infection (LTBI) to prevent future cases. Promising trials of shorter regimens have shown them to be effective as preventative TB treatment, however there is a paucity of data on self-administered treatment completion rates. This pilot trial assessed treatment completion, adherence, safety and the feasibility of treating LTBI in the UK using a weekly rifapentine and isoniazid regimen versus daily rifampicin and isoniazid, both self-administered for 12 weeks. METHODS: An open label, randomised, multi-site pilot trial was conducted in London, UK, between March 2015 and January 2017. Adults between 16 and 65 years with LTBI at two TB clinics who were eligible for and agreed to preventative therapy were consented and randomised 1:1 to receive either a weekly combination of rifapentine/isoniazid ('intervention') or a daily combination of rifampicin/isoniazid ('standard'), with both regimens taken for twelve weeks; treatment was self-administered in both arms. The primary outcome, completion of treatment, was self-reported, defined as taking more than 90% of prescribed doses and corroborated by pill counts and urine testing. Adverse events were recorded. RESULTS: Fifty-two patients were successfully enrolled. In the intervention arm 21 of 27 patients completed treatment (77.8, 95% confidence interval [CI] 57.7-91.4), compared with 19 of 25 (76.0%, CI 54.9-90.6) in the standard of care arm. There was a similar adverse effect profile between the two arms. CONCLUSION: In this pilot trial, treatment completion was comparable between the weekly rifapentine/isoniazid and the daily rifampicin/isoniazid regimens. Additionally, the adverse event profile was similar between the two arms. We conclude that it is safe and feasible to undertake a fully powered trial to determine whether self-administered weekly treatment is superior/non-inferior compared to current treatment. TRIAL REGISTRATION: The trial was funded by the NIHR, UK and registered with ISRCTN ( 26/02/2013-No.04379941 )
An open label, randomised controlled trial of rifapentine versus rifampicin based short course regimens for the treatment of latent tuberculosis in England: the HALT LTBI pilot study
BACKGROUND: Ending the global tuberculosis (TB) epidemic requires a focus on treating individuals with latent TB infection (LTBI) to prevent future cases. Promising trials of shorter regimens have shown them to be effective as preventative TB treatment, however there is a paucity of data on self-administered treatment completion rates. This pilot trial assessed treatment completion, adherence, safety and the feasibility of treating LTBI in the UK using a weekly rifapentine and isoniazid regimen versus daily rifampicin and isoniazid, both self-administered for 12 weeks. METHODS: An open label, randomised, multi-site pilot trial was conducted in London, UK, between March 2015 and January 2017. Adults between 16 and 65 years with LTBI at two TB clinics who were eligible for and agreed to preventative therapy were consented and randomised 1:1 to receive either a weekly combination of rifapentine/isoniazid ('intervention') or a daily combination of rifampicin/isoniazid ('standard'), with both regimens taken for twelve weeks; treatment was self-administered in both arms. The primary outcome, completion of treatment, was self-reported, defined as taking more than 90% of prescribed doses and corroborated by pill counts and urine testing. Adverse events were recorded. RESULTS: Fifty-two patients were successfully enrolled. In the intervention arm 21 of 27 patients completed treatment (77.8, 95% confidence interval [CI] 57.7-91.4), compared with 19 of 25 (76.0%, CI 54.9-90.6) in the standard of care arm. There was a similar adverse effect profile between the two arms. CONCLUSION: In this pilot trial, treatment completion was comparable between the weekly rifapentine/isoniazid and the daily rifampicin/isoniazid regimens. Additionally, the adverse event profile was similar between the two arms. We conclude that it is safe and feasible to undertake a fully powered trial to determine whether self-administered weekly treatment is superior/non-inferior compared to current treatment. TRIAL REGISTRATION: The trial was funded by the NIHR, UK and registered with ISRCTN ( 26/02/2013-No.04379941 )
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The mass distribution of the unusual merging cluster Abell 2146 from strong lensing
Abell 2146 consists of two galaxy clusters that have recently collided close to the plane of the sky, and it is unique in showing two large shocks on images. With an early stage merger, shortly after first core passage, one would expect the cluster galaxies and the dark matter to be leading the X-ray emitting plasma. In this regard, the cluster Abell 2146-A is very unusual in that the X-ray cool core appears to lead, rather than lag, the brightest cluster galaxy (BCG) in their trajectories. Here we present a strong-lensing analysis of multiple-image systems identified on images. In particular, we focus on the distribution of mass in Abell 2146-A in order to determine the centroid of the dark matter halo. We use object colours and morphologies to identify multiple-image systems; very conservatively, four of these systems are used as constraints on a lens mass model. We find that the centroid of the dark matter halo, constrained using the strongly lensed features, is coincident with the BCG, with an offset of ≈2 kpc between the centres of the dark matter halo and the BCG. Thus from the strong-lensing model, the X-ray cool core also leads the centroid of the dark matter in Abell 2146-A, with an offset of ≈30 kpc.JEC acknowledges support from The University of Texas at Dallas, and NASA through a Fellowship of the Texas Space Grant Consortium. Based on observations made with the NASA/ESA HST, obtained through programme 12871 through the Space Telescope Science Institute, which is operated by the Association of Universities for Research in Astronomy, Inc., under NASA contract NAS 5-26555. Additional funding supporting JEC, LJK, and DIC came from a grant from the Space Telescope Science Institute under the same programme 12871. Additional funding supporting JEC and LJK came from a grant from the National Science Foundation, number 1517954. This work was supported in part by World Premier International Research Center Initiative (WPI Initiative), MEXT, Japan, and JSPS KAKENHI Grant Number 26800093 and 15H05892
The relationship between health-related quality of life and social networks among Japanese family caregivers for people with disabilities
<p>Abstract</p> <p>Aims</p> <p>The purpose of this study was to examine HRQOL depending on whether the participants have family members with disabilities or not. In addition, we examined the relationship between HRQOL and social networks among family caregivers in Japan.</p> <p>Methods</p> <p>The study has a cross-sectional design. Survey forms were distributed to 9205 people aged 30 and older who visited a dispensing pharmacy within fifteen areas of Japan. We collected data on gender, age, job status, and care giving status for persons with disabilities. Moreover, we assessed support size, social support, and HRQOL. Out of the 2029 questionnaires returned, 1763 (male: 663, female: 1100, mean age = 63.06 ± 13.34) were valid for statistical analyses (the available response rate was 19.15%).</p> <p>Results</p> <p>A significant difference in HRQOL was identified between family caregivers and non-family caregivers. Further, in males (N = 101), the results confirmed that only social support predicted the PCS and MCS scores, while other variables did not predict either score. On the other hand, in females (N = 144), it was found from the second step of hierarchical multiple regression analysis that only age explained the PCS score, while job status and support size explained the MCS score.</p> <p>Conclusion</p> <p>It is reasonable to conclude that the HRQOL of family caregivers was lower than that of non-family caregivers, and that the HRQOL of family caregivers was estimated by their social networks.</p
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