Assessing the impact of natural policy experiments on socioeconomic inequalities in health

Background: The scientific evidence-base for policies to tackle health inequalities is limited. Natural policy experiments (NPE) have drawn increasing attention as a means to evaluating the effects of policies on health. Several analytical methods can be used to evaluate the outcomes of NPEs in terms of average population health, but it is unclear whether they can also be used to assess the outcomes of NPEs in terms of health inequalities. The aim of this study therefore was to assess whether, and to demonstrate how, a number of commonly used analytical methods for the evaluation of NPEs can be applied to quantify the effect of policies on health inequalities. Methods: We identified seven quantitative analytical methods for the evaluation of NPEs: regression adjustment, propensity score matching, difference-in-differences analysis, fixed effects analysis, instrumental variable analysis, regression discontinuity and interrupted time-series. We assessed whether these methods can be used to quantify the effect of policies on the magnitude of health inequalities either by conducting a stratified analysis or by including an interaction term, and illustrated both approaches in a fictitious numerical example. Results: All seven methods can be used to quantify the equity impact of policies on absolute and relative inequalities in health by conducting an analysis stratified by socioeconomic position, and all but one (propensity score matching) can be used to quantify equity impacts by inclusion of an interaction term between socioeconomic position and policy exposure. Conclusion: Methods commonly used in economics and econometrics for the evaluation of NPEs can also be applied to assess the equity impact of policies, and our illustrations provide guidance on how to do this appropriately. The low external validity of results from instrumental variable analysis and regression discontinuity makes these methods less desirable for assessing policy effects on population-level health inequalities. Increased use of the methods in social epidemiology will help to build an evidence base to support policy making in the area of health inequalities

Temperature dependence and mechanisms for vortex pinning by periodic arrays of Ni dots in Nb films

Pinning interactions between superconducting vortices in Nb and magnetic Ni dots were studied as a function of current and temperature to clarify the nature of pinning mechanisms. A strong current dependence is found for a square array of dots, with a temperature dependent optimum current for the observation of periodic pinning, that decreases with temperature as (1-T/Tc)3/2. This same temperature dependence is found for the critical current at the first matching field with a rectangular array of dots. The analysis of these results allows to narrow the possible pinning mechanisms to a combination of two: the interaction between the vortex and the magnetic moment of the dot and the proximity effect. Moreover, for the rectangular dot array, the temperature dependence of the crossover between the low field regime with a rectangular vortex lattice to the high field regime with a square configuration has been studied. It is found that the crossover field increases with decreasing temperature. This dependence indicates a change in the balance between elastic and pinning energies, associated with dynamical effects of the vortex lattice in the high field range.Comment: 12 text pages (revtex), 6 figures (1st jpeg, 2nd-6th postscript) accepted in Physical Review

Creating a potential diagnostic for prostate cancer risk stratification (InformMDx™) by translating novel scientific discoveries concerning cAMP degrading phosphodiesterase-4D7 (PDE4D7)

Increased PSA-based screening for prostate cancer has resulted in a growing number of diagnosed cases. However, around half of these are ‘indolent’, neither metastasizing nor leading to disease specific death. Treating non-progressing tumours with invasive therapies is currently regarded as unnecessary over-treatment with patients being considered for conservative regimens, such as active surveillance (AS). However, this raises both compliance and protocol issues. Great clinical benefit could accrue from a biomarker able to predict long-term patient outcome accurately at the time of biopsy and initial diagnosis. Here we delineate the translation of a laboratory discovery through to the precision development of a clinically validated, novel prognostic biomarker assay (InformMDx™). This centres on determining transcript levels for phosphodiesterase-4D7 (PDE4D7), an enzyme that breaks down cyclic AMP, a signalling molecule intimately connected with proliferation and androgen receptor function. Quantifiable detection of PDE4D7 mRNA transcripts informs on the longitudinal outcome of post-surgical disease progression. The risk of post-surgical progression increases steeply for patients with very low ‘PDE4D7 scores’, while risk decreases markedly for those patients with very high ‘PDE4D7 scores’. Combining clinical risk variables, such as the Gleason or CAPRA (Cancer of the Prostate Risk Assessment) score, with the ‘PDE4D7 score’ further enhances the prognostic power of this personalized, precision assessment. Thus the ‘PDE4D7 score’ has the potential to define, more effectively, appropriate medical intervention/AS strategies for individual prostate cancer patients

Primary thermometry in the intermediate Coulomb blockade regime

We investigate Coulomb blockade thermometers (CBT) in an intermediate temperature regime, where measurements with enhanced accuracy are possible due to the increased magnitude of the differential conductance dip. Previous theoretical results show that corrections to the half width and to the depth of the measured conductance dip of a sensor are needed, when leaving the regime of weak Coulomb blockade towards lower temperatures. In the present work, we demonstrate experimentally that the temperature range of a CBT sensor can be extended by employing these corrections without compromising the primary nature or the accuracy of the thermometer.Comment: 8 pages, 4 figure

The primary cilium influences interleukin-1 beta-induced NF kappa B signalling by regulating IKK activity

AbstractThe primary cilium is an organelle acting as a master regulator of cellular signalling. We have previously shown that disruption of primary cilia assembly, through targeting intraflagellar transport, is associated with muted nitric oxide and prostaglandin responses to the inflammatory cytokine interleukin-1β (IL-1β). Here, we show that loss of the primary cilium disrupts specific molecular signalling events in cytosolic NFκB signalling. The induction of cyclooxygenase 2 (COX2) and inducible nitrous oxide synthase (iNOS) protein is abolished. Cells unable to assemble cilia exhibit unaffected activation of IκB kinase (IKK), but delayed and reduced degradation of IκB, due to diminished phosphorylation of inhibitor of kappa B (IκB) by IKK. This results in both delayed and reduced NFκB p65 nuclear translocation and nuclear transcript binding. We also demonstrate that heat shock protein 27 (hsp27), an established regulator of IKK, is localized to the ciliary axoneme and cellular levels are dramatically disrupted with loss of the primary cilium. These results suggest that the primary cilia compartment exerts influence over NFκB signalling. We propose that the cilium is a locality for regulation of the molecular events defining NFκB signalling events, tuning signalling as appropriate

The holographic superconductors in higher-dimensional AdS soliton

We explore the behaviors of the holographic superconductors at zero temperature for a charged scalar field coupled to a Maxwell field in higher-dimensional AdS soliton spacetime via analytical way. In the probe limit, we obtain the critical chemical potentials increase linearly as a total dimension $d$ grows up. We find that the critical exponent for condensation operator is obtained as 1/2 independently of $d$, and the charge density is linearly related to the chemical potential near the critical point. Furthermore, we consider a slightly generalized setup the Einstein-Power-Maxwell field theory, and find that the critical exponent for condensation operator is given as $1/(4-2n)$ in terms of a power parameter $n$ of the Power-Maxwell field, and the charge density is proportional to the chemical potential to the power of $1/(2-n)$.Comment: LaTeX, 16 pages, 5 figures, typos corrected, one reference added, version to appear in European Physical Journal

Slow dynamics and aging in spin-glasses

Contribution presented by Eric Vincent in the Conference `Complex Behaviour of Glassy Systems', Sitges, Barcelona, Spain, June, 1996. It contains a review of the experimental results on Slow dynamics and aging in spin-glasses. It also presents their comparison with recent theoretical developments in the description of the out of equilibrium dynamics of disordered systems; namely, the trap model and the mean-field theory.Comment: 35 pages, 12 figures, macro lmamult.sty (included

Instability of the rhodium magnetic moment as origin of the metamagnetic phase transition in alpha-FeRh

Based on ab initio total energy calculations we show that two magnetic states of rhodium atoms together with competing ferromagnetic and antiferromagnetic exchange interactions are responsible for a temperature induced metamagnetic phase transition, which experimentally is observed for stoichiometric alpha-FeRh. A first-principle spin-based model allows to reproduce this first-order metamagnetic transition by means of Monte Carlo simulations. Further inclusion of spacial variation of exchange parameters leads to a realistic description of the experimental magneto-volume effects in alpha-FeRh.Comment: 10 pages, 13 figures, accepted for publication in Phys. Rev.

Metastable States in Spin Glasses and Disordered Ferromagnets

We study analytically M-spin-flip stable states in disordered short-ranged Ising models (spin glasses and ferromagnets) in all dimensions and for all M. Our approach is primarily dynamical and is based on the convergence of a zero-temperature dynamical process with flips of lattice animals up to size M and starting from a deep quench, to a metastable limit. The results (rigorous and nonrigorous, in infinite and finite volumes) concern many aspects of metastable states: their numbers, basins of attraction, energy densities, overlaps, remanent magnetizations and relations to thermodynamic states. For example, we show that their overlap distribution is a delta-function at zero. We also define a dynamics for M=infinity, which provides a potential tool for investigating ground state structure.Comment: 34 pages (LaTeX); to appear in Physical Review