Modeling secondary level of HIV contact tracing: its impact on HIV intervention in Cuba

<p>Abstract</p> <p>Background</p> <p>Universal HIV testing/treatment program has currently been suggested and debated as a useful strategy for elimination of HIV epidemic in Africa, although not without practical issues regarding the costs and feasibility of a fully implemented program.</p> <p>Methods</p> <p>A mathematical model is proposed which considers two levels of detection of HIV-infectives through contact tracing of known infectives in addition to detections through other means such as random screening. Simulations based on Cuban contact tracing data were performed to ascertain the potential impact of the different levels of contact tracing.</p> <p>Results</p> <p>Simulation studies illustrate that: (1) contact tracing is an important intervention measure which, while less effective than random screening, is perhaps less costly and hence ideal for large-scale intervention programs in developing countries with less resources; (2) the secondary level of contact tracing could significantly change the basic disease transmission dynamics, depending on the parameter values; (3) the prevalence of the epidemic at the time of implementation of contact tracing program might be a crucial factor in determining whether the measure will be effective in preventing disease infections and its eventual eradication.</p> <p>Conclusions</p> <p>Our results indicate that contact tracing for detection of HIV infectives could be suitably used to remedy inadequacies in a universal HIV testing program when designing timely and effective intervention measures.</p

On epidemic modeling in real time: An application to the 2009 Novel A (H1N1) influenza outbreak in Canada

<p>Abstract</p> <p>Background</p> <p>Management of emerging infectious diseases such as the 2009 influenza pandemic A (H1N1) poses great challenges for real-time mathematical modeling of disease transmission due to limited information on disease natural history and epidemiology, stochastic variation in the course of epidemics, and changing case definitions and surveillance practices.</p> <p>Findings</p> <p>The Richards model and its variants are used to fit the cumulative epidemic curve for laboratory-confirmed pandemic H1N1 (pH1N1) infections in Canada, made available by the Public Health Agency of Canada (PHAC). The model is used to obtain estimates for turning points in the initial outbreak, the basic reproductive number (R₀), and for expected final outbreak size in the absence of interventions. Confirmed case data were used to construct a best-fit 2-phase model with three turning points. R₀was estimated to be 1.30 (95% CI 1.12-1.47) for the first phase (April 1 to May 4) and 1.35 (95% CI 1.16-1.54) for the second phase (May 4 to June 19). Hospitalization data were also used to fit a 1-phase model with R₀= 1.35 (1.20-1.49) and a single turning point of June 11.</p> <p>Conclusions</p> <p>Application of the Richards model to Canadian pH1N1 data shows that detection of turning points is affected by the quality of data available at the time of data usage. Using a Richards model, robust estimates of R₀were obtained approximately one month after the initial outbreak in the case of 2009 A (H1N1) in Canada.</p

Orbital and Spin Parameter Variations of Partial Eclipsing Low Mass X-ray Binary X 1822-371

We report our measurements for orbital and spin parameters of X 1822-371 using its X-ray partial eclipsing profile and pulsar timing from data collected by the Rossi X-ray Timing Explorer (RXTE). Four more X-ray eclipse times obtained by the RXTE 2011 observations were combined with historical records to trace evolution of orbital period. We found that a cubic ephemeris likely better describes evolution of the X-ray eclipse times during a time span of about 34 years with a marginal second order derivative of $ddot{P}_{orb}=(-1.05 pm 0.59) imes 10^{-19}$ s$^{-1}$. Using the pulse arrival time delay technique, the orbital and spin parameters were obtained from RXTE observations from 1998 to 2011. The detected pulse periods show that the neutron star in X 1822-371 is continuously spun-up with a rate of $dot{P}_{s}=(-2.6288 pm 0.0095) imes 10^{-12}$ s s$^{-1}$. Evolution of the epoch of the mean longitude $l=pi /2$ (i.e. $T_{pi / 2}$) gives an orbital period derivative value consistent with that obtained from the quadratic ephemeris evaluated by the X-ray eclipse but the detected $T_{pi / 2}$ values are significantly and systematically earlier than the corresponding expected X-ray eclipse times by $90 pm 11$ s. This deviation is probably caused by asymmetric X-ray emissions. We also attempted to constrain the mass and radius of the neutron star using the spin period change rate and concluded that the intrinsic luminosity of X 1822-371 is likely more than $10^{38}$ ergs s$^{-1}$.postprin

Age groups and spread of influenza: implications for vaccination strategy

<p>Abstract</p> <p>Background</p> <p>The unpredictable nature of the potentially devastating impact of 2009 pH1N1 influenza pandemic highlights the need for pandemic preparedness planning, where modeling studies could be most useful for simulations of possible future scenarios.</p> <p>Methods</p> <p>A compartmental model with pre-symptomatic and asymptomatic influenza infections is proposed which incorporates age groups as well as intervention measures such as age-specific vaccination, in order to study spread of influenza in a community.</p> <p>Results</p> <p>We derive the basic reproduction number and other effective reproduction numbers under various intervention measures. For illustration, we make use of the Pneumonia and Influenza (P&I) mortality data and vaccination data of the very young (age 0-2) and the very old (age >64) during 2004-2005 Taiwan winter influenza season to fit our model and to compute the relevant reproduction numbers. The reproduction number for this winter flu season is estimated to be slightly above one (~1.0001).</p> <p>Conclusions</p> <p>Comparatively large errors in fitting the P&I mortality data of the elderly (>64) were observed shortly after winter school closings in January, which may indicate the impact of younger, more active age groups transmitting influenza to other age groups outside of the school settings; in particular, to the elderly in the households. Pre-symptomatic infections seemed to have little effect on the model fit, while asymptomatic infection by asymptomatic infectives has a more pronounced impact on the model fit for the elderly mortality, perhaps indicating a larger role in disease transmission by asymptomatic infection. Simulations indicate that the impact of vaccination on the disease incidence might not be fully revealed in the change (or the lack thereof) in the effective reproduction number with interventions, but could still be substantial. The estimated per contact transmission probability for susceptible elderly is significantly higher than that of any other age group, perhaps highlighting the vulnerability of the elderly due to close contacts with their caretakers from other age groups. The relative impact of targeting the very young and the very old for vaccination was weakened by their relative inactivity, thus giving evidence of the lack of impact of vaccinating these two groups on the overall transmissibility of the disease in the community. This further underscores the need for morbidity-based strategy to prevent elderly mortality.</p

Assessment of intervention measures for the 2003 SARS epidemic in Taiwan by use of a back-projection method

OBJECTIVES. To reconstruct the infection curve for the 2003 severe acute respiratory syndrome (SARS) epidemic in Taiwan and to ascertain the temporal changes in the daily number of infections that occurred during the course of the outbreak. METHOD. Back-projection method. RESULTS. The peaks of the epidemic correspond well with the occurrence of major infection clusters in the hospitals. The overall downward trend of the infection curve after early May corresponds well to the date (May 10) when changes in the review and classification procedure were implemented by the SARS Prevention and Extrication Committee. CONCLUSION. The major infection control measures taken by the Taiwanese government over the course of the SARS epidemic, particularly those regarding infection control in hospitals, played a crucial role in containing the outbreak. © 2007 by The Society for Healthcare Epidemiology of America. All rights reserved.published_or_final_versio

Variability in transmissibility of the 2009 H1N1 pandemic in Canadian communities

Abstract Background The prevalence and severity of the 2009 H1N1 pandemic appeared to vary significantly across populations and geographic regions. We sought to investigate the variability in transmissibility of H1N1 pandemic in different health regions (including urban centres and remote, isolated communities) in the province of Manitoba, Canada. Methods The Richards model was used to fit to the daily number of laboratory-confirmed cases and estimate transmissibility (referred to as the basic reproduction number, R0), doubling times, and turning points of outbreaks in both spring and fall waves of the H1N1 pandemic in several health regions. Results We observed considerable variation in R0 estimates ranging from 1.55 to 2.24, with confidence intervals ranging from 1.45 to 2.88, for an average generation time of 2.9 days, and shorter doubling times in some remote and isolated communities compared to urban centres, suggesting a more rapid spread of disease in these communities during the first wave. For the second wave, R e , the effective reproduction number, is estimated to be lower for remote and isolated communities; however, outbreaks appear to have been driven by somewhat higher transmissibility in urban centres. Conclusions There was considerable geographic variation in transmissibility of the 2009 pandemic outbreaks. While highlighting the importance of estimating R0 for informing health responses, the findings indicate that projecting the transmissibility for large-scale epidemics may not faithfully characterize the early spread of disease in remote and isolated communities

Control over topological insulator photocurrents with light polarization

Three-dimensional topological insulators represent a new quantum phase of matter with spin-polarized surface states that are protected from backscattering. The static electronic properties of these surface states have been comprehensively imaged by both photoemission and tunneling spectroscopies. Theorists have proposed that topological surface states can also exhibit novel electronic responses to light, such as topological quantum phase transitions and spin-polarized electrical currents. However, the effects of optically driving a topological insulator out of equilibrium have remained largely unexplored experimentally, and no photocurrents have been measured. Here we show that illuminating the topological insulator Bi2Se3 with circularly polarized light generates a photocurrent that originates from topological helical Dirac fermions, and that reversing the helicity of the light reverses the direction of the photocurrent. We also observe a photocurrent that is controlled by the linear polarization of light, and argue that it may also have a topological surface state origin. This approach may allow the probing of dynamic properties of topological insulators and lead to novel opto-spintronic devices.Comment: Accepted in Nature Nanotechnology, November 2 201

Excess healthcare burden during 1918-1920 influenza pandemic in Taiwan: implications for post-pandemic preparedness

<p>Abstract</p> <p>Background</p> <p>It is speculated that the 2009 pandemic H1N1 influenza virus might fall into a seasonal pattern during the current post-pandemic period with more severe clinical presentation for high-risk groups identified during the 2009 pandemic. Hence the extent of likely excess healthcare needs during this period must be fully considered. We will make use of the historical healthcare record in Taiwan during and after the 1918 influenza pandemic to ascertain the scope of potential excess healthcare burden during the post-pandemic period.</p> <p>Methods</p> <p>To establish the healthcare needs after the initial wave in 1918, the yearly healthcare records (hospitalizations, outpatients, etc.) in Taiwan during 1918-1920 are compared with the corresponding data from the adjacent "baseline" years of 1916, 1917, 1921, and 1922 to estimate the excess healthcare burden during the initial outbreak in 1918 and in the years immediately after.</p> <p>Results</p> <p>In 1918 the number of public hospital outpatients exceeded the yearly average of the baseline years by 20.11% (95% CI: 16.43, 25.90), and the number of hospitalizations exceeded the corresponding yearly average of the baseline years by 12.20% (10.59, 14.38), while the excess number of patients treated by the public medics was statistically significant at 32.21% (28.48, 39.82) more than the yearly average of the baseline years. For 1920, only the excess number of hospitalizations was statistically significant at 19.83% (95% CI: 17.21, 23.38) more than the yearly average of the baseline years.</p> <p>Conclusions</p> <p>Considerable extra burden with significant loss of lives was reported in 1918 by both the public medics system and the public hospitals. In comparison, only a substantial number of excess hospitalizations in the public hospitals was reported in 1920, indicating that the population was relatively unprepared for the first wave in 1918 and did not fully utilize the public hospitals. Moreover, comparatively low mortality was reported by the public hospitals and the public medics during the second wave in 1920 even though significantly more patients were hospitalized, suggesting that there had been substantially less fatal illnesses among the hospitalized patients during the second wave. Our results provide viable parameters for assessing healthcare needs for post-pandemic preparedness.</p

In-Plane Orbital Texture Switch at the Dirac Point in the Topological Insulator Bi2Se3

Topological insulators are novel macroscopic quantum-mechanical phase of matter, which hold promise for realizing some of the most exotic particles in physics as well as application towards spintronics and quantum computation. In all the known topological insulators, strong spin-orbit coupling is critical for the generation of the protected massless surface states. Consequently, a complete description of the Dirac state should include both the spin and orbital (spatial) parts of the wavefunction. For the family of materials with a single Dirac cone, theories and experiments agree qualitatively, showing the topological state has a chiral spin texture that changes handedness across the Dirac point (DP), but they differ quantitatively on how the spin is polarized. Limited existing theoretical ideas predict chiral local orbital angular momentum on the two sides of the DP. However, there have been neither direct measurements nor calculations identifying the global symmetry of the spatial wavefunction. Here we present the first results from angle-resolved photoemission experiment and first-principles calculation that both show, counter to current predictions, the in-plane orbital wavefunctions for the surface states of Bi2Se3 are asymmetric relative to the DP, switching from being tangential to the k-space constant energy surfaces above DP, to being radial to them below the DP. Because the orbital texture switch occurs exactly at the DP this effect should be intrinsic to the topological physics, constituting an essential yet missing aspect in the description of the topological Dirac state. Our results also indicate that the spin texture may be more complex than previously reported, helping to reconcile earlier conflicting spin resolved measurements

Emergent quantum confinement at topological insulator surfaces

Bismuth-chalchogenides are model examples of three-dimensional topological insulators. Their ideal bulk-truncated surface hosts a single spin-helical surface state, which is the simplest possible surface electronic structure allowed by their non-trivial $\mathbb{Z}_2$ topology. They are therefore widely regarded ideal templates to realize the predicted exotic phenomena and applications of this topological surface state. However, real surfaces of such compounds, even if kept in ultra-high vacuum, rapidly develop a much more complex electronic structure whose origin and properties have proved controversial. Here, we demonstrate that a conceptually simple model, implementing a semiconductor-like band bending in a parameter-free tight-binding supercell calculation, can quantitatively explain the entire measured hierarchy of electronic states. In combination with circular dichroism in angle-resolved photoemission (ARPES) experiments, we further uncover a rich three-dimensional spin texture of this surface electronic system, resulting from the non-trivial topology of the bulk band structure. Moreover, our study reveals how the full surface-bulk connectivity in topological insulators is modified by quantum confinement.Comment: 9 pages, including supplementary information, 4+4 figures. A high resolution version is available at http://www.st-andrews.ac.uk/~pdk6/pub_files/TI_quant_conf_high_res.pd