2,917 research outputs found
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
How to delineate the general profiles of functionality of citizen’s aged 65 years and old as a function of Its age
Objectives: A core set of International Classification of Functioning, Disability and Health codes was used, to ascertain the general profile of functionality as a function of biological and sociodemographic characteristics, notably the age of the citizens.
Methods: Data were collected by health professionals in the participants’ houses. The factorial validity of the construct was assessed by a confirmatory factor analysis. An ordinal regression model was built to identify the general profile of functionality as a function of age.
Results: It is expected that people under the age of 74 years will present no functional problems and that, after age 74, the most likely functionality problem will be a “MILD problem”.
Discussion: The functional profile of each elderly is interrelated with his or her sociodemographic context as well as with the overarching biological, cultural, and environmental characteristics of society. A progressive decrease in GPF occurs with age.
Conclusions: The evaluation of each person (even those with no perceived or incipient levels of functional impairment who are at risk of progressing to a more severe disability) about what are the factors that are related with this functional decline as people get older, allows identify the respective nursing interventions to be developed.This work was supported by 4IE project (0045-4IE-4-P) funded by the Interreg V-A Espanha-Portugal (POCTEP) 2014-2020 program
The Main Belt Comets and ice in the Solar System
We review the evidence for buried ice in the asteroid belt; specifically the questions around the so-called Main Belt Comets (MBCs). We summarise the evidence for water throughout the Solar System, and describe the various methods for detecting it, including remote sensing from ultraviolet to radio wavelengths. We review progress in the first decade of study of MBCs, including observations, modelling of ice survival, and discussion on their origins. We then look at which methods will likely be most effective for further progress, including the key challenge of direct detection of (escaping) water in these bodies
Mapping the unconventional orbital texture in topological crystalline insulators
The newly discovered topological crystalline insulators (TCIs) harbor a
complex band structure involving multiple Dirac cones. These materials are
potentially highly tunable by external electric field, temperature or strain
and could find future applications in field-effect transistors, photodetectors,
and nano-mechanical systems. Theoretically, it has been predicted that
different Dirac cones, offset in energy and momentum-space, might harbor vastly
different orbital character, a unique property which if experimentally
realized, would present an ideal platform for accomplishing new spintronic
devices. However, the orbital texture of the Dirac cones, which is of immense
importance in determining a variety of materials properties, still remains
elusive in TCIs. Here, we unveil the orbital texture in a prototypical TCI
PbSnSe. By using Fourier-transform (FT) scanning tunneling
spectroscopy (STS) we measure the interference patterns produced by the
scattering of surface state electrons. We discover that the intensity and
energy dependences of FTs show distinct characteristics, which can directly be
attributed to orbital effects. Our experiments reveal the complex band topology
involving two Lifshitz transitions and establish the orbital nature of the
Dirac bands in this new class of topological materials, which could provide a
different pathway towards future quantum applications
A mitochondrial membrane-bridging machinery mediates signal transduction of intramitochondrial oxidation
Mitochondria are the main site for generating reactive oxygen species, which are key players in diverse biological processes. However, the molecular pathways of redox signal transduction from the matrix to the cytosol are poorly defined. Here we report an inside-out redox signal of mitochondria. Cysteine oxidation of MIC60, an inner mitochondrial membrane protein, triggers the formation of disulfide bonds and the physical association of MIC60 with Miro, an outer mitochondrial membrane protein. The oxidative structural change of this membrane-crossing complex ultimately elicits cellular responses that delay mitophagy, impair cellular respiration and cause oxidative stress. Blocking the MIC60–Miro interaction or reducing either protein, genetically or pharmacologically, extends lifespan and health-span of healthy fruit flies, and benefits multiple models of Parkinson’s disease and Friedreich’s ataxia. Our discovery provides a molecular basis for common treatment strategies against oxidative stress
Nicotine replacement therapy for agitation and delirium management in the intensive care unit: a systematic review of the literature.
BACKGROUND: Active smokers are prevalent within the intensive care setting and place a significant burden on healthcare systems. Nicotine withdrawal due to forced abstinence on admission may contribute to increased agitation and delirium in this patient group. The aim of this systematic review was to determine whether management of nicotine withdrawal, with nicotine replacement therapy (NRT), reduces agitation and delirium in critically ill patients admitted to the intensive care unit (ICU). METHODS: The following sources were used in this review: MEDLINE, EMBASE, and CINAHL Plus databases. Included studies reported delirium or agitation outcomes in current smokers, where NRT was used as management of nicotine withdrawal, in the intensive care setting. Studies were included regardless of design or number of participants. Data were extracted on ICU classification; study design; population baseline characteristics; allocation and dose of NRT; agitation and delirium assessment methods; and the frequency of agitation, delirium, and psychotropic medication use. RESULTS: Six studies were included. NRT was mostly prescribed for smokers with heavier smoking histories. Three studies reported an association between increased agitation or delirium and NRT use; one study could not find any significant benefit or harm from NRT use; and two described a reduction of symptomatic nicotine withdrawal. A lack of consistent and validated assessment measures, combined with limitations in the quality of reported data, contribute to conflicting results. CONCLUSIONS: Current evidence for the use of NRT in agitation and delirium management in the ICU is inconclusive. An evaluation of risk versus benefit on an individual patient basis should be considered when prescribing NRT. Further studies that consider prognostic balance, adjust for confounders, and employ validated assessment tools are urgently needed
Mott physics and band topology in materials with strong spin-orbit interaction
Recent theory and experiment have revealed that strong spin-orbit coupling
can have dramatic qualitative effects on the band structure of weakly
interacting solids. Indeed, it leads to a distinct phase of matter, the
topological band insulator. In this paper, we consider the combined effects of
spin-orbit coupling and strong electron correlation, and show that the former
has both quantitative and qualitative effects upon the correlation-driven Mott
transition. As a specific example we take Ir-based pyrochlores, where the
subsystem of Ir 5d electrons is known to undergo a Mott transition. At weak
electron-electron interaction, we predict that Ir electrons are in a metallic
phase at weak spin-orbit interaction, and in a topological band insulator phase
at strong spin-orbit interaction. Very generally, we show that with increasing
strength of the electron-electron interaction, the effective spin-orbit
coupling is enhanced, increasing the domain of the topological band insulator.
Furthermore, in our model, we argue that with increasing interactions, the
topological band insulator is transformed into a "topological Mott insulator"
phase, which is characterized by gapless surface spin-only excitations. The
full phase diagram also includes a narrow region of gapless Mott insulator with
a spinon Fermi surface, and a magnetically ordered state at still larger
electron-electron interaction.Comment: 10+ pages including 3+ pages of Supplementary Informatio
Estimation of Recurrence of Colorectal Adenomas with Dependent Censoring Using Weighted Logistic Regression
In colorectal polyp prevention trials, estimation of the rate of recurrence of adenomas at the end of the trial may be complicated by dependent censoring, that is, time to follow-up colonoscopy and dropout may be dependent on time to recurrence. Assuming that the auxiliary variables capture the dependence between recurrence and censoring times, we propose to fit two working models with the auxiliary variables as covariates to define risk groups and then extend an existing weighted logistic regression method for independent censoring to each risk group to accommodate potential dependent censoring. In a simulation study, we show that the proposed method results in both a gain in efficiency and reduction in bias for estimating the recurrence rate. We illustrate the methodology by analyzing a recurrent adenoma dataset from a colorectal polyp prevention trial
Exploring 4D Quantum Hall Physics with a 2D Topological Charge Pump
The discovery of topological states of matter has profoundly augmented our
understanding of phase transitions in physical systems. Instead of local order
parameters, topological phases are described by global topological invariants
and are therefore robust against perturbations. A prominent example thereof is
the two-dimensional integer quantum Hall effect. It is characterized by the
first Chern number which manifests in the quantized Hall response induced by an
external electric field. Generalizing the quantum Hall effect to
four-dimensional systems leads to the appearance of a novel non-linear Hall
response that is quantized as well, but described by a 4D topological invariant
- the second Chern number. Here, we report on the first observation of a bulk
response with intrinsic 4D topology and the measurement of the associated
second Chern number. By implementing a 2D topological charge pump with
ultracold bosonic atoms in an angled optical superlattice, we realize a
dynamical version of the 4D integer quantum Hall effect. Using a small atom
cloud as a local probe, we fully characterize the non-linear response of the
system by in-situ imaging and site-resolved band mapping. Our findings pave the
way to experimentally probe higher-dimensional quantum Hall systems, where new
topological phases with exotic excitations are predicted
Prevalence, sources, and predictors of soy consumption in breast cancer
<p>Abstract</p> <p>Background</p> <p>A number of components in soy appear to have anticancer properties, including the isoflavones, genistein and daidzein. The use of soy by women with breast cancer is now being questioned because of the estrogen-like effects of isoflavones and possible interactions with tamoxifen. Clinicians providing nutrition counseling to these women are concerned because the availability of soy foods has increased dramatically in the past few years. The goal of this study was to quantify the intake of isoflavones in women with breast cancer.</p> <p>Methods</p> <p>A cross-sectional study of 100 women with breast cancer treated at Cancer Treatment Centers of America<sup>® </sup>between 09/03 and 02/04. Each patient completed a soy food frequency questionnaire (FFQ) that was scored by Fred Hutchinson Cancer Research Center. Demographic and clinical predictors of soy intake were evaluated using one-way non-parametric Mann Whitney test and non-parametric spearman's rank correlation.</p> <p>Results</p> <p>Mean age was 50.5 years (std. dev. = 9.4; range 31–70) and mean BMI was 27.3 kg/m<sup>2 </sup>(std. dev. = 6.75; range 17–59). Genistein and Daidzein consumption was limited to 65 patients with a mean intake of 11.6 mg/day (std. dev. = 21.9; range 0–97.4) and 7.6 mg/day (std. dev. = 14.1; range 0–68.9) respectively. Soy milk (37%) and pills containing soy, isoflavones, or "natural" estrogen (24%) were the two biggest contributors to isoflavone intake.</p> <p>Conclusion</p> <p>Our study suggests that the isoflavone intake of breast cancer patients at our hospital was quite variable. Thirty-five patients reported no soy intake. The mean daily intake of 11.6 mg genistein and 7.4 mg daidzein, is the equivalent of less than 1/4 cup of tofu per day. This amount is higher than what has been previously reported in non-Asian American women.</p
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