Localised treatment and 6-month outcomes in patients with cytomegalovirus retinitis at a tertiary ophthalmology service in Ga-Rankuwa

Objective. There are few data from before the antiretroviral therapy (ART) era for cytomegalovirus retinitis (CMV-R) from settings where cost limits use of systemic treatment. This study examines CMV-R treatment and survival outcomes in a public hospital ophthalmology service in Ga-Rankuwa, South Africa.Methods. From October 2009 to October 2010, voluntarily consenting participants over the age of 15 years with incident clinically diagnosed CMV-R seen at the Dr George Mukhari Hospital ophthalmology clinic were prospectively enrolled in an observational study. Treatment was per clinicprotocols and patients were followed up with structured data collection for up to 6 months.Results. Eight individuals, all HIV infected and 50% female, were identified and enrolled. At enrolment, median age was 38 years (interquartile range (IQR) 32 - 39 years), median CD4 count 20 cells/ìl (IQR 13 - 46.5 cells/ìl),and 50% were currently receiving ART (mean duration of ART use 18 days, standard deviation (SD) 2.99 days). No participant received systemic ganciclovir, but 6 reported symptom combinations suggesting systemic CMV: shortness of breath (n=3), diarrhoea (n=3) and/or central nervoussystem complaints (n=3). Ten eyes had visual impairment less than counting fingers at enrolment. Treatment combinations were: ART plus intravitreal ganciclovir (n=5), intravitreal ganciclovir alone (n=2), and ART alone (n=1). Six-month outcomes were: death (n=1), survival (n=6), loss to follow-up (n=3), untraceable (n=1), systemic symptom resolution (4/4),visual acuity deterioration (0/5), and persisting uveitis (2/3).Conclusion. In the ART era, incident CMV-R appears to be uncommon in this setting. CMV-R may occur within the first 3 weeks after ART initiation. Even in CMV-R patients with suggestive systemic symptoms, 6-month survival is good despite no systemic CMV therapy

Efficacy optimization of plasma-activated water for food sanitization through two reactor design configurations

The chemistry, antimicrobial efficacy and energy consumption of plasma-activated water (PAW) was optimized by altering the discharge frequency, ground-electrode configuration, gas flow rate and initial water conductivity for two reactor configurations, i.e., air pin-to-liquid discharge and air plasma-bubble discharge in water. The ratio of NO2− and NO3− formation was altered to optimise the antimicrobial effects of PAW, tested against two Gram-negative bacteria. An initial solution conductivity of 0.2 S·m−1 and 2000-Hz discharge frequency with the ground electrode positioned inside the pin reactor showed the highest antimicrobial effect resulting in a 3.99 ± 0.13-log10 reduction within 300 s against Escherichia coli and 5.90 ± 0.24-log10 reduction within 240 s for Salmonella Typhimurium. An excellent energy efficiency of reactive oxygen and nitrogen species (RONS) generation of 10.1 ± 0.1 g·kW−1·h−1 was achieved. Industrial relevance: Plasma-activated water (PAW) is deemed as an eco-friendly alternative to chemical disinfection because its bactericidal activity is temporary. Optimizing the design and operation of PAW reactors to achieve high inactivation rates of more than 5-log10 reductions, as demonstrated in this work, will support the industrial application of this technology and the scaleup at industrial level

Probing Quantum Geometry at LHC

We present an evidence, that the volumes of compactified spaces as well as the areas of black hole horizons must be quantized in Planck units. This quantization has phenomenological consequences, most dramatic being for micro black holes in the theories with TeV scale gravity that can be produced at LHC. We predict that black holes come in form of a discrete tower with well defined spacing. Instead of thermal evaporation, they decay through the sequence of spontaneous particle emissions, with each transition reducing the horizon area by strictly integer number of Planck units. Quantization of the horizons can be a crucial missing link by which the notion of the minimal length in gravity eliminates physical singularities. In case when the remnants of the black holes with the minimal possible area and mass of order few TeV are stable, they might be good candidates for the cold dark matter in the Universe.Comment: 14 pages, Late

Growth and renal function dynamics of renal oncocytomas on active surveillance

OBJECTIVES: To study the natural history of renal oncocytomas and address indications for intervention by determining how growth is associated with renal function over time, the reasons for surgery and ablation, and disease-specific survival. PATIENTS AND METHODS: The study was conducted in a retrospective cohort of consecutive patients with renal oncocytoma on active surveillance reviewed at the Specialist Centre for Kidney Cancer at the Royal Free London NHS Foundation Trust (2012 to 2019). Comparison between groups was performed using Mann–Whitney U-tests and chi-squared tests. A mixed-effects model with a random intercept for patient was used to study the longitudinal association between tumour size and estimated glomerular filtration rate (eGFR). RESULTS: Longitudinal data from 98 patients with 101 lesions were analysed. Most patients were men (68.3%) and the median (interquartile range [IQR]) age was 69 (13) years. The median (IQR) follow-up was 29 (26) months. Most lesions were small renal masses, and 24% measured over 4 cm. Over half (64.4%) grew at a median (IQR) rate of 2 (4) mm per year. No association was observed between tumour size and eGFR over time (P = 0.871). Nine lesions (8.9%) were subsequently treated. Two deaths were reported, neither were related to the diagnosis of renal oncocytoma. CONCLUSION: Natural history data from the largest active surveillance cohort of renal oncocytomas to date show that renal function does not seem to be negatively impacted by growing oncocytomas, and confirms clinical outcomes are excellent after a median follow-up of over 2 years. Active surveillance should be considered the 'gold standard' management of renal oncocytomas up to 7cm

The Role of Individual Variables, Organizational Variables and Moral Intensity Dimensions in Libyan Management Accountants’ Ethical Decision Making

This study investigates the association of a broad set of variables with the ethical decision making of management accountants in Libya. Adopting a cross-sectional methodology, a questionnaire including four different ethical scenarios was used to gather data from 229 participants. For each scenario, ethical decision making was examined in terms of the recognition, judgment and intention stages of Rest’s model. A significant relationship was found between ethical recognition and ethical judgment and also between ethical judgment and ethical intention, but ethical recognition did not significantly predict ethical intention—thus providing support for Rest’s model. Organizational variables, age and educational level yielded few significant results. The lack of significance for codes of ethics might reflect their relative lack of development in Libya, in which case Libyan companies should pay attention to their content and how they are supported, especially in the light of the under-development of the accounting profession in Libya. Few significant results were also found for gender, but where they were found, males showed more ethical characteristics than females. This unusual result reinforces the dangers of gender stereotyping in business. Personal moral philosophy and moral intensity dimensions were generally found to be significant predictors of the three stages of ethical decision making studied. One implication of this is to give more attention to ethics in accounting education, making the connections between accounting practice and (in Libya) Islam. Overall, this study not only adds to the available empirical evidence on factors affecting ethical decision making, notably examining three stages of Rest’s model, but also offers rare insights into the ethical views of practising management accountants and provides a benchmark for future studies of ethical decision making in Muslim majority countries and other parts of the developing world

An examination of cancer epidemiology studies among populations living close to toxic waste sites

<p>Abstract</p> <p>Background</p> <p>Toxic waste sites contain a broad range of suspected or confirmed human carcinogens, and remain a source of concern to many people, particularly those living in the vicinity of a site. Despite years of study, a consensus has not emerged regarding the cancer risk associated with such sites.</p> <p>Methods</p> <p>We examined the published, peer-reviewed literature addressing cancer incidence or mortality in the vicinity of toxic waste sites between 1980 and 2006, and catalogued the methods employed by such studies.</p> <p>Results</p> <p>Nineteen studies are described with respect to eight methodological criteria. Most were ecological, with minimal utilization of hydrogeological or air pathway modeling. Many did not catalogue whether a potable water supply was contaminated, and very few included contaminant measurements at waste sites or in subjects' homes. Most studies did not appear to be responses to a recognized cancer mortality cluster. Studies were highly variable with respect to handling of competing risk factors and multiple comparisons.</p> <p>Conclusion</p> <p>We conclude that studies to date have generated hypotheses, but have been of limited utility in determining whether populations living near toxic waste sites are at increased cancer risk.</p

On the Integrand-Reduction Method for Two-Loop Scattering Amplitudes

We propose a first implementation of the integrand-reduction method for two-loop scattering amplitudes. We show that the residues of the amplitudes on multi-particle cuts are polynomials in the irreducible scalar products involving the loop momenta, and that the reduction of the amplitudes in terms of master integrals can be realized through polynomial fitting of the integrand, without any apriori knowledge of the integral basis. We discuss how the polynomial shapes of the residues determine the basis of master integrals appearing in the final result. We present a four-dimensional constructive algorithm that we apply to planar and non-planar contributions to the 4- and 5-point MHV amplitudes in N=4 SYM. The technique hereby discussed extends the well-established analogous method holding for one-loop amplitudes, and can be considered a preliminary study towards the systematic reduction at the integrand-level of two-loop amplitudes in any gauge theory, suitable for their automated semianalytic evaluation.Comment: 26 pages, 11 figure

Lower Blood Calcium Associates with Unfavorable Prognosis and Predicts for Bone Metastasis in NSCLC

Ionized calcium was involved in various cellular signal pathways,and regulates many cellular processes, including those relevant to tumorigenesis. We hypothesis that imbalance of calcium homeostasis is correlated with development of lung carcinomas. We collected the clinical data of 1084 patients with non small cell lung cancer (NSCLC) treated in Shandong Provincial Hospital, Shandong University. Logistic regression was used to determine the association between calcium levels and clinical characteristics, and COX regression and Kaplan-Meier model were applied to analyze risk factors on overall survival. Blood electrolytes were tested before treatment; and nearly 16% patients with NSCLC were complained with decreased blood calcium, which is more frequent than that in other electrolytes. Further, Multivariate logistic regression analysis disclosed that there were significant correlation between blood calcium decrease and moderate and poor differentiation (P = 0.012, OR = 1.926 (1.203–4.219)), squamous cell carcinoma (P = 0.024, OR = 1.968(1.094–3.540)), and bone metastasis (P = 0.032, OR = 0.396(0.235–0.669)). In multivariate COX regression analysis, advanced lymph node stage and decreased blood calcium were significantly and independent, unfavorable prognostic factors (P<0.001). Finally, the Kaplan-Meier Survival curve revealed that blood calcium decrease was associated with shorter survival (Log-rank; χ2 = 26.172,P<0.001). Our finding indicates that lower blood calcium levels are associated with a higher risk of unfavorable prognosis and bone metastasis of NSCLC

Search For Heavy Pointlike Dirac Monopoles

We have searched for central production of a pair of photons with high transverse energies in $p\bar p$ collisions at $\sqrt{s} = 1.8$ TeV using $70 pb^{-1}$ of data collected with the D\O detector at the Fermilab Tevatron in 1994--1996. If they exist, virtual heavy pointlike Dirac monopoles could rescatter pairs of nearly real photons into this final state via a box diagram. We observe no excess of events above background, and set lower 95% C.L. limits of $610, 870, or 1580 GeV/c^2$ on the mass of a spin 0, 1/2, or 1 Dirac monopole.Comment: 12 pages, 4 figure

The Dijet Mass Spectrum and a Search for Quark Compositeness in bar{p}p Collisions at sqrt{s} = 1.8 TeV

Using the DZero detector at the 1.8 TeV pbarp Fermilab Tevatron collider, we have measured the inclusive dijet mass spectrum in the central pseudorapidity region |eta_jet| < 1.0 for dijet masses greater than 200 Gev/c^2. We have also measured the ratio of spectra sigma(|eta_jet| < 0.5)/sigma(0.5 < |eta_jet| < 1.0). The order alpha_s^3 QCD predictions are in good agreement with the data and we rule out models of quark compositeness with a contact interaction scale < 2.4 TeV at the 95% confidence level.Comment: 11 pages, 4 figures, 2 tables, submitted to Phys. Rev. Let