Double trouble: the impact of multimorbidity and deprivation on preference-weighted health related quality of life - a cross sectional analysis of the Scottish Health Survey

<b>Objective</b> To investigate the association between multimorbidity and Preference_Weighted Health Related Quality of Life (PW_HRQoL), a score that combines physical and mental functioning, and how this varies by socioeconomic deprivation and age.<p></p> <b>Design</b> The Scottish Health Survey (SHeS) is a cross-sectional representative survey of the general population which included the SF-12, a survey of HRQoL, for individuals 20 years and over.<p></p> <b>Methods</b> For 7,054 participants we generated PW_HRQoL scores by running SF-12 responses through the SF-6D algorithm. The resulting scores ranged from 0.29 (worst health) to 1 (perfect health). Using ordinary least squares, we first investigated associations between scores and increasing counts of longstanding conditions, and then repeated for multimorbidity (2+ conditions). Estimates were made for the general population and quintiles of socioeconomic deprivation. For multimorbidity, the analyses were repeated stratifying the population by age group (20--44, 45--64, 65+).<p></p> <b>Results</b> 45% of participants reported a longstanding condition and 18% reported multimorbidity. The presence of 1, 2, or 3+ longstanding conditions were associated with average reductions in PW_HRQoL scores of 0.081, 0.151 and 0.212 respectively. Reduction in scores associated with multimorbidity was 33% greater in the most deprived quintile compared to the least deprived quintile, with the biggest difference (80%) in the 20--44 age groups. There were no significant gender differences.<p></p> <b>Conclusions</b> PW_HRQoL decreases markedly with multimorbidity, and is exacerbated by higher deprivation and younger age. There is a need to prioritise interventions to improve the HRQoL for (especially younger) adults with multimorbidity in deprived areas

A Brodie's abscess with soft tissue collection-complicating an already difficult diagnosis

A healthy 14-year-old boy with a 3-month history of thigh pain and swelling is referred to a specialist centre with an uncertain diagnosis. After extensive tests and imaging a Brodie’s abscess is diagnosed. The abscess is complicated by a fistula (cloaca) through the cortical bone of the femur, resulting in a large complex soft tissue collection. This is a presentation, we are unaware has been documented in any literature. After specialist multi-team combined management (Paediatric Trauma and Orthopaedic and Paediatric Infectious Diseases), the patient undergoes two surgical procedures, and extensive antibiotic cover. The patient makes a good recovery with no long lasting sequelae to date

Einstein Manifolds As Yang-Mills Instantons

It is well-known that Einstein gravity can be formulated as a gauge theory of Lorentz group where spin connections play a role of gauge fields and Riemann curvature tensors correspond to their field strengths. One can then pose an interesting question: What is the Einstein equations from the gauge theory point of view? Or equivalently, what is the gauge theory object corresponding to Einstein manifolds? We show that the Einstein equations in four dimensions are precisely self-duality equations in Yang-Mills gauge theory and so Einstein manifolds correspond to Yang-Mills instantons in SO(4) = SU(2)_L x SU(2)_R gauge theory. Specifically, we prove that any Einstein manifold with or without a cosmological constant always arises as the sum of SU(2)_L instantons and SU(2)_R anti-instantons. This result explains why an Einstein manifold must be stable because two kinds of instantons belong to different gauge groups, instantons in SU(2)_L and anti-instantons in SU(2)_R, and so they cannot decay into a vacuum. We further illuminate the stability of Einstein manifolds by showing that they carry nontrivial topological invariants.Comment: v4; 17 pages, published version in Mod. Phys. Lett.

Flip Distance Between Triangulations of a Simple Polygon is NP-Complete

Let T be a triangulation of a simple polygon. A flip in T is the operation of removing one diagonal of T and adding a different one such that the resulting graph is again a triangulation. The flip distance between two triangulations is the smallest number of flips required to transform one triangulation into the other. For the special case of convex polygons, the problem of determining the shortest flip distance between two triangulations is equivalent to determining the rotation distance between two binary trees, a central problem which is still open after over 25 years of intensive study. We show that computing the flip distance between two triangulations of a simple polygon is NP-complete. This complements a recent result that shows APX-hardness of determining the flip distance between two triangulations of a planar point set.Comment: Accepted versio

Allosteric HIV-1 integrase inhibitors lead to premature degradation of the viral RNA genome and integrase in target cells

ABSTRACT Recent evidence indicates that inhibition of HIV-1 integrase (IN) binding to the viral RNA genome by allosteric integrase inhibitors (ALLINIs) or through mutations within IN yields aberrant particles in which the viral ribonucleoprotein complexes (vRNPs) are eccentrically localized outside the capsid lattice. These particles are noninfectious and are blocked at an early reverse transcription stage in target cells. However, the basis of this reverse transcription defect is unknown. Here, we show that the viral RNA genome and IN from ALLINI-treated virions are prematurely degraded in target cells, whereas reverse transcriptase remains active and stably associated with the capsid lattice. The aberrantly shaped cores in ALLINI-treated particles can efficiently saturate and be degraded by a restricting TRIM5 protein, indicating that they are still composed of capsid proteins arranged in a hexagonal lattice. Notably, the fates of viral core components follow a similar pattern in cells infected with eccentric particles generated by mutations within IN that inhibit its binding to the viral RNA genome. We propose that IN-RNA interactions allow packaging of both the viral RNA genome and IN within the protective capsid lattice to ensure subsequent reverse transcription and productive infection in target cells. Conversely, disruption of these interactions by ALLINIs or mutations in IN leads to premature degradation of both the viral RNA genome and IN, as well as the spatial separation of reverse transcriptase from the viral genome during early steps of infection. IMPORTANCE Recent evidence indicates that HIV-1 integrase (IN) plays a key role during particle maturation by binding to the viral RNA genome. Inhibition of IN-RNA interactions yields aberrant particles with the viral ribonucleoprotein complexes (vRNPs) eccentrically localized outside the conical capsid lattice. Although these particles contain all of the components necessary for reverse transcription, they are blocked at an early reverse transcription stage in target cells. To explain the basis of this defect, we tracked the fates of multiple viral components in infected cells. Here, we show that the viral RNA genome and IN in eccentric particles are prematurely degraded, whereas reverse transcriptase remains active and stably associated within the capsid lattice. We propose that IN-RNA interactions ensure the packaging of both vRNPs and IN within the protective capsid cores to facilitate subsequent reverse transcription and productive infection in target cells. </jats:p

Fermionic Symmetries: Extension of the two to one Relationship Between the Spectra of Even-Even and Neighbouring Odd mass Nuclei

In the single j shell there is a two to one relationship between the spectra of certain even-even and neighbouring odd mass nuclei e.g. the calculated energy levels of J=0^+ states in ^{44}Ti are at twice the energies of corresponding levels in ^{43}Ti(^{43}Sc) with J=j=7/2. Here an approximate extension of the relationship is made by adopting a truncated seniority scheme i.e. for ^{46}Ti and ^{45}Sc we get the relationship if we do not allow the seniority v=4 states to mix with the v=0 and v=2 states. Better than that, we get very close to the two to one relationship if seniority v=4 states are admixed perturbatively. In addition, it is shown that the higher isospin states do not contain seniority 4 admixtures.Comment: 11 pages, RevTex file and no figures, typos added, references changed and changed content

Reply: Koilocytes indicate a role for human papilloma virus in breast cancer

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The 3-53 keV Spectrum of the Quasar 1508+5714: X-rays from z = 4.3

We present a high-quality X-ray spectrum in the 3--53 keV rest-frame band of the radio-loud quasar 1508+5714, by far the brightest known X-ray source at z > 4. A simple power-law model with an absorption column density equal to the Galactic value in the direction of the source provides an excellent and fully adequate fit to the data; the measured power-law photon index Gamma = 1.42 (+0.13,-0.10). Upper limits to Fe K alpha line emission and Compton-reflection components are derived. We offer evidence for both X-ray and radio variability in this object and provide the first contemporaneous radio spectrum (alpha = -0.25). The data are all consistent with a picture in which the emission from this source is dominated by a relativistically beamed component in both the X-ray and radio bands.Comment: 8 pages, TeX, 2 postscript figures; to appear in ApJ Letter

Unlocking datasets by calibrating populations of models to data density: a study in atrial electrophysiology

The understanding of complex physical or biological systems nearly always requires a characterization of the variability that underpins these processes. In addition, the data used to calibrate these models may also often exhibit considerable variability. A recent approach to deal with these issues has been to calibrate populations of models (POMs), multiple copies of a singlemathematicalmodel butwith different parameter values, in response to experimental data. To date, this calibration has been largely limited to selectingmodels that produce outputs that fallwithin the ranges of the data set, ignoring any trends that might be present in the data. We present here a novel and general methodology for calibrating POMs to the distributions of a set of measured values in a data set.We demonstrate our technique using a data set from a cardiac electrophysiology study based on the differences in atrial action potential readings between patients exhibiting sinus rhythm (SR) or chronic atrial fibrillation (cAF) and the Courtemanche-Ramirez-Nattel model for human atrial action potentials. Not only does our approach accurately capture the variability inherent in the experimental population, but we also demonstrate how the POMs that it produces may be used to extract additional information from the data used for calibration, including improved identification of the differences underlying stratified data.We also show how our approach allows different hypotheses regarding the variability in complex systems to be quantitatively compared