Assessing the validity of the Triage Risk Screening Tool in a third world setting

Background: Social risk is rarely evaluated in older emergency department (ED) patients, although its identification can reduce re-attendance. Objectives: This study assessed the diagnostic accuracy of the Triage Risk Screening Tool (TRST) in the ED of a developing country. Methods: The diagnostic accuracy of TRST to detect elders at risk was compared to routine clinical evaluation, using a comprehensive evaluation by an experienced social worker as the ‘gold standard’. The inter-rater reliability of the TRST was assessed on a separate cohort of patients prior to the main study. Results: The sensitivity of the TRST was 94.7% vs 55.6% for physician assessment (p = 0.025). The TRST had good inter-rater reliability (Cohen’ Kappa = .882), and physicians found it easy to use. Conclusion: The TRST provides a rapid means of assessing risk in older ED attenders. This study confirmed the validity of this screening tool in a third world setting

Revival of Superconductivity by Y3+/Ca2+ substitution in YBa2Cu2.7Co0.3O7 without reported phase transformation

Results of phase formation, resistivity (r), and thermo-electric power (S), are reported on Y1-xCaxBa2Cu2.7Co0.3O7 compounds with x = 0.1 and 0.2. Pristine compound i.e. without Co or Ca substitution crystallizes in orthorhombic structure with space group P/mmm. Cu-site Co substituted compound i.e. YBa2Cu2.7Co0.3O7 is tetragonal. With simultaneous doping of Ca at Y site in Co substituted compound i.e. Y1-xCaxBa2Cu2.7Co0.3O7 the tetragonal nature still remains. r(T) measurements showed superconducting transition temperature (Tc) to decrease from 90K (YBa2Cu3O7) to 33 K for YBa2Cu2.7Co0.3O7 which with further Ca substitution increases from 33K to 53K (Y0.9 Ca0.1Ba2Cu2.7Co0.3O7) and 67 K for Y0.8 Ca0.2Ba2Cu2.7Co0.3O7. Tc decreases first with Cu-site Co substitution by hole-filling and later recovers by simultaneous hole creation by Y site Ca substitution. Room temperature thermoelectric power S(300 K), which is an indirect measure of mobile carriers shows the decrease of carriers with Co doping and creation by Ca substitution. Our results demonstrate the hole filling by Co substitution is compensated by simultaneous Ca substitution.Comment: 10 pages of TEXT and Fig

Assessing the discordance rate between local and central HER2 testing in women with locally determined HER2-negative breast cancer.

BackgroundThe importance of human epidermal growth factor receptor 2 (HER2) as a prognostic and predictive marker in invasive breast cancer is well established. Accurate assessment of HER2 status is essential to determine optimal treatment options.MethodsBreast cancer tumor tissue samples from the VIRGO observational cohort tissue substudy that were locally HER2-negative were retested centrally with both US Food and Drug Administration (FDA)-approved immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) assays, using FDA-approved assay cutoffs; results were compared.ResultsOf the 552 unique patient samples centrally retested with local HER2-negative results recorded, tumor samples from 22 (4.0%) patients were determined to be HER2-positive (95% confidence interval [CI] = 2.5%-5.7%). Of these, 18 had been tested locally by only one testing methodology; 15 of 18 were HER2-positive after the central retesting, based on the testing methodology not performed locally. Compared with the 530 patients with centrally confirmed HER2-negative tumors, the 22 patients with centrally determined HER2-positive tumors were younger (median age 56.5 versus 60.0 years) and more likely to have ER/PR-negative tumors (27.3% versus 22.3%). These patients also had shorter median progression-free survival (6.4 months [95% CI = 3.8-15.9 months] versus 9.1 months [95% CI = 8.3-10.3 months]) and overall survival (25.9 months [95% CI = 13.8-not estimable] versus 27.9 months [95% CI = 25.0-32.9 months]).ConclusionsThis study highlights the limitations of employing just one HER2 testing methodology in current clinical practice. It identifies a cohort of patients who did not receive potentially efficacious therapy because their tumor HER2-positivity was not determined by the test initially used. Because of inherent limitations in testing methodologies, it is inadvisable to rely on a single test to rule out potential benefit from HER2-targeted therapy

Polarisation leakage due to errors in track reconstruction in gas pixel detectors

X-ray polarimetry based on gas pixel detectors (GPDs) has reached a high level of maturity thanks to the Imaging X-ray Polarimeter Explorer (IXPE) providing the first-ever spatially resolved polarimetric measurements. However, as this a new technique, a few unexpected effects have emerged in the course of in-flight operations. In particular, it was almost immediately found that, the unpolarized calibration sources on-board were showing radially polarized halos. The origin of these features was recognized in a correlation between the error in reconstructing the absorption point of the X-ray photon and the direction of its electric field vector. Here, we present and discuss this effect in detail, showing that it is possible to provide a simple and robust mathematical formalism to handle it. We further show its role and relevance for the recent IXPE measures as well as for the use of GPD-based techniques in general. We also illustrate how to model it in the context of studying extended sources

Nd3+-doped TeO2–PbF2–AlF3 glasses for laser applications

A study of the optical properties of Nd3+ ion in TeO2–PbF2–AlF3 glasses has been carried out for different Nd3+ concentrations. Based on the Judd–Ofelt theory, intensity parameters and radiative properties were determined from the absorption spectra. Focusing on the suitability of this host for laser applications, the spectroscopic quality factor v was obtained with a value of 1.07, a value of the order of other compositions proposed as laser hosts. For the most intense emission corresponding with the 4F3/2?4I11/2 transition (1.06 lm), the absorption and emission and have been calculated with values of 1.20 10 20 cm2, 2.08 10 20 cm2. A positive value for the gain cross-sections has been found for a population inversion factor c of 0.4 in the spectral range from 1060 to 1110 nm. All these results suggest the potentially use of this system as a laser host

Evaluation of Linked Determinants Between Diabetes and Caries

Dental caries and diabetes mellitus, represent two chronic diseases of public health that present statistics of high prevalence worldwide. One of the main problems that affect these conditions is demography, since the least developed countries are those that have less access to public health services and are limited by the economic costs that represent the treatments. In this work is presented the univariate analysis, of a set of demographic determinants obtained from the National Health and Nutrition Examination Surveys (NHANES), in order to identify those that present the most significant information related to estimation of these diseases. According to the results, the age of the subjects is the main determinant describing the simultaneous presence of these diseases, obtaining an area under the curve (AUC) value ≥ 0.846, concluding that age can be used as tool for their preventive diagnosis