Zika Virus: Can Artificial Contraception Be Condoned?

As the Zika virus pandemic continues to bring worry and fear to health officials and medical scientists, Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) have recommended that residents of the Zika-infected countries, e.g., Brazil, and those who have traveled to the area should delay having babies which may involve artificial contraceptive, particularly condom. This preventive policy, however, is seemingly at odds with the Roman Catholic Church’s position on the contraceptive. As least since the promulgation of Paul VI’s 1968 encyclical, Humanae Vitae, the Church has explicitly condemned artificial birth control as intrinsic evil. However, the current pontiff, Pope Francis, during his recent visit to Latin America, remarked that the use of artificial contraception may not be in contradiction to the teaching of Humanae Vitae while drawing a parallel between the current Zika Crisis and the 1960’s Belgian Congo Nun Controversy. The pope mentioned that the traditional ethical principle of the lesser of two evils may be the doctrine that justified the exceptions. The authors of this paper attempt to expand the theological rationale of the pope’s suggestion. In so doing, the authors rely on casuistical reasoning as an analytic tool that compares the Belgian Congo Nun case and the given Zika case, and suggest that the former is highly similar to, if not the same as, the latter in terms of normative moral feature. That is, in both cases the use of artificial contraception is theologically justified in reference to the criteria that the doctrine of the lesser of two evils requires. The authors wish that the paper would provide a solid theological-ethical ground based on which condom-use as the most immediate and effective preventive measure can be recommended in numerous Catholic hospitals as well as among Catholic communities in the world, particularly the most Zika-affected and largest Catholic community in the world, Brazil – 123 million present Brazilian citizens are reported to be Roman Catholic

High-Dimensional Stochastic Design Optimization by Adaptive-Sparse Polynomial Dimensional Decomposition

This paper presents a novel adaptive-sparse polynomial dimensional decomposition (PDD) method for stochastic design optimization of complex systems. The method entails an adaptive-sparse PDD approximation of a high-dimensional stochastic response for statistical moment and reliability analyses; a novel integration of the adaptive-sparse PDD approximation and score functions for estimating the first-order design sensitivities of the statistical moments and failure probability; and standard gradient-based optimization algorithms. New analytical formulae are presented for the design sensitivities that are simultaneously determined along with the moments or the failure probability. Numerical results stemming from mathematical functions indicate that the new method provides more computationally efficient design solutions than the existing methods. Finally, stochastic shape optimization of a jet engine bracket with 79 variables was performed, demonstrating the power of the new method to tackle practical engineering problems.Comment: 18 pages, 2 figures, to appear in Sparse Grids and Applications--Stuttgart 2014, Lecture Notes in Computational Science and Engineering 109, edited by J. Garcke and D. Pfl\"{u}ger, Springer International Publishing, 201

Abrupt stratospheric vortex weakening associated with North Atlantic anticyclonic wave breaking

The sudden stratospheric warming (SSW) of 12 February 2018 was not forecast by any extended-range model beyond 12 days. From early February, all forecast models that com prise the subseasonal-to-seasonal (S2S) database abruptly transitioned from indicating a strong stratospheric polar vortex (SPV) to a high likelihood of a major SSW. We demonstrate that this forecast evolution was associated with the track and intensity of a cyclone in the north-east Atlantic, with an associated anticyclonic Rossby wave break, which was not well-forecast. The wave break played a pivotal role in building the Ural high, which existing literature has shown was a precursor of the 2018 SSW. The track of the cyclone built an anomalously strong sea-level pressure dipole between Scandinavia and Greenland (termed the S-G dipole) which we use as a diagnostic of the wave break. Forecasts which did not capture the magnitude of this event had the largest errors in the SPV strength and did not show enhanced vertical wave activity. A composite of similarly strong wintertime (November{March) S-G dipoles in reanalysis shows associated anticyclonic wave breaking leading to significantly enhanced vertical wave activity and a weakened SPV in the following days, which occured in 35% of the 15-day periods preceding observed major SSWs. Our results indicate a particular transient trigger for weakening the SPV, complementing existing results on the importance of tropospheric blocking for disruptions to the Northern Hemisphere extratropical stratospheric circulation

TRPV1-expressing primary afferents generate behavioral responses to pruritogens via multiple mechanisms

The mechanisms that generate itch are poorly understood at both the molecular and cellular levels despite its clinical importance. To explore the peripheral neuronal mechanisms underlying itch, we assessed the behavioral responses (scratching) produced by s.c. injection of various pruritogens in PLCβ3- or TRPV1-deficient mice. We provide evidence that at least 3 different molecular pathways contribute to the transduction of itch responses to different pruritogens: 1) histamine requires the function of both PLCβ3 and the TRPV1 channel; 2) serotonin, or a selective agonist, α-methyl-serotonin (α-Me-5-HT), requires the presence of PLCβ3 but not TRPV1, and 3) endothelin-1 (ET-1) does not require either PLCβ3 or TRPV1. To determine whether the activity of these molecules is represented in a particular subpopulation of sensory neurons, we examined the behavioral consequences of selectively eliminating 2 nonoverlapping subsets of nociceptors. The genetic ablation of MrgprD^+ neurons that represent ≈90% of cutaneous nonpeptidergic neurons did not affect the scratching responses to a number of pruritogens. In contrast, chemical ablation of the central branch of TRPV1+ nociceptors led to a significant behavioral deficit for pruritogens, including α-Me-5-HT and ET-1, that is, the TRPV1-expressing nociceptor was required, whether or not TRPV1 itself was essential. Thus, TRPV1 neurons are equipped with multiple signaling mechanisms that respond to different pruritogens. Some of these require TRPV1 function; others use alternate signal transduction pathways

Early and rapid prediction of patency of the infarct-related coronary artery by using left ventricular wall thickness as measured by two-dimensional echocardiography

AbstractObjectives. The aim of this study was to determine whether echocardiography can distinguish between persistent coronary occlusion and reperfusion.Background. There are no adequate clinical or noninvasive laboratory markers to accurately predict successful reperfusion in an acute myocardial infarction.Methods. In a closed chest swine model, the effect of reperfusion on myocardial wall thickness was studied by comparing a 150-min total coronary artery occlusion (group 1) with 120 min of occlusion followed by 30 min of reperfusion (group 2) in the area of risk as measured by echocardiography. Wall thickness was measured at baseline and at 90 and 150 min.Results. In group 1 (n = 4), there was no appreciable change in mean wall thickness from 90 min to 150 min of occlusion at either end-diastole or end-systole (0.54 ± 0.02 to 0.52 ± 0.03 cm, 0.55 ± 0.03 to 0.54 ± 0.03 cm, respectively; p = NS). In contrast, in group 2 (n = 6), an increase in mean wall thickness from 0.53 ± 0.02 to 0.97 ± 0.05 cm at end-diastole and from 0.56 ± 0.04 to 1.04 ± 0.07 cm at end-systole was found from 90 min of occlusion to 30 min of reperfusion (p < 0.001). Reperfusion resulted. in an increase in wall thickness of 83 ± 11% at end-diastole and 92 ± 17% at end-systole. In contrast, persistent coronary occlusion showed minimal changes of −3.0 ± 5% at end-diastole and −2.0 ± 6% at end-systole.Conclusions. This study confirms the hypothesis that an increase in wall thickness can accurately distinguish between reperfusion and permanent coronary occlusion

Selective interlayer ferromagnetic coupling between the Cu spins in YBa2_2 Cu3_3 O7−x_{7-x} grown on top of La0.7_{0.7} Ca0.3_{0.3} MnO3_3

Studies to date on ferromagnet/d-wave superconductor heterostructures focus mainly on the effects at or near the interfaces while the response of bulk properties to heterostructuring is overlooked. Here we use resonant soft x-ray scattering spectroscopy to reveal a novel c-axis ferromagnetic coupling between the in-plane Cu spins in YBa$_2$ Cu$_3$ O$_{7-x}$ (YBCO) superconductor when it is grown on top of ferromagnetic La$_{0.7}$ Ca$_{0.3}$ MnO$_3$ (LCMO) manganite layer. This coupling, present in both normal and superconducting states of YBCO, is sensitive to the interfacial termination such that it is only observed in bilayers with MnO_2but not with La$_{0.7}$ Ca$_{0.3}$ interfacial termination. Such contrasting behaviors, we propose, are due to distinct energetic of CuO chain and CuO$_2$ plane at the La$_{0.7}$ Ca$_{0.3}$ and MnO$_2$ terminated interfaces respectively, therefore influencing the transfer of spin-polarized electrons from manganite to cuprate differently. Our findings suggest that the superconducting/ferromagnetic bilayers with proper interfacial engineering can be good candidates for searching the theorized Fulde-Ferrel-Larkin-Ovchinnikov (FFLO) state in cuprates and studying the competing quantum orders in highly correlated electron systems.Comment: Please note the change of the title. Text might be slightly different from the published versio

On Perturbations in Warm Inflation

Warm inflation is an interesting possibility of describing the early universe, whose basic feature is the absence, at least in principle, of a preheating or reheating phase. Here we analyze the dynamics of warm inflation generalizing the usual slow-roll parameters that are useful for characterizing the inflationary phase. We study the evolution of entropy and adiabatic perturbations, where the main result is that for a very small amount of dissipation the entropy perturbations can be neglected and the purely adiabatic perturbations will be responsible for the primordial spectrum of inhomogeneities. Taking into account the COBE-DMR data of the cosmic microwave background anisotropy as well as the fact that the interval of inflation for which the scales of astrophysical interest cross outside the Hubble radius is about 50 e-folds before the end of inflation, we could estimate the magnitude of the dissipation term. It was also possible to show that at the end of inflation the universe is hot enough to provide a smooth transition to the radiation era.Comment: 12 pages, no figures, requires revtex4. Further explanation on the origin of the entropy perturbation, reference added and minor notation change. Version accepted for publication in Phys. Rev.

Utilization of a novel digital measurement tool for quantitative assessment of upper extremity motor dexterity: a controlled pilot study.

BackgroundThe current methods of assessing motor function rely primarily on the clinician's judgment of the patient's physical examination and the patient's self-administered surveys. Recently, computerized handgrip tools have been designed as an objective method to quantify upper-extremity motor function. This pilot study explores the use of the MediSens handgrip as a potential clinical tool for objectively assessing the motor function of the hand.MethodsEleven patients with cervical spondylotic myelopathy (CSM) were followed for three months. Eighteen age-matched healthy participants were followed for two months. The neuromotor function and the patient-perceived motor function of these patients were assessed with the MediSens device and the Oswestry Disability Index respectively. The MediSens device utilized a target tracking test to investigate the neuromotor capacity of the participants. The mean absolute error (MAE) between the target curve and the curve tracing achieved by the participants was used as the assessment metric. The patients' adjusted MediSens MAE scores were then compared to the controls. The CSM patients were further classified as either "functional" or "nonfunctional" in order to validate the system's responsiveness. Finally, the correlation between the MediSens MAE score and the ODI score was investigated.ResultsThe control participants had lower MediSens MAE scores of 8.09%±1.60%, while the cervical spinal disorder patients had greater MediSens MAE scores of 11.24%±6.29%. Following surgery, the functional CSM patients had an average MediSens MAE score of 7.13%±1.60%, while the nonfunctional CSM patients had an average score of 12.41%±6.32%. The MediSens MAE and the ODI scores showed a statistically significant correlation (r=-0.341, p&lt;1.14×10⁻⁵). A Bland-Altman plot was then used to validate the agreement between the two scores. Furthermore, the percentage improvement of the the two scores after receiving the surgical intervention showed a significant correlation (r=-0.723, p&lt;0.04).ConclusionsThe MediSens handgrip device is capable of identifying patients with impaired motor function of the hand. The MediSens handgrip scores correlate with the ODI scores and may serve as an objective alternative for assessing motor function of the hand

Quality Improvement for Cardiovascular Disease Care in Low- and Middle-Income Countries: A Systematic Review

Background The majority of global cardiovascular disease (CVD) burden falls on people living in low- and middle-income countries (LMICs). In order to reduce preventable CVD mortality and morbidity, LMIC health systems and health care providers need to improve the delivery and quality of CVD care. Objectives As part of the Disease Control Priorities Three (DCP3) Study efforts addressing quality improvement, we reviewed and summarized currently available evidence on interventions to improve quality of clinic-based CVD prevention and management in LMICs. Methods We conducted a narrative review of published comparative clinical trials that evaluated efficacy or effectiveness of clinic-based CVD prevention and management quality improvement interventions in LMICs. Conditions selected a priori included hypertension, diabetes, hyperlipidemia, coronary artery disease, stroke, rheumatic heart disease, and congestive heart failure. MEDLINE and EMBASE electronic databases were systematically searched. Studies were categorized as occurring at the system or patient/provider level and as treating the acute or chronic phase of CVD. Results From 847 articles identified in the electronic search, 49 met full inclusion criteria and were selected for review. Selected studies were performed in 19 different LMICs. There were 10 studies of system level quality improvement interventions, 38 studies of patient/provider interventions, and one study that fit both criteria. At the patient/provider level, regardless of the specific intervention, intensified, team-based care generally led to improved medication adherence and hypertension control. At the system level, studies provided evidence that introduction of universal health insurance coverage improved hypertension and diabetes control. Studies of system and patient/provider level acute coronary syndrome quality improvement interventions yielded inconclusive results. The duration of most studies was less than 12 months. Conclusions The results of this review suggest that CVD care quality improvement can be successfully implemented in LMICs. Most studies focused on chronic CVD conditions; more acute CVD care quality improvement studies are needed. Longer term interventions and follow-up will be needed in order to assess the sustainability of quality improvement efforts in LMICs