Spatial patterns of diabetes related health problems for vulnerable populations in Los Angeles

Abstract Background Rates for Diabetes Mellitus continue to rise in most urban areas of the United States, with a disproportionate burden suffered by minorities and low income populations. This paper presents an approach that utilizes address level data to understand the geography of this disease by analyzing patients seeking diabetes care through an emergency department in a Los Angeles County hospital. The most vulnerable frequently use an emergency room as a common care access point, and such care is especially costly. A fine scale GIS analysis reveals hotspots of diabetes related health problems and provides output useful in a clinic setting. Indeed these results were used to support the work of a progressive diabetes clinic to guide management and intervention strategies. Results Hotspots of diabetes related health problems, including neurological and kidney issues were mapped for vulnerable populations in a central section of Los Angeles County. The resulting spatial grid of rates and significance were overlaid with new patient residential addresses attending an area clinic. In this way neighbourhood diabetes health characteristics are added to each patient's individual health record. Of the 29 patients, 4 were within statistically significant hotspots for at least one of the conditions being investigated. Conclusions Although exploratory in nature, this approach demonstrates a novel method to conduct GIS based investigations of urban diabetes while providing support to a progressive diabetes clinic looking for novel means of managing and intervention. In so doing, this analysis adds to a relatively small literature on fine scale GIS facilitated diabetes research. Similar data should be available for most hospitals, and with due consideration for preserving spatial confidentiality, analysis outputs such as those presented here should become more commonly employed in other investigations of chronic diseases.</p

Exact Master Equation and Non-Markovian Decoherence for Quantum Dot Quantum Computing

In this article, we report the recent progress on decoherence dynamics of electrons in quantum dot quantum computing systems using the exact master equation we derived recently based on the Feynman-Vernon influence functional approach. The exact master equation is valid for general nanostructure systems coupled to multi-reservoirs with arbitrary spectral densities, temperatures and biases. We take the double quantum dot charge qubit system as a specific example, and discuss in details the decoherence dynamics of the charge qubit under coherence controls. The decoherence dynamics risen from the entanglement between the system and the environment is mainly non-Markovian. We further discuss the decoherence of the double-dot charge qubit induced by quantum point contact (QPC) measurement where the master equation is re-derived using the Keldysh non-equilibrium Green function technique due to the non-linear coupling between the charge qubit and the QPC. The non-Markovian decoherence dynamics in the measurement processes is extensively discussed as well.Comment: 15 pages, Invited article for the special issue "Quantum Decoherence and Entanglement" in Quantum Inf. Proces

Outcomes and characteristics of ertapenem-nonsusceptible Klebsiella pneumoniae bacteremia at a university hospital in Northern Taiwan: A matched case-control study

Background and purposeCarbapenem-resistant Klebsiella pneumoniae is an emerging problem worldwide. The object of this study was to investigate the risk factors, characteristics and outcomes of ertapenem-nonsusceptible K pneumoniae (ENSKp) bacteremia.MethodsWe conducted a 1:2 ratio matched case-control study. The controls were randomly selected among patients with ertapenem-susceptible K pneumoniae (ESKp) bacteremia and were matched with ENSKp cases for bacteremia.ResultsSeventy-five patients were included in this study (25 cases and 50 controls). Bivariate analysis showed that prior exposure to either β-Lactam/β-Lactam-lactamase inhibitors (p = 0.008) or 4th generation cephalosporins (p < 0.001), chronic obstructive pulmonary disease (COPD) (p = 0.001), acute renal failure (p = 0.021), chronic kidney disease without dialysis (p = 0.021), recent hospital stay (p = 0.016), intensive care unit stay (p = 0.002), mechanical ventilation (p = 0.003), central venous catheter placement (p = 0.016), Foley indwelling (p = 0.022), polymicrobial bacteremia (p = 0.003) and higher Pittsburgh bacteremia score (p < 0.001) were associated with ENSKp bacteremia. The multivariate analysis showed that prior exposure to 4th generation cephalosporins (odds ratio [OR], 28.05; 95% confidence interval [CI], 2.92–269.85; p = 0.004), COPD (OR, 21.38; 95% CI, 2.95–154.92; p = 0.002) and higher Pittsburgh bacteremia score (OR, 1.35; 95% CI, 1.10–1.66; p = 0.004) were independent factors for ENSKp bacteremia. ENSKp bacteremia had a higher 14-day mortality rate than ESKp bacteremia (44.0% vs. 22.0%; p = 0.049). The overall in-hospital mortality rates for these two groups were 60.0% and 40.0% respectively (p = 0.102).ConclusionENSKp bacteremia had a poor outcome and the risk factors were prior exposure of 4th generation cephalosporins, COPD and higher Pittsburgh bacteremia score. Antibiotic stewardship may be the solution for the preventive strategy

The Association of Thyrotropin and Autoimmune Thyroid Disease in Developing Papillary Thyroid Cancer

Background. Papillary thyroid carcinoma (PTC) is the most common type of malignant thyroid neoplasm. However, the incidence of PTC with autoimmune thyroid disease (AITD) varies between studies. This study aims to investigate whether patients with AITD have increased incidence of PTC. We also analyzed the relationship of serum thyroid-stimulating hormone (TSH) levels and PTC in relation to AITD based on histopathological data. Methods. A total of 533 participants who underwent thyroidectomy were enrolled in this retrospective study based on clinicohistopathological data and known thyroid autoantibodies. Patients were divided into PTC and benign groups according to histopathologic diagnosis. Age, gender, body mass index, and serum TSH level before thyroidectomy were recorded. Results. Of the 533 enrolled patients, 159 (29.8%) were diagnosed with PTC, of which 38 (35.5%) had Hashimoto’s thyroiditis (HT). More patients with HT were female, and patients with HT, Graves’ disease, and thyroid nodules with higher TSH level had a higher incidence of PTC. Conclusions. A high proportion of the patients with PTC had HT. There was a trend that a higher serum TSH level was associated with a greater risk of thyroid cancer

Metal-free sp(3) C-H functionalization: a novel approach for the syntheses of selenide ethers and thioesters from methyl arenes

A DTBP-promoted metal-free and solvent-free formation of C-Se and C-S bonds through sp(3) C-H functionalization of methyl arenes with diselenides and disulfides is described

Unconventional superconductivity of NdFeAsO0.82F0.18 indicated by the low temperature dependence of the lower critical field Hc1

We measured the initial M-H curves for a sample of the newly discovered superconductor NdFeAsO0.82Fe0.18, which had a critical temperature, Tc, of 51 K, and was fabricated at the high pressure of 6 GPa. The lower critical field, Hc1, was extracted from the deviation point of the Meissner linearity in the M-H curves, which show linear temperature dependence in the low temperature region down to 5 K. The Hc1(T) indicates no s-wave superconductivity, but rather an unconventional superconductivity with a nodal gap structure. Furthermore, the linearity of Hc1 at low temperature does not hold at high temperature, but shows other characteristics, indicating that this superconductor might have multi-gap features. Based on the low temperature nodal gap structure, we estimate that the maximum gap magnitude delta 0 = (1.6+- 0.2) kBTc.Comment: 8 pages, 3 figure