247 research outputs found
Idiopathic mediastinal fibrosis
peer reviewedFibrosing mediastinitis is a rare condition characterized by an excessive growth of dense fibrous tissue within the mediastinum. The etiology of the disease is most often a fungal infection and may in some cases be idiopathic. We present the case of a patient with chronic obstructive pulmonary disease (COPD) suffering from fibrosing mediastinitis of undetermined origin and in whom the diagnosis was established by histopathological analysis after mediastinoscopy
Heterogeneous Bond Percolation on Multitype Networks with an Application to Epidemic Dynamics
Considerable attention has been paid, in recent years, to the use of networks
in modeling complex real-world systems. Among the many dynamical processes
involving networks, propagation processes -- in which final state can be
obtained by studying the underlying network percolation properties -- have
raised formidable interest. In this paper, we present a bond percolation model
of multitype networks with an arbitrary joint degree distribution that allows
heterogeneity in the edge occupation probability. As previously demonstrated,
the multitype approach allows many non-trivial mixing patterns such as
assortativity and clustering between nodes. We derive a number of useful
statistical properties of multitype networks as well as a general phase
transition criterion. We also demonstrate that a number of previous models
based on probability generating functions are special cases of the proposed
formalism. We further show that the multitype approach, by naturally allowing
heterogeneity in the bond occupation probability, overcomes some of the
correlation issues encountered by previous models. We illustrate this point in
the context of contact network epidemiology.Comment: 10 pages, 5 figures. Minor modifications were made in figures 3, 4
and 5 and in the text. Explanations and references were adde
The clinical and cost burden of coronary calcification in a Medicare cohort: An economic model to address under-reporting and misclassification
AbstractBackgroundCoronary artery calcification (CAC) is a well-established risk factor for the occurrence of adverse ischemic events. However, the economic impact of the presence of CAC is unknown.ObjectivesThrough an economic model analysis, we sought to estimate the incremental impact of CAC on medical care costs and patient mortality for de novo percutaneous coronary intervention (PCI) patients in the 2012 cohort of the Medicare elderly (≥65) population.MethodsThis aggregate burden-of-illness study is incidence-based, focusing on cost and survival outcomes for an annual Medicare cohort based on the recently introduced ICD9 code for CAC. The cost analysis uses a one-year horizon, and the survival analysis considers lost life years and their economic value.ResultsFor calendar year 2012, an estimated 200,945 index (de novo) PCI procedures were performed in this cohort. An estimated 16,000 Medicare beneficiaries (7.9%) were projected to have had severe CAC, generating an additional cost in the first year following their PCI of 56 million in total. In terms of mortality, the model projects that an additional 397 deaths would be attributable to severe CAC in 2012, resulting in 3770 lost life years, representing an estimated loss of about 100,000 each.ConclusionsThese model-based CAC estimates, considering both moderate and severe CAC patients, suggest an annual burden of illness approaching $1.3 billion in this PCI cohort. The potential clinical and cost consequences of CAC warrant additional clinical and economic attention not only on PCI strategies for particular patients but also on reporting and coding to achieve better evidence-based decision-making
Vaccinations in patients with immune-mediated inflammatory diseases
Patients with immune-mediated inflammatory diseases (IMID) such as RA, IBD or psoriasis, are at increased risk of infection, partially because of the disease itself, but mostly because of treatment with immunomodulatory or immunosuppressive drugs. In spite of their elevated risk for vaccine-preventable disease, vaccination coverage in IMID patients is surprisingly low. This review summarizes current literature data on vaccine safety and efficacy in IMID patients treated with immunosuppressive or immunomodulatory drugs and formulates best-practice recommendations on vaccination in this population. Especially in the current era of biological therapies, including TNF-blocking agents, special consideration should be given to vaccination strategies in IMID patients. Clinical evidence indicates that immunization of IMID patients does not increase clinical or laboratory parameters of disease activity. Live vaccines are contraindicated in immunocompromized individuals, but non-live vaccines can safely be given. Although the reduced quality of the immune response in patients under immunotherapy may have a negative impact on vaccination efficacy in this population, adequate humoral response to vaccination in IMID patients has been demonstrated for hepatitis B, influenza and pneumococcal vaccination. Vaccination status is best checked and updated before the start of immunomodulatory therapy: live vaccines are not contraindicated at that time and inactivated vaccines elicit an optimal immune response in immunocompetent individuals
Diversity in action: Exchange of perspectives and reflections on taxonomies of individual differences
Throughout the last 2500 years, the classification of individual differences in healthy people and their extreme expressions in mental disorders has remained one of the most difficult challenges in science that affects our ability to explore individuals' functioning, underlying psychobiological processes and pathways of development. To facilitate analyses of the principles required for studying individual differences, this theme issue brought together prominent scholars from diverse backgrounds of which many bring unique combinations of cross-disciplinary experiences and perspectives that help establish connections and promote exchange across disciplines. This final paper presents brief commentaries of some of our authors and further scholars exchanging perspectives and reflecting on the contributions of this theme issue
Marketing as a means to transformative social conflict resolution: lessons from transitioning war economies and the Colombian coffee marketing system
Social conflicts are ubiquitous to the human condition and occur throughout markets, marketing processes, and marketing systems.When unchecked or unmitigated, social conflict can have devastating consequences for consumers, marketers, and societies, especially when conflict escalates to war. In this article, the authors offer a systemic analysis of the Colombian war economy, with its conflicted shadow and coping markets, to show how a growing network of fair-trade coffee actors has played a key role in transitioning the country’s war economy into a peace economy. They particularly draw attention to the sources of conflict in this market and highlight four transition mechanisms — i.e., empowerment, communication, community building and regulation — through which marketers can contribute to peacemaking and thus produce mutually beneficial outcomes for consumers and society. The article concludes with a discussion of implications for marketing theory, practice, and public policy
Evidence for Type Ia Supernova Diversity from Ultraviolet Observations with the Hubble Space Telescope
We present ultraviolet (UV) spectroscopy and photometry of four Type Ia
supernovae (SNe 2004dt, 2004ef, 2005M, and 2005cf) obtained with the UV prism
of the Advanced Camera for Surveys on the Hubble Space Telescope. This dataset
provides unique spectral time series down to 2000 Angstrom. Significant
diversity is seen in the near maximum-light spectra (~ 2000--3500 Angstrom) for
this small sample. The corresponding photometric data, together with archival
data from Swift Ultraviolet/Optical Telescope observations, provide further
evidence of increased dispersion in the UV emission with respect to the
optical. The peak luminosities measured in uvw1/F250W are found to correlate
with the B-band light-curve shape parameter dm15(B), but with much larger
scatter relative to the correlation in the broad-band B band (e.g., ~0.4 mag
versus ~0.2 mag for those with 0.8 < dm15 < 1.7 mag). SN 2004dt is found as an
outlier of this correlation (at > 3 sigma), being brighter than normal SNe Ia
such as SN 2005cf by ~0.9 mag and ~2.0 mag in the uvw1/F250W and uvm2/F220W
filters, respectively. We show that different progenitor metallicity or
line-expansion velocities alone cannot explain such a large discrepancy.
Viewing-angle effects, such as due to an asymmetric explosion, may have a
significant influence on the flux emitted in the UV region. Detailed modeling
is needed to disentangle and quantify the above effects.Comment: 17 pages, 13 figures, accepted by Ap
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