552 research outputs found
Mice null for brush border myosin I assemble brush borders and lack an overt phenotype
published_or_final_versio
Patterns of primary care and mortality among patients with schizophrenia or diabetes: a cluster analysis approach to the retrospective study of healthcare utilization
Abstract Background Patients with schizophrenia have difficulty managing their medical healthcare needs, possibly resulting in delayed treatment and poor outcomes. We analyzed whether patients reduced primary care use over time, differentially by diagnosis with schizophrenia, diabetes, or both schizophrenia and diabetes. We also assessed whether such patterns of primary care use were a significant predictor of mortality over a 4-year period. Methods The Veterans Healthcare Administration (VA) is the largest integrated healthcare system in the United States. Administrative extracts of the VA's all-electronic medical records were studied. Patients over age 50 and diagnosed with schizophrenia in 2002 were age-matched 1:4 to diabetes patients. All patients were followed through 2005. Cluster analysis explored trajectories of primary care use. Proportional hazards regression modelled the impact of these primary care utilization trajectories on survival, controlling for demographic and clinical covariates. Results Patients comprised three diagnostic groups: diabetes only (n = 188,332), schizophrenia only (n = 40,109), and schizophrenia with diabetes (Scz-DM, n = 13,025). Cluster analysis revealed four distinct trajectories of primary care use: consistent over time, increasing over time, high and decreasing, low and decreasing. Patients with schizophrenia only were likely to have low-decreasing use (73% schizophrenia-only vs 54% Scz-DM vs 52% diabetes). Increasing use was least common among schizophrenia patients (4% vs 8% Scz-DM vs 7% diabetes) and was associated with improved survival. Low-decreasing primary care, compared to consistent use, was associated with shorter survival controlling for demographics and case-mix. The observational study was limited by reliance on administrative data. Conclusion Regular primary care and high levels of primary care were associated with better survival for patients with chronic illness, whether psychiatric or medical. For schizophrenia patients, with or without comorbid diabetes, primary care offers a survival benefit, suggesting that innovations in treatment retention targeting at-risk groups can offer significant promise of improving outcomes.http://deepblue.lib.umich.edu/bitstream/2027.42/78274/1/1472-6963-9-127.xmlhttp://deepblue.lib.umich.edu/bitstream/2027.42/78274/2/1472-6963-9-127.pdfPeer Reviewe
Polybrominated biphenyls in lactating Michigan women: Persistence in the population
Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47988/1/128_2005_Article_BF01607475.pd
Condensate cosmology in O'Raifeartaigh models
Flat directions charged under an R-symmetry are a generic feature of
O'Raifeartaigh models. Non-topological solitons associated with this symmetry,
R-balls, are likely to form through the fragmentation of a condensate, itself
created by soft terms induced during inflation. In gravity mediated SUSY
breaking R-balls decay to gravitinos, reheating the universe. For gauge
mediation R-balls can provide a good dark matter candidate. Alternatively they
can decay, either reheating or cooling the universe. Conserved R-symmetry
permits decay to gravitinos or gauginos, whereas spontaneously broken
R-symmetry results in decay to visible sector gauge bosons.Comment: 29 pages, 5 figures. Comments and references added, accepted for
publication in JHE
Accelerated expansion from ghost-free bigravity: a statistical analysis with improved generality
We study the background cosmology of the ghost-free, bimetric theory of
gravity. We perform an extensive statistical analysis of the model using both
frequentist and Bayesian frameworks and employ the constraints on the expansion
history of the Universe from the observations of supernovae, the cosmic
microwave background and the large scale structure to estimate the model's
parameters and test the goodness of the fits. We explore the parameter space of
the model with nested sampling to find the best-fit chi-square, obtain the
Bayesian evidence, and compute the marginalized posteriors and mean
likelihoods. We mainly focus on a class of sub-models with no explicit
cosmological constant (or vacuum energy) term to assess the ability of the
theory to dynamically cause a late-time accelerated expansion. The model
behaves as standard gravity without a cosmological constant at early times,
with an emergent extra contribution to the energy density that converges to a
cosmological constant in the far future. The model can in most cases yield very
good fits and is in perfect agreement with the data. This is because many
points in the parameter space of the model exist that give rise to
time-evolution equations that are effectively very similar to those of the
CDM. This similarity makes the model compatible with observations as
in the CDM case, at least at the background level. Even though our
results indicate a slightly better fit for the CDM concordance model
in terms of the -value and evidence, none of the models is statistically
preferred to the other. However, the parameters of the bigravity model are in
general degenerate. A similar but perturbative analysis of the model as well as
more data will be required to break the degeneracies and constrain the
parameters, in case the model will still be viable compared to the
CDM.Comment: 42 pages, 9 figures; typos corrected in equations (2.12), (2.13),
(3.7), (3.8) and (3.9); more discussions added (footnotes 5, 8, 10 and 13)
and abstract, sections 4.2, 4.3 and 5 (conclusions) modified in response to
referee's comments; references added; acknowledgements modified; all results
completely unchanged; matches version accepted for publication in JHE
Fluids in cosmology
We review the role of fluids in cosmology by first introducing them in
General Relativity and then by applying them to a FRW Universe's model. We
describe how relativistic and non-relativistic components evolve in the
background dynamics. We also introduce scalar fields to show that they are able
to yield an inflationary dynamics at very early times (inflation) and late
times (quintessence). Then, we proceed to study the thermodynamical properties
of the fluids and, lastly, its perturbed kinematics. We make emphasis in the
constrictions of parameters by recent cosmological probes.Comment: 34 pages, 4 figures, version accepted as invited review to the book
"Computational and Experimental Fluid Mechanics with Applications to Physics,
Engineering and the Environment". Version 2: typos corrected and references
expande
The Cosmological Constant
This is a review of the physics and cosmology of the cosmological constant.
Focusing on recent developments, I present a pedagogical overview of cosmology
in the presence of a cosmological constant, observational constraints on its
magnitude, and the physics of a small (and potentially nonzero) vacuum energy.Comment: 50 pages. Submitted to Living Reviews in Relativity
(http://www.livingreviews.org/), December 199
A Survey on Continuous Time Computations
We provide an overview of theories of continuous time computation. These
theories allow us to understand both the hardness of questions related to
continuous time dynamical systems and the computational power of continuous
time analog models. We survey the existing models, summarizing results, and
point to relevant references in the literature
Issues in the management of simple and complex meconium ileus
Various surgical methods are used to treat meconium ileus (MI), including resection with enterostomy (RES), primary anastomosis (RPA), and purse-string enterotomy with intra-operative lavage (PSI). The aim of this study is to discuss the surgical treatment of MI, based on our experience. Of the 41 MI patients treated at our institution between 1984 and 2007, 18 had simple MI and 23 had complex MI. These groups were analyzed according to treatment modality, concentrating on length of hospital stay, complications [peritonitis, septicemia, adhesive small bowel obstruction (ASBO), and malabsorption/diarrhea], need for additional surgical procedures, mortality. Of the 18 patients with simple MI, 7 (39%) were successfully treated with diluted Gastrografin® enema. The remaining 11 patients were treated surgically: two underwent RPA, of whom one died; five had RES, of whom one developed ASBO; four underwent PSI, of whom two developed peritonitis. In the complex MI group, 14 patients underwent RPA, with peritonitis occurring in three (one died); nine underwent RES, of whom two developed ASBO. In patients with simple MI, conservative treatment with diluted Gastrografin® enema is an effective initial treatment in our hands. In case of failure, RES is advisable. Patients with complex MI are candidates for RES. RPA and PSI seem to have higher complication rate
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