Household expenditure for dental care in low and middle income countries.

This study assessed the extent of household catastrophic expenditure in dental health care and its possible determinants in 41 low and middle income countries. Data from 182,007 respondents aged 18 years and over (69,315 in 18 low income countries, 59,645 in 15 lower middle income countries and 53,047 in 8 upper middle income countries) who participated in the WHO World Health Survey (WHS) were analyzed. Expenditure in dental health care was defined as catastrophic if it was equal to or higher than 40% of the household capacity to pay. A number of individual and country-level factors were assessed as potential determinants of catastrophic dental health expenditure (CDHE) in multilevel logistic regression with individuals nested within countries. Up to 7% of households in low and middle income countries faced CDHE in the last 4 weeks. This proportion rose up to 35% among households that incurred some dental health expenditure within the same period. The multilevel model showed that wealthier, urban and larger households and more economically developed countries had higher odds of facing CDHE. The results of this study show that payments for dental health care can be a considerable burden on households, to the extent of preventing expenditure on basic necessities. They also help characterize households more likely to incur catastrophic expenditure on dental health care. Alternative health care financing strategies and policies targeted to improve fairness in financial contribution are urgently required in low and middle income countries

Draft genome sequence of "Candidatus Cronobacter colletis" NCTC 14934T, a new species in the genus Cronobacter

Members of the Cronobacter genus are associated with serious infections in neonates. This is the first report of the draft genome sequence for the newly proposed species Cronobacter colletis

Two Loop Low Temperature Corrections to Electron Self Energy

We recalculate the two loop corrections in the background heat bath using real time formalism. The procedure of the integrations of loop momenta with dependence on finite temperature before the momenta without it, has been followed. We determine the mass and wavefunction renormalization constants in the low temperature limit of QED, for the first time with this preferred order of integrations. The correction to electron mass and spinors in this limit is important in the early universe at the time of primordial nucleosynthesis as well as in astrophysics.Comment: 8 pages and 1 figure to appear in Chinese Physics

Integrated multi-band WSS: from design to performance evaluation

Modern day optical communications require ever-increasing bandwidths and capacity, in order to keep up with the growth of traffic and resource-intensive applications. This increase in network capacity can be achieved through the use of the residual capacity of current-day infrastructure, although this requires switching and routing devices capable of wide-band operation in multiple transmission windows. In this work, we describe the design principle, architecture, and performance simulation of a photonic integrated circuit (PIC) based multi-band WSS, which is envisioned to operate on the S+C+L windows. While the architecture is scalable to an arbitrary channel and port count, we showcase a 24-channel implementation deployed on the 400ZR standard, providing both the penalty evaluation through DSP simulations, as well as a footprint evaluation based on the components design

Bactrim, Spironolactone and Lisinopril. Stay Away! A Dangerous Cocktail for Hyperkalemia

Introduction: Hyperkalemia is a potentially life-threatening complication of several medications, particularly in situations of polypharmacy. Trimethoprim/sulfamethoxazole (TMP-SMX) is a first line antibiotic for outpatient treatment of MRSA for skin and soft tissue infections that can enhance the hyperkalemic effects of spironolactone and Angiotensin receptor inhibitors (ACEI). Case Presentation: A 53-year-old female with history of HTN, stage 3 CKD, CHF, hypercholesterolemia and DM II, chronic left foot ulcer presented to our local hospital with generalized malaise, severe lower extremity weakness and heaviness of 2 days duration. She normally uses a walker but has had increasing difficulty standing from a seated position. Her medications included: spironolactone, carvedilol, lisinopril, amlodipine, aspirin, atorvastatin, and insulin and had been started on TMP-SMX for the management of an infected chronic ulcer. Physical exam was significant for a blood pressure of 182/87 mm Hg, BMI of 52, lethargy, dry oral mucous membranes, and nonsignificant musculoskeletal examination. The laboratory results revealed significantly elevated potassium levels at 8.6 mmol/L; GFR of 31 and creatinine: 1.79 mg/dL. EKG revealed tall, peaked T-waves with widened QRS complexes in the precordial leads and a right BBB. TMP-SMX, spironolactone and lisinopril were discontinued, and the patient was started on a hyperkalemia treatment protocol. The patient improved rapidly over the next 3 days with resolution of the ECG changes, improved muscle strength and the potassium level was back to normal limits by the time of discharge. Conclusion: Clinicians and pharmacists should be aware of the enhanced hyperkalemic effects of TMP-SMX, spironolactone and lisinopril and should avoid this combination

Baryon Density and the Dilated Chiral Quark Model

We calculate perturbatively the effect of density on hadronic properties using the chiral quark model implemented by the QCD trace anomaly to see the possibility of constructing Lorentz invariant Lagrangian at finite density. We calculate the density dependent masses of the constituent quark, the scalar field and the pion in one-loop order using the technique of thermo field dynamics. In the chiral limit, the pion remains massless at finite density. It is found that the tadpole type corrections lead to the decreasing masses with increasing baryon density, while the radiative corrections induce Lorentz-symmetry-breaking terms. We found in the large $N_c$ limit with large scalar mass that the tadpoles dominate and the mean-field approximation is reliable, giving rise a Lorentz-invariant Lagrangian with masses decreasing as the baryon density increases.Comment: Late

Stability in Designer Gravity

We study the stability of designer gravity theories, in which one considers gravity coupled to a tachyonic scalar with anti-de Sitter boundary conditions defined by a smooth function W. We construct Hamiltonian generators of the asymptotic symmetries using the covariant phase space method of Wald et al.and find they differ from the spinor charges except when W=0. The positivity of the spinor charge is used to establish a lower bound on the conserved energy of any solution that satisfies boundary conditions for which $W$ has a global minimum. A large class of designer gravity theories therefore have a stable ground state, which the AdS/CFT correspondence indicates should be the lowest energy soliton. We make progress towards proving this, by showing that minimum energy solutions are static. The generalization of our results to designer gravity theories in higher dimensions involving several tachyonic scalars is discussed.Comment: 29 page

CLINICOPATHOLOGICAL SPECTRUM OF ORAL SQUAMOUS CELL CARCINOMA AT A PUBLIC SECTOR HEALTH FACILITY

ABSTRAC

Monitoring lower limb biomechanical asymmetry and psychological measures in athletic populations - A scoping review

Background: Lower limb biomechanics, including asymmetry, are frequently monitored to determine sport performance level and injury risk. However, contributing factors extend beyond biomechanical and asymmetry measures to include psychological, sociological, and environmental factors. Unfortunately, inadequate research has been conducted using holistic bio-psycho-social models to characterize sport performance and injury risk. Therefore, this scoping review summarized the research landscape of studies concurrently assessing measures of lower limb biomechanics, asymmetry, and introspective psychological state (e.g., pain, fatigue, perceived exertion, stress, etc.) in healthy, competitive athletes. Methods: A systematic search of Medline, Embase, CINAHL, SPORT Discus, and Web of Science Core Collections was designed and conducted in accordance with PRISMA guidelines. 51 articles were included in this review. Results: Significant relationships between biomechanics (k = 22 studies) or asymmetry (k = 20 studies) and introspective state were found. Increased self-reported pain was associated with decreased range of motion, strength, and increased lower limb asymmetry. Higher ratings of perceived exertion were related to increased lower limb asymmetry, self-reported muscle soreness, and worse jump performance. Few studies (k = 4) monitored athletes longitudinally throughout one or more competitive season(s). Conclusion: This review highlights the need for concurrent analysis of introspective, psychological state, and biomechanical asymmetry measures along with longitudinal research to understand the contributing factors to sport performance and injury risk from bio-psycho-social modeling. In doing so, this framework of bio-psycho-social preventive and prognostic patient-centered practices may provide an actionable means of optimizing health, well-being, and sport performance in competitive athletes

Uniqueness Theorem for Static Black Hole Solutions of sigma-models in Higher Dimensions

We prove the uniqueness theorem for self-gravitating non-linear sigma-models in higher dimensional spacetime. Applying the positive mass theorem we show that Schwarzschild-Tagherlini spacetime is the only maximally extended, static asymptotically flat solution with non-rotating regular event horizon with a constant mapping.Comment: 5 peges, Revtex, to be published in Class.Quantum Gra