Patient-Provider Race and Sex Concordance: New Insights into Antibiotic Prescribing for Acute Bronchitis

Objective: To examine whether patient and provider concordance by sex or race predicts antibiotic prescribing for acute bronchitis. Study setting: General Internal Medicine and Family Medicine adult clinics at a large safety-net hospital. Study design: We used a logistic model of prescribing as a function of race and sex concordance. Data extraction: Data were extracted from de-identified patient records for those with an acute bronchitis visit between 2008 and 2010. Principal findings: 71% (95% CI 68%-73%) of visits resulted in an antibiotic prescription. Patients in race-concordant visits were 17% (95% CI 8%-25%) less likely to receive a prescription. Conclusions: Race-concordant outpatient visits were associated with more appropriate antibiotic use. Examination of characteristics such as concordance can improve our understanding of the prescribing process and inform stewardship efforts

The malaria parasite chaperonin containing TCP-1 (CCT) complex: Data integration with other CCT proteomes

The multi-subunit chaperonin containing TCP-1 (CCT) is an essential molecular chaperone that functions in the folding of key cellular proteins. This paper reviews the interactome of the eukaryotic chaperonin CCT and its primary clients, the ubiquitous cytoskeletal proteins, actin and tubulin. CCT interacts with other nascent proteins, especially the WD40 propeller proteins, and also assists in the assembly of several protein complexes. A new proteomic dataset is presented for CCT purified from the human malarial parasite, P. falciparum (PfCCT). The CCT8 subunit gene was C-terminally FLAG-tagged using Selection Linked Integration (SLI) and CCT complexes were extracted from infected human erythrocyte cultures synchronized for maximum expression levels of CCT at the trophozoite stage of the parasite’s asexual life cycle. We analyze the new PfCCT proteome and incorporate it into our existing model of the CCT system, supported by accumulated data from biochemical and cell biological experiments in many eukaryotic species. Together with measurements of CCT mRNA, CCT protein subunit copy number and the post-translational and chemical modifications of the CCT subunits themselves, a cumulative picture is emerging of an essential molecular chaperone system sitting at the heart of eukaryotic cell growth control and cell cycle regulation

The lexicocalorimeter: Gauging public health through caloric input and output on social media

We propose and develop a Lexicocalorimeter: an online, interactive instrument for measuring the caloric content of social media and other large-scale texts. We do so by constructing extensive yet improvable tables of food and activity related phrases, and respectively assigning them with sourced estimates of caloric intake and expenditure. We show that for Twitter, our naive measures of caloric input , caloric output , and the ratio of these measures are all strong correlates with health and well-being measures for the contiguous United States. Our caloric balance measure in many cases outperforms both its constituent quantities; is tunable to specific health and well-being measures such as diabetes rates; has the capability of providing a real-time signal reflecting a population\u27s health; and has the potential to be used alongside traditional survey data in the development of public policy and collective self-awareness. Because our Lexicocalorimeter is a linear superposition of principled phrase scores, we also show we can move beyond correlations to explore what people talk about in collective detail, and assist in the understanding and explanation of how population-scale conditions vary, a capacity unavailable to black-box type methods

Human language reveals a universal positivity bias

Using human evaluation of 100,000 words spread across 24 corpora in 10 languages diverse in origin and culture, we present evidence of a deep imprint of human sociality in language, observing that (i ) the words of natural human language possess a universal positivity bias, (ii ) the estimated emotional content of words is consistent between languages under translation, and (iii ) this positivity bias is strongly independent of frequency of word use. Alongside these general regularities, we describe interlanguage variations in the emotional spectrum of languages that allow us to rank corpora. We also show how our word evaluations can be used to construct physical-like instruments for both real-time and offline measurement of the emotional content of large-scale texts

Reply to Garcia et al.: Common mistakes in measuring frequency-dependent word characteristics

We demonstrate that the concerns expressed by Garcia et al. are misplaced, due to (1) a misreading of our findings in [1]; (2) a widespread failure to examine and present words in support of asserted summary quantities based on word usage frequencies; and (3) a range of misconceptions about word usage frequency, word rank, and expert-constructed word lists. In particular, we show that the English component of our study compares well statistically with two related surveys, that no survey design influence is apparent, and that estimates of measurement error do not explain the positivity biases reported in our work and that of others. We further demonstrate that for the frequency dependence of positivity---of which we explored the nuances in great detail in [1]---Garcia et al. did not perform a reanalysis of our data---they instead carried out an analysis of a different, statistically improper data set and introduced a nonlinearity before performing linear regression.Comment: 5 pages, 2 figures, 1 table. Expanded version of reply appearing in PNAS 201

Cost Effectiveness and Cost Containment in the Era of Interferon-Free Therapies to Treat Hepatitis C Virus Genotype 1

Abstract Background. Interferon-free regimens to treat hepatitis C virus (HCV) genotype 1 are effective but costly. At this time, payers in the United States use strategies to control costs including (1) limiting treatment to those with advanced disease and (2) negotiating price discounts in exchange for exclusivity. Methods. We used Monte Carlo simulation to investigate budgetary impact and cost effectiveness of these treatment policies and to identify strategies that balance access with cost control. Outcomes included nondiscounted 5-year payer cost per 10000 HCV-infected patients and incremental cost-effectiveness ratios. Results. We found that the budgetary impact of HCV treatment is high, with 5-year undiscounted costs of $1.0 billion to 2.3 billion per 10000 HCV-infected patients depending on regimen choices. Among noncirrhotic patients, using the least costly interferon-free regimen leads to the lowest payer costs with negligible difference in clinical outcomes, even when the lower cost regimen is less convenient and/or effective. Among cirrhotic patients, more effective but costly regimens remain cost effective. Controlling costs by restricting treatment to those with fibrosis stage 2 or greater disease was cost ineffective for any patient type compared with treating all patients. Conclusions. Treatment strategies using interferon-free therapies to treat all HCV-infected persons are cost effective, but short-term cost is high. Among noncirrhotic patients, using the least costly interferon-free regimen, even if it is not single tablet or once daily, is the cost-control strategy that results in best outcomes. Restricting treatment to patients with more advanced disease often results in worse outcomes than treating all patients, and it is not preferred

LSST Science Book, Version 2.0

A survey that can cover the sky in optical bands over wide fields to faint magnitudes with a fast cadence will enable many of the exciting science opportunities of the next decade. The Large Synoptic Survey Telescope (LSST) will have an effective aperture of 6.7 meters and an imaging camera with field of view of 9.6 deg^2, and will be devoted to a ten-year imaging survey over 20,000 deg^2 south of +15 deg. Each pointing will be imaged 2000 times with fifteen second exposures in six broad bands from 0.35 to 1.1 microns, to a total point-source depth of r~27.5. The LSST Science Book describes the basic parameters of the LSST hardware, software, and observing plans. The book discusses educational and outreach opportunities, then goes on to describe a broad range of science that LSST will revolutionize: mapping the inner and outer Solar System, stellar populations in the Milky Way and nearby galaxies, the structure of the Milky Way disk and halo and other objects in the Local Volume, transient and variable objects both at low and high redshift, and the properties of normal and active galaxies at low and high redshift. It then turns to far-field cosmological topics, exploring properties of supernovae to z~1, strong and weak lensing, the large-scale distribution of galaxies and baryon oscillations, and how these different probes may be combined to constrain cosmological models and the physics of dark energy.Comment: 596 pages. Also available at full resolution at http://www.lsst.org/lsst/sciboo

Recreating the OSIRIS-REx Slingshot Manoeuvre from a Network of Ground-Based Sensors

Optical tracking systems typically trade-off between astrometric precision and field-of-view. In this work, we showcase a networked approach to optical tracking using very wide field-of-view imagers that have relatively low astrometric precision on the scheduled OSIRIS-REx slingshot manoeuvre around Earth on September 22nd, 2017. As part of a trajectory designed to get OSIRIS-REx to NEO 101955 Bennu, this flyby event was viewed from 13 remote sensors spread across Australia and New Zealand to promote triangulatable observations. Each observatory in this portable network was constructed to be as lightweight and portable as possible, with hardware based off the successful design of the Desert Fireball Network. Over a 4 hour collection window, we gathered 15,439 images of the night sky in the predicted direction of the OSIRIS-REx spacecraft. Using a specially developed streak detection and orbit determination data pipeline, we detected 2,090 line-of-sight observations. Our fitted orbit was determined to be within about 10~km of orbital telemetry along the observed 109,262~km length of OSIRIS-REx trajectory, and thus demonstrating the impressive capability of a networked approach to SSA

Low-Frequency Spectral Energy Distributions of Radio Pulsars Detected with the Murchison Widefield Array

We present low-frequency spectral energy distributions of 60 known radio pulsars observed with the Murchison Widefield Array telescope. We searched the GaLactic and Extragalactic All-sky Murchison Widefield Array survey images for 200-MHz continuum radio emission at the position of all pulsars in the Australia Telescope National Facility (ATNF) pulsar catalogue. For the 60 confirmed detections, we have measured flux densities in 20 × 8 MHz bands between 72 and 231 MHz. We compare our results to existing measurements and show that the Murchison Widefield Array flux densities are in good agreement