Nonbacterial and bacterial osteomyelitis in children: a case–control retrospective study

PurposeOsteomyelitis is a group of bone infectious (bacterial osteomyeilitis—BO) and noninfectious inflammatory diseases (nonbacterial osteomyelitis—NBO) with similar clinical, radiology, and laboratory features. Many patients with NBO are misdiagnosed as BO and receive unnecessary antibiotics and surgery. Our study aimed to compare clinical and laboratory features of NBO and BO in children, to define key discriminative criteria, and to create an NBO diagnostic score (NBODS).MethodsThe retrospective multicenter cohort study included clinical, laboratory, and instrumental information about histologically confirmed NBO (n = 91) and BO (n = 31). The variables allowed us to differentiate both conditions used to construct and validate the NBO DS.ResultsThe main differences between NBO and BO are as follows: onset age—7.3 (2.5; 10.6) vs. 10.5 (6.5; 12.7) years (p = 0.03), frequency of fever (34.1% vs. 90.6%, p = 0.0000001), symptomatic arthritis (67% vs. 28.1%, p = 0.0001), monofocal involvement (28.6% vs. 100%, p = 0.0000001), spine (32% vs. 6%, p = 0.004), femur (41% vs. 13%, p = 0.004), foot bones (40% vs. 13%, p = 0.005), clavicula (11% vs. 0%, p = 0.05), and sternum (11% vs. 0%, p = 0.039) involvement. The following four criteria are included in the NBO DS: CRP ≤ 55 mg/l (56 points), multifocal involvement (27 points), femur involvement (17 points), and neutrophil bands ≤ 220 cell/μl (15 points). The sum > 17 points allowed to differentiate NBO from BO with a sensitivity of 89.0% and a specificity of 96.9%.ConclusionThe diagnostic criteria may help discriminate NBO and BO and avoid excessive antibacterial treatment and surgery

On Coding for Reliable Communication over Packet Networks

We present a capacity-achieving coding scheme for unicast or multicast over lossy packet networks. In the scheme, intermediate nodes perform additional coding yet do not decode nor even wait for a block of packets before sending out coded packets. Rather, whenever they have a transmission opportunity, they send out coded packets formed from random linear combinations of previously received packets. All coding and decoding operations have polynomial complexity. We show that the scheme is capacity-achieving as long as packets received on a link arrive according to a process that has an average rate. Thus, packet losses on a link may exhibit correlation in time or with losses on other links. In the special case of Poisson traffic with i.i.d. losses, we give error exponents that quantify the rate of decay of the probability of error with coding delay. Our analysis of the scheme shows that it is not only capacity-achieving, but that the propagation of packets carrying "innovative" information follows the propagation of jobs through a queueing network, and therefore fluid flow models yield good approximations. We consider networks with both lossy point-to-point and broadcast links, allowing us to model both wireline and wireless packet networks.Comment: 33 pages, 6 figures; revised appendi

Toward the detection of permafrost using land-surface temperature mapping

Permafrost is degrading under current warming conditions, disrupting infrastructure, releasing carbon from soils, and altering seasonal water availability. Therefore, it is important to quantitatively map the change in the extent and depth of permafrost. We used satellite images of land-surface temperature to recognize and map the zero curtain, i.e., the isothermal period of ground temperature during seasonal freeze and thaw, as a precursor for delineating permafrost boundaries from remotely sensed thermal-infrared data. The phase transition of moisture in the ground allows the zero curtain to occur when near-surface soil moisture thaws or freezes, and also when ice-rich permafrost thaws or freezes. We propose that mapping the zero curtain is a precursor to mapping permafrost at shallow depths. We used ASTER and a MODIS-Aqua daily afternoon land-surface temperature (LST) timeseries to recognize the zero curtain at the 1-km scale as a "proof of concept. " Our regional mapping of the zero curtain over an area around the 7000 m high volcano Ojos del Salado in Chile suggests that the zero curtain can be mapped over arid regions of the world. It also indicates that surface heterogeneity, snow cover, and cloud cover can hinder the effectiveness of our approach. To be of practical use in many areas, it may be helpful to reduce the topographic and compositional heterogeneity in order to increase the LST accuracy. The necessary finer spatial resolution to reduce these problems is provided by ASTER (90 m).Fil: Batbaatar, Jigjidsurengiin. University of Washington; Estados UnidosFil: Gillespie , Alan R.. University of Washington; Estados UnidosFil: Sletten, Ronald S.. University of Washington; Estados UnidosFil: Mushkin , Amit. University of Washington; Estados UnidosFil: Amit, Rivka. Geological Survey Of Israel; IsraelFil: Trombotto, Dario Tomas. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Provincia de Mendoza. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales. Universidad Nacional de Cuyo. Instituto Argentino de Nivología, Glaciología y Ciencias Ambientales; ArgentinaFil: Liu , Lu. University of Washington; Estados UnidosFil: Petrie, Gregg. University of Washington; Estados Unido

INVASIVE ASPERGILLOSIS IN AN ADOLESCENT

The article presents the clinical case of invasive aspergillosis in a 15-year-old adolescent with lesions in the spine, ribs and both lungs, and primary immune deficiency which was not diagnosed earlier. In order to diagnose this disease it was necessary to differentiate it from the generalized form of tuberculosis and to perform integral X-ray examination and surgery with consequent morphological and bacteriological examination of the surgical samples

Estimating the returns to UK publicly funded cancer-related research in terms of the net value of improved health outcomes

© 2014 Glover et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background - Building on an approach developed to assess the economic returns to cardiovascular research, we estimated the economic returns from UK public and charitable funded cancer-related research that arise from the net value of the improved health outcomes. Methods - To assess these economic returns from cancer-related research in the UK we estimated: 1) public and charitable expenditure on cancer-related research in the UK from 1970 to 2009; 2) net monetary benefit (NMB), that is, the health benefit measured in quality adjusted life years (QALYs) valued in monetary terms (using a base-case value of a QALY of GB£25,000) minus the cost of delivering that benefit, for a prioritised list of interventions from 1991 to 2010; 3) the proportion of NMB attributable to UK research; 4) the elapsed time between research funding and health gain; and 5) the internal rate of return (IRR) from cancer-related research investments on health benefits. We analysed the uncertainties in the IRR estimate using sensitivity analyses to illustrate the effect of some key parameters. Results - In 2011/12 prices, total expenditure on cancer-related research from 1970 to 2009 was £15 billion. The NMB of the 5.9 million QALYs gained from the prioritised interventions from 1991 to 2010 was £124 billion. Calculation of the IRR incorporated an estimated elapsed time of 15 years. We related 17% of the annual NMB estimated to be attributable to UK research (for each of the 20 years 1991 to 2010) to 20 years of research investment 15 years earlier (that is, for 1976 to 1995). This produced a best-estimate IRR of 10%, compared with 9% previously estimated for cardiovascular disease research. The sensitivity analysis demonstrated the importance of smoking reduction as a major source of improved cancer-related health outcomes. Conclusions - We have demonstrated a substantive IRR from net health gain to public and charitable funding of cancer-related research in the UK, and further validated the approach that we originally used in assessing the returns from cardiovascular research. In doing so, we have highlighted a number of weaknesses and key assumptions that need strengthening in further investigations. Nevertheless, these cautious estimates demonstrate that the returns from past cancer research have been substantial, and justify the investments made during the period 1976 to 1995.Wellcome Trust, Cancer Research UK, the National Institute of Health Research, and the Academy of Medical Sciences

Половозрастная структура заболеваемости туберкулезом различных локализаций в Российской Федерации: динамика в XXI в.

The article describes the statistic rates reflecting the incidence of tuberculosis of various localizations in the Russian Federation during 2001-2016, putting special emphasis on gender and age. The authors demonstrate the impact of HIV infection on the level of tuberculosis incidence. The article also presents and summarizes data on extrapulmonary tuberculosis, describes the difficulties arising during notification of such cases and limiting the reliability of epidemiological analysis, and gives the estimated incidence.Проведен анализ статистических показателей заболеваемости туберкулезом различных локализаций в Российской Федерации за 2001-2016 гг. с акцентом на гендерные и возрастные особенности. Показано влияние ВИЧ-инфекции на уровень заболеваемости туберкулезом. Приведены и обобщены данные о внелегочных локализациях специфического процесса, дано описание сложностей их официальной регистрации, ограничивающих достоверность эпидемиологического анализа, и представлена расчетная картина заболеваемости

Introduction to Disease, Human Health, and Regional Growth and Development in Asia

We have two objectives in this book. First, we bring together in one place, original research that sheds light on the myriad connections between disease, human health, and regional economic growth and development. Second, given the contemporary salience of Asia in world affairs, we concentrate on the trinity of disease, human health, and regional economic growth and development in different regions within Asia. Following this introductory chapter, there are nine chapters and each of these chapters—written by an expert or by a team of experts—discusses a particular research question or questions about disease, human health, and regional economic growth and development within Asia

Conceptual frameworks and empirical approaches used to assess the impact of health research: an overview of reviews

<p>Abstract</p> <p>Background</p> <p>How to assess the impact of research is of growing interest to funders, policy makers and researchers mainly to understand the value of investments and to increase accountability. Broadly speaking the term "research impact" refers to the contribution of research activities to achieve desired societal outcomes. The aim of this overview is to identify the most common approaches to research impact assessment, categories of impact and their respective indicators.</p> <p>Methods</p> <p>We systematically searched the relevant literature (PubMed, The Cochrane Library (1990-2009)) and funding agency websites. We included systematic reviews, theoretical and methodological papers, and empirical case-studies on how to evaluate research impact. We qualitatively summarised the included reports, as well the conceptual frameworks.</p> <p>Results</p> <p>We identified twenty-two reports belonging to four systematic reviews and 14 primary studies. These publications reported several theoretical frameworks and methodological approaches (bibliometrics, econometrics, ad hoc case studies). The "payback model" emerged as the most frequently used. Five broad categories of impact were identified: a) advancing knowledge, b) capacity building, c) informing decision-making, d) health benefits, e) broad socio-economic benefits. For each proposed category of impact we summarized a set of indicators whose pros and cons are presented and briefly discussed.</p> <p>Conclusions</p> <p>This overview is a comprehensive, yet descriptive, contribution to summarize the conceptual framework and taxonomy of an heterogeneous and evolving area of research. A shared and comprehensive conceptual framework does not seem to be available yet and its single components (epidemiologic, economic, and social) are often valued differently in different models.</p