Statistical modelling to predict silicosis risk in deceased Southern African gold miners without medical evaluation

The Qhubeka Trust was established in 2016 in a legal settlement on behalf of former gold miners seeking compensation for silicosis contracted on the South African mines. Settlements resulting from lawsuits on behalf of gold miners aim to provide fair compensation. However, occupational exposure and medical records kept by South African mining companies for their employees have been very limited. Some claimants to the Qhubeka Trust died before medical evaluation was possible, thus potentially disadvantaging their dependants from receiving any compensation. With medical evaluation no longer possible, a statistical approach to this problem was developed. The records for claimants with medical evaluation were used to develop a logistic regression prediction model for the likelihood of silicosis, based on the potential predictors: cumulative exposure to respirable dust, age, years since first exposure, years of life lost prematurely, vital status at 31 December 2019, and a history of tuberculosis diagnosis. The prediction model allowed estimation of the likelihood of silicosis for each miner who had died without medical evaluation and is a novel approach in this setting. In addition, we were able to quantitatively evaluate the trade-offs of different silicosis risk classification thresholds in terms of true and false positives and negatives. Significance:• A statistical approach can be used for risk estimation in settings where the outcome of interest is unknown for some members of a class.• The likelihood of silicosis in deceased miners without medical evaluation in the Qhubeka Trust can be accurately estimated, using information from finalised claims.• Strategies for classifying the silicosis status of deceased miners without medical evaluation in theQhubeka Trust can be assessed in a rigorous, quantitative framework

Evaluation of an HIV/AIDS peer education programme in a South African workplace

Objectives. To evaluate a South African workplace HIV I AIDS peer-education programme running since 1997.Methods. In 2001 a cross-sectional study was done of 900 retail-section employees in three  geographical areas. The study measured HIV I AIDS knowledge, attitudes towards people living with HIV I AIDS, belief about self-risk of infection, and condom use as a practice indicator. The impact of an HIV I AIDS peer-education programme on these outcomes was examined.Results. Training by peer educators had no significant impact on any outcome. Fifty-nine per cent of subjects had a good knowledge score, 62% had a positive attitude towards people with HIV I AIDS, 34%  used condoms frequently, and the majority of participants (73%) believed they were at low risk of  infection. Logistical regression showed that a very small proportion of the variance in the four outcomes was explained by potential determinants of interest (8% for knowledge, 6% for attitude, 7% for risk and 17% for condom use).Conclusions. The HIV peer-education programme was found to be ineffective and may have involved an  opportunity cost. The programme contrasts with more costly comprehensive care that includes  antiretrovirals. The private sector appears to have been as tardy as the public sector in addressing theepidemic effectively

The relationship between reproductive outcome measures in DDT exposed malaria vector control workers: a cross-sectional study

BACKGROUND: The utility of blood reproductive endocrine biomarkers for assessing or estimating semen quality was explored. METHODS: A cross-sectional study of 47 DDT exposed malaria vector control workers was performed. Tests included blood basal and post gonadotrophin releasing hormone (GnRH), lutenizing hormone (LH), follicle stimulating hormone (FSH), testosterone, sex hormone binding globulin (SHBG), estradiol (E2) and inhibin; a questionnaire (demographics and general medical history); a physical examination and semen analysis. Semen parameters were determined using either/or or both WHO or the strict Tygerberg criteria. Relationships between semen parameters and endocrine measures were adjusted for age, duration of abstinence before sampling, presence of physical abnormalities and fever in the last two months. All relationships between specific endocrine hormones were adjusted for age and basal SHBG. RESULTS: Multiple logistic regression showed a consistent positive relationship (prevalence odds ratio (POR) = 8.2, CI:1.4–49.2) between low basal inhibin (<100 pg/ml) and low semen count (< 40 million) and density (< 20 million/ml); consistent positive, but weaker relationships (1> POR < 2) between abnormally low semen count as well as density and baseline and post GnRH FSH; and positive relationships (POR = 37, CI:2–655) between the prevalence of high basal estradiol (> 50 pg/ml) and abnormal morphology (proportion < 5%) and low motility (proportion <50%). Most of the expected physiological relationships between specific endocrines were significant. CONCLUSION: The study has demonstrated that low basal inhibin, elevated basal FSH and high basal E2 can serve as markers of impaired semen quality

Impossibility to eliminate observer effect in the assessment of adherence in clinical trials.

PURPOSE: To utilize the Travoprost Dosing Aid (DA) in the assessment of patient medication adherence, while also determining whether or not altering the functionality of the DA in three randomized subject groups can reduce observer effect. METHODS: Forty-five subjects were randomized into three groups: two with monitored DAs and one without monitoring. One group of subjects was given a DA that both monitored drop usage and had visual and audible alarms, while the other monitored group included subjects given a DA that had no alarms but continued to monitor drop usage. The third group was given a DA that had no alarm reminders or dose usage monitoring. Subjects were informed that some monitors would not be functional, in an attempt to reduce observer effect, or the effect of being monitored on subject behavior and adherence. A six-item questionnaire was also utilized to assess how the subjects felt about their adherence and DA use. RESULTS: The overall adherence rates were found to be 78% in the fully functional group (95% confidence interval: 70-88) and 76% in the no alarms group (95% confidence interval: 65-89). No association was seen between questionnaire response and medication adherence. The patients in the DA group without alarms had a significantly higher odds ratio of medication adherence if they reported on the questionnaire that using the DA did affect how much they used their drops. CONCLUSION: Though the use of DA was expected to reveal different rates of adherence depending on the functionality of the DA between groups, patients with a nonfunctioning DA did not have a significant difference in medication adherence compared to those given a fully functional DA. This supports that an observer effect was not reduced despite these interventions, and that the subjects adhered to taking their medications as if they had a functioning DA and were being monitored

A Contracting, Turbulent, Starless Core in the Serpens Cluster

We present combined single-dish and interferometric CS(2--1) and N2H+(1--0) observations of a compact core in the NW region of the Serpens molecular cloud. The core is starless according to observations from optical to millimeter wavelengths and its lines have turbulent widths and ``infall asymmetry''. Line profile modeling indicates supersonic inward motions v_in>0.34 km/s over an extended region L>12000AU. The high infall speed and large extent exceeds the predictions of most thermal ambipolar diffusion models and points to a more dynamical process for core formation. A short (dynamic) timescale, ~1e5 yr=L/v_in, is also suggested by the low N2H+ abundance ~1e-10.Comment: 11 pages including 2 figures. Accepted for publication in the Astrophysical Journal Letter

Universal Holographic Chiral Dynamics in an External Magnetic Field

In this work we further extend the investigation of holographic gauge theories in external magnetic fields, continuing earlier work. We study the phenomenon of magnetic catalysis of mass generation in 1+3 and 1+2 dimensions, using D3/D7- and D3/D5-brane systems, respectively. We obtain the low energy effective actions of the corresponding pseudo Goldstone bosons and study their dispersion relations. The D3/D7 system exhibits the usual Gell-Mann--Oakes--Renner (GMOR) relation and a relativistic dispersion relation, while the D3/D5 system exhibits a quadratic non-relativistic dispersion relation and a modified linear GMOR relation. The low energy effective action of the D3/D5 system is related to that describing magnon excitations in a ferromagnet. We also study properties of general Dp/Dq systems in an external magnetic field and verify the universality of the magnetic catalysis of dynamical symmetry breaking.Comment: 41 pages, 11 figures, references adde