Comparison between Kidney and Hemoperfusion for Paraquat Elimination

The mortality rate of acute paraquat (PQ) poisoning depends on the PQ concentration in the blood. It has been shown that the kidneys eliminate PQ effectively. However, early renal function deterioration is frequently observed in acute PQ intoxication. This study is designed to compare the efficacy of PQ elimination with hemoperfusion (HP) and kidneys, taking into account the functional deterioration of the kidneys. The amount of renal and HP excretion of PQ were measured during the procedure of HP in patients with acute PQ intoxication. The PQ clearance and the actual amount of PQ elimination by the HP cartridge during the HP procedure were 111±11 mL/min (range; 13.2-162.2 mL/min) and 251.4±506.3 mg (range; 4.6-1,655.7) each. While, the renal clearance and actual amount of renal elimination of PQ was 79.8±56.0 mL/min (range; 9.7-177.0) and 75.4±73.6 mg (range; 4.9-245.8). As the creatinine clearance decreased, the PQ elimination by HP was as effective as or more effective than the renal elimination. In conclusion, early HP must be provided for life saving treatment in patients with acute PQ intoxication

Seiberg-Witten Monopole Equations on Noncommutative R^4

It is well known that, due to vanishing theorems, there are no nontrivial finite action solutions to the Abelian Seiberg-Witten (SW) monopole equations on Euclidean four-dimensional space R^4. We show that this is no longer true for the noncommutative version of these equations, i.e., on a noncommutative deformation R^4_\theta of R^4 there exist smooth solutions to the SW equations having nonzero topological charge. We introduce action functionals for the noncommutative SW equations and construct explicit regular solutions. All our solutions have finite energy. We also suggest a possible interpretation of the obtained solutions as codimension four vortex-like solitons representing D(p-4)- and anti-D(p-4)-branes in a Dp-anti-Dp brane system in type II superstring theory.Comment: 33 pages, v2: typos corrected, to appear in J.Math.Phy

Naomi: a new modelling tool for estimating HIV epidemic indicators at the district level in sub-Saharan Africa.

INTRODUCTION: HIV planning requires granular estimates for the number of people living with HIV (PLHIV), antiretroviral treatment (ART) coverage and unmet need, and new HIV infections by district, or equivalent subnational administrative level. We developed a Bayesian small-area estimation model, called Naomi, to estimate these quantities stratified by subnational administrative units, sex, and five-year age groups. METHODS: Small-area regressions for HIV prevalence, ART coverage and HIV incidence were jointly calibrated using subnational household survey data on all three indicators, routine antenatal service delivery data on HIV prevalence and ART coverage among pregnant women, and service delivery data on the number of PLHIV receiving ART. Incidence was modelled by district-level HIV prevalence and ART coverage. Model outputs of counts and rates for each indicator were aggregated to multiple geographic and demographic stratifications of interest. The model was estimated in an empirical Bayes framework, furnishing probabilistic uncertainty ranges for all output indicators. Example results were presented using data from Malawi during 2016-2018. RESULTS: Adult HIV prevalence in September 2018 ranged from 3.2% to 17.1% across Malawi's districts and was higher in southern districts and in metropolitan areas. ART coverage was more homogenous, ranging from 75% to 82%. The largest number of PLHIV was among ages 35 to 39 for both women and men, while the most untreated PLHIV were among ages 25 to 29 for women and 30 to 34 for men. Relative uncertainty was larger for the untreated PLHIV than the number on ART or total PLHIV. Among clients receiving ART at facilities in Lilongwe city, an estimated 71% (95% CI, 61% to 79%) resided in Lilongwe city, 20% (14% to 27%) in Lilongwe district outside the metropolis, and 9% (6% to 12%) in neighbouring Dowa district. Thirty-eight percent (26% to 50%) of Lilongwe rural residents and 39% (27% to 50%) of Dowa residents received treatment at facilities in Lilongwe city. CONCLUSIONS: The Naomi model synthesizes multiple subnational data sources to furnish estimates of key indicators for HIV programme planning, resource allocation, and target setting. Further model development to meet evolving HIV policy priorities and programme need should be accompanied by continued strengthening and understanding of routine health system data

Statistical Methods for Official Statistics and Mortality Estimation

Thesis (Ph.D.)--University of Washington, 2023This dissertation develops statistical methodology for small area estimation, the analysis of official statistics, and mortality estimation. All methods are developed with the statistical challenges faced in data from low- and middle-income countries in mind. We first consider a problem in small area estimation known as benchmarking, where subnational estimates must agree in some sense with a national estimate or estimates. We then consider two related problems addressing data challenges specific to low- and middle-income country child mortality data, where data comes from a survey, is interval censored, and may need to be smoothed across time to ensure reasonable and precise estimates in situations with little data. The outline of the dissertation is as follows. In Chapter 2, we propose a benchmarking method for subnational estimates of a proportion in a setting where a national estimate is available with uncertainty. In Chapter 3 we develop a pseudo-likelihood approach to mortality estimation that allows us to obtain continuous mortality curves for children under the age of 5 across time from interval-censored survey data. In Chapter 4 we consider different temporal smoothing models for the direct estimates produced in Chapter 3, and develop a multivariate random walk prior to simultaneously smooth multiple, correlated summaries across time. Finally, we conclude with discussion of future work in Chapter 5