Distribution of selected healthcare resources for influenza pandemic response in Cambodia.

INTRODUCTION: Human influenza infection poses a serious public health threat in Cambodia, a country at risk for the emergence and spread of novel influenza viruses with pandemic potential. Prior pandemics demonstrated the adverse impact of influenza on poor communities in developing countries. Investigation of healthcare resource distribution can inform decisions regarding resource mobilization and investment for pandemic mitigation. METHODS: A health facility survey performed across Cambodia obtained data on availability of healthcare resources important for pandemic influenza response. Focusing on five key resources considered most necessary for treating severe influenza (inpatient beds, doctors, nurses, oseltamivir, and ventilators), resource distributions were analyzed at the Operational District (OD) and Province levels, refining data analysis from earlier studies. Resources were stratified by respondent type (hospital vs. District Health Office [DHO]). A summary index of distribution inequality was calculated using the Gini coefficient. Indices for local spatial autocorrelation were measured at the OD level using geographical information system (GIS) analysis. Finally, a potential link between socioeconomic status and resource distribution was explored by mapping resource densities against poverty rates. RESULTS: Gini coefficient calculation revealed variable inequality in distribution of the five key resources at the Province and OD levels. A greater percentage of the population resides in areas of relative under-supply (28.5%) than over-supply (21.3%). Areas with more resources per capita showed significant clustering in central Cambodia while areas with fewer resources clustered in the northern and western provinces. Hospital-based inpatient beds, doctors, and nurses were most heavily concentrated in areas of the country with the lowest poverty rates; however, beds and nurses in Non-Hospital Medical Facilities (NHMF) showed increasing concentrations at higher levels of poverty. CONCLUSIONS: There is considerable heterogeneity in healthcare resource distribution across Cambodia. Distribution mapping at the local level can inform policy decisions on where to stockpile resources in advance of and for reallocation in the event of a pandemic. These findings will be useful in determining future health resource investment, both for pandemic preparedness and for general health system strengthening, and provide a foundation for future analyses of equity in health services provision for pandemic mitigation planning in Cambodia

A two measure model of dark energy and dark matter

In this work we construct a unified model of dark energy and dark matter. This is done with the following three elements: a gravitating scalar field, phi with a non-conventional kinetic term, as in the string theory tachyon; an arbitrary potential, V(phi); two measures -- a metric measure (sqrt{-g}) and a non-metric measure (Phi). The model has two interesting features: (i) For potentials which are unstable and would give rise to tachyonic scalar field, this model can stabilize the scalar field. (ii) The form of the dark energy and dark matter that results from this model is fairly insensitive to the exact form of the scalar field potential.Comment: 8 pages,no figures, revtex, typos corrected to match published versio

Cosmological Equation of State and Interacting Energies

In this paper we study a model of cosmic evolution, assuming that the different components of the universe could interact between them any time. An effective equation of state (EOS) for the universe has been used as well. A particular function for w, which gives a good agreement between our results and the experimental data, has been studied. Finally, the model obtained has been applied to different important cases

A transcriptome-driven analysis of epithelial brushings and bronchial biopsies to define asthma phenotypes in U-BIOPRED

RATIONALE AND OBJECTIVES: Asthma is a heterogeneous disease driven by diverse immunologic and inflammatory mechanisms. We used transcriptomic profiling of airway tissues to help define asthma phenotypes. METHODS: The transcriptome from bronchial biopsies and epithelial brushings of 107 moderate-to-severe asthmatics were annotated by gene-set variation analysis (GSVA) using 42 gene-signatures relevant to asthma, inflammation and immune function. Topological data analysis (TDA) of clinical and histological data was used to derive clusters and the nearest shrunken centroid algorithm used for signature refinement. RESULTS: 9 GSVA signatures expressed in bronchial biopsies and airway epithelial brushings distinguished two distinct asthma subtypes associated with high expression of T-helper type 2 (Th-2) cytokines and lack of corticosteroid response (Group 1 and Group 3). Group 1 had the highest submucosal eosinophils, high exhaled nitric oxide (FeNO) levels, exacerbation rates and oral corticosteroid (OCS) use whilst Group 3 patients showed the highest levels of sputum eosinophils and had a high BMI. In contrast, Group 2 and Group 4 patients had an 86% and 64% probability of having non-eosinophilic inflammation. Using machine-learning tools, we describe an inference scheme using the currently-available inflammatory biomarkers sputum eosinophilia and exhaled nitric oxide levels along with OCS use that could predict the subtypes of gene expression within bronchial biopsies and epithelial cells with good sensitivity and specificity. CONCLUSION: This analysis demonstrates the usefulness of a transcriptomic-driven approach to phenotyping that segments patients who may benefit the most from specific agents that target Th2-mediated inflammation and/or corticosteroid insensitivity

Lecture archiving on a larger scale at the University of Michigan and CERN

The ATLAS Collaboratory Project at the University of Michigan has been a leader in the area of collaborative tools since 1999. Its activities include the development of standards, software and hardware tools for lecture archiving, and making recommendations for videoconferencing and remote teaching facilities. Starting in 2006 our group became involved in classroom recordings, and in early 2008 we spawned CARMA, a University-wide recording service. This service uses a new portable recording system that we developed. Capture, archiving and dissemination of rich multimedia content from lectures, tutorials and classes are increasingly widespread activities among universities and research institutes. A growing array of related commercial and open source technologies is becoming available, with several new products introduced in the last couple years. As the result of a new close partnership between U-M and CERN IT, a market survey of these products was conducted and a summary of the results are presented here. It is informing an ambitious effort in 2009 to equip many CERN rooms with automated lecture archiving systems, on a much larger scale than before. This new technology is being integrated with CERN's existing webcast, CDS, and Indico applications.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/85420/1/jpconf10_219_082003.pd

The Distinguishability of Interacting Dark Energy from Modified Gravity

We study the observational viability of coupled quintessence models with their expansion and growth histories matched to modified gravity cosmologies. We find that for a Dvali-Gabadadze-Porrati model which has been fitted to observations, the matched interacting dark energy models are observationally disfavoured. We also study the distinguishability of interacting dark energy models matched to scalar-tensor theory cosmologies and show that it is not always possible to find a physical interacting dark energy model which shares their expansion and growth histories.Comment: 8 pages, 5 figure

Sputum macrophage diversity and activation in asthma: role of severity and inflammatory phenotype

BACKGROUND:Macrophages control innate and acquired immunity, but their role in severe asthma remains ill-defined. We investigated gene signatures of macrophage subtypes in the sputum of 104 asthmatics and 16 healthy volunteers from the U-BIOPRED cohort. METHODS:Forty-nine gene signatures (modules) for differentially stimulated macrophages, one to assess lung tissue-resident cells (TR-Mφ) and two for their polarization (classically and alternatively activated macrophages: M1 and M2, respectively) were studied using gene set variation analysis. We calculated enrichment scores (ES) across severity and previously identified asthma transcriptome-associated clusters (TACs). RESULTS:Macrophage numbers were significantly decreased in severe asthma compared to mild-moderate asthma and healthy volunteers. The ES for most modules were also significantly reduced in severe asthma except for 3 associated with inflammatory responses driven by TNF and Toll-like receptors via NF-κB, eicosanoid biosynthesis via the lipoxygenase pathway and IL-2 biosynthesis (all P < .01). Sputum macrophage number and the ES for most macrophage signatures were higher in the TAC3 group compared to TAC1 and TAC2 asthmatics. However, a high enrichment was found in TAC1 for 3 modules showing inflammatory pathways linked to Toll-like and TNF receptor activation and arachidonic acid metabolism (P < .001) and in TAC2 for the inflammasome and interferon signalling pathways (P < .001). Data were validated in the ADEPT cohort. Module analysis provides additional information compared to conventional M1 and M2 classification. TR-Mφ were enriched in TAC3 and associated with mitochondrial function. CONCLUSIONS:Macrophage activation is attenuated in severe granulocytic asthma highlighting defective innate immunity except for specific subsets characterized by distinct inflammatory pathways

Cosmological solutions in multidimensional model with multiple exponential potential

A family of cosmological solutions with $(n+1)$ Ricci-flat spaces in the theory with several scalar fields and multiple exponential potential is obtained when coupling vectors in exponents obey certain relations. Two subclasses of solutions with power-law and exponential behaviour of scale factors are singled out. It is proved that power-law solutions may take place only when coupling vectors are linearly independent and exponential dependence occurs for linearly dependent set of coupling vectors. A subfamily of solutions with accelerated expansion is singled out. A generalized isotropization behaviours of certain classes of general solutions are found. In quantum case exact solutions to Wheeler-DeWitt equation are obtained and special "ground state" wave functions are considered.Comment: 22 pages, 1 figur

Probing the course of cosmic expansion with a combination of observational data

We study the cosmic expansion history by reconstructing the deceleration parameter $q(z)$ from the SDSS-II type Ia supernova sample (SNIa) with two different light curve fits (MLCS2k2 and SALT-II), the baryon acoustic oscillation (BAO) distance ratio, the cosmic microwave background (CMB) shift parameter, and the lookback time-redshift (LT) from the age of old passive galaxies. Three parametrization forms for the equation of state of dark energy (CPL, JBP, and UIS) are considered. Our results show that, for the CPL and the UIS forms, MLCS2k2 SDSS-II SNIa+BAO+CMB and MLCS2k2 SDSS-II SNIa+BAO+CMB+LT favor a currently slowing-down cosmic acceleration, but this does not occur for all other cases, where an increasing cosmic acceleration is still favored. Thus, the reconstructed evolutionary behaviors of dark energy and the course of the cosmic acceleration are highly dependent both on the light curve fitting method for the SNIa and the parametrization form for the equation of state of dark energy.Comment: 19 pages, 6 figures, accepted for publication in JCA