Barriers to enrollment in a randomized controlled trial of hydrocortisone for cardiovascular insufficiency in term and late preterm newborn infants.

ObjectiveTo analyze reasons for low enrollment in a randomized controlled trial (RCT) of the effect of hydrocortisone for cardiovascular insufficiency on survival without neurodevelopmental impairment (NDI) in term/late preterm newborns.Study designThe original study was a multicenter RCT. Eligibility: ⩾34 weeks' gestation, <72 h old, mechanically ventilated, receiving inotrope. Primary outcome was NDI at 2 years; infants with diagnoses at high risk for NDI were excluded. This paper presents an analysis of reasons for low patient enrollment.ResultsTwo hundred and fifty-seven of the 932 otherwise eligible infants received inotropes; however, 207 (81%) had exclusionary diagnoses. Only 12 infants were randomized over 10 months; therefore, the study was terminated. Contributing factors included few eligible infants after exclusions, open-label steroid therapy and a narrow enrollment window.ConclusionDespite an observational study to estimate the population, very few infants were enrolled. Successful RCTs of emergent therapy may require fewer exclusions, a short-term primary outcome, waiver of consent and/or other alternatives

Optimal schedule of home care visits for a health care center

The provision of home health care services is becoming an important research area, mainly because in Portugal the population is ageing. Home care visits are organized taking into account the medical treatments and general support that elder/sick people need at home. This health service can be provided by nurse teams from Health Care Centers. Usually, the visits are manually planned and without computer support. The main goal of this work is to carry out the automatic schedule of home care visits, of one Portuguese Health Care Center, in order to minimize the time spent in all home care visits and, consequently, reduce the costs involved. The developed algorithms were coded in MatLab Software and the problem was efficiently solved, obtaining several schedule solutions of home care visits for the presented data. Solutions found by genetic and particle swarm algorithms lead to significant time reductions for both nurse teams and patients.This work has been supported by COMPETE: POCI-01-0145- FEDER-007043 and FCT - Fundru;ao para a Ciencia e Tecnologia within the Project Scope: UID/CEC/00319/2013.info:eu-repo/semantics/publishedVersio

Gauge-theoretic invariants for topological insulators: A bridge between Berry, Wess-Zumino, and Fu-Kane-Mele

We establish a connection between two recently-proposed approaches to the understanding of the geometric origin of the Fu-Kane-Mele invariant $\mathrm{FKM} \in \mathbb{Z}_2$, arising in the context of 2-dimensional time-reversal symmetric topological insulators. On the one hand, the $\mathbb{Z}_2$ invariant can be formulated in terms of the Berry connection and the Berry curvature of the Bloch bundle of occupied states over the Brillouin torus. On the other, using techniques from the theory of bundle gerbes it is possible to provide an expression for $\mathrm{FKM}$ containing the square root of the Wess-Zumino amplitude for a certain $U(N)$-valued field over the Brillouin torus. We link the two formulas by showing directly the equality between the above mentioned Wess-Zumino amplitude and the Berry phase, as well as between their square roots. An essential tool of independent interest is an equivariant version of the adjoint Polyakov-Wiegmann formula for fields $\mathbb{T}^2 \to U(N)$, of which we provide a proof employing only basic homotopy theory and circumventing the language of bundle gerbes.Comment: 23 pages, 1 figure. To appear in Letters in Mathematical Physic

Testing special relativity with geodetic VLBI

Geodetic Very Long Baseline Interferometry (VLBI) measures the group delay in the barycentric reference frame. As the Earth is orbiting around the Solar system barycentre with the velocity $V$ of 30 km/s, VLBI proves to be a handy tool to detect the subtle effects of the special and general relativity theory with a magnitude of $(V/\textrm{c})^2$. The theoretical correction for the second order terms reaches up to 300~ps, and it is implemented in the geodetic VLBI group delay model. The total contribution of the second order terms splits into two effects - the variation of the Earth scale, and the deflection of the apparent position of the radio source. The Robertson-Mansouri-Sexl (RMS) generalization of the Lorenz transformation is used for many modern tests of the special relativity theory. We develop an alteration of the RMS formalism to probe the Lorenz invariance with the geodetic VLBI data. The kinematic approach implies three parameters (as a function of the moving reference frame velocity) and the standard Einstein synchronisation. A generalised relativistic model of geodetic VLBI data includes all three parameters that could be estimated. Though, since the modern laboratory Michelson-Morley and Kennedy-Thorndike experiments are more accurate than VLBI technique, the presented equations may be used to test the VLBI group delay model itself.Comment: Proceedings of the IAG 2017 Scientific Meeting, Kobe, Japa

The Bulk Channel in Thermal Gauge Theories

We investigate the thermal correlator of the trace of the energy-momentum tensor in the SU(3) Yang-Mills theory. Our goal is to constrain the spectral function in that channel, whose low-frequency part determines the bulk viscosity. We focus on the thermal modification of the spectral function, $\rho(\omega,T)-\rho(\omega,0)$. Using the operator-product expansion we give the high-frequency behavior of this difference in terms of thermodynamic potentials. We take into account the presence of an exact delta function located at the origin, which had been missed in previous analyses. We then combine the bulk sum rule and a Monte-Carlo evaluation of the Euclidean correlator to determine the intervals of frequency where the spectral density is enhanced or depleted by thermal effects. We find evidence that the thermal spectral density is non-zero for frequencies below the scalar glueball mass $m$ and is significantly depleted for $m\lesssim\omega\lesssim 3m$.Comment: (1+25) pages, 6 figure

Identifying Critical Non-Catalytic Residues that Modulate Protein Kinase A Activity

Distal interactions between discrete elements of an enzyme are critical for communication and ultimately for regulation. However, identifying the components of such interactions has remained elusive due to the delicate nature of these contacts. Protein kinases are a prime example of an enzyme with multiple regulatory sites that are spatially separate, yet communicate extensively for tight regulation of activity. Kinase misregulation has been directly linked to a variety of cancers, underscoring the necessity for understanding intramolecular kinase regulation.A genetic screen was developed to identify suppressor mutations that restored catalytic activity in vivo from two kinase-dead Protein Kinase A mutants in S. cerevisiae. The residues defined by the suppressors provide new insights into kinase regulation. Many of the acquired mutations were distal to the nucleotide binding pocket, highlighting the relationship of spatially dispersed residues in regulation.The suppressor residues provide new insights into kinase regulation, including allosteric effects on catalytic elements and altered protein-protein interactions. The suppressor mutations identified in this study also share overlap with mutations identified from an identical screen in the yeast PKA homolog Tpk2, demonstrating functional conservation for some residues. Some mutations were independently isolated several times at the same sites. These sites are in agreement with sites previously identified from multiple cancer data sets as areas where acquired somatic mutations led to cancer progression and drug resistance. This method provides a valuable tool for identifying residues involved in kinase activity and for studying kinase misregulation in disease states