Fast integral equation methods for the modified Helmholtz equation

We present a collection of integral equation methods for the solution to the two-dimensional, modified Helmholtz equation, u(\x) - \alpha^2 \Delta u(\x) = 0, in bounded or unbounded multiply-connected domains. We consider both Dirichlet and Neumann problems. We derive well-conditioned Fredholm integral equations of the second kind, which are discretized using high-order, hybrid Gauss-trapezoid rules. Our fast multipole-based iterative solution procedure requires only O(N) or $O(N\log N)$ operations, where N is the number of nodes in the discretization of the boundary. We demonstrate the performance of the methods on several numerical examples.Comment: Published in Computers & Mathematics with Application

Neuroimmune Interaction in Inflammatory Diseases

The inflammatory response is modulated through interactions among the nervous, endocrine, and immune systems. Intercommunication between immune cells and the autonomic nervous system is a growing area of interest. Spatial and temporal information about inflammatory processes is relayed to the central nervous system (CNS) where neuroimmune modulation serves to control the extent and intensity of the inflammation. Over the past few decades, research has revealed various routes by which the nervous system and the immune system communicate. The CNS regulates the immune system via hormonal and neuronal pathways, including the sympathetic and parasympathetic nerves. The immune system signals the CNS through cytokines that act both centrally and peripherally. This review aims to introduce the concept of neuroimmune interaction and discuss its potential clinical application, in an attempt to broaden the awareness of this rapidly evolving area and open up new avenues that may aid in the treatment of inflammatory diseases

Trends and variability of implicit rationing of care across time and shifts in an acute care hospital : a longitudinal study

The proposed study was funded for 2 years (2018‐2020) by the Medical Practice Plan, Faculty of Medicine, American University of Beirut, Lebanon.Background Implicit rationing of nursing care is associated with work environment factors. Yet a deeper understanding of trends and variability is needed. Aims To explore the trends and variability of rationing of care per shift between individual nurses, services over time, and its relationship with work environment factors. Methods Longitudinal study including 1,329 responses from 90 nurses. Intraclass correlation coefficients (ICC) were computed to examine variability of rationing per shift between individual nurses, services, and data collection time; generalized linear mixed models were used to explore the relationship with work environment factors. Results Percentage of rationing of nursing activities exceeded 10% during day and night shifts. Significant variability in rationing items was observed between nurses, with ICCs ranging between 0.20 and 0.59 in day shifts, and between 0.35 and 0.85 in night shifts. Rationing of care was positively associated with nurses’ self‐perceived workload in both shifts, but not with patient‐to‐nurse ratios. Conclusion Most variability in rationing over time was explained by the individual.PostprintPeer reviewe

Reports of my death are greatly exaggerated: The persistence of neoliberalism in Britain

Recent declarations of the end of neoliberalism in the United Kingdom, especially since the Covid-19 pandemic, are underpinned by diffuse and unstructured understandings of the neoliberal state. We argue that state intervention is both necessary and unavoidable under neoliberalism. This article shows that the ‘market-based’ reforms and the ‘rollback of the state’ that overtly characterise neoliberalism are heavily reliant upon public policy and entail an ongoing role for state intervention both over time and across economic sectors. Using sectoral case studies of housing and water from within the United Kingdom, we demonstrate, through a tight analytical framing of both financialisation and commodification, the variegated though crucial role of the neoliberal state in restructuring provision to facilitate financialised accumulation and their transformations in response to the contradictions, dysfunctions and limitations of neoliberalised social reproduction

Failure to recognize Low non-treponemal titer syphilis infections in pregnancy May lead to widespread under-treatment

Objectives: Rates of maternal syphilis have increased five-fold in Brazil in the past decade. While penicillin remains the only appropriate treatment for maternal syphilis, we hypothesized that low non-treponemal titers (<1:16) may lead to reduced penicillin treatment in Brazil. Methods: Using Brazilian Ministry of Health data on women diagnosed with maternal syphilis between January 1, 2010, and December 31, 2018, we conducted a random-effects logistic regression model with a cluster correction at the state level to evaluate predictive factors of penicillin treatment. Results: We observed yearly increases in cases of pregnant women with syphilis from 2010 to 2018. There was significant variation by state: 52,451 cases were reported in São Paulo, followed by 26,838 in Rio de Janeiro. Among 215,937 cases of maternal syphilis, 91·3% received penicillin. In the random-effects model, a non-treponemal titer ≥1:16 was associated with 1·44 higher odds of receiving penicillin (95% confidence interval [CI]: 1·391·48), and prenatal care was associated with a 2·12 increased odds of receiving penicillin (95% CI: 2·022·21). Although there is an association between the absence of prenatal care and inadequate treatment for syphilis, 83·2% of women in this cohort who did not receive penicillin were engaged in prenatal care. Conclusions: Providers may inappropriately exclude low non-treponemal titers and thereby fail to use penicillin treatment in maternal syphilis. While the cause of the maternal syphilis epidemic in Brazil is multifactorial, we believe our findings can be used to develop targeted interventions throughout Brazil as well as shape public health initiatives globally.National Institute of Mental HealthRevisión por pare

Lessons for COVID-19 vaccination from eight federal government direct communication evaluations

We discuss eight randomized evaluations intended to increase vaccination uptake conducted by the US General Services Administration’s Office of Evaluation Sciences (OES). These evaluations had a median sample size of 55,000, deployed a variety of behaviorally-informed direct communications, and used administrative data to measure vaccination uptake. The confidence interval from an internal meta-analysis shows changes in vaccination rates ranging from -0.004 to 0.394 percentage points. Two studies yielded statistically significant increases, of 0.59 and 0.16 percentage points. The other six were not statistically significant, although the studies were powered to detect effect sizes in line with published research. This work highlights the likely effects of government communications and demonstrates the value of conducting rapid evaluations to support COVID-19 vaccination efforts

Ocorrência de plantas fôsseis do subgrupo Itararé, em Salto, SP

A small collection of plants from the basal part of the Itararé Subgroup (Late Paleozoic), near Salto, São Paulo State, contains Samaropsis, Cordaicarpus, Carpolithus, (?)Trigonocarpus, (?)Noeggerathiopsis and (?)Paracalamites, associated to fragments of smooth and striate stems, leaves and possible fructifications. It is probably the lowermost occurence of Late Paleozoic plant fossils in the nor then part of Paraná Basin

Nonsystematic Reporting Biases of the SARS-CoV-2 Variant Mu Could Impact Our Understanding of the Epidemiological Dynamics of Emerging Variants

Developing a timely and effective response to emerging SARS-CoV-2 variants of concern (VOCs) is of paramount public health importance. Global health surveillance does not rely on genomic data alone to identify concerning variants when they emerge. Instead, methods that utilize genomic data to estimate the epidemiological dynamics of emerging lineages have the potential to serve as an early warning system. However, these methods assume that genomic data are uniformly reported across circulating lineages. In this study, we analyze differences in reporting delays among SARS-CoV-2 VOCs as a plausible explanation for the timing of the global response to the former VOC Mu. Mu likely emerged in South America in mid-2020, where its circulation was largely confined. In this study, we demonstrate that Mu was designated as a VOC ∼1 year after it emerged and find that the reporting of genomic data for Mu differed significantly than that of other VOCs within countries, states, and individual laboratories. Our findings suggest that nonsystematic biases in the reporting of genomic data may have delayed the global response to Mu. Until they are resolved, the surveillance gaps that affected the global response to Mu could impede the rapid and accurate assessment of future emerging variants