Multi-Disease Data Management System Platform for Vector-Borne Diseases

Background Emerging information technologies present new opportunities to reduce the burden of malaria, dengue and other infectious diseases. For example, use of a data management system software package can help disease control programs to better manage and analyze their data, and thus enhances their ability to carry out continuous surveillance, monitor interventions and evaluate control program performance. Methods and Findings We describe a novel multi-disease data management system platform (hereinafter referred to as the system) with current capacity for dengue and malaria that supports data entry, storage and query. It also allows for production of maps and both standardized and customized reports. The system is comprised exclusively of software components that can be distributed without the user incurring licensing costs. It was designed to maximize the ability of the user to adapt the system to local conditions without involvement of software developers. Key points of system adaptability include 1) customizable functionality content by disease, 2) configurable roles and permissions, 3) customizable user interfaces and display labels and 4) configurable information trees including a geographical entity tree and a term tree. The system includes significant portions of functionality that is entirely or in large part re-used across diseases, which provides an economy of scope as new diseases downstream are added to the system at decreased cost. Conclusions We have developed a system with great potential for aiding disease control programs in their task to reduce the burden of dengue and malaria, including the implementation of integrated vector management programs. Next steps include evaluations of operational implementations of the current system with capacity for dengue and malaria, and the inclusion in the system platform of other important vector-borne diseases

The hemoglobin glycation index is not an independent predictor of the risk of microvascular complications in the Diabetes Control and Complications Trial

W badaniu DCCT wykazano, że intensywne leczenie mające na celu poprawę wyrównania glikemii znacząco zmniejszyło ryzyko powikłań cukrzycowych w porównaniu z konwencjonalnym leczeniem. Najistotniejszym wyznacznikiem ryzyka był wywiad dotyczący stężenia glukozy we krwi. Ostatnio McCarter i wsp. (Diabetes Care 2004; 27: 1259-1264) przedstawili analizę ogólnie dostępnych danych z DCCT dotyczących indeksu glikacji (HGI), obliczonego jako różnica między obserwowanym stężeniem HbA1c a stężeniem przewidywanym na podstawie wartości glikemii. W tej analizie wykazano, że wartość HGI była znamiennym czynnikiem predykcyjnym progresji retinopatii i nefropatii w DCCT, co autorzy uznali za poparcie tezy, że biologiczna skłonność do glikacji, tak zwana biologiczna wariacja glikacji, jest kolejnym mechanizmem, który odpowiada za ryzyko powstawania powikłań. Jednak w niniejszej pracy skrytykowano te analizy i wnioski, ponieważ z zasad statystyki wynika, że HGI musi być dodatnio skorelowany ze stężeniem HbA1c i dlatego może je zastępować. Autorzy przedstawiają statystyczne własności HGI w celu udokumentowania jego wysokiej korelacji z HBA1c. Następnie powtarzają analizę McCartera i wsp. z użyciem zarówno HGI, jak i HbA1c. W analizie wykazano ostatecznie, że HGI nie jest niezależnym czynnikiem ryzyka powikłań mikronaczyniowych i że stężenie HbA1c całkowicie tłumaczy wpływ indeksu glikacji na to ryzyko. Nie należy używać HGI do oceny ryzyka powikłań ani uzależniać od niego decyzji terapeutycznych.The Diabetes Control and Complications Trial (DCCT) demonstrated that intensive therapy aimed at improved glucose control markedly reduced the risk of diabetes complications compared with conventional therapy. The principal determinant of risk was the history of glycemia. Recently, McCarter et al. (Diabetes Care 2004; 27: 1259–1264) have presented analyses of the publicly available DCCT data using their hemoglobin glycation index (HGI), which is computed as the difference between the observed HbA1c (A1C) and that predicted from the level of blood glucose. In their analyses, the HGI level was a significant predictor of progression of retinopathy and nephropathy in the DCCT, which the authors claimed to support the hypothesis that the biological propensity for glycation, socalled biological variation in glycation, is another mechanism that determines risk of complications. However, we have criticized these analyses and conclusions because, from statistical principles, the glycation index must be positively correlated with the A1C level and thus may simply be a surrogate for A1C. Herein, we present the statistical properties of the glycation index to document its high correlation with A1C. We then replicate the analyses of McCarter et al. using both the HGI and the A1C together. Analyses show conclusively that the glycation index is not an independent risk factor for microvascular complications and that the effect of the glycation index on risk is wholly explained by the associated level of A1C. The HGI should not be used to estimate risk of complications or to guide therapy

Truthmakers and modality

This paper attempts to locate, within an actualist ontology, truthmakers for modal truths: truths of the form or . In section 1 I motivate the demand for substantial truthmakers for modal truths. In section 2 I criticise Armstrong’s account of truthmakers for modal truths. In section 3 I examine essentialism and defend an account of what makes essentialist attributions true, but I argue that this does not solve the problem of modal truth in general. In section 4 I discuss, and dismiss, a theistic account of the source of modal truth proposed by Alexander Pruss. In section 5 I offer a means of (dis)solving the problem

Antimicrobial Resistance and Urinary Tract Infection Recurrence

The Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) trial found that recurrent urinary tract infections (rUTI) with resistant organisms were more common in the trimethoprim-sulfamethoxazole prophylaxis (TSP) arm. We describe factors associated with trimethoprim-sulfamethoxazole (TMP-SMX) resistance of rUTIs in RIVUR

Recurrent Urinary Tract Infections in Children With Bladder and Bowel Dysfunction

Little generalizable information is available on the outcomes of children diagnosed with bladder and bowel dysfunction (BBD) after a urinary tract infection (UTI). Our objectives were to describe the clinical characteristics of children with BBD and to examine the effects of BBD on patient outcomes in children with and without vesicoureteral reflux (VUR)

Local Interstellar Neutral Hydrogen sampled in-situ by IBEX

Hydrogen gas is the dominant component of the local interstellar medium. However, due to ionization and interaction with the heliosphere, direct sampling of neutral hydrogen in the inner heliosphere is more difficult than sampling the local interstellar neutral helium, which penetrates deep into the heliosphere. In this paper we report on the first detailed analysis of the direct sampling of neutral hydrogen from the local interstellar medium. We confirm that the arrival direction of hydrogen is offset from that of the local Helium component. We further report the discovery of a variation of the penetrating Hydrogen over the first two years of IBEX observations. Observations are consistent with hydrogen experiencing an effective ratio of outward solar radiation pressure to inward gravitational force greater than unity ({\mu}>1); the temporal change observed in the local interstellar hydrogen flux can be explained with solar variability

Error-analysis and comparison to analytical models of numerical waveforms produced by the NRAR Collaboration

The Numerical-Relativity-Analytical-Relativity (NRAR) collaboration is a joint effort between members of the numerical relativity, analytical relativity and gravitational-wave data analysis communities. The goal of the NRAR collaboration is to produce numerical-relativity simulations of compact binaries and use them to develop accurate analytical templates for the LIGO/Virgo Collaboration to use in detecting gravitational-wave signals and extracting astrophysical information from them. We describe the results of the first stage of the NRAR project, which focused on producing an initial set of numerical waveforms from binary black holes with moderate mass ratios and spins, as well as one non-spinning binary configuration which has a mass ratio of 10. All of the numerical waveforms are analysed in a uniform and consistent manner, with numerical errors evaluated using an analysis code created by members of the NRAR collaboration. We compare previously-calibrated, non-precessing analytical waveforms, notably the effective-one-body (EOB) and phenomenological template families, to the newly-produced numerical waveforms. We find that when the binary's total mass is ~100-200 solar masses, current EOB and phenomenological models of spinning, non-precessing binary waveforms have overlaps above 99% (for advanced LIGO) with all of the non-precessing-binary numerical waveforms with mass ratios <= 4, when maximizing over binary parameters. This implies that the loss of event rate due to modelling error is below 3%. Moreover, the non-spinning EOB waveforms previously calibrated to five non-spinning waveforms with mass ratio smaller than 6 have overlaps above 99.7% with the numerical waveform with a mass ratio of 10, without even maximizing on the binary parameters.Comment: 51 pages, 10 figures; published versio