95 research outputs found
Cost-effectiveness of tuberculosis evaluation and treatment of newly-arrived immigrants
BACKGROUND: Immigrants to the U.S. are required to undergo overseas screening for tuberculosis (TB), but the value of evaluation and treatment following entry to the U.S. is not well understood. We determined the cost-effectiveness of domestic follow-up of immigrants identified as tuberculosis suspects through overseas screening. METHODS: Using a stochastic simulation for tuberculosis reactivation, transmission, and follow-up for a hypothetical cohort of 1000 individuals, we calculated the incremental cost-effectiveness of follow-up and evaluation interventions. We utilized published literature, California Reports of Verified Cases of Tuberculosis (RVCTs), demographic estimates from the California Department of Finance, Medicare reimbursement, and Medi-Cal reimbursement rates. Our target population was legal immigrants to the United States, our time horizon is twenty years, and our perspective was that of all domestic health-care payers. We examined the intervention to offer latent tuberculosis therapy to infected individuals, to increase the yield of domestic evaluation, and to increase the starting and completion rates of LTBI therapy with INH (isoniazid). Our outcome measures were the number of cases averted, the number of deaths averted, the incremental dollar cost (year 2004), and the number of quality-adjusted life-years saved. RESULTS: Domestic follow-up of B-notification patients, including LTBI treatment for latently infected individuals, is highly cost-effective, and at times, cost-saving. B-notification follow-up in California would reduce the number of new tuberculosis cases by about 6–26 per year (out of a total of approximately 3000). Sensitivity analysis revealed that domestic follow-up remains cost-effective when the hepatitis rates due to INH therapy are over fifteen times our best estimates, when at least 0.4 percent of patients have active disease and when hospitalization of cases detected through domestic follow-up is no less likely than hospitalization of passively detected cases. CONCLUSION: While the current immigration screening program is unlikely to result in a large change in case rates, domestic follow-up of B-notification patients, including LTBI treatment, is highly cost-effective. If as many as three percent of screened individuals have active TB, and early detection reduces the rate of hospitalization, net savings may be expected
A review of elliptical and disc galaxy structure, and modern scaling laws
A century ago, in 1911 and 1913, Plummer and then Reynolds introduced their
models to describe the radial distribution of stars in `nebulae'. This article
reviews the progress since then, providing both an historical perspective and a
contemporary review of the stellar structure of bulges, discs and elliptical
galaxies. The quantification of galaxy nuclei, such as central mass deficits
and excess nuclear light, plus the structure of dark matter halos and cD galaxy
envelopes, are discussed. Issues pertaining to spiral galaxies including dust,
bulge-to-disc ratios, bulgeless galaxies, bars and the identification of
pseudobulges are also reviewed. An array of modern scaling relations involving
sizes, luminosities, surface brightnesses and stellar concentrations are
presented, many of which are shown to be curved. These 'redshift zero'
relations not only quantify the behavior and nature of galaxies in the Universe
today, but are the modern benchmark for evolutionary studies of galaxies,
whether based on observations, N-body-simulations or semi-analytical modelling.
For example, it is shown that some of the recently discovered compact
elliptical galaxies at 1.5 < z < 2.5 may be the bulges of modern disc galaxies.Comment: Condensed version (due to Contract) of an invited review article to
appear in "Planets, Stars and Stellar
Systems"(www.springer.com/astronomy/book/978-90-481-8818-5). 500+ references
incl. many somewhat forgotten, pioneer papers. Original submission to
Springer: 07-June-201
Implications of Recent Data on Neutrino Mixing and Lepton Flavour Violating Decays for the Zee Model
We study implications of recent data on neutrino mixing from T2K, MINOS,
Double Chooz and from MEG for the Zee model. The simplest
version of this model has been shown to be ruled out by experimental data some
time ago. The general Zee model is still consistent with recent data. We
demonstrate this with a constrained Zee model based on naturalness
consideration. In this constrained model, only inverted mass hierarchy for
neutrino masses is allowed, and must be non-zero in order to have
correct ratio for neutrino mass-squared differences and for mixing in solar and
atmospherical neutrino oscillations. The best fit value of our model for
is from T2K and MINOS data, very close to the central
value obtained by Double Chooz experiment. There are solutions with non-zero CP
violation with the Jarlskog parameter predicted in the range , and respectively for a 1, 2 and 3
ranges of other input parameters. However, without any constraint on the
-parameter above respective ranges become ,
and . We analyse different cases to obtain a branching ratio for
close to the recent MEG bound. We also discuss other
radiative as well as the charged trilepton flavour violating decay modes of the
-lepton.Comment: References added, one extra figure added, typos corrected, few more
related phenomenology discussion added/modified; 25 pages, 10 figure
Household income determines access to specialized pediatric chronic pain treatment in Germany
Constrained SUSY seesaws with a 125 GeV Higgs
Motivated by the ATLAS and CMS discovery of a Higgs-like boson with a mass
around 125 GeV, and by the need of explaining neutrino masses, we analyse the
three canonical SUSY versions of the seesaw mechanism (type I, II and III) with
CMSSM boundary conditions. In type II and III cases, SUSY particles are lighter
than in the CMSSM (or the constrained type I seesaw), for the same set of input
parameters at the universality scale. Thus, to explain
at low energies, one is forced into regions of parameter space with very large
values of , or . We compare the squark and gluino masses
allowed by the ATLAS and CMS ranges for (extracted from the 2011-2012
data), and discuss the possibility of distinguishing seesaw models in view of
future results on SUSY searches. In particular, we briefly comment on the
discovery potential of LHC upgrades, for squark/gluino mass ranges required by
present Higgs mass constraints. A discrimination between different seesaw
models cannot rely on the Higgs mass data alone, therefore we also take into
account the MEG upper limit on BR and show that, in some
cases, this may help to restrict the SUSY parameter space, as well as to set
complementary limits on the seesaw scale.Comment: 28 pages, 7 figures. v2: comments and references added. Final version
to appear in JHE
Diagnosis and severity criteria for sinusoidal obstruction syndrome/veno-occlusive disease in pediatric patients : a new classification from the European society for blood and marrow transplantation
The advances in hematopoietic cell transplantation (HCT) over the last decade have led to a transplant-related mortality below 15%. Hepatic sinusoidal obstruction syndrome/veno-occlusive disease (SOS/VOD) is a life-threatening complication of HCT that belongs to a group of diseases increasingly identified as transplant-related, systemic endothelial diseases. In most cases, SOS/VOD resolves within weeks; however, severe SOS/VOD results in multi-organ dysfunction/failure with a mortality rate > 80%. A timely diagnosis of SOS/VOD is of critical importance, given the availability of therapeutic options with favorable tolerability. Current diagnostic criteria are used for adults and children. However, over the last decade it has become clear that SOS/VOD is significantly different between the age groups in terms of incidence, genetic predisposition, clinical presentation, prevention, treatment and outcome. Improved understanding of SOS/VOD and the availability of effective treatment questions the use of the Baltimore and Seattle criteria for diagnosing SOS/VOD in children. The aim of this position paper is to propose new diagnostic and severity criteria for SOS/VOD in children on behalf of the European Society for Blood and Marrow Transplantation.Peer reviewe
A preliminary screening and characterization of suitable acids for sandstone matrix acidizing technique: a comprehensive review
Matrix acidizing is a broadly developed technique in sandstone stimulation to improve the permeability and porosity of a bottom-hole well. The most popular acid used is mud acid (HF–HCl). It is a mixture of hydrofluoric acid and hydrochloric acid. However, one of the conventional problems in sandstone acidizing is that mud acid faces significant issues at high temperature such as rapid rate of reaction, resulting in early acid consumption. This downside has given a negative impact to sandstone acidizing as it will result in not only permeability reduction, but can even extend to acid treatment failure. So, the aim of this study is to provide a preliminary screening and comparison of different acids based on the literature to optimize the acid selection, and targeting various temperatures of sandstone environment. This paper has comprehensively reviewed the experimental works using different acids to understand the chemical reactions and transport properties of acid in sandstone environment. The results obtained indicated that fluoroboric acid (HBF4) could be useful in enhancing the sandstone acidizing process, although more studies are still required to consolidate this conclusion. HBF4 is well known as a low damaging acid for sandstone acidizing due to its slow hydrolytic reaction to produce HF. This would allow deeper penetration of the acid into the sandstone formation at a slower rate, resulting in higher porosity and permeability enhancement. Nevertheless, little is known about the effective temperature working range for a successful treatment. Considering the pros and cons of different acids, particularly those which are associated with HF and HBF4, it is recommended to perform a comprehensive analysis to determine the optimum temperature range and effective working window for sandstone acidizing before treatment operation. Prior to sandstone acid stimulation, it is essential to predict the feasibility of acid selected by integrating the effects of temperature, acid concentration and injection rate. Therefore, this manuscript has thrown light into the research significance of further studies
3,4-Methylenedioxymethamphetamine (MDMA) neurotoxicity in rats: a reappraisal of past and present findings
RATIONALE: 3,4-Methylenedioxymethamphetamine (MDMA) is a widely abused illicit drug. In animals, high-dose administration of MDMA produces deficits in serotonin (5-HT) neurons (e.g., depletion of forebrain 5-HT) that have been interpreted as neurotoxicity. Whether such 5-HT deficits reflect neuronal damage is a matter of ongoing debate. OBJECTIVE: The present paper reviews four specific issues related to the hypothesis of MDMA neurotoxicity in rats: (1) the effects of MDMA on monoamine neurons, (2) the use of “interspecies scaling” to adjust MDMA doses across species, (3) the effects of MDMA on established markers of neuronal damage, and (4) functional impairments associated with MDMA-induced 5-HT depletions. RESULTS: MDMA is a substrate for monoamine transporters, and stimulated release of 5-HT, NE, and DA mediates effects of the drug. MDMA produces neurochemical, endocrine, and behavioral actions in rats and humans at equivalent doses (e.g., 1–2 mg/kg), suggesting that there is no reason to adjust doses between these species. Typical doses of MDMA causing long-term 5-HT depletions in rats (e.g., 10–20 mg/kg) do not reliably increase markers of neurotoxic damage such as cell death, silver staining, or reactive gliosis. MDMA-induced 5-HT depletions are accompanied by a number of functional consequences including reductions in evoked 5-HT release and changes in hormone secretion. Perhaps more importantly, administration of MDMA to rats induces persistent anxiety-like behaviors in the absence of measurable 5-HT deficits. CONCLUSIONS: MDMA-induced 5-HT depletions are not necessarily synonymous with neurotoxic damage. However, doses of MDMA which do not cause long-term 5-HT depletions can have protracted effects on behavior, suggesting even moderate doses of the drug may pose risks
Observations of Ly Emitters at High Redshift
In this series of lectures, I review our observational understanding of
high- Ly emitters (LAEs) and relevant scientific topics. Since the
discovery of LAEs in the late 1990s, more than ten (one) thousand(s) of LAEs
have been identified photometrically (spectroscopically) at to . These large samples of LAEs are useful to address two major astrophysical
issues, galaxy formation and cosmic reionization. Statistical studies have
revealed the general picture of LAEs' physical properties: young stellar
populations, remarkable luminosity function evolutions, compact morphologies,
highly ionized inter-stellar media (ISM) with low metal/dust contents, low
masses of dark-matter halos. Typical LAEs represent low-mass high- galaxies,
high- analogs of dwarf galaxies, some of which are thought to be candidates
of population III galaxies. These observational studies have also pinpointed
rare bright Ly sources extended over kpc, dubbed
Ly blobs, whose physical origins are under debate. LAEs are used as
probes of cosmic reionization history through the Ly damping wing
absorption given by the neutral hydrogen of the inter-galactic medium (IGM),
which complement the cosmic microwave background radiation and 21cm
observations. The low-mass and highly-ionized population of LAEs can be major
sources of cosmic reionization. The budget of ionizing photons for cosmic
reionization has been constrained, although there remain large observational
uncertainties in the parameters. Beyond galaxy formation and cosmic
reionization, several new usages of LAEs for science frontiers have been
suggested such as the distribution of {\sc Hi} gas in the circum-galactic
medium and filaments of large-scale structures. On-going programs and future
telescope projects, such as JWST, ELTs, and SKA, will push the horizons of the
science frontiers.Comment: Lecture notes for `Lyman-alpha as an Astrophysical and Cosmological
Tool', Saas-Fee Advanced Course 46. Verhamme, A., North, P., Cantalupo, S., &
Atek, H. (eds.) --- 147 pages, 103 figures. Abstract abridged. Link to the
lecture program including the video recording and ppt files :
https://obswww.unige.ch/Courses/saas-fee-2016/program.cg
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