Cost-effectiveness analysis of HPV extended versus partial genotyping for cervical cancer screening in Singapore

Human papillomavirus (HPV) partial genotyping (PGT) identifies HPV16 and HPV18 individually, alongside 12 other high-risk HPV genotypes (hrHPV) collectively. HPV extended genotyping (XGT) identifies four additional hrHPV individually (HPV31, 45, 51, and 52), and reports the remaining eight in three groups (HPV33|58; 56|59|66; 35|39|68). Quality-adjusted life years (QALY), health care resource use, and costs of XGT were compared to PGT for cervical cancer screening in Singapore using DICE simulation. Women with one of the three hrHPV identified by XGT (HPV35|39|68; 56|59|66; 51), and atypical squamous cells of undetermined significance (ASCUS) on cytology, are recalled for a repeat screening in one year, instead of undergoing an immediate colposcopy with PGT. At the repeat screening, the colposcopy is performed only for persistent same-genotype infections in XGT, while with PGT, all the women with persistent HPV have a colposcopy. Screening 500,122 women, aged 30–69, with XGT, provided an incremental cost-effectiveness ratio (ICER) versus PGT of SGD 16,370/QALY, with 7130 (19.4%) fewer colposcopies, 6027 (7.0%) fewer cytology tests, 9787 (1.6%) fewer clinic consultations, yet 2446 (0.5%) more HPV tests. The XGT ICER remains well below SGD 100,000 in sensitivity analyses, (-SGD 17,736/QALY to SGD 50,474/QALY). XGT is cost-effective compared to PGT, utilizes fewer resources, and provides a risk-based approach as the primary cervical cancer screening method

Refeeding syndrome in adults receiving total parenteral nutrition: An audit of practice at a tertiary UK centre

Background & aims: The key to preventing refeeding syndrome (RS) is identifying and appropriately managing patients at risk. We evaluated our clinical management of RS risk in patients starting total parenteral nutrition (TPN). / Methods: Patients commencing TPN at University College London Hospital between January and July 2015 were prospectively followed-up for 7-days. Eighty patients were risk assessed for RS and categorized into risk groups. High and low risk RS groups were compared focussing on the onset of biochemical features of RS (hypophosphatemia, hypokalaemia and hypomagnesemia) and initial clinical assessment. Statistical analysis was conducted using t-tests and Mann–Whitney U tests. / Results: Sixty patients (75%) were identified as high-risk for RS and received lower initial calories (12.8 kcal/kg/day, p < 0.05). All high-risk patients received a high potency vitamin preparation compared to 35% in the low risk group (p < 0.05). Daily phosphate, magnesium and potassium plasma levels were monitored for seven days in 25%, 30% and 53.8% of patients, respectively. Hypophosphatemia developed in 30% and hypomagnesaemia and hypokalaemia in 27.5% of all patients. Approximately 84% of patients had one or more electrolyte abnormalities, which occurred more frequently in high-risk RS patients (p < 0.05). Low risk patients developed mild hypophosphatemia at a much lower percentage than high-risk RS (20% vs 33.3%, respectively). / Conclusion: A significant proportion of patients commencing TPN developed biochemical features of RS (but no more serious complications) despite nutritional assessment, treatment, and follow up in accordance with national recommendations. High vs low risk RS patients were more likely to have electrolyte abnormalities after receiving TPN regardless of preventative measures. Additional research is required to further optimise the initial nutritional approach to prevent RS in high-risk patients

La ortopodología en el síndrome de Apert

Los autores describen las características morfológicas y funcionales del pie y de la marcha de un niño afectado de un síndrome de Apert. Asimismo proponen varios tratamientos ortopodológicos, y describen su diseño, confección y aplicación con las técnicas: TAD y sobre molde positivo

Theoretical and experimental analysis of the photoluminescence and photoluminescence excitation spectroscopy spectra of m\textit{m}-plane InGaN/GaN quantum wells

We present a combined theoretical and experimental analysis of the optical properties of $\textit{m}$-plane InGaN/GaN quantum wells. The sample was studied by photoluminescence and photoluminescence excitation spectroscopy at low temperature. The spectra show a large Stokes shift between the lowest exciton peak in the excitation spectra and the peak of the photoluminescence spectrum. This behavior is indicative of strong carrier localization effects. These experimental results are complemented by tight-binding calculations, accounting for random alloy fluctuations and Coulomb effects. The theoretical data explain the main features of the experimental spectra. Moreover, by comparison with calculations based on a virtual crystal approximation, the importance of carrier localization effects due to random alloy fluctuations is explicitly shown.This work was supported by Science Foundation Ireland (Project No. 13/SIRG/2210) and the United Kingdom Engineering and Physical Sciences Research Council (Grant Agreement Nos. EP\J001627\1 and EP\J003603\1). S.S. acknowledges computing resources provided by the SFI/HEA Irish Centre for High-End Computing. R.A.O. and F.T. acknowledge the support of the European Research Council under the European Community's 7th Framework Programme (FP7/2007–2013)/ERC Grant Agreement No. 279361 (MACONS)

Double Λ\Lambda Hypernuclei and the Nuclear Medium Effective ΛΛ\Lambda\Lambda Interaction

We fit the $^1 S_0 \Lambda\Lambda$ interaction in the nuclear medium to the masses of the experimentally known double-$\Lambda$ hypernuclei: $^{\phantom{6}6}_{\Lambda\Lambda}$He, $^{10}_{\Lambda\Lambda}$Be and $^{13}_{\Lambda\Lambda}$B. We derive this effective interaction from OBE J\"ulich $\Lambda\Lambda$-type potentials and using both Hartree-Fock and variational approaches. We find that the inclusion of $\Lambda\Lambda$ correlations in the variational scheme leads to significant differences and a better understanding of the dynamical features of the system. We investigate the sensitivity of the binding energies and the mesonic decay widths of the above double-$\Lambda$ hypernuclei to the $\omega \Lambda\Lambda$ coupling and the form factor at the $\sigma \Lambda\Lambda$ vertex. We also use this effective interaction to predict binding energies and pionic decay widths of heavier double-$\Lambda$ hypernuclei, not discovered yet. Finally, we discard the existence of $^1 S_0$ $\Lambda\Lambda$ bound states provided the $\Lambda\Lambda-\Xi N$ coupling can be neglected.Comment: 49 pages, LaTeX + 8 ps-figure file

Isolation of KPC 3-producing Enterobacter aerogenes in a patient colonized by MDR Klebsiella pneumoniae

We describe the interspecies transmission of the plasmid-mediated blaKPC-3 gene, which confers carbapenem resistance, between clinically relevant gram-negative bacteria in a single patient. A KPC-3 producing Enterobacter aerogenes was isolated from a hospitalized patient previously colonized and then infected by a Klebsiella pneumoniae ST101 carrying the blaKPC-3 gene. The strains showed identical plasmids. Since intense horizontal exchanges among bacteria can occur in the gut, clinicians should be aware that patients colonized by carbapenem-resistant K. pneumoniae could become carriers of other carbapenem-resistant Enterobacteriaceae. © 2016 by Edimes - Edizioni Internazionali Srl. All rights reserved

Relación entre el engagement por uso de redes sociales y la práctica de ejercicio físico en los centros deportivos municipales de Barcelona

Introducción. El presente estudio analiza el uso de las redes sociales por parte de los centros deportivos municipales (CEM) de Barcelona y como esto puede relacionarse con la práctica de ejercicio físico. Metodología. Se calculó el engagement de los centros deportivos municipales de Barcelona mediante el registro de las interacciones en sus redes sociales (Facebook y Twitter), para luego determinar la relación existente entre el engagement y la práctica de ejercicio físico en Barcelona. Resultados. Los datos muestran que existe una relación positiva entre el engagement y la práctica de actividad física. Además, se identifica que los likes de Facebook determinaron la mayor relación. Discusión y conclusiones. A pesar de que la recogida de datos fue muy acotada (82 días), se recomienda que los centros deportivos gestionen la comunicación mediante redes sociales y presten atención en como involucrar a los usuarios

Machine-learning of atomic-scale properties based on physical principles

We briefly summarize the kernel regression approach, as used recently in materials modelling, to fitting functions, particularly potential energy surfaces, and highlight how the linear algebra framework can be used to both predict and train from linear functionals of the potential energy, such as the total energy and atomic forces. We then give a detailed account of the Smooth Overlap of Atomic Positions (SOAP) representation and kernel, showing how it arises from an abstract representation of smooth atomic densities, and how it is related to several popular density-based representations of atomic structure. We also discuss recent generalisations that allow fine control of correlations between different atomic species, prediction and fitting of tensorial properties, and also how to construct structural kernels---applicable to comparing entire molecules or periodic systems---that go beyond an additive combination of local environments