P/2010 A2 LINEAR II: dynamical dust modelling

P/2010 A2 is an object on an asteroidal orbit that was observed to have an extended tail or debris trail in January 2010. In this work, we fit the outburst of P/2010 A2 with a conical burst model, and verify previous suspicions that this was a one--time collisional event rather than an sustained cometary outburst, implying that P/2010 A2 is not a new Main Belt Comet driven by ice sublimation. We find that the best--fit cone opening angle is about 40 to 50 degrees, in agreement with numerical and laboratory simulations of cratering events. Mapping debris orbits to sky positions suggests that the distinctive arc features in the debris correspond to the same debris cone inferred from the extended dust. From the velocity of the debris, and from the presence of a velocity maximum at around 15 cm/s, we infer that the surface of A2 probably has a very low strength (<1 kPa), comparable to lunar regolith.Comment: 14 pages, 25 figures; accepted by Astronomy and Astrophysic

P/2010A2 LINEAR - I: An impact in the Asteroid Main Belt

Comet P/2010A2 LINEAR is a good candidate for membership with the Main Belt Comet family. It was observed with several telescopes (ESO NTT, La Silla; Gemini North, Mauna Kea; UH 2.2m, Mauna Kea) from 14 Jan. until 19 Feb. 2010 in order to characterize and monitor it and its very unusual dust tail, which appears almost fully detached from the nucleus; the head of the tail includes two narrow arcs forming a cross. The immediate surroundings of the nucleus were found dust-free, which allowed an estimate of the nucleus radius of 80-90m. A model of the thermal evolution indicates that such a small nucleus could not maintain any ice content for more than a few million years on its current orbit, ruling out ice sublimation dust ejection mechanism. Rotational spin-up and electrostatic dust levitations were also rejected, leaving an impact with a smaller body as the favoured hypothesis, and ruling out the cometary nature of the object. The impact is further supported by the analysis of the tail structure. Finston-Probstein dynamical dust modelling indicates the tail was produced by a single burst of dust emission. More advanced models, independently indicate that this burst populated a hollow cone with a half-opening angle alpha~40degr and with an ejection velocity v_max ~ 0.2m/s, where the small dust grains fill the observed tail, while the arcs are foreshortened sections of the burst cone. The dust grains in the tail are measured to have radii between a=1-20mm, with a differential size distribution proportional to a^(-3.44 +/- 0.08). The dust contained in the tail is estimated to at least 8x10^8kg, which would form a sphere of 40m radius. Analysing these results in the framework of crater physics, we conclude that a gravity-controlled crater would have grown up to ~100m radius, i.e. comparable to the size of the body. The non-disruption of the body suggest this was an oblique impact.Comment: 15 pages, 11 figures, in pres

Diabetes screening with hemoglobin A1c prior to a change in guideline recommendations: prevalence and patient characteristics

<p>Abstract</p> <p>Background</p> <p>In January 2010, the American Diabetes Association recommended the use of hemoglobin A1c (Hgb A1c) to screen and diagnose diabetes. This study explored the prevalence and clinical context of Hgb A1c tests done for non-diabetic primary care patients for the three years prior to the release of the new guidelines. We sought to determine the provision of tests in non-diabetic patients age 19 or over, patients age 45 and over (eligible for routine diabetes screening), the annual change in the rate of this screening test, and the patient characteristics associated with the provision of Hgb A1c screening.</p> <p>Methods</p> <p>We conducted a retrospective study using data routinely collected in Electronic Medical Records. The participants were thirteen community-based family physicians in Toronto, Ontario. We calculated the proportion of non diabetic patients who had at least one Hbg A1c done in three years. We used logistic generalized estimating equation with year treated as a continuous variable to test for a non-zero slope in yearly Hbg A1c provision. We modelled screening using multivariable logistic regression.</p> <p>Results</p> <p>There were 11,792 non-diabetic adults. Of these, 1,678 (14.2%; 95%CI 13.6%-14.9%) had at least one Hgb A1c test done; this was higher for patients 45 years of age or older (20.2%; 95% CI 19.3% - 21.2%). The proportion of non-diabetic patients with an A1c test increased from 5.2% in 2007 to 8.8% in 2009 (p < 0.0001 for presence of slope). Factors associated with significantly greater adjusted odds ratios of having the test done included increasing diastolic blood pressure, increasing fasting glucose, increasing body mass index, increasing age, as well as male gender and presence of hypertension, but not smoking status or LDL cholesterol. Patients living in the highest income quintile neighbourhoods had significantly lower odds ratios of having this test done than those in the lowest quintile (p < 0.001).</p> <p>Conclusions</p> <p>A large and increasing proportion of the non-diabetic patients we studied have had an Hgb A1c for screening prior to guidelines recommending the test for this purpose. Several risk factors for cardiovascular disease or diabetes were associated with the provision of the Hgb A1c. Early uptake of the test may represent appropriate utilization.</p

Challenges to the surveillance of non-communicable diseases – a review of selected approaches

Background: The rising global burden of non-communicable diseases (NCDs) necessitates the institutionalization of surveillance systems to track trends and evaluate interventions. However, NCD surveillance capacities vary across high- and low- and middle-income countries. The objective of the review was to analyse existing literature with respect to structures of health facility-based NCD surveillance systems and the lessons low- and middle-income countries can learn in setting up and running these systems. Methods: A literature review was conducted using Pub Med, Web of Knowledge and WHOLIS databases to identify citations published in English language between 1993 and 2013. In total, 20 manuscripts met inclusion criteria: 12 studies were analysed in respect to the surveillance approach, eight supporting documents in respect to general and regional challenges in NCD surveillance. Results: Eleven of the 12 studies identified were conducted in high-income countries. Five studies had a single disease focus, three a multiple NCD focus and three covered communicable as well as non-communicable diseases. Nine studies were passive assisted sentinel surveillance systems, of which six focused on the primary care level and three had additional active surveillance components, i.e., population-based surveys. The supporting documents reveal that NCD surveillance is rather limited in most low- and middle-income countries despite the increasing disease burden and its socioeconomic impact. Major barriers include institutional surveillance capacities and hence data availability. Conclusions: The review suggests that given the complex system requirements, multiple surveillance approaches are necessary to collect comprehensive information for effective NCD surveillance. Sentinel augmented facility-based surveillance, preferably supported by population-based surveys, can provide improved evidence and help budget scarce resources. Electronic supplementary material: The online version of this article (doi:10.1186/s12889-015-2570-z) contains supplementary material, which is available to authorized users

A Protocol for the Secure Linking of Registries for HPV Surveillance

In order to monitor the effectiveness of HPV vaccination in Canada the linkage of multiple data registries may be required. These registries may not always be managed by the same organization and, furthermore, privacy legislation or practices may restrict any data linkages of records that can actually be done among registries. The objective of this study was to develop a secure protocol for linking data from different registries and to allow on-going monitoring of HPV vaccine effectiveness.A secure linking protocol, using commutative hash functions and secure multi-party computation techniques was developed. This protocol allows for the exact matching of records among registries and the computation of statistics on the linked data while meeting five practical requirements to ensure patient confidentiality and privacy. The statistics considered were: odds ratio and its confidence interval, chi-square test, and relative risk and its confidence interval. Additional statistics on contingency tables, such as other measures of association, can be added using the same principles presented. The computation time performance of this protocol was evaluated.The protocol has acceptable computation time and scales linearly with the size of the data set and the size of the contingency table. The worse case computation time for up to 100,000 patients returned by each query and a 16 cell contingency table is less than 4 hours for basic statistics, and the best case is under 3 hours.A computationally practical protocol for the secure linking of data from multiple registries has been demonstrated in the context of HPV vaccine initiative impact assessment. The basic protocol can be generalized to the surveillance of other conditions, diseases, or vaccination programs

Physician privacy concerns when disclosing patient data for public health purposes during a pandemic influenza outbreak

Background: Privacy concerns by providers have been a barrier to disclosing patient information for public health\ud purposes. This is the case even for mandated notifiable disease reporting. In the context of a pandemic it has been\ud argued that the public good should supersede an individual’s right to privacy. The precise nature of these provider\ud privacy concerns, and whether they are diluted in the context of a pandemic are not known. Our objective was to\ud understand the privacy barriers which could potentially influence family physicians’ reporting of patient-level\ud surveillance data to public health agencies during the Fall 2009 pandemic H1N1 influenza outbreak.\ud Methods: Thirty seven family doctors participated in a series of five focus groups between October 29-31 2009.\ud They also completed a survey about the data they were willing to disclose to public health units. Descriptive\ud statistics were used to summarize the amount of patient detail the participants were willing to disclose, factors that\ud would facilitate data disclosure, and the consensus on those factors. The analysis of the qualitative data was based\ud on grounded theory.\ud Results: The family doctors were reluctant to disclose patient data to public health units. This was due to concerns\ud about the extent to which public health agencies are dependable to protect health information (trusting beliefs),\ud and the possibility of loss due to disclosing health information (risk beliefs). We identified six specific actions that\ud public health units can take which would affect these beliefs, and potentially increase the willingness to disclose\ud patient information for public health purposes.\ud Conclusions: The uncertainty surrounding a pandemic of a new strain of influenza has not changed the privacy\ud concerns of physicians about disclosing patient data. It is important to address these concerns to ensure reliable\ud reporting during future outbreaks.University of Ottawa Open Access Author Fun