Validity of rapid estimates of household wealth and income for health surveys in rural Africa

Drawing data from four different integrated household surveys in rural areas of Mali, Malawi, and two national surveys in Côte d'Ivoire, this paper tests the validity of proxy measures of household wealth and income that can be readily implemented in health surveys in rural Africa. The assumptions underlying the choice of wealth proxy are described, and correlations with the true value are assessed in two different settings. The expenditure proxy is developed and then tested for replicability in two independent data sets representing the same population. The study found that in both Mali and Malawi, the wealth proxy correlated highly (r $ 0.74) with the more complex monetary value method. For rural areas of Côte d'Ivoire, it was possible to generate a list of just 10 expenditure items, the values of which, when summed, correlated highly with expenditures on all items combined (r = 0.74, development data set; r = 0.72, validation data set). Total household expenditure is an accepted alternative measure of household wealth and income in developing country settings. This paper thus shows that it can be feasible to approximate both household wealth and expenditures in rural African settings without dramatically lengthening questionnaires whose primary focus is on health.Africa Rural conditions. ,Household surveys. ,Income Rural areas Africa. ,Health surveys. ,

Safety Recommendations for Evaluation and Surgery of the Head and Neck During the COVID-19 Pandemic

Importance The rapidly expanding novel coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2, has challenged the medical community to an unprecedented degree. Physicians and health care workers are at added risk of exposure and infection during the course of patient care. Because of the rapid spread of this disease through respiratory droplets, health care workers who come in close contact with the upper aerodigestive tract during diagnostic and therapeutic procedures, such as otolaryngologists–head and neck surgeons, are particularly at risk. A set of safety recommendations was created based on a review of the literature and communications with physicians with firsthand knowledge of safety procedures during the COVID-19 pandemic. Observations A high number of health care workers were infected during the first phase of the pandemic in the city of Wuhan, China. Subsequently, by adopting strict safety precautions, other regions were able to achieve high levels of safety for health care workers without jeopardizing the care of patients. The most common procedures related to the examination and treatment of upper aerodigestive tract diseases were reviewed. Each category was reviewed based on the potential risk imposed to health care workers. Specific recommendations were made based on the literature, when available, or consensus best practices. Specific safety recommendations were made for performing tracheostomy in patients with COVID-19. Conclusions and Relevance Preserving a highly skilled health care workforce is a top priority for any community and health care system. Based on the experience of health care systems in Asia and Europe, by following strict safety guidelines, the risk of exposure and infection of health care workers could be greatly reduced while providing high levels of care. The provided recommendations, which may evolve over time, could be used as broad guidance for all health care workers who are involved in the care of patients with COVID-19

Inappropriate Use of Radioactive Iodine for Low-Risk Papillary Thyroid Cancer Is Most Common in Regions with Poor Access to Healthcare

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140266/1/thy.2015.0112.pd

Engineering visible light emitting point defects in Zr-implanted polycrystalline AlN films

We have investigated the impact of thermal annealing gaseous atmosphere of argon, nitrogen, and forming gas on the structural and optical properties of thin polycrystalline AlN films subjected to high-energy zirconium ions implantation. X-ray diffraction, Raman spectroscopy, scanning electron microscopy, and atomic force microscopy measurements show that the structural and morphological properties of the Zr-implanted AlN films depend on the annealing gaseous environment. Post-implantation annealing under argon atmosphere yields the lowest structured surface roughness with increased grain size. Photoluminescence spectroscopy revealed multiple point defects and defect complexes related emission bands in the visible range. A series of absorption bands have been observed using photoluminescence excitation spectroscopy. The origin of the emission or absorption bands is identified and attributed to various types of point defects and defect complexes, theoretically reported for AlN. New emission and absorption peaks at 1.7eV (730nm) and 2.6eV (466nm), respectively, have been identified and attributed to the (ZrAl–VN)0 defect complexes

MOSAIC optical relay module: optical design, performance, and flexure analysis

The Optical Relay Module of the MOSAIC multiple-object spectrograph is used to relay 400-1800nm light picked off from the ELT focal plane to either a fibre-based integral field unit or a natural guide star wavefront sensor. Here we present the preliminary optical design offering a telecentric exit beam with a focal-ratio of F/17.718 and the opto-mechanical analysis of flexures with a study of the impact in the optical layout performances such as: deviation of the PSF centroid, tip-tilt of the image focal plane, variations of the wavefront error, optical quality and pupil wandering at the deformable mirror position

Periodontal pathogens are a risk factor of oral cavity squamous cell carcinoma, independent of tobacco and alcohol and human papillomavirus

Over the past decade, there has been a change in the epidemiology of oral cavity squamous cell cancer (OC-SCC). Many new cases of OC-SCC lack the recognized risk factors of smoking, alcohol and human papilloma virus. The aim of this study was to determine if the oral microbiome may be associated with OC-SCC in nonsmoking HPV negative patients. We compared the oral microbiome of HPV-negative nonsmoker OC-SCC(n = 18), premalignant lesions(PML) (n = 8) and normal control patients (n = 12). Their oral microbiome was sampled by oral wash and defined by 16S rRNA gene sequencing. We report that the periodontal pathogens Fusobacterium, Prevotella, Alloprevotella were enriched while commensal Streptococcus depleted in OC-SCC. Based on the four genera plus a marker genus Veillonella for PML, we classified the oral microbiome into two types. Gene/pathway analysis revealed a progressive increase of genes encoding HSP90 and ligands for TLRs 1, 2 and 4 along the controls→PML → OC-SCC progression sequence. Our findings suggest an association between periodontal pathogens and OC-SCC in non smoking HPV negative patients

Disparities and guideline adherence for HPV testing among patients with oropharyngeal squamous cell carcinoma, NCDB, and SEER

BACKGROUND: Human papilloma virus testing for oropharyngeal squamous-cell carcinoma has been recommended by the National Comprehensive Cancer Network since 2012. We examine disparities, reported rates of human papillomavirus (HPV) testing, and the impact on these findings of limitations with the variable in database registries. METHODS: The HPV variable was queried for patients with oropharyngeal squamous carcinoma (OPSCC) from 2013 to 2016 in National Cancer Data Base (NCDB) and Surveillance, Epidemiology, and End Results (SEER). Multivariable regression was used to identify disparities based on sociodemographic variables. Sensitivity analyses were used to investigate limitations of the variable. RESULTS: Despite limitations in the HPV variable in the databases, there was less than 100% adherence to recommended testing, and there were significant disparities in multiple sociodemographic variables. For example, in NCDB 70% of white versus 60.4% of black patients were tested (odds ratio [OR] 0.75, confidence interval [CI] 0.66-0.85, p ≤ 0.0001); in SEER 59.8% of white and 47.6% of black patients were tested (OR 0.73, CI 0.67-0.81; p ≤ 0.0001). CONCLUSIONS: Disparities exist among patients undergoing testing for HPV-associated OPSCC and adherence to guideline recommended HPV testing has been suboptimal. In addition, the HPV variable definition, especially as it relates to p16 positivity, and use in these two registries should be improved

Adaptive optics telemetry standard: Design and specification of a novel data exchange format

Context. The amount of adaptive optics (AO) telemetry generated by visible/near-infrared ground-based observatories is ever greater, leading to a growing need for a standardised data exchange format to support performance analysis, AO research, and development activities that involve large-scale telemetry mining, processing, and curation.Aims. This paper introduces the Adaptive Optics Telemetry (AOT) data exchange format as a standard for sharing AO telemetry from visible/infrared ground-based observatories. AOT is based on the flexible image transport system (FITS) and aims to provide unambiguous and consistent data access across various systems and configurations, including natural and single- or multiple-laser guide-star AO systems.Methods. We designed AOT with a focus on two key use cases: atmospheric turbulence parameter estimation and point-spread function reconstruction. We prototyped and tested the design using existing AO telemetry datasets from multiple systems: single conjugate with natural and laser guide stars, tomographic systems with multi-channel wavefront sensors, and single- and multi-wavefront correctors in systems featuring either a Shack-Hartmann or Pyramid as the main wavefront sensor.Results. The AOT file structure has been thoroughly defined, with specified data fields, descriptions, data types, units, and expected dimensions. To support this format, we have developed a Python package that enables the data conversion, reading, writing, and exploration of AOT files; it has been made publicly available and is compatible with a general-purpose Python package manager. We have demonstrated the flexibility of the AOT format by packaging data from five different instruments, installed on different telescopes

Podoplanin expression in lymph node metastases of head and neck cancer and cancer of unknown primary patients

Introduction: Head and neck squamous cell carcinomas (HNSCCs) are cancers with generally poor prognosis. Outcomes have not improved in decades, with more than half of the patients presenting with lymph node metastases at the time of diagnosis. A unique subtype of HNSCC, cancer of unknown primary of the head and neck (HNCUP) is associated with a poor outcome. Increased expression of the D2-40 gene (podoplanin) has been described for several human malignancies and has been associated with increased metastatic potential of cancer cells. Methods: In order to examine the role of podoplanin in lymph node metastasis of HNSCC generally and HNCUP specifically, we evaluated the prognostic impact of podoplanin expression in HNSCC- (n=68) and HNCUP-associated lymph node metastases (n =30). The expression of podoplanin was analyzed by immunohistochemical staining of lymph node tissue samples and correlated with clinical and histopathological data. Results: We found a non-significant tendency towards a higher podoplanin expression in HNCUP compared to HNSCC lymph node metastases and a significant correlation between a high podoplanin expression and advanced node-stage classification. Podoplanin expression had no significant impact on overall survival for both groups and did not correlate with human papillomavirus tumor status. Conclusion: Taken together, our results suggest that upregulation of podoplanin may be associated with a stimulation of lymphatic metastasis in head and neck cancer

Does Concomitant CABG Influence the Outcomes of Post-Myocardial Infarction Ventricular Septal Defect Repair?

Introduction: Ventricular septal defect (VSD) following myocardial infarction (MI) is a relatively infrequent complication with high mortality. Over time, understanding of the pathology and its management has resulted in improved outcomes; however, controversies remain. Objective: We sought to investigate the effect of concomitant coronary artery bypass graft (CABG) on outcomes following post-MI VSD repair. Methods: Electronic search was performed to identify all relevant studies published from 2000 to 2018. After assessment for inclusion and exclusion criteria, 66 studies were selected for the analysis. Data were extracted and pooled for systematic review and meta-analysis. Results: Average age was 68.7 years (95% CI 67.3-70.1) with 57% (95% CI 54-60) males. Coronary angiogram was available preoperatively in 94% (95% CI 92-96) of patients. Single-vessel disease was most common (47%, 95% CI 42-52) with left anterior descending coronary artery the most commonly involved vessel (55%, 95% CI 46-63). Concomitant CABG was performed in 52% (95% CI 46-57) of patients. Of these, infarcted territory was revascularized in 54% (95% CI 23-82). No significant survival difference was observed between those who had concomitant CABG versus those without CABG at 30 days (65%, 95% CI 58-72) vs (60%, 95% CI 47-72), 1 year (59%, 95% CI 50-68) vs (51%, 95% CI 41-61), and 5 years (46%, 95% CI 38-54) vs (39%, 95% CI 27-52) respectively. Discussion: Overall, concomitant CABG did not have a significant effect on survival following VSD repair, therefore, decision on revascularization should be weighed against the risks associated with prolonged cardiopulmonary bypass