Area deprivation across the life course and physical capability in mid-life: findings from the 1946 British Birth Cohort

Physical capability in later life is influenced by factors occurring across the life course, yet exposures to area conditions have only been examined cross-sectionally. Data from the National Survey of Health and Development, a longitudinal study of a 1946 British birth cohort, were used to estimate associations of area deprivation (defined as percentage of employed people working in partly skilled or unskilled occupations) at ages 4, 26, and 53 years (residential addresses linked to census data in 1950, 1972, and 1999) with 3 measures of physical capability at age 53 years: grip strength, standing balance, and chair-rise time. Cross-classified multilevel models with individuals nested within areas at the 3 ages showed that models assessing a single time point underestimate total area contributions to physical capability. For balance and chair-rise performance, associations with area deprivation in midlife were robust to adjustment for individual socioeconomic position and prior area deprivation (mean change for a 1-standard-deviation increase: balance, −7.4% (95% confidence interval (CI): −12.8, −2.8); chair rise, 2.1% (95% CI: −0.1, 4.3)). In addition, area deprivation in childhood was related to balance after adjustment for childhood socioeconomic position (−5.1%, 95% CI: −8.7, −1.6). Interventions aimed at reducing midlife disparities in physical capability should target the socioeconomic environment of individuals—for standing balance, as early as childhood

Efficient Immunization Strategies for Computer Networks and Populations

We present an effective immunization strategy for computer networks and populations with broad and, in particular, scale-free degree distributions. The proposed strategy, acquaintance immunization, calls for the immunization of random acquaintances of random nodes (individuals). The strategy requires no knowledge of the node degrees or any other global knowledge, as do targeted immunization strategies. We study analytically the critical threshold for complete immunization. We also study the strategy with respect to the susceptible-infected-removed epidemiological model. We show that the immunization threshold is dramatically reduced with the suggested strategy, for all studied cases.Comment: Revtex, 5 pages, 4 ps fig

Uveal Hematocysts in a Golden Retriever Dog

Case Description. A 7-year-old neutered male golden retriever presented for examination 1 month following the observation of multifocal round brown structures in the anterior chamber of the left eye and similar, but blood-filled, structures in the right eye. Clinical Findings. Ophthalmic examination revealed bilateral iris hyperpigmentation, pigment deposition on the anterior lens capsule, and uveal cysts. The uveal cysts in the right eye were partially blood filled. Clinical findings were consistent with pigmentary uveitis of golden retrievers. Treatment and Outcome. The patient has been maintained on topical anti-inflammatories and no progression of the disease has occurred in eight months. Clinical Relevance. This paper emphasizes the importance of recognizing the unique clinical signs of pigmentary uveitis and highlights uveal hematocysts, a rare manifestation of the disease

Percolation Critical Exponents in Scale-Free Networks

We study the behavior of scale-free networks, having connectivity distribution P(k) k^-a, close to the percolation threshold. We show that for networks with 3<a<4, known to undergo a transition at a finite threshold of dilution, the critical exponents are different than the expected mean-field values of regular percolation in infinite dimensions. Networks with 2<a<3 possess only a percolative phase. Nevertheless, we show that in this case percolation critical exponents are well defined, near the limit of extreme dilution (where all sites are removed), and that also then the exponents bear a strong a-dependence. The regular mean-field values are recovered only for a>4.Comment: Latex, 4 page

Fractal and Transfractal Recursive Scale-Free Nets

We explore the concepts of self-similarity, dimensionality, and (multi)scaling in a new family of recursive scale-free nets that yield themselves to exact analysis through renormalization techniques. All nets in this family are self-similar and some are fractals - possessing a finite fractal dimension - while others are small world (their diameter grows logarithmically with their size) and are infinite-dimensional. We show how a useful measure of "transfinite" dimension may be defined and applied to the small world nets. Concerning multiscaling, we show how first-passage time for diffusion and resistance between hub (the most connected nodes) scale differently than for other nodes. Despite the different scalings, the Einstein relation between diffusion and conductivity holds separately for hubs and nodes. The transfinite exponents of small world nets obey Einstein relations analogous to those in fractal nets.Comment: Includes small revisions and references added as result of readers' feedbac

Association between surgical volume and failure of primary total hip replacement in England and Wales: findings from a prospective national joint replacement register

Objective To investigate the association of volume of total hip arthroplasty (THA) between consultants and within the same consultant in the previous year and the hazard of revision using multilevel survival models. Design Prospective cohort study using data from a national joint replacement register. Setting Elective THA across all private and public centres in England and Wales between April 2003 and February 2017. Participants Patients aged 50 years or more undergoing THA for osteoarthritis. Intervention The volume of THA conducted in the preceding 365 days to the index procedure. Main outcome and measure Revision surgery (excision, addition or replacement) of a primary THA. Results Of the 579 858 patients undergoing primary THA (mean baseline age 69.8 years (SD 10.2)), 61.1% were women. Multilevel survival found differing results for between and within-consultant effects. There was a strong volume–revision association between consultants, with a near-linear 43.3% (95% CI 29.1% to 57.4%) reduction of the risk of revision comparing consultants with volumes between 1 and 200 procedures annually. Changes in individual surgeons (within-consultant) case volume showed no evidence of an association with revision. Conclusion Separation of between-consultant and within- consultant effects of surgical volume reveals how volume contributes to the risk of revision after THA. The lack of association within-consultants suggests that individual changes to consultant volume alone will have little effect on outcomes following THA. These novel findings provide strong evidence supporting the practice of specialisation of hip arthroplasty. It does not support the practice of low-volume consultants increasing their personal volume as it is unlikely their results would improve if this is the only change. Limiting the exposure of patients to consultants with low volumes of THA and greater utilisation of centres with higher volume surgeons with better outcomes may be beneficial to patients

Scale-Free Networks are Ultrasmall

We study the diameter, or the mean distance between sites, in a scale-free network, having N sites and degree distribution p(k) ~ k^-a, i.e. the probability of having k links outgoing from a site. In contrast to the diameter of regular random networks or small world networks which is known to be d ~ lnN, we show, using analytical arguments, that scale free networks with 2<a<3 have a much smaller diameter, behaving as d ~ lnlnN. For a=3, our analysis yields d ~ lnN/lnlnN, as obtained by Bollobas and Riordan, while for a>3, d ~ lnN. We also show that, for any a>2, one can construct a deterministic scale free network with d ~ lnlnN, and this construction yields the lowest possible diameter.Comment: Latex, 4 pages, 2 eps figures, small corrections, added explanation