406 research outputs found
An introduction to Graph Data Management
A graph database is a database where the data structures for the schema
and/or instances are modeled as a (labeled)(directed) graph or generalizations
of it, and where querying is expressed by graph-oriented operations and type
constructors. In this article we present the basic notions of graph databases,
give an historical overview of its main development, and study the main current
systems that implement them
Radiation chemistry of solid-state carbohydrates using EMR
We review our research of the past decade towards identification of radiation-induced radicals in solid state sugars and sugar phosphates. Detailed models of the radical structures are obtained by combining EPR and ENDOR experiments with DFT calculations of g and proton HF tensors, with agreement in their anisotropy serving as most important criterion. Symmetry-related and Schonland ambiguities, which may hamper such identification, are reviewed. Thermally induced transformations of initial radiation damage into more stable radicals can also be monitored in the EPR (and ENDOR) experiments and in principle provide information on stable radical formation mechanisms. Thermal annealing experi-ments reveal, however, that radical recombination and/or diamagnetic radiation damage is also quite important. Analysis strategies are illustrated with research on sucrose. Results on dipotassium glucose-1-phosphate and trehalose dihydrate, fructose and sorbose are also briefly discussed. Our study demonstrates that radiation damage is strongly regio-selective and that certain general principles govern the stable radical formation
Mechanisms and treatment of ischaemic stroke: insights from genetic associations
The precise pathophysiology of ischaemic stroke is unclear, and a greater understanding of the different mechanisms that underlie large-artery, cardioembolic and lacunar ischaemic stroke subtypes would enable the development of more-effective, subtype-specific therapies. Genome-wide association studies (GWASs) are identifying novel genetic variants that associate with the risk of stroke. These associations provide insight into the pathophysiological mechanisms, and present opportunities for novel therapeutic approaches. In this Review, we summarize the genetic variants that have been linked to ischaemic stroke in GWASs to date and discuss the implications of these associations for both our understanding and treatment of ischaemic stroke. The majority of genetic variants identified are associated with specific subtypes of ischaemic stroke, implying that these subtypes have distinct genetic architectures and pathophysiological mechanisms. The findings from the GWASs highlight the need to consider whether therapies should be subtype-specific. Further GWASs that include large cohorts are likely to provide further insights, and emerging technologies will complement and build on the GWAS findings
Further evidence for association of hepatitis C infection with parenteral schistosomiasis treatment in Egypt
BACKGROUND: Hepatitis C virus (HCV) infection and schistosomiasis are major public health problems in the Nile Delta of Egypt. To control schistosomiasis, mass treatment campaigns using tartar emetic injections were conducted in the 1960s through 1980s. Evidence suggests that inadequately sterilized needles used in these campaigns contributed to the transmission of HCV in the region. To corroborate this evidence, this study evaluates whether HCV infections clustered within houses in which household members had received parenteral treatment for schistosomiasis. METHODS: A serosurvey was conducted in a village in the Nile Delta and residents were questioned about prior treatment for schistosomiasis. Sera were evaluated for the presence of antibodies to HCV. The GEE2 approach was used to test for clustering of HCV infections, where correlation of HCV infections within household members who had been treated for schistosomiasis was the parameter of interest. RESULTS: A history of parenteral treatment for schistosomiasis was observed to cluster within households, OR for clustering: 2.44 (95% CI: 1.47–4.06). Overall, HCV seropositivity was 40% (321/796) and was observed to cluster within households that had members who had received parenteral treatment for schistosomiasis, OR for clustering: 1.76 (95% CI: 1.05–2.95). No such evidence for clustering was found in the remaining households. CONCLUSION: Clustering of HCV infections and receipt of parenteral treatment for schistosomiasis within the same households provides further evidence of an association between the schistosomiasis treatment campaigns and the high HCV seroprevalence rates currently observed in the Nile delta of Egypt
Income and education as predictors of return to working life among younger stroke patients
<p>Abstract</p> <p>Background</p> <p>Socioeconomic conditions are not only related to poor health outcomes, they also contribute to the chances of recovery from stroke. This study examines whether income and education were predictors of return to work after a first stroke among persons aged 40-59.</p> <p>Methods</p> <p>All first-stroke survivors aged 40-59 who were discharged from a hospital in 1996-2000 and who had received income from work during the year prior to the stroke were sampled from the Swedish national register of in-patient care (n = 7,081). Income and education variables were included in hazard regressions, modelling the probability of returning to work from one to four years after discharge. Adjustments for age, sex, stroke subtype, and length of in-patient care were included in the models.</p> <p>Results</p> <p>Both higher income and higher education were associated with higher probability of returning to work. While the association between education and return to work was attenuated by income, individuals with university education were 13 percent more likely to return than those who had completed only compulsory education, and individuals in the highest income quartile were about twice as likely to return as those in the lowest. The association between socioeconomic position and return to work was similar for different stroke subtypes. Income differences between men and women also accounted for women's lower probability of returning to work.</p> <p>Conclusions</p> <p>The study demonstrates that education and income were independent predictors of returning to work among stroke patients during the first post-stroke years. Taking the relative risk of return to work among those in the higher socioeconomic positions as the benchmark, there may be considerable room for improvement among patients in lower socioeconomic strata.</p
Interactions between Global Health Initiatives and Country Health Systems: The Case of a Neglected Tropical Diseases Control Program in Mali
Prevention of neglected tropical diseases was recently significantly scaled up in sub-Saharan Africa, protecting entire populations with mass distribution of drugs: five different diseases are now addressed simultaneously with a package of four drugs. Some argue however that, similarly to other major control programs dealing with specific diseases, this NTD campaign fails to strengthen health systems and might even negatively affect regular care provision. In 2007, we conducted an exploratory field study in Mali, observing how the program was implemented in two rural areas and how it affected the health system. At the local level, we found that the campaign effects of care delivery differed across health services. In robust and well staffed health centres, the personnel successfully facilitated mass drug distribution while running routine consultations, and overall service functioning benefitted from programme resources. In more fragile health centres however, additional program workload severely disturbed access to regular care, and we observed operational problems affecting the quality of mass drug distribution. Strong health services appeared to be profitable to the NTD control program as well as to general care
Antibiotic use for common illnesses in children living with disability: a multi-country study across 42 low- and middle-income countries
Background: Approximately 240 million children worldwide are living with disabilities. Understanding the association between disability status and reported antibiotic use for common illnesses can help develop strategies to address the critical intersection of antimicrobial resistance (AMR) and disability.
Methods: Data were collected from 42 low- and middle-income countries through the UNICEF-supported Multiple Indicator Cluster Survey (2017–2023). Disability status was assessed using the Washington Group-Child Functioning Module. Reported antibiotic use was measured by whether children with disabilities received antibiotic treatment for common childhood illnesses. Logistic regression models were applied to investigate the association between disability status and the prevalence of acute respiratory infection (ARI), diarrhea, and fever in the past two weeks, as well as reported antibiotic use for these illnesses. Analyses controlled for age, sex, place of residence, mother's education, the number of children under five in the household and country.
Findings: The study included 301,857 children, 6.9% of whom were living with disabilities. Children with disabilities were more likely to experience common illnesses compared to those without disabilities: aOR = 1.78 (95% CI: 1.34–2.36) for ARI and aOR = 1.54 (95% CI: 1.22–1.96) for fever. The odds of antibiotic use among children with disabilities were comparable to those without disabilities: aOR = 1.13 (95% CI: 0.68–1.87) for ARI, aOR = 0.93 (95% CI: 0.64–1.36) for diarrhea, and aOR = 1.23 (95% CI: 0.81–1.86) for fever. This varied across countries, the lower-middle income countries had lower odds of reported antibiotic use for ARI and diarrhea (aOR = 0.85, 95% CI: 0.74–0.97, aOR = 0.78, 95% CI: 0.64–0.95, respectively). Lesotho, Iraq, Comoros and Honduras had higher odds of reported antibiotic use for children with disabilities, and in Pakistan where children with disabilities had lower odds of reported antibiotic use. Subgroup analyses showed that girls with disabilities were less likely to use antibiotics for diarrhea (aOR = 0.78, 95% CI: 0.63–0.96) compared to girls without disabilities. Similarly, girls with disabilities had lower odds of using antibiotics (aOR = 0.53, 95% CI: 0.29–0.98) compared to boys with disabilities. The associations also varied by impairment type, children with seeing, controlling behaviour or learning impairments are less likely to have reported antibiotic use.
Interpretation: Children with disabilities are at a higher risk of developing common illnesses but are not necessarily more or less likely to use antibiotics for these conditions compared to children without disabilities. However, gender, country and impairment type disparities persist. Targeted efforts are needed to address these health inequities and ensure equitable access to care.
Funding: This research was partially supported by National Natural Science Foundation of China (grant number: 72374228, 72074234), Guangdong Basic and Applied Basic Research Foundation (grant number: 2023A1515010163), Guangzhou Basic and Applied Basic Research Program (grant number: 2025A04J5118), and Fundamental Scientific Research Funds for Central Universities, China (grant number: SYSU-25wkjc02)
Variation in guideline adherence in non-Hodgkin’s lymphoma care: impact of patient and hospital characteristics
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