Theory of Current and Shot Noise Spectroscopy in Single-Molecular Quantum Dots with Phonon Mode

Using the Keldysh nonequilibrium Green function technique, we study the current and shot noise spectroscopy of a single molecular quantum dot coupled to a local phonon mode. It is found that in the presence of electron-phonon coupling, in addition to the resonant peak associated with the single level of the dot, satellite peaks with the separation set by the frequency of phonon mode appear in the differential conductance. In the ``single level'' resonant tunneling region, the differential shot noise power exhibit two split peaks. However, only single peaks show up in the ``phonon assisted'' resonant-tunneling region. An experimental setup to test these predictions is also proposed.Comment: 5 pages, 3 eps figures embedde

Chikungunya virus: an update on the biology and pathogenesis of this emerging pathogen

Re-emergence of chikungunya virus, a mosquito-transmitted pathogen, is of serious public health concern. In the past 15 years, after decades of infrequent, sporadic outbreaks, the virus has caused major epidemic outbreaks in Africa, Asia, the Indian Ocean, and more recently the Caribbean and the Americas. Chikungunya virus is mainly transmitted by Aedes aegypti mosquitoes in tropical and subtropical regions, but the potential exists for further spread because of genetic adaptation of the virus to Aedes albopictus, a species that thrives in temperate regions. Chikungunya virus represents a substantial health burden to affected populations, with symptoms that include severe joint and muscle pain, rashes, and fever, as well as prolonged periods of disability in some patients. The inflammatory response coincides with raised levels of immune mediators and infiltration of immune cells into infected joints and surrounding tissues. Animal models have provided insights into disease pathology and immune responses. Although host innate and adaptive responses have a role in viral clearance and protection, they can also contribute to virus-induced immune pathology. Understanding the mechanisms of host immune responses is essential for the development of treatments and vaccines. Inhibitory compounds targeting key inflammatory pathways, as well as attenuated virus vaccines, have shown some success in animal models, including an attenuated vaccine strain based on an isolate from La Reunion incorporating an internal ribosome entry sequence that prevents the virus from infecting mosquitoes and a vaccine based on virus-like particles expressing envelope proteins. However, immune correlates of protection, as well as the safety of prophylactic and therapeutic candidates, are important to consider for their application in chikungunya infections. In this Review, we provide an update on chikungunya virus with regard to its epidemiology, molecular virology, virus-host interactions, immunological responses, animal models, and potential antiviral therapies and vaccines

Indirect Search for Neutralino Dark Matter with High Energy Neutrinos

We investigate the prospects of indirect searches for supersymmetric neutralino dark matter. Relic neutralinos gravitationally accumulate in the Sun and their annihilations produce high energy neutrinos. Muon neutrinos of this origin can be seen in large detectors like AMANDA, IceCube and ANTARES. We evaluate the relic density and the detection rate in several models---the minimal supersymmetric model, minimal supergravity, and supergravity with non-universal Higgs boson masses at the grand unification scale. We make realistic estimates for the indirect detection rates including effects of the muon detection threshold, quark hadronization, and solar absorption. We find good prospects for detection of neutralinos with mass above 200 GeV.Comment: 36 pages in REVTEX, 18 figure

IceHEP High Energy Physics at the South Pole

With the solar and SN87 neutrino observations as proofs of concepts, the kilometer-scale neutrino experiment IceCube will scrutinize its data for new particle physics. In this paper we review the prospects for the realization of such a program. We begin with a short overview of the detector response and discuss the reach of ``beam'' luminosity. After that we discuss the potential of IceCube to probe deviations of neutrino-nucleon cross sections from the Standard Model predictions at center-of-mass energies well beyond those accessible in man-made accelerators. Then we review the prospects for extremely long-baseline analyses and discuss the sensitivity to measure tiny deviations of the flavor mixing angle, expected to be induced by quantum gravity effects. Finally we discuss the potential to uncover annihilation of dark matter particles gravitationally trapped at the center of the Sun, as well as processes occurring in the early Universe at energies close to the Grand Unification scale.Comment: Typos corrected and references added. Version with high resolution figures available at http://www.hep.physics.neu.edu/staff/doqui/icehep_rev6.p

It Is Not Pneumocystis jiroveci (PCP), It Is Cyclophosphamide-Induced Pneumonitis

Cyclophosphamide (CYC) is an immunosuppressive medication used to treat life-threatening complications of various rheumatic diseases like vasculitis and systemic lupus erythematosus. A rare side effect of this medication is pneumonitis, which occurs in less than 1% of patients. We describe a case of an 83-year-old woman with a past medical history of microscopic polyangiitis, who presented with progressive dyspnea at rest, exacerbated on exertion, and associated with orthopnea that was attributed to CYC-induced pneumonitis. Three months before this presentation, the patient was diagnosed with antineutrophil cytoplasmic antibodies (ANCA)-positive pauci-immune crescentic and necrotizing glomerulonephritis and started on CYC. On admission, a computed tomography (CT) chest showed worsening bilateral ground-glass opacities in a mosaic distribution and inter and intralobular septal thickening, not present on the CT performed three months prior. The patient underwent an extensive workup, which included an echocardiogram, bronchoscopy with bronchoalveolar lavage, and viral respiratory panel to rule out infectious and cardiac pathologies. She was started on empiric treatment with antibiotics and diuretics, however, despite these interventions, she continued with respiratory distress. A multidisciplinary team convened, and the diagnosis of CYC-induced lung injury was entertained. The CYC was discontinued, and the patient was started on prednisone with significant improvement in symptoms. This case highlights the importance of recognizing CYC as a rare cause of interstitial pneumonitis. When considering CYC-induced lung toxicity, other etiologies, such as opportunistic infections, cardiac etiologies, and diffuse alveolar hemorrhage, should be ruled out

It is not PCP; it is Cyclophosphamide Induced toxicity

Background: Cyclophosphamide (CYC) is an immunosuppressive medication used to treat life threatening complications of various rheumatic diseases like vasculitis and systemic lupus erythematosus. 1% of patients on this medication develop pneumonitis. When considering CYC induced lung toxicity, other etiologies such as opportunistic infections and diffuse alveolar hemorrhage should be ruled out. Case presentation: The patient is an 83-year-old woman with a past medical history of microscopic polyangiitis, and hypothyroidism who presented with progressive dyspnea at rest, exacerbated on exertion, associated with orthopnea. The patient was admitted due to acute on chronic hypoxemic respiratory failure with multifactorial etiology and heart failure exacerbation with preserved ejection fraction of 65%. Three months prior to this admission, the patient was diagnosed with ANCA-positive pauci immune crescentic and necrotizing glomerulonephritis; she was started on CY, as well as prednisone. On admission, her pulse oximetry was 88% on room air, with a systolic murmur at the right upper parasternal border, and bibasilar inspiratory crackles. Initial workup showed pancytopenia. Echocardiogram revealed severe aortic stenosis, and a right systolic ventricular pressure of 65mmHg, suggestive of pulmonary hypertension-likely group 2. Medical management was recommended since the patient was a poor candidate for procedures. CT Chest showed worsening bilateral ground-glass densities and inter and intralobular septal thickening, not present on CT performed three months ago. Empiric coverage for opportunistic infections with clindamycin, primaquine, and azithromycin was started. Bronchoscopy ruled out diffuse alveolar hemorrhage, and bronchoalveolar lavage was negative for Coccidioides, Histoplasma, acid-fast bacilli, Pneumocystis jiroveci, and Aspergillus, same for the viral respiratory panel. Antibiotics were de-escalated. The patient was discharged home on oxygen, CYC was discontinued given significant detrimental adverse effects and prednisone tapering with a close follow-up of renal function. Conclusion: Patient presented with progressive shortness of breath, and respiratory failure, CYC-induced pneumonitis was diagnosed after ruling out other causes. The patient\u27s symptoms started within six months of ANCA therapy use, which placed the patient in the early-onset type with more favorable outcomes. Pulmonary toxicity associated with CYC is underscored by the low prevalence rates in patients with ANCA-associated vasculitis, so it is essential to have a high rate of suspicion

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Enhancing appropriate statin therapy in Type 2 Diabetic patients aged between 40-75 years at Graduate Medical Education (GME) Internal Medicine clinic

Background: The prevalence of type 2 diabetes mellitus (T2DM) is significantly higher in Rio Grande Valley than the rest of the United States. T2DM patients have an elevated risk of Atherosclerotic cardiovascular disease (ASCVD), and clinical trials have demonstrated the beneficial effects of statin therapy on ASCVD. A quality-improvement project was implemented in the GME Internal Medicine (IM) Clinic at Doctors Hospital at Renaissance to improve statin therapy appropriateness. Methods: T2DM patients aged 40-75 were selected from the GME IM Clinic visits from July 2021 to October 2021 for baseline data and from January 2022 to April 2022 after implementing our interventions, which included education of the new practice guidelines of statin therapy in T2DM to the internal medicine residents, as well as development of a clinical decision support tool designed to assess the indication and intensity of statin therapy. Exclusion criteria included patients without T2DM, ages above 75/below 40 years of age, and missing information for ASCVD risk stratification. Statin appropriateness was determined according to the American Diabetes Association standards in diabetes management. Results: The number of patients in the four months after the exclusions pre-intervention and post-intervention were 153 and 207, respectively. Overall, 71.9% (n=110) of the patients pre-intervention were receiving an appropriate statin therapy; the number increased to 80% (n=166) post-intervention (p = 0.003), considered statistically significant using t-test analysis. Of the total patients (N=43) with inappropriate statin therapy, 37% (n=16) had inadequate dose, and 63% (n=27) were not receiving any statin in the pre-intervention cohort. This percentage of inadequate statin dose and no statin therapy decreased to 65% (n=27) and 35% (n=14), respectively post-intervention. Conclusion: Appropriate statin therapy has been shown to reduce all-cause mortality by 19% in T2DM. Appropriateness of statin therapy was increased by 10%, and more than 50% reduction of patients without receiving any statin therapy, after our intervention. Effective implementation of new guidelines regarding risk stratification and prevention of ASCVD in T2DM age 40-75 years of age may be challenging. Barriers such as physicians\u27 adoption and knowledge regarding new guidelines can be overcome with appropriate tools and education, such as those implemented in our project