Distribution of selected healthcare resources for influenza pandemic response in Cambodia.

INTRODUCTION: Human influenza infection poses a serious public health threat in Cambodia, a country at risk for the emergence and spread of novel influenza viruses with pandemic potential. Prior pandemics demonstrated the adverse impact of influenza on poor communities in developing countries. Investigation of healthcare resource distribution can inform decisions regarding resource mobilization and investment for pandemic mitigation. METHODS: A health facility survey performed across Cambodia obtained data on availability of healthcare resources important for pandemic influenza response. Focusing on five key resources considered most necessary for treating severe influenza (inpatient beds, doctors, nurses, oseltamivir, and ventilators), resource distributions were analyzed at the Operational District (OD) and Province levels, refining data analysis from earlier studies. Resources were stratified by respondent type (hospital vs. District Health Office [DHO]). A summary index of distribution inequality was calculated using the Gini coefficient. Indices for local spatial autocorrelation were measured at the OD level using geographical information system (GIS) analysis. Finally, a potential link between socioeconomic status and resource distribution was explored by mapping resource densities against poverty rates. RESULTS: Gini coefficient calculation revealed variable inequality in distribution of the five key resources at the Province and OD levels. A greater percentage of the population resides in areas of relative under-supply (28.5%) than over-supply (21.3%). Areas with more resources per capita showed significant clustering in central Cambodia while areas with fewer resources clustered in the northern and western provinces. Hospital-based inpatient beds, doctors, and nurses were most heavily concentrated in areas of the country with the lowest poverty rates; however, beds and nurses in Non-Hospital Medical Facilities (NHMF) showed increasing concentrations at higher levels of poverty. CONCLUSIONS: There is considerable heterogeneity in healthcare resource distribution across Cambodia. Distribution mapping at the local level can inform policy decisions on where to stockpile resources in advance of and for reallocation in the event of a pandemic. These findings will be useful in determining future health resource investment, both for pandemic preparedness and for general health system strengthening, and provide a foundation for future analyses of equity in health services provision for pandemic mitigation planning in Cambodia

A two measure model of dark energy and dark matter

In this work we construct a unified model of dark energy and dark matter. This is done with the following three elements: a gravitating scalar field, phi with a non-conventional kinetic term, as in the string theory tachyon; an arbitrary potential, V(phi); two measures -- a metric measure (sqrt{-g}) and a non-metric measure (Phi). The model has two interesting features: (i) For potentials which are unstable and would give rise to tachyonic scalar field, this model can stabilize the scalar field. (ii) The form of the dark energy and dark matter that results from this model is fairly insensitive to the exact form of the scalar field potential.Comment: 8 pages,no figures, revtex, typos corrected to match published versio

Cosmological Equation of State and Interacting Energies

In this paper we study a model of cosmic evolution, assuming that the different components of the universe could interact between them any time. An effective equation of state (EOS) for the universe has been used as well. A particular function for w, which gives a good agreement between our results and the experimental data, has been studied. Finally, the model obtained has been applied to different important cases

Induced cosmological constant and other features of asymmetric brane embedding

We investigate the cosmological properties of an "induced gravity" brane scenario in the absence of mirror symmetry with respect to the brane. We find that brane evolution can proceed along one of four distinct branches. By contrast, when mirror symmetry is imposed, only two branches exist, one of which represents the self-accelerating brane, while the other is the so-called normal branch. This model incorporates many of the well-known possibilities of brane cosmology including phantom acceleration (w < -1), self-acceleration, transient acceleration, quiescent singularities, and cosmic mimicry. Significantly, the absence of mirror symmetry also provides an interesting way of inducing a sufficiently small cosmological constant on the brane. A small (positive) Lambda-term in this case is induced by a small asymmetry in the values of bulk fundamental constants on the two sides of the brane.Comment: 17 pages, 4 figures. New results and two figures discussing transient acceleration are included. Version accepted for publication in JCA

A transcriptome-driven analysis of epithelial brushings and bronchial biopsies to define asthma phenotypes in U-BIOPRED

RATIONALE AND OBJECTIVES: Asthma is a heterogeneous disease driven by diverse immunologic and inflammatory mechanisms. We used transcriptomic profiling of airway tissues to help define asthma phenotypes. METHODS: The transcriptome from bronchial biopsies and epithelial brushings of 107 moderate-to-severe asthmatics were annotated by gene-set variation analysis (GSVA) using 42 gene-signatures relevant to asthma, inflammation and immune function. Topological data analysis (TDA) of clinical and histological data was used to derive clusters and the nearest shrunken centroid algorithm used for signature refinement. RESULTS: 9 GSVA signatures expressed in bronchial biopsies and airway epithelial brushings distinguished two distinct asthma subtypes associated with high expression of T-helper type 2 (Th-2) cytokines and lack of corticosteroid response (Group 1 and Group 3). Group 1 had the highest submucosal eosinophils, high exhaled nitric oxide (FeNO) levels, exacerbation rates and oral corticosteroid (OCS) use whilst Group 3 patients showed the highest levels of sputum eosinophils and had a high BMI. In contrast, Group 2 and Group 4 patients had an 86% and 64% probability of having non-eosinophilic inflammation. Using machine-learning tools, we describe an inference scheme using the currently-available inflammatory biomarkers sputum eosinophilia and exhaled nitric oxide levels along with OCS use that could predict the subtypes of gene expression within bronchial biopsies and epithelial cells with good sensitivity and specificity. CONCLUSION: This analysis demonstrates the usefulness of a transcriptomic-driven approach to phenotyping that segments patients who may benefit the most from specific agents that target Th2-mediated inflammation and/or corticosteroid insensitivity

One loop photon-graviton mixing in an electromagnetic field: Part 2

In part 1 of this series compact integral representations had been obtained for the one-loop photon-graviton amplitude involving a charged spin 0 or spin 1/2 particle in the loop and an arbitrary constant electromagnetic field. In this sequel, we study the structure and magnitude of the various polarization components of this amplitude on-shell. Explicit expressions are obtained for a number of limiting cases.Comment: 31 pages, 3 figure

Cosmological Evolution of a Tachyon-Quintom Model of Dark Energy

In this work we study the cosmological evolution of a dark energy model with two scalar fields, i.e. the tachyon and the phantom tachyon. This model enables the equation of state $w$ to change from $w>-1$ to $w<-1$ in the evolution of the universe. The phase-space analysis for such a system with inverse square potentials shows that there exists a unique stable critical point, which has power-law solutions. In this paper, we also study another form of tachyon-quintom model with two fields, which voluntarily involves the interactions between both fields.Comment: 17 pages, 10 figure

Observational consequences of the Standard Model Higgs inflation variants

We consider the possibility to observationally differentiate the Standard Model (SM) Higgs driven inflation with non-minimal couplingto gravity from other variants of SM Higgs inflation based on the scalar field theories with non-canonical kinetic term such as Galileon-like kinetic term and kinetic term with non-minimal derivative coupling to the Einstein tensor. In order to ensure consistent results, we study the SM Higgs inflation variants by using the same method, computing the full dynamics of the background and perturbations of the Higgs field during inflation at quantum level. Assuming that all the SM Higgs inflation variants are consistent theories, we use the MCMC technique to derive constraints on the inflationnoary parameters and the Higgs boson mass from their fit to WMAP7+SN+BAO data set. We conclude that a combination of a Higgs mass measurement by the LHC and accurate determination by the PLANCK satellite of the spectral index of curvature perturbations and tensor-to-scalar ratio will enable to distinguish among these models. We also show that the consistency relations of the SM Higgs inflation variants are distinct enough to differentiate the models.Comment: 22 pages, 4 figure

How close can an Inhomogeneous Universe mimic the Concordance Model?

Recently, spatially inhomogeneous cosmological models have been proposed as an alternative to the LCDM model, with the aim of reproducing the late time dynamics of the Universe without introducing a cosmological constant or dark energy. This paper investigates the possibility of distinguishing such models from the standard LCDM using background or large scale structure data. It also illustrates and emphasizes the necessity of testing the Copernican principle in order to confront the tests of general relativity with the large scale structure.Comment: 15 pages, 7 figure