3,163 research outputs found
Health-state utilities in a prisoner population : a cross-sectional survey
Background: Health-state utilities for prisoners have not been described.
Methods: We used data from a 1996 cross-sectional survey of Australian prisoners (n = 734).
Respondent-level SF-36 data was transformed into utility scores by both the SF-6D and Nichol's
method. Socio-demographic and clinical predictors of SF-6D utility were assessed in univariate
analyses and a multivariate general linear model.
Results: The overall mean SF-6D utility was 0.725 (SD 0.119). When subdivided by various medical
conditions, prisoner SF-6D utilities ranged from 0.620 for angina to 0.764 for those with none/mild
depressive symptoms. Utilities derived by the Nichol's method were higher than SF-6D scores,
often by more than 0.1. In multivariate analysis, significant independent predictors of worse utility
included female gender, increasing age, increasing number of comorbidities and more severe
depressive symptoms.
Conclusion: The utilities presented may prove useful for future economic and decision models
evaluating prison-based health programs
Protecting an Ecosystem Service: Approaches to Understanding and Mitigating Threats to Wild Insect Pollinators
An extracellular steric seeding mechanism for Eph-ephrin signaling platform assembly
Erythropoetin-producing hepatoma (Eph) receptors are cell-surface protein tyrosine kinases mediating cell-cell communication. Upon activation, they form signaling clusters. We report crystal structures of the full ectodomain of human EphA2 (eEphA2) both alone and in complex with the receptor-binding domain of the ligand ephrinA5 (ephrinA5 RBD). Unliganded eEphA2 forms linear arrays of staggered parallel receptors involving two patches of residues conserved across A-class Ephs. eEphA2-ephrinA5 RBD forms a more elaborate assembly, whose interfaces include the same conserved regions on eEphA2, but rearranged to accommodate ephrinA5 RBD. Cell-surface expression of mutant EphA2s showed that these interfaces are critical for localization at cell-cell contacts and activation-dependent degradation. Our results suggest a 'nucleation' mechanism whereby a limited number of ligand-receptor interactions 'seed' an arrangement of receptors which can propagate into extended signaling arrays
The Impact of HAART on the Respiratory Complications of HIV Infection: Longitudinal Trends in the MACS and WIHS Cohorts
Objective: To review the incidence of respiratory conditions and their effect on mortality in HIV-infected and uninfected individuals prior to and during the era of highly active antiretroviral therapy (HAART). Design: Two large observational cohorts of HIV-infected and HIV-uninfected men (Multicenter AIDS Cohort Study [MACS]) and women (Women's Interagency HIV Study [WIHS]), followed since 1984 and 1994, respectively. Methods: Adjusted odds or hazards ratios for incident respiratory infections or non-infectious respiratory diagnoses, respectively, in HIV-infected compared to HIV-uninfected individuals in both the pre-HAART (MACS only) and HAART eras; and adjusted Cox proportional hazard ratios for mortality in HIV-infected persons with lung disease during the HAART era. Results: Compared to HIV-uninfected participants, HIV-infected individuals had more incident respiratory infections both pre-HAART (MACS, odds ratio [adjusted-OR], 2.4; 95% confidence interval [CI], 2.2-2.7; p<0.001) and after HAART availability (MACS, adjusted-OR, 1.5; 95%CI 1.3-1.7; p<0.001; WIHS adjusted-OR, 2.2; 95%CI 1.8-2.7; p<0.001). Chronic obstructive pulmonary disease was more common in MACS HIV-infected vs. HIV-uninfected participants pre-HAART (hazard ratio [adjusted-HR] 2.9; 95%CI, 1.02-8.4; p = 0.046). After HAART availability, non-infectious lung diseases were not significantly more common in HIV-infected participants in either MACS or WIHS participants. HIV-infected participants in the HAART era with respiratory infections had an increased risk of death compared to those without infections (MACS adjusted-HR, 1.5; 95%CI, 1.3-1.7; p<0.001; WIHS adjusted-HR, 1.9; 95%CI, 1.5-2.4; p<0.001). Conclusion: HIV infection remained a significant risk for infectious respiratory diseases after the introduction of HAART, and infectious respiratory diseases were associated with an increased risk of mortality. © 2013 Gingo et al
Systematic review and meta-analysis of the diagnostic accuracy of ultrasonography for deep vein thrombosis
Background
Ultrasound (US) has largely replaced contrast venography as the definitive diagnostic test for deep vein thrombosis (DVT). We aimed to derive a definitive estimate of the diagnostic accuracy of US for clinically suspected DVT and identify study-level factors that might predict accuracy.
Methods
We undertook a systematic review, meta-analysis and meta-regression of diagnostic cohort studies that compared US to contrast venography in patients with suspected DVT. We searched Medline, EMBASE, CINAHL, Web of Science, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, Database of Reviews of Effectiveness, the ACP Journal Club, and citation lists (1966 to April 2004). Random effects meta-analysis was used to derive pooled estimates of sensitivity and specificity. Random effects meta-regression was used to identify study-level covariates that predicted diagnostic performance.
Results
We identified 100 cohorts comparing US to venography in patients with suspected DVT. Overall sensitivity for proximal DVT (95% confidence interval) was 94.2% (93.2 to 95.0), for distal DVT was 63.5% (59.8 to 67.0), and specificity was 93.8% (93.1 to 94.4). Duplex US had pooled sensitivity of 96.5% (95.1 to 97.6) for proximal DVT, 71.2% (64.6 to 77.2) for distal DVT and specificity of 94.0% (92.8 to 95.1). Triplex US had pooled sensitivity of 96.4% (94.4 to 97.1%) for proximal DVT, 75.2% (67.7 to 81.6) for distal DVT and specificity of 94.3% (92.5 to 95.8). Compression US alone had pooled sensitivity of 93.8 % (92.0 to 95.3%) for proximal DVT, 56.8% (49.0 to 66.4) for distal DVT and specificity of 97.8% (97.0 to 98.4). Sensitivity was higher in more recently published studies and in cohorts with higher prevalence of DVT and more proximal DVT, and was lower in cohorts that reported interpretation by a radiologist. Specificity was higher in cohorts that excluded patients with previous DVT. No studies were identified that compared repeat US to venography in all patients. Repeat US appears to have a positive yield of 1.3%, with 89% of these being confirmed by venography.
Conclusion
Combined colour-doppler US techniques have optimal sensitivity, while compression US has optimal specificity for DVT. However, all estimates are subject to substantial unexplained heterogeneity. The role of repeat scanning is very uncertain and based upon limited data
Otoferlin acts as a Ca2+ sensor for vesicle fusion and vesicle pool replenishment at auditory hair cell ribbon synapses
Hearing relies on rapid, temporally precise, and sustained neurotransmitter release at the ribbon synapses of sensory cells, the inner hair cells (IHCs). This process requires otoferlin, a six C2-domain, Ca2+-binding transmembrane protein of synaptic vesicles. To decipher the role of otoferlin in the synaptic vesicle cycle, we produced knock-in mice (Otof Ala515,Ala517/Ala515,Ala517) with lower Ca2+-binding affinity of the C2C domain. The IHC ribbon synapse structure, synaptic Ca2+ currents, and otoferlin distribution were unaffected in these mutant mice, but auditory brainstem response wave-I amplitude was reduced. Lower Ca2+ sensitivity and delay of the fast and sustained components of synaptic exocytosis were revealed by membrane capacitance measurement upon modulations of intracellular Ca2+ concentration, by varying Ca2+ influx through voltage-gated Ca2+-channels or Ca2+ uncaging. Otoferlin thus functions as a Ca2+ sensor, setting the rates of primed vesicle fusion with the presynaptic plasma membrane and synaptic vesicle pool replenishment in the IHC active zone
The International-Trade Network: Gravity Equations and Topological Properties
This paper begins to explore the determinants of the topological properties
of the international - trade network (ITN). We fit bilateral-trade flows using
a standard gravity equation to build a "residual" ITN where trade-link weights
are depurated from geographical distance, size, border effects, trade
agreements, and so on. We then compare the topological properties of the
original and residual ITNs. We find that the residual ITN displays, unlike the
original one, marked signatures of a complex system, and is characterized by a
very different topological architecture. Whereas the original ITN is
geographically clustered and organized around a few large-sized hubs, the
residual ITN displays many small-sized but trade-oriented countries that,
independently of their geographical position, either play the role of local
hubs or attract large and rich countries in relatively complex
trade-interaction patterns
Scientific Opportunities with an X-ray Free-Electron Laser Oscillator
An X-ray free-electron laser oscillator (XFELO) is a new type of hard X-ray
source that would produce fully coherent pulses with meV bandwidth and stable
intensity. The XFELO complements existing sources based on self-amplified
spontaneous emission (SASE) from high-gain X-ray free-electron lasers (XFEL)
that produce ultra-short pulses with broad-band chaotic spectra. This report is
based on discussions of scientific opportunities enabled by an XFELO during a
workshop held at SLAC on June 29 - July 1, 2016Comment: 21 pages, 12 figure
The dependence of dijet production on photon virtuality in ep collisions at HERA
The dependence of dijet production on the virtuality of the exchanged photon,
Q^2, has been studied by measuring dijet cross sections in the range 0 < Q^2 <
2000 GeV^2 with the ZEUS detector at HERA using an integrated luminosity of
38.6 pb^-1.
Dijet cross sections were measured for jets with transverse energy E_T^jet >
7.5 and 6.5 GeV and pseudorapidities in the photon-proton centre-of-mass frame
in the range -3 < eta^jet <0. The variable xg^obs, a measure of the photon
momentum entering the hard process, was used to enhance the sensitivity of the
measurement to the photon structure. The Q^2 dependence of the ratio of low- to
high-xg^obs events was measured.
Next-to-leading-order QCD predictions were found to generally underestimate
the low-xg^obs contribution relative to that at high xg^obs. Monte Carlo models
based on leading-logarithmic parton-showers, using a partonic structure for the
photon which falls smoothly with increasing Q^2, provide a qualitative
description of the data.Comment: 35 pages, 6 eps figures, submitted to Eur.Phys.J.
Planck intermediate results. XLI. A map of lensing-induced B-modes
The secondary cosmic microwave background (CMB) -modes stem from the
post-decoupling distortion of the polarization -modes due to the
gravitational lensing effect of large-scale structures. These lensing-induced
-modes constitute both a valuable probe of the dark matter distribution and
an important contaminant for the extraction of the primary CMB -modes from
inflation. Planck provides accurate nearly all-sky measurements of both the
polarization -modes and the integrated mass distribution via the
reconstruction of the CMB lensing potential. By combining these two data
products, we have produced an all-sky template map of the lensing-induced
-modes using a real-space algorithm that minimizes the impact of sky masks.
The cross-correlation of this template with an observed (primordial and
secondary) -mode map can be used to measure the lensing -mode power
spectrum at multipoles up to . In particular, when cross-correlating with
the -mode contribution directly derived from the Planck polarization maps,
we obtain lensing-induced -mode power spectrum measurement at a significance
level of , which agrees with the theoretical expectation derived
from the Planck best-fit CDM model. This unique nearly all-sky
secondary -mode template, which includes the lensing-induced information
from intermediate to small () angular scales, is
delivered as part of the Planck 2015 public data release. It will be
particularly useful for experiments searching for primordial -modes, such as
BICEP2/Keck Array or LiteBIRD, since it will enable an estimate to be made of
the lensing-induced contribution to the measured total CMB -modes.Comment: 20 pages, 12 figures; Accepted for publication in A&A; The B-mode map
is part of the PR2-2015 Cosmology Products; available as Lensing Products in
the Planck Legacy Archive http://pla.esac.esa.int/pla/#cosmology; and
described in the 'Explanatory Supplement'
https://wiki.cosmos.esa.int/planckpla2015/index.php/Specially_processed_maps#2015_Lensing-induced_B-mode_ma
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