Still a house divided King, Desmond S; Smith, Rogers M
2011., 20110822, 2011, 2011-08-22, Volume:
125
eBook
Why have American policies failed to reduce the racial inequalities still pervasive throughout the nation? Has President Barack Obama defined new political approaches to race that might spur unity ...and progress? Still a House Divided examines the enduring divisions of American racial politics and how these conflicts have been shaped by distinct political alliances and their competing race policies. Combining deep historical knowledge with a detailed exploration of such issues as housing, employment, criminal justice, multiracial census categories, immigration, voting in majority-minority districts, and school vouchers, Desmond King and Rogers Smith assess the significance of President Obama's election to the White House and the prospects for achieving constructive racial policies for America's future.
To provide evidence-based guidance on the optimum prevention and treatment approaches in the management of chemotherapy-induced peripheral neuropathies (CIPN) in adult cancer survivors.
A systematic ...literature search identified relevant, randomized controlled trials (RCTs) for the treatment of CIPN. Primary outcomes included incidence and severity of neuropathy as measured by neurophysiologic changes, patient-reported outcomes, and quality of life.
A total of 48 RCTs met eligibility criteria and comprise the evidentiary basis for the recommendations. Trials tended to be small and heterogeneous, many with insufficient sample sizes to detect clinically important differences in outcomes. Primary outcomes varied across the trials, and in most cases, studies were not directly comparable because of different outcomes, measurements, and instruments used at different time points. The strength of the recommendations is based on the quality, amount, and consistency of the evidence and the balance between benefits and harms.
On the basis of the paucity of high-quality, consistent evidence, there are no agents recommended for the prevention of CIPN. With regard to the treatment of existing CIPN, the best available data support a moderate recommendation for treatment with duloxetine. Although the CIPN trials are inconclusive regarding tricyclic antidepressants (such as nortriptyline), gabapentin, and a compounded topical gel containing baclofen, amitriptyline HCL, and ketamine, these agents may be offered on the basis of data supporting their utility in other neuropathic pain conditions given the limited other CIPN treatment options. Further research on these agents is warranted.
A revised set of propositions about ecology in arid Australia is presented, based on research literature since publication of Stafford Smith and Morton (1990). Fourteen propositions distil our ...argument that most features of the Australian deserts are explicable in terms of two dominant physical and climatic elements: rainfall variability, leading to extended droughts and occasional flooding rains; and widespread nutrient poverty. Different landscapes within the arid zone show these features to varying degrees, and so it is important to think about different places separately when considering our propositions. Plant life-histories strongly reflect temporal patterns of soil moisture; because Australian deserts receive more variable rainfall than most others, there is a distinctive spectrum of life-histories. Low levels of phosphorus (together with abundant soil moisture on irregular occasions) favour plants producing a relative excess of carbohydrate (C). In turn, C-rich plant products sometimes lead to fire-prone ecosystems, assemblages dominated by consumers of sap and other C-based products, and abundant detritivores (particularly termites). Fluctuations in production due to variable rainfall provide openings for consumers with opportunistic life-histories, including inhabitants of extensive but ephemeral rivers and lakes. Most consumer species exhibit some dietary flexibility or utilise more dependable resources; these strategies give rise to greater stability in species dynamics and composition of assemblages than might first be imagined under the variable rainfall regime. Aboriginal people have had long-standing ecological influence as they accessed resources. For each proposition we suggest the extent to which it is ‘different’, ‘accentuated’ or ‘universal’ in comparison with other deserts of the world, recognising that this categorisation is in need of critical testing. Further tests of each proposition are also suggested to fill the many gaps that still exist in our knowledge of the structure and functioning of Australia’s deserts.
► Revised propositions about arid Australia are presented based on research since Stafford Smith and Morton (1990, Journal of Arid Environments 18, 255-278. ► Australian plant life-histories distinctively reflect variable temporal patterns of soil moisture. ► Low phosphorus levels favour plants producing a relative excess of carbohydrate, leading to fire-proneness and abundant detritivores. ► Irregular fluctuations in production due to variable rainfall encourage consumers with opportunistic life-histories.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Aim
To estimate the healthcare costs of diabetic foot disease in England.
Methods
Patient‐level data sets at a national and local level, and evidence from clinical studies, were used to estimate the ...annual cost of health care for foot ulceration and amputation in people with diabetes in England in 2014–2015.
Results
The cost of health care for ulceration and amputation in diabetes in 2014–2015 is estimated at between £837 million and £962 million; 0.8% to 0.9% of the National Health Service (NHS) budget for England. More than 90% of expenditure was related to ulceration, and 60% was for care in community, outpatient and primary settings. For inpatients, multiple regression analysis suggested that ulceration was associated with a length of stay 8.04 days longer (95% confidence interval 7.65 to 8.42) than that for diabetes admissions without ulceration.
Conclusions
Diabetic foot care accounts for a substantial proportion of healthcare expenditure in England, more than the combined cost of breast, prostate and lung cancers. Much of this expenditure arises through prolonged and severe ulceration. If the NHS were to reduce the prevalence of diabetic foot ulcers in England by one‐third, the gross annual saving would be more than £250 million. Diabetic foot ulceration is a large and growing problem globally, and it is likely that there is potential to improve outcomes and reduce expenditure in many countries.
What's new?
At least 2% of people with diabetes experience new foot ulcers annually, and one in 400 undergoes amputation.
The cost of diabetic foot disease in England is almost 1% of the health service budget.
More than 90% of these costs are for ulcer care.
It is hoped that knowledge of human and financial costs will increase research effort, clinical attention and compliance with national guidance, to improve ulcer healing rates and reduce amputations.
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Summary Background Cryptococcus is the most common cause of meningitis in adults living with HIV in sub-Saharan Africa. Global burden estimates are crucial to guide prevention strategies and to ...determine treatment needs, and we aimed to provide an updated estimate of global incidence of HIV-associated cryptococcal disease. Methods We used 2014 Joint UN Programme on HIV and AIDS estimates of adults (aged >15 years) with HIV and antiretroviral therapy (ART) coverage. Estimates of CD4 less than 100 cells per μL, virological failure incidence, and loss to follow-up were from published multinational cohorts in low-income and middle-income countries. We calculated those at risk for cryptococcal infection, specifically those with CD4 less than 100 cells/μL not on ART, and those with CD4 less than 100 cells per μL on ART but lost to follow-up or with virological failure. Cryptococcal antigenaemia prevalence by country was derived from 46 studies globally. Based on cryptococcal antigenaemia prevalence in each country and region, we estimated the annual numbers of people who are developing and dying from cryptococcal meningitis. Findings We estimated an average global cryptococcal antigenaemia prevalence of 6·0% (95% CI 5·8–6·2) among people with a CD4 cell count of less than 100 cells per μL, with 278 000 (95% CI 195 500–340 600) people positive for cryptococcal antigen globally and 223 100 (95% CI 150 600–282 400) incident cases of cryptococcal meningitis globally in 2014. Sub-Saharan Africa accounted for 73% of the estimated cryptococcal meningitis cases in 2014 (162 500 cases 95% CI 113 600–193 900). Annual global deaths from cryptococcal meningitis were estimated at 181 100 (95% CI 119 400–234 300), with 135 900 (75%; 95% CI 93 900–163 900) deaths in sub-Saharan Africa. Globally, cryptococcal meningitis was responsible for 15% of AIDS-related deaths (95% CI 10–19). Interpretation Our analysis highlights the substantial ongoing burden of HIV-associated cryptococcal disease, primarily in sub-Saharan Africa. Cryptococcal meningitis is a metric of HIV treatment programme failure; timely HIV testing and rapid linkage to care remain an urgent priority. Funding None.
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Shoot architecture is determined by the organization and activities of apical, axillary, intercalary, secondary, and inflorescence meristems and by the subsequent development of stems, leaves, shoot ...branches, and inflorescences. In this review, we discuss the unifying principles of hormonal and genetic control of shoot architecture including advances in our understanding of lateral branch outgrowth; control of stem elongation, thickness, and angle; and regulation of inflorescence development. We focus on recent progress made mainly in
Arabidopsis thaliana
, rice, pea, maize, and tomato, including the identification of new genes and mechanisms controlling shoot architecture. Key advances include elucidation of mechanisms by which strigolactones, auxins, and genes such as
IDEAL PLANT ARCHITECTURE1
and
TEOSINTE BRANCHED1
control shoot architecture. Knowledge now available provides a foundation for rational approaches to crop breeding and the generation of ideotypes with defined architectural features to improve performance and productivity.
This paper is the second in a pair of papers presenting data release 1 (DR1) of the Herschel Astrophysical Terahertz Large Area Survey (H-ATLAS), the largest single open-time key project carried out ...with the Herschel
Space Observatory. The H-ATLAS is a wide-area imaging survey carried out in five photometric bands at 100, 160, 250, 350 and 500 μm covering a total area of 600 deg2. In this paper, we describe the identification of optical counterparts to submillimetre sources in DR1, comprising an area of 161 deg2 over three equatorial fields of roughly 12 × 4.5 deg centred at 9h, 12h and 14
${^{\rm h}_{.}}$
5, respectively. Of all the H-ATLAS fields, the equatorial regions benefit from the greatest overlap with current multi-wavelength surveys spanning ultraviolet (UV) to mid-infrared regimes, as well as extensive spectroscopic coverage. We use a likelihood ratio technique to identify Sloan Digital Sky Survey counterparts at r < 22.4 for 250-μm-selected sources detected at ≥4σ (≈28 mJy). We find ‘reliable’ counterparts (reliability R ≥ 0.8) for 44 835 sources (39 per cent), with an estimated completeness of 73.0 per cent and contamination rate of 4.7 per cent. Using redshifts and multi-wavelength photometry from GAMA and other public catalogues, we show that H-ATLAS-selected galaxies at z < 0.5 span a wide range of optical colours, total infrared (IR) luminosities and IR/UV ratios, with no strong disposition towards mid-IR-classified active galactic nuclei in comparison with optical selection. The data described herein, together with all maps and catalogues described in the companion paper, are available from the H-ATLAS website at www.h-atlas.org.
SARS-CoV-2 Variants of Concern Choi, Jun Yong; Smith, Davey M.
Yonsei Medical Journal/Yonsei medical journal,
11/2021, Volume:
62, Issue:
11
Journal Article
Peer reviewed
Open access
Since the COVID-19 pandemic first began in December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus has continuously evolved with many variants emerging across the world. ...These variants are categorized as the variant of interest (VOI), variant of concern (VOC), and variant under monitoring (VUM). As of September 15, 2021, there are four SARS-CoV-2 lineages designated as the VOC (alpha, beta, gamma, and delta variants). VOCs have increased transmissibility compared to the original virus, and have the potential for increasing disease severity. In addition, VOCs exhibit decreased susceptibility to vaccine-induced and infection-induced immune responses, and thus possess the ability to reinfect previously infected and recovered individuals. Given their ability to evade immune responses, VOC are less susceptible to monoclonal antibody treatments. VOCs can also impact the effectiveness of mRNA and adenovirus vector vaccines, although the currently authorized COVID-19 vaccines are still effective in preventing infection and severe disease. Current measures to reduce transmission as well as efforts to monitor and understand the impact of variants should be continued. Here, we review the molecular features, epidemiology, impact on transmissibility, disease severity, and vaccine effectiveness of VOCs.
We report the first plausible optical electromagnetic counterpart to a (candidate) binary black hole merger. Detected by the Zwicky Transient Facility, the electromagnetic flare is consistent with ...expectations for a kicked binary black hole merger in the accretion disk of an active galactic nucleus B. McKernan, K. E. S. Ford, I. Bartoset al., Astrophys. J. Lett.884, L50 (2019) and is unlikely <O(0.01%)) due to intrinsic variability of this source. The lack of color evolution implies that it is not a supernova and instead is strongly suggestive of a constant temperature shock. Other false-positive events, such as microlensing ora tidal disruption event, are ruled out or constrained to be <O(0.1%). If the flare is associated withS190521g, we find plausible values of total mass M(BBH) ∼ 100 Mꙩ, kick velocity v(k) ∼ 200 km/s at θ ∼ 60° in a disk with aspect ratio H/a ∼ 0.01(i.e., disk height H at radius a) and gas density ρ ∼ 10^(−10)g/cu.cm. The merger could have occurred at a disk migration trap (a ∼ 700 r(g); r(g) ≡ GM(SMBH)/sq.c, where M(SMBH) is the mass of the active galactic nucleus supermassive black hole). The combination of parameters implies a significant spin for at least one of the black holes in S190521g. The timing of our spectroscopy prevents useful constraints on broad-line asymmetry due to an off-center flare. We predict a repeat flare in this source due to a reencountering with the disk in ∼ 1.6 yr(M(SMBH)/10^(8) Mꙩ)(a/10^(3)r(g))^(3/2).
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