This study estimates the impact of type of insurance coverage on the receipt of guideline therapy in a population-based sample of cancer patients treated in the community.
Patients (n = 7,134) from ...the National Cancer Institute's Patterns of Care studies who were newly diagnosed with 11 different types of cancer were analyzed. The definition of guideline therapy was based on the National Comprehensive Cancer Network treatment recommendations. Insurance status was categorized as a mutually exclusive hierarchical variable (no insurance, any private insurance, any Medicaid, Medicare only, and all other). Multivariate analyses were used to examine the association between insurance and receipt of guideline therapy.
Adjusting for clinical and nonclinical variables, insurance status was a modest, although statistically significant, determinant of receipt of guideline therapy, with 65% of the privately insured patients receiving recommended therapy compared with 60% of patients with Medicaid. Seventy percent of the uninsured patients received guideline therapy, which was nonsignificantly different compared with private insurance. When stratified by race, insurance was a statistically significant predictor of the receipt of guideline therapy only for non-Hispanic blacks.
Overall, levels of guideline treatment were lower than expected and particularly low for patients with Medicaid or Medicare only. The use of guideline therapy for ovarian and cervical cancer patients and for patients with rectal cancers was unrelated to type of insurance. Of particular concern is the significantly lower use of guideline therapy for non-Hispanic black patients with Medicaid. After adjusting for other factors, only half of these patients received guideline therapy.
The fundamental building blocks of the proton—quarks and gluons—have been known for decades. However, we still have an incomplete theoretical and experimental understanding of how these particles and ...their dynamics give rise to the quantum bound state of the proton and its physical properties, such as its spin1. The two up quarks and the single down quark that comprise the proton in the simplest picture account only for a few per cent of the proton mass, the bulk of which is in the form of quark kinetic and potential energy and gluon energy from the strong force2. An essential feature of this force, as described by quantum chromodynamics, is its ability to create matter–antimatter quark pairs inside the proton that exist only for a very short time. Their fleeting existence makes the antimatter quarks within protons difficult to study, but their existence is discernible in reactions in which a matter–antimatter quark pair annihilates. In this picture of quark–antiquark creation by the strong force, the probability distributions as a function of momentum for the presence of up and down antimatter quarks should be nearly identical, given that their masses are very similar and small compared to the mass of the proton3. Here we provide evidence from muon pair production measurements that these distributions are considerably different, with more abundant down antimatter quarks than up antimatter quarks over a wide range of momenta. These results are expected to revive interest in several proposed mechanisms for the origin of this antimatter asymmetry in the proton that had been disfavoured by previous results4, and point to future measurements that can distinguish between these mechanisms.
Abstract
Background
Hypertension remains the leading risk factor for cardiovascular disease worldwide. In Brazil, a third of adults have hypertension. The prevalence and impact of this risk factor on ...disease burden in Brazil and its federal units should be assessed in order to better address the issue.
Objective
To describe trends in prevalence and burden of diseases attributable to high systolic blood pressure (HSBP) among Brazilians ≥25 years old according to sex and federal units using the Global Burden of Disease (GBD) 2017 estimates.
Methods
We used the comparative risk assessment developed for the GBD study to estimate trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALY), by sex, and federal units for HSBP from 1990 to 2017. This study included 14 HSBP-outcome pairs that met the GBD study criteria for evidence of causation. HSBP was defined as ≥140mmHg for prevalence estimates and, to evaluate the burden of HSBP, a theoretical minimum risk exposure level (TMREL) of 110–115 mmHg was considered. We estimated the portion of deaths and DALYs that could be attributed to HSBP. We also explored the drivers of trends in attributable burden of HSBP, as well as the relation of HSBP burden and sociodemographic development.
Results
In Brazil, the prevalence of HSBP is 18.9 (95% uncertainty intervals UI 18.5 to 19.3%) and the age-standardized death rate attributable to HSBP decreased from 189.2 (95%UI 168.5 to 209.2) deaths to 104.8 (95%UI 94.9 to 114.4) deaths per 100,000 from 1990 to 2017. In spite of that, the total number of deaths attributable to HSBP increased 53.4% and HSBP raised from 3rd to 1st position, as the leading risk factor for deaths during the period. Regarding total DALYs, HSBP raised from 4th in 1990 to 2nd cause in 2017 - in the last, only behind smoking. The main driver in the change of HSBP burden in Brazil is population aging. Across federal units, the reduction in the age-standardized death rates attributable to HSBP are heterogeneous and the greater reduction correlated to higher sociodemographic development.
Conclusions
The age-standardized death and DALY rates attributable to HSBP are decreasing in Brazil, probably as results of successful public health policies for primary prevention and control of HSBP. However, the reduction was more significant in federal units with higher sociodemographic development, suggesting that the effect of health policies was heterogeneous. Moreover, HSBP has become the main risk factor for death in the country, mainly due to population aging. As such, the Brazilian health system should increase investments in policies to address the situation and prepare itself to cope with higher burden of HSBP in the near future.
Acknowledgement/Funding
The GBD 2017 Brazil study is primarily funded by the Bill & Melinda Gates Foundation
Quantum teleportation is not merely a fascinating corollary of quantum entanglement, it also finds utility in quantum processing and circuit compilation. In this paper, we measure and track the ...entanglement and fidelity of two-qubit states prepared on a 127-qubit IBM Quantum device, as one of the qubits is teleported across 19 qubits. We design, evaluate and compare two distinct approaches to teleportation: post-selected measurement categorisation and dynamic circuit corrections based on mid-circuit measurements, and compare with direct state transportation using SWAP gates. By optimally choosing the teleportation path which exhibits the highest total negativity entanglement measure across nearest-neighbour pairs, we show the entanglement of a two-qubit graph state is sustained after at least 19 hops in teleportation using the post-selection approach and 17 hops using the dynamic circuit approach. We observe a higher level of teleported entanglement in paths determined from two-qubit negativities compared to those obtained from gate errors, demonstrating an advantage in using the negativity map over the gate error map for compiling quantum circuits.
Estimates of 8-oxo-2′-deoxyguanosine (8-oxo-dG) in DNA vary at least one order of magnitude using different quantitative methods or even the same method. Our hypothesis is that an incomplete DNA ...hydrolysis to nucleosides by the conventional nuclease P1 (NP1) and alkaline phosphatase (AP) digestion system plays an important role in contributing to the variability of measurements using HPLC coupled with UV and electrochemical (EC) detection. We show here that factors, such as the amount of DNA, choice of enzymes, their activities, and incubation time, can affect DNA digestion and, thus, cause variability in 8-oxo-dG levels. The addition of DNase I and phosphodiesterases I and II to the NP1 + AP system improves the DNA digestion by completely releasing normal nucleosides and 8-oxo-dG, thereby reducing the interday variations of 8-oxo-dG levels. Diethylenetriamine pentaacetic acid (DTPA), an iron chelator, prevented background increases of 8-oxo-dG during DNA digestion, as well as during the waiting period in the autosampler when a batch of DNA samples is analyzed by HPLC. After optimization of the DNA digestion conditions, the interday variability of 8-oxo-dG measurements using commercially available salmon testes DNA (ST DNA) were 26% over a period of 2 years. Under these optimal conditions, our laboratory variability may contribute as little as 13% to the overall variability as shown by assessment of oxidative DNA damage in a population of smokers. Based on our results, we believe that the modified DNA digestion conditions will provide much more accurate 8-oxo-dG determinations and, thus, more reliable estimates of cancer risk.
Compilation of papers presented by the VERITAS Collaboration at the 38th International Cosmic Ray Conference (ICRC), held July 26 through August 3, 2023 in Nagoya, Japan.
Abstract
The ground-based gamma-ray observatory Very Energetic Radiation Imaging Telescope Array System (VERITAS,
https://veritas.sao.arizona.edu/
) is sensitive to photons of astrophysical origin ...with energies in the range between ≈85 GeV and ≈30 TeV. The instrument consists of four 12 m diameter imaging Cherenkov telescopes operating at the Fred Lawrence Whipple Observatory in southern Arizona. VERITAS started four-telescope operations in 2007 and collects about 1100 hr of good-weather data per year. The VERITAS collaboration has published over 100 journal articles since 2008 reporting on gamma-ray observations of a large variety of objects: Galactic sources like supernova remnants, pulsar wind nebulae, and binary systems; extragalactic sources like star-forming galaxies, dwarf-spheroidal galaxies, and highly variable active galactic nuclei. This note presents VTSCat: the catalog of high-level data products from all VERITAS publications.
One of the fundamental tasks in information theory is the compression of information. To achieve this in the quantum domain, quantum autoencoders that aim to compress quantum states to ...low-dimensional ones have been proposed. When taking a pure state as the reference state, there exists an upper bound for the encoding fidelity. This bound limits the compression rate for high-rank states that have high entropy. To overcome the entropy inconsistency between the initial states and the reconstructed states, we allow the reference state to be a mixed state. A new cost function that combines the encoding fidelity and the quantum mutual information is proposed for compressing general input states. In particular, we consider the reference states to be a mixture of maximally mixed states and pure states. To achieve efficient compression for different states, two strategies for setting the ratio of mixedness (in the mixture of maximally mixed states and pure states) are provided based on prior knowledge about quantum states or observations obtained from the training process. Numerical results on thermal states of the transverse-field Ising model, Werner states, and maximally mixed states blended with pure states illustrate the effectiveness of the proposed method. In addition, quantum autoencoders using mixed reference states are experimentally implemented on IBM Quantum devices to compress and reconstruct thermal states and Werner states.
Polarized segregation of proteins in T cells is thought to play a role in diverse cellular functions including signal transduction, migration, and directed secretion of cytokines. Persistence of this ...polarization can result in asymmetric segregation of fate-determining proteins during cell division, which may enable a T cell to generate diverse progeny. Here, we provide evidence that a lineage-determining transcription factor, T-bet, underwent asymmetric organization in activated T cells preparing to divide and that it was unequally partitioned into the two daughter cells. This unequal acquisition of T-bet appeared to result from its asymmetric destruction during mitosis by virtue of concomitant asymmetric segregation of the proteasome. These results suggest a mechanism by which a cell may unequally localize cellular activities during division, thereby imparting disparity in the abundance of cell fate regulators in the daughter cells.
► A dividing T cell unequally apportions T-bet to its daughter cells ► Localized destruction of T-bet occurs in the setting of proteasome asymmetry ► Phosphorylation of T-bet is critical for its degradation and asymmetry ► Inhibiting proteasome activity or asymmetry prevents unequal T-bet partitioning
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