Particle creation due to cosmological contraction of extra dimensions

Particle production in a cosmological spacetime with extra dimensions is discussed. A five-dimensional cosmological model with a three-dimensional space expanding isotropically like in a radiative Friedmann-Robertson-Walker model and an internal space contracting to a constant small size is considered. The parameters of the model are adjusted so that time variations in internal space are compatible with present limits on time variations of the fundamental constants. By requiring that the energy density of the particles produced be less than the critical density at the radiation era we set restrictions on two more parameters: namely, the initial time of application of the semiclassical approach and the relative sizes between the internal space and the horizon of the ordinary Universe at this time. Whereas the production of massless particles allows a large range of variation to these parameters, the production of massive particles sets severe constraints on them, since, if they are overproduced, their energy density might very soon dominate the Universe and make cosmological dimensional reduction by extradimensional contraction unlikely.

FY2008 Annual Summary July 1, 2007 - June 30, 2008

It’s really quite simple. IPERS is a sure thing. IPERS benefits carry a lifetime guarantee. A bad economy and declining stock market do not decrease your benefits. Instead, your benefit amount is determined by a pre-established formula that replaces a percentage of your pre-retirement wages. How close your benefits get to the maximum of the IPERS plan—replacing 65 percent of pre-retirement wages or 72 percent for public safety personnel—is mostly up to you. Current employees don’t have to worry about where to invest or what to do when there is a slump in the stock market. Retirees don’t have to worry that a down market will reduce their monthly payments, and they never have to worry about outliving their IPERS benefits. Disability payments and death benefits act as a safety net for members and their families.

Legislators’ Guide of IPERBS, January 2006

For more than 50 years, IPERS has provided a core retirement plan covering most Iowa local and state public employees. With approximately 300,000 members and almost 2,400 covered employers, IPERS is the largest public retirement system in Iowa. The Legislature designed IPERS to provide monthly lifetime annuities that supplement social security benefits and personal savings, enabling public employees to care for themselves in retirement. The Legislature also intended for IPERS to be an employee benefit that would help Iowa’s public employers recruit and retain qualified personnel. As a defined benefit plan, the monthly benefit IPERS members receive is calculated using a formula. A member’s benefit increases as his or her years of service and salary increase. Because IPERS is a defined benefit plan, the Legislature is assured that the money contributed by public employees and their employers for retirement is used as intended. The benefit is paid as a lifetime monthly annuity. IPERS members cannot borrow or withdraw their money while in public employment.

Special Sentence Sex Offender Caseloads Adding Up, Data Downloads, Iowa Department of Corrections, December 2008

Several years ago the General Assembly increased the penalties for certain sex offenses by an additional ten years of community-based supervision, and in some case lifetime supervision. The Division of Criminal and Juvenile Justice Planning (CJJP) studied the effect the new law would have on CBC supervision caseloads:

Classical predictive electrodynamics of two charges with radiation: General framework. I.

Outgoing radiation is introduced in the framework of the classical predictive electrodynamics using LorentzDiracs equation as a subsidiary condition. In a perturbative scheme in the charges the first radiative self-terms of the accelerations, momentum and angular momentum of a two charge system without external field are calculated.

Prise en charge des coliques néphrétiques en urgence [Emergency management of renal colic]

Renal colic (RC) is a common problem in primary care practice. It is estimated that 5-12% of the general population will suffer once RC during his lifetime. The primary care physicians play a central role in the management of urolithiasis. This article summarizes the current recommendations in terms of renal colic emergency management: biological assessment, imaging, pain relief and specific treatment. The vast majority of patients only needs efficient antalgic treatment and an outpatient monitoring. A minimal assessment must however be undertaken to detect complicated RC that will require urgent treatment in urology department. The analysis of the stone after the crisis is crucial to set up a preventive treatment.

Economics of dialysis dependence following renal replacement therapy for critically ill acute kidney injury patients.

BACKGROUND: The obective of this study was to perform a cost-effectiveness analysis comparing intermittent with continuous renal replacement therapy (IRRT versus CRRT) as initial therapy for acute kidney injury (AKI) in the intensive care unit (ICU). METHODS: Assuming some patients would potentially be eligible for either modality, we modeled life year gained, the quality-adjusted life years (QALYs) and healthcare costs for a cohort of 1000 IRRT patients and a cohort of 1000 CRRT patients. We used a 1-year, 5-year and a lifetime horizon. A Markov model with two health states for AKI survivors was designed: dialysis dependence and dialysis independence. We applied Weibull regression from published estimates to fit survival curves for CRRT and IRRT patients and to fit the proportion of dialysis dependence among CRRT and IRRT survivors. We then applied a risk ratio reported in a large retrospective cohort study to the fitted CRRT estimates in order to determine the proportion of dialysis dependence for IRRT survivors. We conducted sensitivity analyses based on a range of differences for daily implementation cost between CRRT and IRRT (base case: CRRT day $632 more expensive than IRRT day; range from $200 to $1000) and a range of risk ratios for dialysis dependence for CRRT as compared with IRRT (from 0.65 to 0.95; base case: 0.80). RESULTS: Continuous renal replacement therapy was associated with a marginally greater gain in QALY as compared with IRRT (1.093 versus 1.078). Despite higher upfront costs for CRRT in the ICU ($4046 for CRRT versus $1423 for IRRT in average), the 5-year total cost including the cost of dialysis dependence was lower for CRRT ($37 780 for CRRT versus $39 448 for IRRT on average). The base case incremental cost-effectiveness analysis showed that CRRT dominated IRRT. This dominance was confirmed by extensive sensitivity analysis. CONCLUSIONS: Initial CRRT is cost-effective compared with initial IRRT by reducing the rate of long-term dialysis dependence among critically ill AKI survivors.

Deciding the sale of a life policy in the viatical market: Implications on individual welfare

[cat] En aquest article, es presenta un model econòmic que permet determinar la venda o no d'una pòlissa de vida (total o en part) per part d'un assegurat malalt terminal en el mercat dels viatical settlements. Aquest mercat va aparèixer a finals de la dècada dels 80 a conseqüència de l'epidèmia de la SIDA. Actualment, representa una part del mercat dels life settlements. Les pòlisses que es comercialitzen en el mercat dels viaticals són aquelles on l'assegurat és malalt terminal amb una esperança de vida de dos anys o menys. El model és discret i considera només dos períodes (anys), ja que aquesta és la vida residual màxima que contempla el mercat. L'agent posseix una riquesa inicial que ha de repartir entre consum i herència. S'introdueix en primer lloc la funció d'utilitat esperada del decisor i, utilitzant programació dinàmica, es dedueix l'estratègia que reporta una utilitat més gran (no vendre/vendre (en part) la pòlissa en el moment zero/vendre (en part) la pòlissa en el moment ú). L'òptim depèn del preu de la pòlissa venuda i de paràmetres personals de l'individu. Es troba una expressió analítica per l'estratègia òptima i es realitza un anàlisi de sensibilitat.

Cost-effectiveness analysis of a European primary-care physician training in smoking cessation counseling.

BACKGROUND: Physician training in smoking cessation counseling has been shown to be effective as a means to increase quit success. We assessed the cost-effectiveness ratio of a smoking cessation counseling training programme. Its effectiveness was previously demonstrated in a cluster randomized, control trial performed in two Swiss university outpatients clinics, in which residents were randomized to receive training in smoking interventions or a control educational intervention. DESIGN AND METHODS: We used a Markov simulation model for effectiveness analysis. This model incorporates the intervention efficacy, the natural quit rate, and the lifetime probability of relapse after 1-year abstinence. We used previously published results in addition to hospital service and outpatient clinic cost data. The time horizon was 1 year, and we opted for a third-party payer perspective. RESULTS: The incremental cost of the intervention amounted to US$2.58 per consultation by a smoker, translating into a cost per life-year saved of US$25.4 for men and 35.2 for women. One-way sensitivity analyses yielded a range of US$4.0-107.1 in men and US$9.7-148.6 in women. Variations in the quit rate of the control intervention, the length of training effectiveness, and the discount rate yielded moderately large effects on the outcome. Variations in the natural cessation rate, the lifetime probability of relapse, the cost of physician training, the counseling time, the cost per hour of physician time, and the cost of the booklets had little effect on the cost-effectiveness ratio. CONCLUSIONS: Training residents in smoking cessation counseling is a very cost-effective intervention and may be more efficient than currently accepted tobacco control interventions.

Coming into Focus A Needs Assessment and State Plan for Iowans with Brain Injury, November 1998

Coming Into Focus presents a needs assessment related to Iowans with brain injury, and a state action plan to improve Iowa’s ability to meet those needs. Support for this project came from a grant from the Office of Maternal and Child Health to the Iowa Department of Public Health, Iowa’s lead agency for brain injury. The report is a description of the needs of people with brain injuries in Iowa, the status of services to meet those needs and a plan for improving Iowa’s system of supports. Brain injury can result from a skull fracture or penetration of the brain, a disease process such as tumor or infection, or a closed head injury, such as shaken baby syndrome. Traumatic brain injury is a leading cause of death and disability in children and young adults (Fick, 1997). In the United States there are as many as 2 million brain injuries per year, with 300,000 severe enough to require hospitalization. Some 50,000 lives are lost every year to TBI. Eighty to 90 thousand people have moderate to acute brain injuries that result in disabling conditions which can last a lifetime. These conditions can include physical impairments, memory defects, limited concentration, communication deficits, emotional problems and deficits in social abilities. In addition to the personal pain and challenges to survivors and their families, the financial cost of brain injuries is enormous. With traumatic brain injuries, it is estimated that in 1995 Iowa hospitals charged some $38 million for acute care for injured persons. National estimates offer a lifetime cost of $4 million for one person with brain injury (Schootman and Harlan, 1997). With this estimate, new injuries in 1995 could eventually cost over $7 billion dollars. Dramatic improvements in medicine, and the development of emergency response systems, means that more people sustaining brain injuries are being saved. How can we insure that supports are available to this emerging population? We have called the report Coming into Focus, because, despite the prevalence and the personal and financial costs to society, brain injury is poorly understood. The Iowa Department of Public Health, the Iowa Advisory Council on Head Injuries State Plan Task Force, the Brain Injury Association of Iowa and the Iowa University Affiliated Program have worked together to begin answering this question. A great deal of good information already existed. This project brought this information together, gathered new information where it was needed, and carried out a process for identifying what needs to be done in Iowa, and what the priorities will be.

Duration of untreated psychosis : a proposition regarding treatment definition

La durée de psychose non traitée (Duration of Untreated Psychosis, DUP) est définie par le temps écoulé entre l'émergence d'un trouble psychotique et le début de son traitement. La réduction de la DUP est un des objectifs principaux des programmes spécialisés dans le traitement de la psychose émergente, de nombreux travaux de recherche suggérant qu'une DUP longue est associée à une évolution défavorable de la maladie. Ces résultats restent cependant controversés, certaines études ne démontrant pas une telle association. Cette contradiction dans les résultats pourrait être la conséquence d'un manque d'uniformité dans les définitions appliquées pour mesurer la DUP, plus particulièrement en ce qui concerne la définition de ce que l'on considère être « début » du traitement. En effet, si l'étude de la phase d'émergence de la pathologie psychotique a été le focus d'une attention considérable qui a conduit à un certain degré de consensus quant à sa définition, le concept de début du traitement n'est clairement pas défini de manière aussi homogène. Compte tenu de l'importance des enjeux relatifs à l'intervention précoce dans les troubles psychotiques, il nous a semblé utile d'explorer cette question de manière plus approfondie, considérant qu'un manque de consensus dans la définition de la DUP contribue certainement à troubler les résultats des études qui visent à évaluer son impact sur l'évolution de ces maladies. En conséquence, l'objectif premier de ce travail est d'explorer l'impact de l'application de diverses définitions de début de traitement sur l'estimation de la DUP. Dans un premier article, publié dans Acta Neuropsychiatrica en 2009 (Duration of untreated psychosis : What are we talking about ?), le focus a été placé sur une revue de littérature concernant les définitions utilisées pour caractériser la fin de la DUP ainsi que sur les conséquences possibles d'un manque de précision dans cette définition sur l'évaluation de l'impact d'un retard de traitement dans la psychose débutante. Ce travail nous a permis d'identifier trois groupes principaux de définition de fin de DUP (End of DUP ; E-DUP) parmi les multiples critères utilisés dans les études publiées. E-DUP-1 est définie par la mise en route d'un traitement antipsychotique, le plus souvent sans tenir compte ni du dosage prescrit, ni de l'adhérence au traitement. E-DUP-2 est définie par l'entrée dans un programme de traitement spécialisé, et E-DUP-3 enfin est définie par la conjonction de la prescription d'un traitement antipsychotique adapté, de l'adhérence à ce traitement, et de la mise en route d'une prise en charge dans un programme spécialisé. En conclusion, nous relevions que cette grande variété dans les définitions appliquées pour l'évaluation de la DUP avait probablement contribué à l'aspect contradictoire des résultats des études de son impact sur l'évolution des psychoses et qu'il était donc temps de proposer une définition de consensus. La deuxième étude a été conduite dans le cadre d'un suivi de cohorte mis en place dans le programme de Traitement et Intervention Précoce dans les troubles Psychotiques (TIPP) établi dans le Département de Psychiatrie du CHUV à Lausanne depuis 2004. Les objectifs de cette seconde étude étaient au nombre de trois: (1) Exploration des variations de la DUP en fonction de l'application de trois principales définitions de fin de DUP (E-DUP) identifiées dans la littérature ; (2) Evaluation de la proportion de patients remplissant au moins une fois au cours des 18 mois de traitement la définition de E-DUP la plus compatible avec les directives de traitement proposées par l'International Early Psychosis Association (patient est à la fois engagé dans le traitement et se montre compliant à la médication, E-DUP-3); (3) Enfin, identification desfacteurs qui caractérisent les patients qui ne remplissent jamais les critères de cette dernière définition. L'exploration de différentes durées de DUP en utilisant les trois définitions d'E-DUP a donné les résultats suivants : La DUP1 médiane (2.2 mois) était significativement plus courte que la DUP2 (7.4 mois), et la DUP3 (13.6 mois) était significativement la plus longue des trois. De plus, 19.7% des patients n'avaient jamais rempli les critères de E-DUP-3 ; on peut donc considérer que près de 20% des patients traités dans ce programme spécialisé ne recevaient pas un traitement adéquat selon les directives intrernationales actuellement reconnues. Sur la base de ces chiffres, il apparaît clairement que, dans les études de l'impact de la DUP sur l'évolution de la psychose débutante, bon nombre des patients pour lesquels on considère que la DUP est terminée ne sont en fait pas adéquatement traités. Il est en conséquence très probable que ceci ait faussé les résultats de ces études, et qu'une définition plus restrictive permettrait de répondre de manière plus précise à cette question. Les patients qui ne remplissaient pas les critères E-DUP3 au cours des 18 premiers mois de traitement étaient caractérisés par un moins bon niveau de fonctionnement au cours de leur vie (« lower lifetime SOFAS » ; p=0.017) et ils étaient plus susceptibles de consommer du cannabis à l'entrée du programme ???? (?2 (1, n=49)=4.241, p=0.039). Pour ceux qui avaient rempli les critères E-DUP-3 au cours des 18 mois, une longue DUP3 était associée avec un jeune âge au début des symptômes psychotiques (rs =-0.573, p<0.001), et avec un faible niveau de fonctionnement pré-morbide (score de PAS élevés (rs =0.373, p=0.001), niveau maximal au cours de la vie bas pour le GAF(rs =-0.367, p<0.001) et pour le SOFAS (rs =-0.314, p=0.003)). En conclusion, ce travail a permis de mettre en évidence une grande variabilité dans la définition de la fin de la DUP parmi les études publiées jusque à ce jour, et l'impact important que le choix d'une ou l'autre de ces définitions peut avoir sur l'estimation de la DUP. De plus, nous avons observé que malgré la mise en place d'un programme spécialisé, près de 20% des patients ne remplissent pas les critères d'exposition à un traitement adéquat au cours des 18 premiers mois de prise en charge. Il est donc probable que l'estimation de l'impact de la DUP ait été faussé par cette variabilité, et il semble important que la communauté scientifique s'accorde sur une définition plus rigoureuse de cette variable. Enfin, certaines caractéristiques permettent d'identifier les patients qui sont à risque de ne pas remplir les critères de traitement adéquat a cours des 18 premiers mois de prise en charge ; il est possible qu'une identification précoce de ceux-ci permette la mise en place de stratégies mieux adaptées pour les aider à s'engager dans les soins. Le futur développement de ce travail sera d'évaluer l'impact de la DUP sur l'évolution des patients au cours des 36 mois de traitement proposés dans le programme TIPP, en appliquant les divers critères E-DUP, afin de voir si notre hypothèse que la variation des définitions a effectivement faussé les résultats de telles études. Nous devons pour cela attendre qu'un nombre suffisant de patients ait complété les 36 mois de traitement, de manière à avoir une puissance statistique suffisante pour répondre clairement à cette question.

Defining the genomic signature of the parous breast.

ABSTRACT: BACKGROUND: It is accepted that a woman's lifetime risk of developing breast cancer after menopause is reduced by early full term pregnancy and multiparity. This phenomenon is thought to be associated with the development and differentiation of the breast during pregnancy. METHODS: In order to understand the underlying molecular mechanisms of pregnancy induced breast cancer protection, we profiled and compared the transcriptomes of normal breast tissue biopsies from 71 parous (P) and 42 nulliparous (NP) healthy postmenopausal women using Affymetrix Human Genome U133 Plus 2.0 arrays. To validate the results, we performed real time PCR and immunohistochemistry. RESULTS: We identified 305 differentially expressed probesets (208 distinct genes). Of these, 267 probesets were up- and 38 down-regulated in parous breast samples; bioinformatics analysis using gene ontology enrichment revealed that up-regulated genes in the parous breast represented biological processes involving differentiation and development, anchoring of epithelial cells to the basement membrane, hemidesmosome and cell-substrate junction assembly, mRNA and RNA metabolic processes and RNA splicing machinery. The down-regulated genes represented biological processes that comprised cell proliferation, regulation of IGF-like growth factor receptor signaling, somatic stem cell maintenance, muscle cell differentiation and apoptosis. CONCLUSIONS: This study suggests that the differentiation of the breast imprints a genomic signature that is centered in the mRNA processing reactome. These findings indicate that pregnancy may induce a safeguard mechanism at post-transcriptional level that maintains the fidelity of the transcriptional process.

Prevalence and correlates of DSM-5 bipolar and related disorders and hyperthymic personality in the community.

BACKGROUND: To 1) establish the lifetime and 12-month prevalence of DSM-5 bipolar and related disorders including the new algorithmically defined conditions grouped within Other Specified Bipolar and Related Disorders (OSBARD) as well as hyperthymic personality in a randomly selected community sample, and 2) determine the clinical relevance of the OSBARD category in terms of sociodemographic characteristics, course, comorbidity and treatment patterns by comparing the subjects of this category to those with bipolar-I (BP-I), bipolar-II (BP-II), major depressive disorder (MDD), and those with no history of mood disorders. METHODS: The semi-structured Diagnostic Interview for Genetic Studies was administered by masterslevel psychologists to a random sample of an urban area (n=3'719). RESULTS: The lifetime prevalence was 1.0% for BP-I, 0.8% for BP-II, 1.0% for OSBARD and 3% for hyperthymic personality. Subjects with OSBARD were more severely affected than subjects without a history of mood disorders regarding almost all clinical correlates. Compared to those with MDD, they also revealed an elevated risk of suicidal attempts, lower global functioning, more treatment seeking and more lifetime comorbidity including anxiety, substance use and impulse-control disorders. However, they did not differ from subjects with BP-II. LIMITATIONS: Small sample sizes for bipolar and related disorders and potential inaccurate recall of symptoms. CONCLUSIONS: The modifications of diagnostic criteria for manic/hypomanic episodes according to the DSM-5 only marginally affect the prevalence estimates for BP-I and BP-II. The new DSM-5 OSBARD category is associated with significant clinical burden, is hardly distinct from BP-II with respect to clinical correlates and deserves similar clinical attention.

Associations of serum uric acid and SLC2A9 variant with depressive and anxiety disorders: a population-based study

Background: Limited information exists regarding the association between serum uric acid (SUA) and psychiatric disorders. We explored the relationship between SUA and subtypes of major depressive disorder (MDD) and specific anxiety disorders. Additionally, we examined the association of SLC2A9 rs6855911 variant with anxiety disorders. Methods: We conducted a cross-sectional analysis on 3,716 individuals aged 35-66 years previously selected for the population-based CoLaus survey and who agreed to undergo further psychiatric evaluation. SUA was measured using uricase-PAP method. The French translation of the semi-structured Diagnostic Interview for Genetic Studies was used to establish lifetime and current diagnoses of depression and anxiety disorders according to the DSM-IV criteria. Results: Men reported significantly higher levels of SUA compared to women (357}74 μmol/L vs. 263}64 μmol/L). The prevalence of lifetime and current MDD was 44% and 18% respectively while the corresponding estimates for any anxiety disorders were 18% and 10% respectively. A quadratic hockey-stick shaped curve explained the relationship between SUA and social phobia better than a linear trend. However, with regards to the other specific anxiety disorders and other subtypes of MDD, there was no consistent pattern of association. Further analyses using SLC2A9 rs6855911 variant, known to be strongly associated with SUA, supported the quadratic relationship observed between SUA phenotype and social phobia. Conclusions: A quadratic relationship between SUA and social phobia was observed consistent with a protective effect of moderately elevated SUA on social phobia, which disappears at higher concentrations. Further studies are needed to confirm our observations.

R6le de l'urotlogue dans le dépistage des maladies osseuses [Role of the urologist in the screening of bone diseases].

During their lifetime, 20% of men will suffer from a fracture secondary to osteoporosis, and morbidity and mortality of a hip fracture in men are more severe than in women. Despite these facts, there are only few studies on osteoporosis in men. Hyopgonadism is a known risk factor for bone mineral density decrease. Hypogonadism can be found in patients diagnosed with prostate cancer who are receiving androgen deprivation therapy, but can also be discovered in patients with male infertility or erectile dysfunction. Urologists have central role in men's health aftercare, and therefore have key role in the screening and in the multidisciplinary treatment of osteoporosis and osteopenia.