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Stuttgart Mühlhausen, Germany

McCollum E.D.,Johns Hopkins University | King C.,University College London | Hollowell R.,The Boston Consulting Group | Zhou J.,Bill and Melinda Gates Foundation | And 4 more authors.
BMC Pediatrics | Year: 2015

Background: Improved referral algorithms for children with non-severe pneumonia at the community level are desirable. We sought to identify predictors of oral antibiotic failure in children who fulfill the case definition of World Health Organization (WHO) non-severe pneumonia. Predictors of greatest interest were those not currently utilized in referral algorithms and feasible to obtain at the community level. Methods: We systematically reviewed prospective studies reporting independent predictors of oral antibiotic failure for children 2-59 months of age in resource-limited settings with WHO non-severe pneumonia (either fast breathing for age and/or lower chest wall indrawing without danger signs), with an emphasis on predictors not currently utilized for referral and reasonable for community health workers. We searched PubMed, Cochrane, and Embase and qualitatively analyzed publications from 1997-2014. To supplement the limited published evidence in this subject area we also surveyed respiratory experts. Results: Nine studies met criteria, seven of which were performed in south Asia. One eligible study occurred exclusively at the community level. Overall, oral antibiotic failure rates ranged between 7.8-22.9 %. Six studies found excess age-adjusted respiratory rate (either WHO-defined very fast breathing for age or 10-15 breaths/min faster than normal WHO age-adjusted thresholds) and four reported young age as predictive for oral antibiotic failure. Of the seven predictors identified by the expert panel, abnormal oxygen saturation and malnutrition were most highly favored per the panel's rankings and comments. Conclusions: This review identified several candidate predictors of oral antibiotic failure not currently utilized in childhood pneumonia referral algorithms; excess age-specific respiratory rate, young age, abnormal oxygen saturation, and moderate malnutrition. However, the data was limited and there are clear evidence gaps; research in rural, low-resource settings with community health workers is needed. © 2015 McCollum et al. Source


McCollum E.D.,University College London | King C.,University College London | Hollowell R.,The Boston Consulting Group | Zhou J.,Bill and Melinda Gates Foundation | And 4 more authors.
BMC Pediatrics | Year: 2015

Background: Improved referral algorithms for children with non-severe pneumonia at the community level are desirable. We sought to identify predictors of oral antibiotic failure in children who fulfill the case definition of World Health Organization (WHO) non-severe pneumonia. Predictors of greatest interest were those not currently utilized in referral algorithms and feasible to obtain at the community level. Methods: We systematically reviewed prospective studies reporting independent predictors of oral antibiotic failure for children 2-59 months of age in resource-limited settings with WHO non-severe pneumonia (either fast breathing for age and/or lower chest wall indrawing without danger signs), with an emphasis on predictors not currently utilized for referral and reasonable for community health workers. We searched PubMed, Cochrane, and Embase and qualitatively analyzed publications from 1997-2014. To supplement the limited published evidence in this subject area we also surveyed respiratory experts. Results: Nine studies met criteria, seven of which were performed in south Asia. One eligible study occurred exclusively at the community level. Overall, oral antibiotic failure rates ranged between 7.8-22.9%. Six studies found excess age-adjusted respiratory rate (either WHO-defined very fast breathing for age or 10-15 breaths/min faster than normal WHO age-adjusted thresholds) and four reported young age as predictive for oral antibiotic failure. Of the seven predictors identified by the expert panel, abnormal oxygen saturation and malnutrition were most highly favored per the panel's rankings and comments. Conclusions: This review identified several candidate predictors of oral antibiotic failure not currently utilized in childhood pneumonia referral algorithms; excess age-specific respiratory rate, young age, abnormal oxygen saturation, and moderate malnutrition. However, the data was limited and there are clear evidence gaps; research in rural, low-resource settings with community health workers is needed. © 2015 McCollum et al. Source


Shah N.A.,University of Pennsylvania | Shah N.A.,The Boston Consulting Group | Levesque M.J.,University of Pennsylvania | Raj A.,University of Pennsylvania | Sarkar C.A.,University of Minnesota
Journal of Cell Science | Year: 2015

Hematopoietic lineage commitment is regulated by cytokines and master transcription factors, but it remains unclear how a progenitor cell chooses a lineage in the face of conflicting cues. Through transcript counting in megakaryocyte-erythroid progenitors undergoing erythropoiesis, we show that the expression levels of the pro-erythropoiesis transcription factor EKLF (also known as KLF1) and receptor EpoR are inversely correlated with their pro-megakaryopoiesis counterparts, FLI-1 and TpoR (also known as MPL). Notably, as progenitors commit to the erythrocyte lineage, EpoR is upregulated and TpoR is strongly downregulated, thus boosting the potency of the pro-erythropoiesis cue erythropoietin and effectively eliminating the activity of the pro-megakaryopoiesis cue thrombopoietin. Based on these findings, we propose a newmodel for exclusive decision making that explicitly incorporates signals from extrinsic cues, and we experimentally confirm a model prediction of temporal changes in transcript noise levels in committing progenitors. Our study suggests that lineage-specific receptor levels can modulate potencies of cues to achieve robust commitment decisions. © 2015. Published by The Company of Biologists Ltd. Source


Nigmatkulov G.A.,National Research Nuclear University MEPhI | Ponosov A.K.,National Research Nuclear University MEPhI | Akgun U.,University of Iowa | Alkhazov G.,RAS Petersburg Nuclear Physics Institute | And 119 more authors.
Physics Letters, Section B: Nuclear, Elementary Particle and High-Energy Physics | Year: 2016

We report the measurement of the one-dimensional charged kaon correlation functions using 600GeV/c σ-, π- and 540GeV/c p beams from the SELEX (E781) experiment at the Fermilab Tevatron. K±K± correlation functions are studied for three transverse pair momentum, kT, ranges and parameterized by a Gaussian form. The emission source radii, R, and the correlation strength, λ, are extracted. The analysis shows a decrease of the source radii with increasing kaon transverse pair momentum for all beam types. © 2015 The Authors. Source


Bistline J.E.,Stanford University | Blum D.M.,Stanford University | Rinaldi C.,Stanford University | Shields-Estrada G.,The Boston Consulting Group | And 2 more authors.
Science and Global Security | Year: 2015

This article presents a model to estimate North Korea’s uranium enrichment capacity and to identify probable bottlenecks for scaling up that capacity. Expert assessment is used to identify and estimate the size of key centrifuge materials and component stockpiles. Bayesian probability networks are used to characterize uncertainties in these stockpiles and a deterministic optimization model to estimate the capacity of North Korea’s uranium enrichment program given the assumed components and materials constraints. A Monte Carlo simulation model is used to propagate uncertainties through the optimization model. An illustration of this approach, based on the opinions of three experts, suggests that North Korea was likely (about 80 percent chance) to have a larger uranium enrichment capacity than what was displayed to visitors to the Yongbyon nuclear complex in 2010. The three most important bottlenecks to increases in enrichment capacity are the availability of pivot bearings, maraging steel, and high-strength aluminum. The nature of the model allows it to be easily updated as new information becomes available about centrifuge materials and component stockpiles. © Taylor & Francis Group, LLC. Source

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