Ronald Hattis

Welcome to all intellectually curious Academia.edu readers with an interest in what the universe is made of and how it works. No matter what your background, this paper will stimulate your mind, making you think. In simple language that requires only high school science training, I present a new model of the universe, extrapolating from established science and historical precedents, including (and explaining) the substantivalist views of DesCarte, Newton, and others. This new model resolves some mysteries of physics.. This is latest version (July 2023)., It resolves some puzzling mysteries of physics. In the “Nothing but Space” model, space is the fundamental substance of the universe. It is quantized, and the medium of gravitational and electromagnetic fields. Waves, additions and deletions, and other processes in space produce the properties attributed to matter and energy. Time is a function of motion, and spacetime an unnecessary concept.  Underlying this model, space is known to have physical properties and is expanding. Particles are known to have wave properties, conducted in fields that exist in space. Conceptualizing them as solid bodies is misleading. Problems in current theory that call for new thinking include incompatible quantum and relativity theories, “dark energy” and “dark matter” not satisfactorily explained, and a “standard model” with multiple “fundamental” particles unstable for even a tiny fraction of a second. “Singularities,” points with no dimensions, and infinity are shown to lack physical reality. This model can explain gravitation (space deletion), the Hubble expansion and “dark energy” (space addition), and some aspects of special and general relativity and possibly electromagnetism. “Big Bounce” theory is favored over “Big Bang.” The Hubble equation is speculatively adjusted.  The new concept has implications for mechanical motion, quantum theory, and cosmology. It provides causal mechanisms for aspects of physics that are currently merely described by equations showing mathematical relationships. New ideas in physics from outsiders have been strongly resisted, but may be needed for further progress. This new model might contribute to progress in both theoretical physics and the philosophy of science.

We surveyed U.S. HIV/AIDS directors or designees in states and non-state regions, regarding factors influencing HIV viral suppression: (1) non-federal prevention funding; (2) contacting newly reported patients and providers, for care linkage and partner services; (3) follow-up of non-received viral load reports, to identify untreated patients; and (4) genotype/phenotype surveillance, to monitor drug resistance. The survey was conducted April-July 2015; 50 (87.7%) participated. Eighty percent of jurisdictions contacted all newly reported patients; 60% contacted all providers. HIV resistance tests were reportable in 38%; 66% contacted providers and/or patients about missed viral loads. Non-federal funding was significantly associated with annual diagnoses (p = .0001) and population (p = .0002), but not with other factors studied. Many jurisdictions lacked non-federal funding (28%), or experienced unrestored reductions since 2008 (33%). Jurisdictions' funding and preventive practices varied greatly. HIV viral suppression could be enhanced by restoring (or establishing) non-federal prevention funding, and by more standardized surveillance/outreach practices.

Keywords: HIV; funding; outreach; public health; standardization; surveillance.

This short paper briefly reviews the history of antiviral treatment of HIV/AIDS. It also describes 4 drugs either newly approved by FDA or approved for new uses, 2018-20, and one that is pending approval. It explains the rationale for the 3-drug combinations used since 1996, and the new trend toward treatment with only 2 drugs, providing an update to manuscripts on HIV treatment that the author has previously uploaded on Academia.edu.

The lesson from this study is that when vaccines are expensive, screening tests are less so, and a substantial portion of an exposed population is likely to already be immune to the disease, it can be cost-effective to screen for antibodies and to immunize only those who are found to be susceptible.

In response to a measles outbreak in the community, a measles immunization program was developed at our hospital for forensic psychiatric patients. Measles antibody screening of all employees and patients by means of an enzyme-linked immunosorbent assay was followed by vaccination of susceptible persons. Serum samples from 813 employees and 868 patients during a 6-month period were analyzed. The susceptibility rate was 16.15% for employees and 13.60% for patients born in or after 1957. It was 4.67% for employees and 5.40% for patients born before 1957. The overall rate was 7.38% for employees and 8.53% for patients. A rate of 5% is known to be sufficient for transmission in institutions. Vaccine was given to 84.51% of susceptible patients. Vaccine failure occurred in 8.33%. Residual susceptibility rate was 1.84%. Cost analysis showed that screening of all individuals and immunization of susceptible persons was the most cost-effective method for measles control in our institutional setting.

Primary care providers are going to need to start patients on treatment for HIV, in order to make "treatment as prevention" work and to promote the HIV Care Continuum. There may be too much delay and too much patient dropout if the onset of treatment is delayed until an appointment with an infectious disease or HIV specialist can be arranged. This presentation instructs primary care providers how to fairly simply start treatment for HIV. It can be presented to audiences of providers in less than 30 minutes. A more complete review of early treatment is also posted on Academia.edu that may take up to an hour to present.

This slide presentation accompanies and provides a brief summary of the proposals in my paper: "Is Space the Only Substance in the Universe?
The “Nothing but Space” Model: A Simpler New Theory of Space, Time, Gravity, Dark Energy, and More"

This slide presentation is suitable for both professional and law audiences. It provides introductory information about HIV and its pandemic, gives recent U.S. and global statistics, explains the concept of treatment as prevention, and advocates for the HIV Care Continuum to assist patients in reaching viral suppression (which almost eliminates sexual transmission).

Primary care providers are going to need to start patients on treatment for HIV, in order to make "treatment as prevention" work and to promote the HIV Care Continuum. There may be too much delay and too much patient dropout if the onset of treatment is delayed until an appointment with an infectious disease or HIV specialist can be arranged. Primary care providers, and others who are not Infectious Disease or HIV specialists, can and should start immediate antiretroviral treatment for HIV upon receiving a positive test result. Here is how to do it, and why. This full version gives more complete information than the abbreviated version also posted on Academia.edu (which was edited to permit  a one-hour lecture), but has not been updated to 2022.

The typical classification of prevention into primary, secondary, and tertiary categories has encountered various criticisms. We review the history and limitations of this and other classifications, and offer a substitute paradigm: five Stages of Prevention, which address consecutive steps in the development of chronic and gradually developing diseases, and corresponding stages for prevention: 1) avoiding exposure to causative agents, 2) reducing acquisition of disease resulting from exposure, 3) interrupting advancement of acquired disease, 4) preventing complications from advanced disease, and 5) delay (or palliation) of death, or rehabilitation of disability, from complications. This new model can serve as a tool for health planning, including calculation of costs vs. benefits for investment of resources. It can also be applied to counseling patients on personal options for prevention.

This slide presentation was first developed at Loma Linda University 2006-2009, with resident Melody Law).  In various versions, it has had over 20,000 online views, 14,537 on Academia.edu by over 10,000 unique viewers, and about 10,000 on Researchgate.net. This 2022 version has replaced previous versions posted on Academia, and adds references at the end, which were not included in early versions.

At many medical schools, epidemiology and biostatistics are taught in a single isolated course, primarily to help students pass a Board exam. But that does not integrate epidemiology and prevention into instruction on diseases and clinical care, and the course content may be forgotten. I have previously identified five stages of the development of chronic and slowly-developing diseases (exposure, acquisition from exposure, progression of acquired disease, complications resulting from progressed disease, and disability or death usually caused by complications). For each of these stages, there is a corresponding stage of prevention. For every specialty, and no matter how advanced a disease is, there is something preventive to do (including specific measures but also lifestyle and nutrition), and this should be addressed at every clinical contact. Epidemiology is relevant to differential diagnosis, as patients from different population groups are at risk for different diseases that may have similar symptoms. Epidemiological and biostatistical concepts like sensitivity and specificity help the physician decide what diagnostic measure to order and how to interpret the results. He concluded by recommending that lecturers and case reviewers be required to devote a few minutes of each session to the epidemiology and prevention measures for the diseases being taught.  Using this approach, additional courses would not need to be fit into the curriculum.

This is the 2022 version of an innovative model proposing that space, far from being "nothing," is a substance, and in fact the only substance in the universe as well as the medium for electromagnetic and gravitation fields. Matter and energy are processes that occur within this space substance. The model better explains gravitation, the Hubble expansion, the Lorentz transformations, and many phenomena of classical and quantum mechanics. It proposes solutions for some mysterious and previously unsolved phenomena of physics and cosmology (including dark energy), and a simpler quantum gravity solution, . It postulates that space consists of standard and quantized units that can be added or deleted, and that matter and energy are wave-related processes occurring in the medium of space. The relevance of particles is questioned. Time is defined in terms of repetitive motion in 3-D space, making 4-D spacetime unnecessary.

Both an article and a slide presentation (Space, the Ultimate Substance of the Universe?) summarizing the main points have been provided.