353 research outputs found
Unionized Data Governance in Virtual Power Plants
Flexible electricity networks continuously coordinate and optimize operations
through ICT systems. An overlay data grid conveys information about the state
of the electricity grid, as well as the status of demand and production of
electricity in households and industry. Data is thus the basis for decisions
that affect electricity costs and availability of assets on the electricity
grid. It is crucial that these decisions are formed and monitored according to
a well-defined governance model. No such data governance model exists today. In
this paper, we focus on the central role of virtual power plants in flexible
electricity networks. We define the problem of data governance in a virtual
power plant, insisting on the issues linked to the inherent asymmetry of this
system. We propose unionization as a framing device to reason about this issue.
The central contribution of this paper is thus principles for a unionized data
governance model for virtual power plants
Ensayo y error: un anĂĄlisis marxista de las polĂticas pĂșblicas
Este artĂculo aborda la problemĂĄtica de la racionalidad del proceso de formulaciĂłn de polĂticas pĂșblicas y su objetivo es esbozar lineamientos desde una perspectiva distinta de la concepciĂłn racionalista. Propone como hipĂłtesis que el proceso de polĂticas pĂșblicas constituye un ensayo y error signado por una racionalidad acotada. Aunque estos conceptos provienen del debate "racionalistas/incrementalistas", aquĂ se redefinen a partir de un anĂĄlisis del Estado capitalista y de los lĂmites que le impone a su capacidad de intervenir conforme a los requerimientos de la reproducciĂłn capitalista, enmarcado en la vertiente derivacionista de la teorĂa marxista del Estado. El artĂculo constituye un trabajo teĂłrico-metodolĂłgico, apoyado en observaciones propias del marco de investigaciones empĂricas sobre procesos concretos de polĂticas pĂșblicas.This article addresses the problem of the rationality of the public policy making process aimed
at outlining guidelines from a different perspective to the rationalist approach. The hypothesis
advanced is that the public policy process is one of trial and error marked by a bounded rationality. Although these concepts come from the "rationalist/incrementalist" debate, they are redefined here based on an analysis of the capitalist state and the limits it imposes on its ability to intervene according to the requirements of capitalist reproduction framed in the derivationist version of the Marxist state theory. The article constitutes a theoretica-methodological work, although it is based on conclusions drawn from specific empirical research on specific public policy processes
Fosmetpantotenate Randomized Controlled Trial in Pantothenate KinaseâAssociated Neurodegeneration
Fosmetpantotenate; Randomized controlled trialFosmetpantotenato; Ensayo controlado aleatorizadoFosmetpantotenat; Assaig controlat aleatoritzatBackground Pantothenate kinaseâassociated neurodegeneration (PKAN) currently has no approved treatments. Objectives The Fosmetpantotenate Replacement Therapy pivotal trial examined whether treatment with fosmetpantotenate improves PKAN symptoms and stabilizes disease progression. Methods This randomized, double-blind, placebo-controlled, multicenter study evaluated fosmetpantotenate, 300âmg oral dose three times daily, versus placebo over a 24-week double-blind period. Patients with pathogenic variants of PANK2, aged 6 to 65âyears, with a score â„6 on the PKAN-Activities of Daily Living (PKAN-ADL) scale were enrolled. Patients were randomized to active (fosmetpantotenate) or placebo treatment, stratified by weight and age. The primary efficacy endpoint was change from baseline at week 24 in PKAN-ADL. Results Between July 23, 2017, and December 18, 2018, 84 patients were randomized (fosmetpantotenate: n = 41; placebo: n = 43); all 84 patients were included in the analyses. Six patients in the placebo group discontinued treatment; two had worsening dystonia, two had poor compliance, and two died of PKAN-related complications (aspiration during feeding and disease progression with respiratory failure, respectively). Fosmetpantotenate and placebo group PKAN-ADL mean (standard deviation) scores were 28.2 (11.4) and 27.4 (11.5) at baseline, respectively, and were 26.9 (12.5) and 24.5 (11.8) at week 24, respectively. The difference in least square mean (95% confidence interval) at week 24 between fosmetpantotenate and placebo was â0.09 (â1.69 to 1.51; P = 0.9115). The overall incidence of treatment-emergent serious adverse events was similar in the fosmetpantotenate (8/41; 19.5%) and placebo (6/43; 14.0%) groups. Conclusions Treatment with fosmetpantotenate was safe but did not improve function assessed by the PKAN-ADL in patients with PKAN.The FORT trial was supported by Retrophin, Inc
Nevirapine versus Efavirenz for patients co-infected with HIV and Tuberculosis: A Randomised Non-Inferiority Trial
BACKGROUND: In countries with a high incidence of HIV and tuberculosis co-infection, nevirapine and efavirenz are widely used as antiretroviral therapy but both interact with antituberculosis drugs. We aimed to compare efficacy and safety of a nevirapine-based antiretroviral therapy (started at full dose) with an efavirenz-based regimen in co-infected patients. METHODS: We did a multicentre, open-label, randomised, non-inferiority trial at three health centres in Maputo, Mozambique. We enrolled adults (â„18 years) with tuberculosis and previously untreated HIV infection (CD4 cell counts <250 cells per ÎŒL) and alanine aminotransferase and total bilirubin concentrations of less than five times the upper limit of normal. 4-6 weeks after the start of tuberculosis treatment, we randomly allocated patients (1:1) with central randomisation, block sizes of two to six, and stratified by site and CD4 cell count to nevirapine (200 mg twice daily) or efavirenz (600 mg once daily), plus lamivudine and stavudine. The primary endpoint was virological suppression at 48 weeks (HIV-1 RNA <50 copies per mL) in all patients who received at least one dose of study drug (intention-to-treat population); death and loss to follow-up were recorded as treatment failure. The non-inferiority margin for the difference of efficacy was 10%. We assessed efficacy in intention-to-treat and per-protocol populations and safety in all patients who received study drug. This study is registered with ClinicalTrials.gov, number NCT00495326. FINDINGS: Between October, 2007, and March, 2010, we enrolled 285 patients into each group. 242 (85%) patients in the nevirapine group and 233 (82%) patients in the efavirenz group completed follow-up. In the intention-to-treat population, 184 patients (64·6%, 95% CI 58·7-70·1) allocated nevirapine achieved virological suppression at week 48, as did 199 patients (69·8%, 64·1-75·1) allocated efavirenz (one-sided 95% CI of the difference of efficacy 11·7%). In the per-protocol population, 170 (70·0%, 63·8-75·7) of 243 patients allocated nevirapine achieved virological suppression at week 48, as did 194 (78·9%, 73·2-83·8) of 246 patients allocated efavirenz (one-sided 95% CI 15·4%). The median CD4 cell count at randomisation was 89 cells per ÎŒL. 15 patients substituted nevirapine with efavirenz and six patients substituted efavirenz with nevirapine. 20 patients allocated nevirapine (7%) had grade 3-4 increase of alanine aminotransferase compared with 17 patients allocated efavirenz (6%). Three patients had severe rash after receipt of nevirapine (1%) but no patients did after receipt of efavirenz. 18 patients in the nevirapine group died, as did 17 patients in the efavirenz group. INTERPRETATION: Although non-inferiority of the nevirapine-regimen was not shown, nevirapine at full dose could be a safe, acceptable alternative for patients unable to tolerate efavirenz. FUNDING: French Research Agency for HIV/AIDS and hepatitis (ANRS)
Pre-existing health conditions and severe COVID-19 outcomes: an umbrella review approach and meta-analysis of global evidence
Background
This study applies an umbrella review approach to summarise the global evidence on the risk of severe COVID-19 outcomes in patients with pre-existing health conditions.
Methods
Systematic reviews (SRs) were identified in PubMed, Embase/Medline and seven pre-print servers until December 11, 2020. Due to the absence of age-adjusted risk effects stratified by geographical regions, a re-analysis of the evidence was conducted. Primary studies were extracted from SRs and evaluated for inclusion in the re-analysis. Studies were included if they reported risk estimates (odds ratio (OR), hazard ratio (HR), relative risk (RR)) for hospitalisation, intensive care unit admission, intubation or death. Estimated associations were extracted from the primary studies for reported pre-existing conditions. Meta-analyses were performed stratified for each outcome by regions of the World Health Organization. The evidence certainty was assessed using GRADE. Registration number CRD42020215846.
Results
In total, 160 primary studies from 120 SRs contributed 464 estimates for 42 pre-existing conditions. Most studies were conducted in North America, European, and Western Pacific regions. Evidence from Africa, South/Latin America, and the Eastern Mediterranean region was scarce. No evidence was available from the South-East Asia region. Diabetes (HR range 1.2â2.0 (CI range 1.1â2.8)), obesity (OR range 1.5â1.75 (CI range 1.1â2.3)), heart failure (HR range 1.3â3.3 (CI range 0.9â8.2)), COPD (HR range 1.12â2.2 (CI range 1.1â3.2)) and dementia (HR range 1.4â7.7 (CI range 1.2â39.6)) were associated with fatal COVID-19 in different regions, although the estimates varied. Evidence from Europe and North America showed that liver cirrhosis (OR range 3.2â5.9 (CI range 0.9â27.7)) and active cancer (OR range 1.6â4.7 (CI range 0.5â14.9)) were also associated with increased risk of death. Association between HIV and undesirable COVID-19 outcomes showed regional heterogeneity, with an increased risk of death in Africa (HR 1.7 (CI 1.3â2.2)). GRADE certainty was moderate to high for most associations.
Conclusion
Risk of undesirable COVID-19 health outcomes is consistently increased in certain patient subgroups across geographical regions, showing high variability in others. The results can be used to inform COVID-19 vaccine prioritisation or other intervention strategies.Peer Reviewe
Novel Insights into the Bovine Polled Phenotype and Horn Ontogenesis in Bovidae
Despite massive research efforts, the molecular etiology of bovine polledness and the developmental pathways involved in horn ontogenesis are still poorly understood. In a recent article, we provided evidence for the existence of at least two different alleles at the Polled locus and identified candidate mutations for each of them. None of these mutations was located in known coding or regulatory regions, thus adding to the complexity of understanding the molecular basis of polledness. We confirm previous results here and exhaustively identify the causative mutation for the Celtic allele (PC) and four candidate mutations for the Friesian allele (PF). We describe a previously unreported eyelash-and-eyelid phenotype associated with regular polledness, and present unique histological and gene expression data on bovine horn bud differentiation in fetuses affected by three different horn defect syndromes, as well as in wild-type controls. We propose the ectopic expression of a lincRNA in PC/p horn buds as a probable cause of horn bud agenesis. In addition, we provide evidence for an involvement of OLIG2, FOXL2 and RXFP2 in horn bud differentiation, and draw a first link between bovine, ovine and caprine Polled loci. Our results represent a first and important step in understanding the genetic pathways and key process involved in horn bud differentiation in Bovidae
Machine learning using digitized herbarium specimens to advance phenological research
Machine learning (ML) has great potential to drive scientific discovery by harvesting data from images of herbarium specimensâpreserved plant material curated in natural history collectionsâbut ML techniques have only recently been applied to this rich resource. ML has particularly strong prospects for the study of plant phenological events such as growth and reproduction. As a major indicator of climate change, driver of ecological processes, and critical determinant of plant fitness, plant phenology is an important frontier for the application of ML techniques for science and society. In the present article, we describe a generalized, modular ML workflow for extracting phenological data from images of herbarium specimens, and we discuss the advantages, limitations, and potential future improvements of this workflow. Strategic research and investment in specimen-based ML methods, along with the aggregation of herbarium specimen data, may give rise to a better understanding of life on Earth
Home Sweet Home
The British's attachment to their homes has continued to assert itself since the early nineteenth century, becoming an important component of their identity. The English language has invented the words comfort and comfortable, words imported into French because nothing better expressed the link between the well-being of soul and body and the domestic interior. What's better than the theme of the home, the home so dear to the heart of the British, to highlight the richness, the diversity and the development of photography across the Channel? Home Sweet Home brings together thirty artists of all generations who allow us to share the intimacy and the everyday life of Britain from the 1970s to the present day. A look around the property that sheds light from different angles on the social, cultural and political realities, past and present, of British society
Articles Nevirapine versus efavirenz for patients co-infected with HIV and tuberculosis: a randomised non-inferiority trial
Summary Background In countries with a high incidence of HIV and tuberculosis co-infection, nevirapine and efavirenz are widely used as antiretroviral therapy but both interact with antituberculosis drugs. We aimed to compare effi cacy and safety of a nevirapine-based antiretroviral therapy (started at full dose) with an efavirenz-based regimen in coinfected patients
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Immunodeficiency, auto-inflammation and amylopectinosis in humans with inherited HOIL-1 and LUBAC deficiency
We report the clinical description and molecular dissection of a new fatal human inherited disorder characterized by chronic auto-inflammation, invasive bacterial infections and muscular amylopectinosis. Patients from two kindreds carried biallelic loss-of-expression and loss-of-function mutations in HOIL1, a component the linear ubiquitination chain assembly complex (LUBAC). These mutations resulted in impairment of LUBAC stability. NF-ÎșB activation in response to interleukin-1ÎČ (IL-1ÎČ) was compromised in the patientsâ fibroblasts. By contrast, the patientsâ mononuclear leukocytes, particularly monocytes, were hyperresponsive to IL-1ÎČ. The consequences of human HOIL-1 and LUBAC deficiencies for IL-1ÎČ responses thus differed between cell types, consistent with the unique association of auto-inflammation and immunodeficiency in these patients. These data suggest that LUBAC regulates NF-ÎșB-dependent IL-1ÎČ responses differently in different cell types
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