Public Hospital Spending in England: Evidence from National Health Service Administrative Records

© 2016 The Authors. Fiscal Studies published by John Wiley & Sons Ltd. on behalf of Institute for Fiscal StudiesHealth spending per capita in England has almost doubled since 1997, yet relatively little is known about how that spending is distributed across the population. This paper uses administrative National Health Service (NHS) hospital records to examine key features of public hospital spending in England. We describe how costs vary across the life cycle, and the concentration of spending among people and over time. We find that costs per person start to increase after age 50 and escalate after age 70. Spending is highly concentrated in a small section of the population, but the degree of concentration is lower for older age groups. For those aged 25 and under, a third of all hospital spending is accounted for by 1 per cent of the population under 25 and a fifth of spending is accounted for by 1 per cent of patients under 25. For those aged 65 and over, these figures fall to 22 and 13 per cent, respectively. There is persistence in spending over time, with patients with high spending more likely to have spending in subsequent years and those with zero expenditures more likely to remain out of hospital

A Study of Full Scale CMS Tracker Alignment using High Momentum Muons and Cosmics

The positions of the silicon modules of the CMS tracker will be known to $O(100$ $\mu$m) from survey measurements, mounting precision and the laser alignment system. However, in order to fully exploit the capabilities of the tracker, these positions need to be known to a precision of a few $\mu$m. Only a track-based alignment procedure can reach this required precision. Such an alignment procedure is a major challenge given that about 50000 geometry constants need to be measured. Making use of the novel $\chi^2$ minimization program Millepede II an alignment strategy has been developed in which all detector components are aligned simultaneously and all correlations between their position parameters taken into account. Different datasets, such as Z$^0$ decays and cosmic muons, plus information about the mechanical structure of the tracker, and initial position uncertainties have been used as input for the alignment procedure. A proof of concept of this alignment strategy is demonstrated using simulated data

Challenges to Promoting Social Inclusion of the Extreme Poor: Evidence from a Large-Scale Experiment in Colombia

We evaluate the large scale pilot of an innovative and major welfare intervention in Colom- bia, which combines homes visits by trained social workers to households in extreme poverty with preferential access to social programs. We use a randomized control trial and a very rich dataset collected as part of the evaluation to identify program impacts on the knowledge and take-up of social programs and the labor supply of targeted households. We find no consistent impact of the program on these outcomes, possibly because the way the pilot was implemented resulted in very light treatment in terms of home visits. Importantly, administrative data in- dicates that the program has been rolled out nationally in a very similar fashion, suggesting that this major national program is likely to fail in making a significant contribution to re- ducing extreme poverty. We suggest that the program should undergo substantial reforms, which in turn should be evaluated

A novel approach to remote homology detection: jumping alignments

Spang R, Rehmsmeier M, Stoye J. A novel approach to remote homology detection: jumping alignments. Journal of Computational Biology. 2002;9(5):747-760.We describe a new algorithm for protein classification and the detection of remote homologs. The rationale is to exploit both vertical and horizontal information of a multiple alignment in a well-balanced manner. This is in contrast to established methods such as profiles and profile hidden Markov models which focus on vertical information as they model the columns of the alignment independently and to family pairwise search which focuses on horizontal information as it treats given sequences separately. In our setting, we want to select from a given database of "candidate sequences" those proteins that belong to a given superfamily. In order to do so, each candidate sequence is separately tested against a multiple alignment of the known members of the superfamily by means of a new jumping alignment algorithm. This algorithm is an extension of the Smith-Waterman algorithm and computes a local alignment of a single sequence and a multiple alignment. In contrast to traditional methods, however, this alignment is not based on a summary of the individual columns of the multiple alignment. Rather, the candidate sequence is at each position aligned to one sequence of the multiple alignment, called the "reference sequence". In addition, the reference sequence may change within the alignment, while each such jump is penalized. To evaluate the discriminative quality of the jumping alignment algorithm, we compare it to profiles, profile hidden Markov models, and family pairwise search on a subset of the SCOP database of protein domains. The discriminative quality is assessed by median false positive counts (med-FP-counts). For moderate med-FP-counts, the number of successful searches with our method is considerably higher than with the competing methods

Signal-to-Noise Measurements on Irradiated CMS Tracker Detector Modules in an Electron Testbeam

The CMS experiment at the Large Hadron Collider at CERN is in the last phase of its construction. The harsh radiation environment at LHC will put strong demands in radiation hardness to the innermost parts of the detector. To assess the performance of irradiated microstrip detector modules, a testbeam was conducted at the Testbeam 22 facility of the DESY research center. The primary objective was the signal-to-noise measurement of irradiated CMS Tracker modules to ensure their functionality up to 10 years of LHC operation. The paper briefly summarises the basic setup at the facility and the hardware and software used to collect and analyse the data. Some interesting subsidiary results are shown, which confirm the expected behaviour of the detector with respect to the signal-to-noise performance over the active detector area and for different electron energies. The main focus of the paper are the results of the signal-to-noise measurements for CMS Tracker Modules which were exposed to different radiation doses

Structural basis for Fullerene geometry in a human endogenous retrovirus capsid

The HML2 (HERV-K) group constitutes the most recently acquired family of human endogenous retroviruses, with many proviruses less than one million years old. Many maintain intact open reading frames and provirus expression together with HML2 particle formation are observed in early stage human embryo development and are associated with pluripotency as well as inflammatory disease, cancers and HIV-1 infection. Here, we reconstruct the core structural protein (CA) of an HML2 retrovirus, assemble particles in vitro and employ single particle cryogenic electron microscopy (cryo-EM) to determine structures of four classes of CA Fullerene shell assemblies. These icosahedral and capsular assemblies reveal at high-resolution the molecular interactions that allow CA to form both pentamers and hexamers and show how invariant pentamers and structurally plastic hexamers associate to form the unique polyhedral structures found in retroviral cores

Who Watches the Watchmen? An Appraisal of Benchmarks for Multiple Sequence Alignment

Multiple sequence alignment (MSA) is a fundamental and ubiquitous technique in bioinformatics used to infer related residues among biological sequences. Thus alignment accuracy is crucial to a vast range of analyses, often in ways difficult to assess in those analyses. To compare the performance of different aligners and help detect systematic errors in alignments, a number of benchmarking strategies have been pursued. Here we present an overview of the main strategies--based on simulation, consistency, protein structure, and phylogeny--and discuss their different advantages and associated risks. We outline a set of desirable characteristics for effective benchmarking, and evaluate each strategy in light of them. We conclude that there is currently no universally applicable means of benchmarking MSA, and that developers and users of alignment tools should base their choice of benchmark depending on the context of application--with a keen awareness of the assumptions underlying each benchmarking strategy.Comment: Revie

What will the cardiovascular disease slowdown cost? Modelling the impact of CVD trends on dementia, disability, and economic costs in England and Wales from 2020-2029.

To model the health impact and economic costs of the recent slowing of the historical decline in cardiovascular disease (CVD) incidence

GUIDANCE: a web server for assessing alignment confidence scores

Evaluating the accuracy of multiple sequence alignment (MSA) is critical for virtually every comparative sequence analysis that uses an MSA as input. Here we present the GUIDANCE web-server, a user-friendly, open access tool for the identification of unreliable alignment regions. The web-server accepts as input a set of unaligned sequences. The server aligns the sequences and provides a simple graphic visualization of the confidence score of each column, residue and sequence of an alignment, using a color-coding scheme. The method is generic and the user is allowed to choose the alignment algorithm (ClustalW, MAFFT and PRANK are supported) as well as any type of molecular sequences (nucleotide, protein or codon sequences). The server implements two different algorithms for evaluating confidence scores: (i) the heads-or-tails (HoT) method, which measures alignment uncertainty due to co-optimal solutions; (ii) the GUIDANCE method, which measures the robustness of the alignment to guide-tree uncertainty. The server projects the confidence scores onto the MSA and points to columns and sequences that are unreliably aligned. These can be automatically removed in preparation for downstream analyses. GUIDANCE is freely available for use at http://guidance.tau.ac.il