1,031 research outputs found
Health Reform: The Cost of Failure
Estimates the intermediate and long-term implications of not enacting healthcare reform. Simulates the effects on employer-sponsored insurance, private non-group coverage, and Medicaid and State Children's Health Insurance Programs under three scenarios
Scalable Tuning of Building Models to Hourly Data
Energy models of existing buildings are unreliable unless calibrated so that they correlate well with actual energy usage. Manual tuning requires a skilled professional and is prohibitively expensive for small projects, imperfect, nonrepeatable, and not scalable to the dozens of sensor channels that smart meters, smart appliances, and sensors are making available. A scalable, automated methodology is needed to quickly, intelligently calibrate building energy models to all available data, increase the usefulness of those models, and facilitate speed-and-scale penetration of simulation-based capabilities into the marketplace for actualized energy savings. The Autotune project is a novel, model-agnostic methodology that leverages supercomputing, large simulation ensembles, and big data mining with multiple machine learning algorithms to allow automatic calibration of simulations that match measured experimental data in a way that is deployable on commodity hardware. This paper shares several methodologies employed to reduce the combinatorial complexity to a computationally tractable search problem for hundreds of input parameters. Accuracy metrics are provided that quantify model error to measured data for either monthly or hourly electrical usage from a highly instrumented, emulated-occupancy research home
The Coverage and Cost Impacts of Expanding Medicaid
Estimates the drop in the number of uninsured and the rise in government costs from not limiting Medicaid eligibility for adults to the disabled and those with dependent children but basing it on income level, under two scenarios. Discusses implications
Treatment of Headache in Aneurysmal Subarachnoid Hemorrhage: Multimodal Approach
Sudden severe headache is a cardinal symptom and the most common complaint amongst patients presenting with aneurysmal subarachnoid hemorrhage. The multifactorial etiology of these headaches makes pharmacotherapy problematic. Current aneurysmal subarachnoid hemorrhage guidelines have limited or no recommendations for headache treatment. Our institution utilizes a multimodal pharmacotherapy protocol in the management of aneurysmal subarachnoid hemorrhage headache. The purpose of this study was to evaluate the efficacy of the current aneurysmal subarachnoid hemorrhage headache treatment approach at our institution. This was a retrospective cohort study of patients presenting with aneurysmal subarachnoid hemorrhage. A multimodal aneurysmal subarachnoid hemorrhage headache treatment protocol was implemented in February 2014. After an eight-month washout period, patients treated between September 2014 and November 2017 represented the study cohort. Data collected included severity of aneurysmal subarachnoid hemorrhage and headache, interventions to secure the aneurysm, pain score response related to specific analgesic administered, and discharge status. Multivariate analysis and linear regression were used to identify predictors of treatment efficacy. A total of 249 patients were identified in the study cohort. The majority of patients were female (61.4%) with a median age of 54 years (±12.5), median Hunt and Hess score of 2 (interquartile range 2–3), and mean length of hospitalization of 15.2 days. Magnesium infusion had the largest reduction in mean pain score compared to baseline pain score (−0.75; p = 0.0002). In this retrospective cohort study involving patients presenting with headache secondary to aneurysmal subarachnoid hemorrhage, no agent resulted in a clinically significant improvement on headache pain scores
Gew gaws, baubles, frivolous objects, and trinkets: Adam Smith (and Cugoano) on Slavery
Adam Smith sought to explain the persistence of slavery as an institution in Wealth of Nations and Lectures on Jurispridence. In order to accomplish this he also drew on arguments he had developed in the Theory of Moral Sentiments. The result was a sophisticated explanation which bridged economic, psychological, and moral considerations. After presenting Smith’s explanation I will consider a discussion of the moral wrong of slavery in Ottobah Cugoano, the author of the incisive criticism of the slave trade Thoughts and Sentiments on the Evil of Slavery (1787). I will suggest that Cugoano’s account of what is morally wrong in slavery shows an important lacuna in Smith‘s views
Semi-autonomous exploration of multi-floor buildings with a legged robot
This paper presents preliminary results of a semi-autonomous building exploration behavior using the hexapedal robot RHex. Stairwells are used in virtually all multi-floor buildings, and so in order for a mobile robot to effectively explore, map, clear, monitor, or patrol such buildings it must be able to ascend and descend stairwells. However most conventional mobile robots based on a wheeled platform are unable to traverse stairwells, motivating use of the more mobile legged machine. This semi-autonomous behavior uses a human driver to provide steering input to the robot, as would be the case in, e.g., a tele-operated building exploration mission. The gait selection and transitions between the walking and stair climbing gaits are entirely autonomous. This implementation uses an RGBD camera for stair acquisition, which offers several advantages over a previously documented detector based on a laser range finder, including significantly reduced acquisition time. The sensor package used here also allows for considerable expansion of this behavior. For example, complete automation of the building exploration task driven by a mapping algorithm and higher level planner is presently under development.
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APOBEC-related mutagenesis and neo-peptide hydrophobicity: implications for response to immunotherapy.
Tumor-associated neo-antigens are mutated peptides that allow the immune system to recognize the affected cell as foreign. Cells carrying excessive mutation load often develop mechanisms of tolerance. PD-L1/PD-1 checkpoint immunotherapy is a highly promising approach to overcome these protective signals and induce tumor shrinkage. Yet, the nature of the neo-antigens driving those beneficial responses remains unclear. Here, we show that APOBEC-related mutagenesis - a mechanism at the crossroads between anti-viral immunity and endogenous nucleic acid editing - increases neo-peptide hydrophobicity (a feature of immunogenicity), as demonstrated by in silico computation and in the TCGA pan-cancer cohort, where APOBEC-related mutagenesis was also strongly associated with immune marker expression. Moreover, APOBEC-related mutagenesis correlated with immunotherapy response in a cohort of 99 patients with diverse cancers, and this correlation was independent of the tumor mutation burden (TMB). Combining APOBEC-related mutagenesis estimate and TMB resulted in greater predictive ability than either parameter alone. Based on these results, further investigation of APOBEC-related mutagenesis as a marker of response to anti-cancer checkpoint blockade is warranted
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