686 research outputs found
Transforming Yekaterinburg into a Safe, Resilient-Smart and Sustainable City
The initiative (since 2014) project described in this paper is a product of a joint innovative research and implementation effort of the Civil Engineering and Architecture Institute, Ural Federal University, the Science and Engineering Centre "Reliability and Safety of Large Systems and Machines", Ural Branch Russian Academy of Sciences (both Yekaterinburg), Start-up OptiCits, Barcelona, Spain and the Old Dominion University, Norfolk, VA, USA. The project is based on using the MAICS convergent technology [1] to create a versatile multi-purpose tool for optimizing the science and art of risk based governance of resilience-smart and sustainable city infrastructure and communities operating in usual and extreme conditions. The tool being developed is tailored to the needs of the City of Yekaterinburg-the capital of the Urals Region and allegedly the third most important and vibrant city of Russia. It is also being offered to the Yekaterinburg City Administration as an every-day decision-support work-tool and addendum to the Strategic Program "Yekaterinburg 2030 - a Safe City"[2] during preparation of the city for winning and conducting the World Expo-2025. Authors believe that the findings of this research would also be useful to the Sverdlovsk Oblast cities of every size and type of communities that inhabit them, including, first and foremost, Nizhny Tagil, Kamensk Uralsky, Serov, Pervouralsk, Revda, Verkhnyaya Pyshma, multiple mono-cities et al. The project also incorporates block-chain technology, smart contracts and digital currency as an effective tool for implementing the project. © 2018 Institute of Physics Publishing. All rights reserved
Graph-Controlled Insertion-Deletion Systems
In this article, we consider the operations of insertion and deletion working
in a graph-controlled manner. We show that like in the case of context-free
productions, the computational power is strictly increased when using a control
graph: computational completeness can be obtained by systems with insertion or
deletion rules involving at most two symbols in a contextual or in a
context-free manner and with the control graph having only four nodes.Comment: In Proceedings DCFS 2010, arXiv:1008.127
The impact of direct acting antivirals on hepatitis C virus disease burden and associated costs in four european countries
Background and Aims We assessed the clinical and economic impact of direct-acting antiviral (DAA) therapy for hepatitis C virus (HCV) in England, Italy, Romania and Spain.Methods An HCV progression Markov model was developed considering DAA eligibility and population data during the years 2015-2019. The period of time to recover the investment in DAAs was calculated as the cost saved by avoiding estimated clinical events for 1000 standardized treated patients. A delayed treatment scenario because of coronavirus disease (COVID-19) was also developed.Results The estimated number of avoided hepatocellular carcinoma, decompensated cirrhosis and liver transplantations over a 20-year time horizon was: 1,057 in England; 1,221 in Italy; 1,211 in Romania; and 1,103 in Spain for patients treated during 2015-2016 and 640 in England; 626 in Italy; 739 in Romania; and 643 in Spain for patients treated during 2017-2019. The cost-savings ranged from euro 45 to euro 275 million. The investment needed to expand access to DAAs in 2015-2019 is estimated to be recovered in 6.5 years in England; 5.4 years in Italy; 6.7 years in Romania; and 4.5 years in Spain. A delay in treatment because of COVID-19 will increase liver mortality in all countries.Conclusion Direct-acting antivirals have significant clinical benefits and can bring substantial cost-savings over the next 20 years, reaching a Break-even point in a short period of time. When pursuing an exit strategy from strict lockdown measures for COVID-19, providing DAAs should remain high on the list of priorities in order to maintain HCV elimination efforts
N-Terminal Pro–B-Type Natriuretic Peptide in the Emergency Department: The ICON-RELOADED Study
Background
Contemporary reconsideration of diagnostic N-terminal pro–B-type natriuretic peptide (NT-proBNP) cutoffs for diagnosis of heart failure (HF) is needed.
Objectives
This study sought to evaluate the diagnostic performance of NT-proBNP for acute HF in patients with dyspnea in the emergency department (ED) setting.
Methods
Dyspneic patients presenting to 19 EDs in North America were enrolled and had blood drawn for subsequent NT-proBNP measurement. Primary endpoints were positive predictive values of age-stratified cutoffs (450, 900, and 1,800 pg/ml) for diagnosis of acute HF and negative predictive value of the rule-out cutoff to exclude acute HF. Secondary endpoints included sensitivity, specificity, and positive (+) and negative (−) likelihood ratios (LRs) for acute HF.
Results
Of 1,461 subjects, 277 (19%) were adjudicated as having acute HF. The area under the receiver-operating characteristic curve for diagnosis of acute HF was 0.91 (95% confidence interval [CI]: 0.90 to 0.93; p < 0.001). Sensitivity for age stratified cutoffs of 450, 900, and 1,800 pg/ml was 85.7%, 79.3%, and 75.9%, respectively; specificity was 93.9%, 84.0%, and 75.0%, respectively. Positive predictive values were 53.6%, 58.4%, and 62.0%, respectively. Overall LR+ across age-dependent cutoffs was 5.99 (95% CI: 5.05 to 6.93); individual LR+ for age-dependent cutoffs was 14.08, 4.95, and 3.03, respectively. The sensitivity and negative predictive value for the rule-out cutoff of 300 pg/ml were 93.9% and 98.0%, respectively; LR− was 0.09 (95% CI: 0.05 to 0.13).
Conclusions
In acutely dyspneic patients seen in the ED setting, age-stratified NT-proBNP cutpoints may aid in the diagnosis of acute HF. An NT-proBNP <300 pg/ml strongly excludes the presence of acute HF
Differential requirements for actin during yeast and mammalian endocytosis
Key features of clathrin-mediated endocytosis have been conserved across evolution. However, endocytosis in Saccharomyces cerevisiae is completely dependent on a functional actin cytoskeleton, whereas actin appears to be less critical in mammalian cell endocytosis. We reveal that the fundamental requirement for actin in the early stages of yeast endocytosis is to provide a strong framework to support the force generation needed to direct the invaginating plasma membrane into the cell against turgor pressure. By providing osmotic support, pressure differences across the plasma membrane were removed and this reduced the requirement for actin-bundling proteins in normal endocytosis. Conversely, increased turgor pressure in specific yeast mutants correlated with a decreased rate of endocytic patch invagination
Centre selection for clinical trials and the generalisability of results: a mixed methods study.
BACKGROUND: The rationale for centre selection in randomised controlled trials (RCTs) is often unclear but may have important implications for the generalisability of trial results. The aims of this study were to evaluate the factors which currently influence centre selection in RCTs and consider how generalisability considerations inform current and optimal practice. METHODS AND FINDINGS: Mixed methods approach consisting of a systematic review and meta-summary of centre selection criteria reported in RCT protocols funded by the UK National Institute of Health Research (NIHR) initiated between January 2005-January 2012; and an online survey on the topic of current and optimal centre selection, distributed to professionals in the 48 UK Clinical Trials Units and 10 NIHR Research Design Services. The survey design was informed by the systematic review and by two focus groups conducted with trialists at the Birmingham Centre for Clinical Trials. 129 trial protocols were included in the systematic review, with a total target sample size in excess of 317,000 participants. The meta-summary identified 53 unique centre selection criteria. 78 protocols (60%) provided at least one criterion for centre selection, but only 31 (24%) protocols explicitly acknowledged generalisability. This is consistent with the survey findings (n = 70), where less than a third of participants reported generalisability as a key driver of centre selection in current practice. This contrasts with trialists' views on optimal practice, where generalisability in terms of clinical practice, population characteristics and economic results were prime considerations for 60% (n = 42), 57% (n = 40) and 46% (n = 32) of respondents, respectively. CONCLUSIONS: Centres are rarely enrolled in RCTs with an explicit view to external validity, although trialists acknowledge that incorporating generalisability in centre selection should ideally be more prominent. There is a need to operationalize 'generalisability' and incorporate it at the design stage of RCTs so that results are readily transferable to 'real world' practice
Healthcare Costs and Life-years Gained From Treatments Within the Advancing Cryptococcal Meningitis Treatment for Africa (ACTA) Trial on Cryptococcal Meningitis: A Comparison of Antifungal Induction Strategies in Sub-Saharan Africa
Background. Mortality from cryptoccocal meningitis remains high. The ACTA trial demonstrated that, compared with 2 weeks
of amphotericin B (AmB) plus flucystosine (5FC), 1 week of AmB and 5FC was associated with lower mortality and 2 weeks of oral
flucanozole (FLU) plus 5FC was non-inferior. Here, we assess the cost-effectiveness of these different treatment courses.
Methods. Participants were randomized in a ratio of 2:1:1:1:1 to 2 weeks of oral 5FC and FLU, 1 week of AmB and FLU, 1 week
of AmB and 5FC, 2 weeks of AmB and FLU, or 2 weeks of AmB and 5FC in Malawi, Zambia, Cameroon, and Tanzania. Data on individual resource use and health outcomes were collected. Cost-effectiveness was measured as incremental costs per life-year saved,
and non-parametric bootstrapping was done.
Results. Total costs per patient were US 1763 for 1 week of AmB and FLU, 2125 for 2 weeks of AmB and FLU, and 208 (95% confidence interval
$91–1210) per life-year saved
Remarcs on the shape transition from spherical to deformed gamma unstable nuclei
Energies and transition probabilities for low lying states in Ba and
^{104Ru were calculated within a hybrid model.The ground and the first
states are described alternatively as a harmonic and anharmonic vibrator states
while the remaining states as states with E(5) symmetry. One concludes that a
gradual setting of the 'critical' potential yields a better agreement with the
experimental data. Very good agreement with the data is obtained for
Ru. Comparing the present results with those of E(5) symmetry, it is
conspicuous that the present formalism add corrections to the E(5) formalism by
bringing the predictions closer to the experimental data. Analytical
relationship between the states with U(5) symmetry and those given by the E(5)
description is established.Comment: 21 pages, 3 figures, submitted for publicatio
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