83 research outputs found
Statistical Laws in Urban Mobility from microscopic GPS data in the area of Florence
The application of Statistical Physics to social systems is mainly related to
the search for macroscopic laws, that can be derived from experimental data
averaged in time or space,assuming the system in a steady state. One of the
major goals would be to find a connection between the statistical laws to the
microscopic properties: for example to understand the nature of the microscopic
interactions or to point out the existence of interaction networks. The
probability theory suggests the existence of few classes of stationary
distributions in the thermodynamics limit, so that the question is if a
statistical physics approach could be able to enroll the complex nature of the
social systems. We have analyzed a large GPS data base for single vehicle
mobility in the Florence urban area, obtaining statistical laws for path
lengths, for activity downtimes and for activity degrees. We show also that
simple generic assumptions on the microscopic behavior could explain the
existence of stationary macroscopic laws, with an universal function describing
the distribution. Our conclusion is that understanding the system complexity
requires dynamical data-base for the microscopic evolution, that allow to solve
both small space and time scales in order to study the transients.Comment: 17 pages, 14 figures .jpg, use imsart.cl
Venice As Pedestrian City And Tourist Magnet Mass Events And Ordinary Life
In Venice the famous network of pedestrian foot-ways deserves attention and research since has to face very often mass events. Even the ordinary mobility has peculiar needs. The efficiency of main road and rail transportation infrastructures and of the principal hub of modal interchange, relays on the service quality of the pedestrian infrastructure in the old city. This is matter for an original investigation.En Venecia, la famosa red de vÃas peatonales merece atención y análisis ya que se enfrenta muy frecuentemente a eventos masificados. Incluso la movilidad ordinaria cuenta con necesidades particulares. La eficiencia de la carretera principal, las infraestructuras ferroviarias, y el hub principal de intercambio modal, depende de la calidad del servicio de la infraestructura peatonal de la antigua ciudad. Este es el tema de una original investigación. Â
Venice as pedestrian city and tourist magnet: mass events and ordinary life
In Venice the famous network of pedestrian foot-ways deserves attention and research since has to face very often mass events. Even the ordinary mobility has peculiar needs. The efficiency of main road and rail
transportation infrastructures and of the principal hub of modal interchange, relays on the service quality of the pedestrian infrastructure in the old city. This is matter for an original investigation.Peer Reviewe
Enhanced performance of longitudinally post-tensioned long-span LVL beams
The scope of this paper is to highlight the advantages of using longitudinally post-tensioning for long-span timber beams compared to traditional glulam or LVL solutions. The analysis is limited to serviceability limit states for gravity loads. An analtycal iterative procedure which takes into account tendon elongation within beam deflecting has been implemented and validated through experimental tests carried out at the University of Canterbury.In particular, two different static configurations have been studied and different tendon profile configurations (straight and draped) internal and external to the beam section have been investigated and compared with traditional solid timber beams.
The experimental results confirm the enhanced performance in terms of deflections at serviceability limit state of the longitudinally post-tensioned solutions with respect to traditional timber beams, especially if external draped tendons are adopted
Liver function following hepatitis C virus eradication by direct acting antivirals in patients with liver cirrhosis: data from the PITER cohort
Background: The development of direct-acting antivirals (DAA) for HCV has revolutionized the treatment of HCV, including its treatment in patients with HIV coinfection. The aim of this study was to compare the changes in liver function between coinfected and monoinfected patients with cirrhosis who achieved HCV eradication by DAA. Methods: Patients with pre-treatment diagnosis of HCV liver cirrhosis, consecutively enrolled in the multicenter PITER cohort, who achieved a sustained virological response 12 weeks after treatment cessation (SVR12) were analysed. Changes in Child-Pugh (C-P) class and the occurrence of a decompensating event was prospectively evaluated after the end of DAA treatment. Cox regression analysis was used to evaluate factors independently associated with changes in liver function following viral eradication. Results: We evaluated 1350 patients, of whom 1242 HCV monoinfected (median follow-up 24.7, range 6.8–47.5 months after viral eradication) and 108 (8%) HCV/HIV coinfected (median follow-up 27.1, range 6.0–44.6). After adjusting for age, sex, HCV-genotype, HBsAg positivity and alcohol use, HIV was independently associated with a more advanced liver disease before treatment (C-P class B/C vs A) (OR: 3.73, 95% CI:2.00–6.98). Following HCV eradication, C-P class improved in 17/20 (85%) coinfected patients (from B to A and from C to B) and in 53/82 (64.6%) monoinfected patients (from B to A) (p = 0.08). C-P class worsened in 3/56 coinfected (5.3%) (from A to B) and in 84/1024 (8.2%) monoinfected patients (p = 0.45) (from A to B or C and from B to C). Baseline factors independently associated with C-P class worsening were male sex (HR = 2.00; 95% CI = 1.18–3.36), platelet count < 100,000/μl (HR = 1.75; 95% CI 1.08–2.85) and increased INR (HR = 2.41; 95% CI 1.51–3.84). Following viral eradication, in 7 of 15 coinfected (46.6%) and in 61 of 133 (45.8%) monoinfected patients with previous history of decompensation, a new decompensating event occurred. A first decompensating event was recorded in 4 of 93 (4.3%) coinfected and in 53 of 1109 (4.8%) monoinfected patients (p = 0.83). Conclusions: Improvement of liver function was observed following HCV eradication in the majority of patients with cirrhosis; however viral eradication did not always mean cure of liver disease in both monoinfected and coinfected patients with advanced liver disease
Liver function following hepatitis C virus eradication by direct acting antivirals in patients with liver cirrhosis: data from the PITER cohort
Background: The development of direct-acting antivirals (DAA) for HCV has revolutionized the treatment of HCV, including its treatment in patients with HIV coinfection. The aim of this study was to compare the changes in liver function between coinfected and monoinfected patients with cirrhosis who achieved HCV eradication by DAA. Methods: Patients with pre-treatment diagnosis of HCV liver cirrhosis, consecutively enrolled in the multicenter PITER cohort, who achieved a sustained virological response 12 weeks after treatment cessation (SVR12) were analysed. Changes in Child-Pugh (C-P) class and the occurrence of a decompensating event was prospectively evaluated after the end of DAA treatment. Cox regression analysis was used to evaluate factors independently associated with changes in liver function following viral eradication. Results: We evaluated 1350 patients, of whom 1242 HCV monoinfected (median follow-up 24.7, range 6.8–47.5 months after viral eradication) and 108 (8%) HCV/HIV coinfected (median follow-up 27.1, range 6.0–44.6). After adjusting for age, sex, HCV-genotype, HBsAg positivity and alcohol use, HIV was independently associated with a more advanced liver disease before treatment (C-P class B/C vs A) (OR: 3.73, 95% CI:2.00–6.98). Following HCV eradication, C-P class improved in 17/20 (85%) coinfected patients (from B to A and from C to B) and in 53/82 (64.6%) monoinfected patients (from B to A) (p = 0.08). C-P class worsened in 3/56 coinfected (5.3%) (from A to B) and in 84/1024 (8.2%) monoinfected patients (p = 0.45) (from A to B or C and from B to C). Baseline factors independently associated with C-P class worsening were male sex (HR = 2.00; 95% CI = 1.18–3.36), platelet count < 100,000/μl (HR = 1.75; 95% CI 1.08–2.85) and increased INR (HR = 2.41; 95% CI 1.51–3.84). Following viral eradication, in 7 of 15 coinfected (46.6%) and in 61 of 133 (45.8%) monoinfected patients with previous history of decompensation, a new decompensating event occurred. A first decompensating event was recorded in 4 of 93 (4.3%) coinfected and in 53 of 1109 (4.8%) monoinfected patients (p = 0.83). Conclusions: Improvement of liver function was observed following HCV eradication in the majority of patients with cirrhosis; however viral eradication did not always mean cure of liver disease in both monoinfected and coinfected patients with advanced liver disease
Clinical features and comorbidity pattern of HCV infected migrants compared to native patients in care in Italy: A real-life evaluation of the PITER cohort
Background: Direct-acting antivirals are highly effective for the treatment of hepatitis C virus (HCV) infection, regardless race/ethnicity. We aimed to evaluate demographic, virological and clinical data of HCV-infected migrants vs. natives consecutively enrolled in the PITER cohort. Methods: Migrants were defined by country of birth and nationality that was different from Italy. Mann-Whitney U test, Chi-squared test and multiple logistic regression were used. Results: Of 10,669 enrolled patients, 301 (2.8%) were migrants: median age 47 vs. 62 years, (p < 0.001), females 56.5% vs. 45.3%, (p < 0.001), HBsAg positivity 3.8% vs. 1.4%, (p < 0.05). Genotype 1b was prevalent in both groups, whereas genotype 4 was more prevalent in migrants (p < 0.05). Liver disease severity and sustained virologic response (SVR) were similar. A higher prevalence of comorbidities was reported for natives compared to migrants (p < 0.05). Liver disease progression cofactors (HBsAg, HIV coinfection, alcohol abuse, potential metabolic syndrome) were present in 39.1% and 47.1% (p > 0.05) of migrants and natives who eradicated HCV, respectively. Conclusion: Compared to natives, HCV-infected migrants in care have different demographics, HCV genotypes, viral coinfections and comorbidities and similar disease severity, SVR and cofactors for disease progression after HCV eradication. A periodic clinical assessment after HCV eradication in Italians and migrants with cofactors for disease progression is warranted
Economic consequences of investing in anti-HCV antiviral treatment from the Italian NHS perspective : a real-world-based analysis of PITER data
OBJECTIVE:
We estimated the cost consequence of Italian National Health System (NHS) investment in direct-acting antiviral (DAA) therapy according to hepatitis C virus (HCV) treatment access policies in Italy.
METHODS:
A multistate, 20-year time horizon Markov model of HCV liver disease progression was developed. Fibrosis stage, age and genotype distributions were derived from the Italian Platform for the Study of Viral Hepatitis Therapies (PITER) cohort. The treatment efficacy, disease progression probabilities and direct costs in each health state were obtained from the literature. The break-even point in time (BPT) was defined as the period of time required for the cumulative costs saved to recover the Italian NHS investment in DAA treatment. Three different PITER enrolment periods, which covered the full DAA access evolution in Italy, were considered.
RESULTS:
The disease stages of 2657 patients who consecutively underwent DAA therapy from January 2015 to December 2017 at 30 PITER clinical centres were standardized for 1000 patients. The investment in DAAs was considered to equal €25 million, €15 million, and €9 million in 2015, 2016, and 2017, respectively. For patients treated in 2015, the BPT was not achieved, because of the disease severity of the treated patients and high DAA prices. For 2016 and 2017, the estimated BPTs were 6.6 and 6.2 years, respectively. The total cost savings after 20 years were €50.13 and €55.50 million for 1000 patients treated in 2016 and 2017, respectively.
CONCLUSIONS:
This study may be a useful tool for public decision makers to understand how HCV clinical and epidemiological profiles influence the economic burden of HCV
L'Italia come modello per l'Europa e per il mondo nelle politiche sanitarie per il trattamento dell'epatite cronica da HCV
The World Health Organization foresees the
elimination of HCV infection by 2030. In light of this and the curre
nt, nearly worldwide, restriction in direct-acting agents
(DAA) accessibility due to their high price, we aimed to evaluate
the cost-effectiveness of two alternative DAA treatment
policies: Policy 1 (universal): treat all patients, regardless of the fibrosis stage; Policy 2 (prioritized): treat only priori
tized
patients and delay treatment of the
remaining patients until reaching stage F3. T
he model was based on patient’s data
from the PITER cohort. We demonstrated that extending HC
V treatment of patients in any fibrosis stage improves health
outcomes and is cost-effective
- …