An economic evaluation of rosuvastatin treatment in systolic heart failure: evidence from the CORONA trial

Aims: To estimate the cost-effectiveness of 10 mg rosuvastatin daily for older patients with systolic heart failure in the Controlled Rosuvastatin Multinational Study in Heart Failure (CORONA) trial. Methods and results: This within trial analysis of CORONA used major cardiovascular (CV) events as the outcome measure. Resource use was valued and the costs of hospitalizations, procedures, and statin use compared. Cost-effectiveness was estimated as cost per major CV event avoided. There were significantly fewer major CV events in the rosuvastatin group compared with the placebo group (1.04 vs. 1.20 per patient; difference 0.164; 95% CI: 0.075–0.254, P < 0.001). The average cost of CV hospitalizations and procedures was significantly lower for those receiving rosuvastatin (£1531 vs. £1769; difference £238; 95% CI: £73–403, P = 0.005); the additional cost of the statin resulted in significantly higher total costs for the rosuvastatin group (£1769 vs. £2072; difference £303; 95% CI: £138–468, P < 0.001). Overall, rosuvastatin was found to cost £1840 (95% CI: £562–6028) per major CV event avoided. Conclusion: This economic analysis showed that a significant reduction in major CV events with rosuvastatin led to significantly reduced costs of CV hospitalizations and procedures. The reduction in associated costs for major CV events was found to offset partially (by 44%) the cost of rosuvastatin treatment in patients with systolic heart failure

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

A Neural Spot Counter

In this paper we present an alternative approach to the problem of spot counting in interphase cell nuclei. Spot counting is a technique to detect defects of chromosomes in cells. By counting the number of spots which are labeled (read coloured) chromosomes one is able to indicate whether this cell has abberation that indicates a serious illness. We will not focus on the staining techniques used to colour the different chromosomes and how they are processed by the scanning system, but it is assumed that we have some preparated specimen. These specimen are scanned using a microscope system and resulting in computer images of the single cell nuclei (see for instance [Netten 1994]). These single cell images are used to detect and count spots. The existing dot counting system, ie. a system consisting of a microscope, CCD camera and computer to scan and process digitized images, extracts from these single cell images the number of dots. We propose a neural network to perform the counting ta..

Role of linguistic and sociocultural diversity in reading literacy achievement: a multilevel approach

This study examined how linguistic and sociocultural diversity have an impact on the reading literacy outcomes of a representative sample of 3,549 first-language (L1) and 208 second-language (L2) fourth-grade students in the Netherlands. A multilevel modelling analysis was conducted using Progress in International Reading Literacy Study 2006 data to explore to what extent linguistic background, socioeconomic status (SES), home and school literacy environment and reading attitudes explain differences in reading literacy achievement. Significant differences between L1 and L2 students were found with regard to reading literacy achievement, SES and the home and school literacy environment. Multilevel modelling analysis showed 34.7% of explained variance in reading literacy achievement, whereby the student level accounts for most of the explained variance. In the final model, linguistic background, SES, home and school literacy environment and reading attitudes were found to have a significant effect on reading literacy achievement

Nieuwe media voor facilitaire discipline : tweede editie festival voor de facilitaire film toont kansen

De Academie voor Facility Management aan de Haagse Hogeschool streeft naar excellent onderwijs. Onderdeel hiervan is een permanente vernieuwing van inhoud en vorm van het curriculum. Een voorbeeld van die vernieuwing is het 'Festival voor de Facilitaire film'; een opdracht waarbij studenten de resultaten van een facilitair onderzoek weergeven in een zelfgemaakte filmdocumentaire. Die documentaires worden tijdens een slotmanifestatie op De Haagse Hogeschool vertoond

A Neural Network Applied to Spot Counting

Neural networks have been reported to be succesful in all kinds of pattern recognition and image processing applications. In this paper a neural network is proposed to solve the problem of spot counting in bio-imaging. Currently we have a microscope system coupled to a computer which performs the image acquisition and classification task. Neural networks offer a flexibility which might be used to boost the performance of the current system's performance. Experiments with real-life data show that, although the network performs slightly worse, a neural approach to spot couning might be beneficial. 1 Introduction In this paper an alternative approach to the problem of spot counting in interphase cell nuclei is presented. Spot counting is a technique to detect numerical chromosome abnormalities. By counting the number of spots which are labeled (read: coloured) chromosomes, one is able to indicate whether the cell has an abberation that indicates a serious illness. The staining techniques..

The dangers of urban decline and the role of facility management in reducing associated safety and health risks

Background and aim – This paper studies urban decline, the process in which the built environment suddenly or gradually loses its practical, technical and economic functionality, resulting in it being abandoned by its legitimate occupants and neglected by its owners for an extended period of time. Recent European examples of urban decline from around the globe as well as five German examples were studied. This is followed by a reflection on the risks for public safety and public health that these examples show and the possible role of facility managers in diminishing these risks. Methods / Methodology – Data were collected by means of desk research and direct observations Results – At all locations public safety and public health risks were considerable. Direct observations at five German locations show extensive urban decline. Originality –Identifying safety and health risks in abandoned buildings and connecting these issues to the facility management profession offers a new perspective on dealing with urban decay. Practical or social implications – Abandoned buildings that are easily accessible to the public generate considerable risks for public safety and health. This paper calls for a debate about how to deal with these risks. Part of the debate should be whether or not such situations should be allowed to continue. Moreover, this paper suggests a prominent role for the facility management profession in order to deal with these safety and health issues. Type of paper – Research paper