Sticky Particles and Stochastic Flows

Gaw\c{e}dzki and Horvai have studied a model for the motion of particles carried in a turbulent fluid and shown that in a limiting regime with low levels of viscosity and molecular diffusivity, pairs of particles exhibit the phenomena of stickiness when they meet. In this paper we characterise the motion of an arbitrary number of particles in a simplified version of their model

Retrospective Database Analysis Evaluating the Clinical Outcomes of Changing Treatment of People with Type 2 Diabetes Mellitus (T2DM) from Other DPP-4 Inhibitor Therapy to Alogliptin in a Primary Care Setting

This is the final version. Available on open access from Springer via the DOI in this recordIntroduction: Although some differences between individual dipeptidyl peptidase-4 (DPP-4) inhibitors may exist, the National Institute for Health and Clinical Excellence (NICE) have recommended that ‘prescribers should be encouraged to select the individual DPP-4 inhibitor with the lowest acquisition cost available to them, where all other factors are equal’. We aimed to determine whether or not ‘within class’ switching to alogliptin, the DPP-4 inhibitor with lowest acquisition cost, is a clinically appropriate strategy. Methods: This study evaluated people with type 2 diabetes taking DPP-4 inhibitor therapy in addition to at least one other diabetes therapy. Primary care records were reviewed from six clinical commissioning groups (CCGs). For people who had been switched from other DPP-4 inhibitors to alogliptin, an assessment of the impact of switch on both absolute haemoglobin A1c (HbA1c) levels and on HbA1c trajectory was undertaken. Persistence on alogliptin and the need for therapy intensification was also assessed. Results: Overall, 865 people with diabetes met the eligibility criteria for the study. There was no significant difference between pre- and post-switch mean HbA1c level [8.44% (SD 1.52%) vs 8.42% (1.62%), p = 0.6]. Similarly, for patients where there was sufficient data to assess the impact of switching on HbA1c trajectory (n = 319) minimal impact was identified (actual HbA1c at 3 months 8.33% vs projected 8.31%). The majority of people with diabetes (80.76%) remained on alogliptin treatment at 6 months and only 4.54% required additional diabetes therapies. Switching to alogliptin resulted in a median saving of £7.24 per patient-month. Conclusion: Switching United Kingdom (UK) primary care patients from other DPP-4 inhibitors to alogliptin did not result in a statistically significant or clinically meaningful change in HbA1c level and few required the addition of further diabetes therapies, suggesting that therapy change or intensification was not considered necessary in most patients who were switched to alogliptin. Trial Registration: ENCePP clinical trial registration number EUPAS29153. Funding: Takeda UK Ltd.National Institute for Health Research (NIHR

A Detailed Hydro-Economic Model for Assessing the Effects of Surface Water and Groundwater Policies: A Demonstration Model from Brazil

Policymakers, managers of water use associations, and many others in developing countries are considering policy actions that will directly or indirectly change the costs and availability of groundwater and surface water for agricultural users. While in many cases such actions may bring about welcomed increases in water use efficiency, little is known about the likely effects of changes in irrigation costs or water access on farmer behavior, or on farmer incomes in the short or long runs, and virtually nothing is known about the detailed immediate or knock-on effects on water resources that such policy actions might cause. This paper reports the preliminary results of research aiming to fill these large scientific gaps by developing a detailed hydrologic model and a detailed economic model of agriculture in the context of the Buriti Vermelho (BV) sub-catchment area of the São Francisco River Basin in Brazil. A spatially explicit, farm-level, positive mathematical programming model capable of accommodating a broad array of farm sizes and farm/farmer characteristics is being developed to predict the effects of alternative water policies and neighbors water use patterns on agricultural production. Special attention is given to precisely defining and estimating the distinct variable costs (including labor and electrical energy costs) and capital costs of surface water and groundwater, which are considered perfect substitutes for irrigation. Shadow values for non-marketed inputs (land, family labor, and water) are estimated in the first step of the modeling process. A high-resolution, spatially distributed hydrologic model (MOD-HMS) is being developed to simulate three-dimensional, variably-saturated subsurface flow and solute transport. Subsurface flow is simulated using the three-dimensional Richards equation while accounting for a) application of water at the surface, b) precipitation, c) soil evaporation and crop transpiration, and d) agricultural pumping. Demonstration versions of both models are presented and tested: the economic model assesses the effects of increasing water scarcity on cultivated area, crop mix, input mix and farm profits; the hydrologic model uses two irrigation water use scenarios to demonstrate the effects of each on surface water flows and storage, and on groundwater storage and well depth. The models are not currently linked, but a detailed plan to do so is presented and discussed. The paper concludes by discussing next steps in research and policy simulations.Resource /Energy Economics and Policy,

The effects of entry on incumbent innovation and productivity

How does firm entry affect innovation incentives in incumbent firms? Microdata suggest that there is heterogeneity across industries. Specifically, incumbent productivity growth and patenting is positively correlated with lagged greenfield foreign firm entry in technologically advanced industries, but not in laggard industries. In this paper we provide evidence that these correlations arise from a causal effect predicted by Schumpeterian growth theory—the threat of technologically advanced entry spurs innovation incentives in sectors close to the technology frontier, where successful innovation allows incumbents to survive the threat, but discourages innovation in laggard sectors, where the threat reduces incumbents' expected rents from innovating. We find that the empirical patterns hold using rich micro panel data for the United Kingdom. We control for the endogeneity of entry by exploiting major European and U.K. policy reforms, and allow for endogeneity of additional factors. We complement the analysis for foreign entry with evidence for domestic entry and entry through imports

A Novel Patient-Specific Model for Predicting Severe Oliguria; Development and Comparison With Kidney Disease: Improving Global Outcomes Acute Kidney Injury Classification

Objectives: The Kidney Disease: Improving Global Outcomes urine output criteria for acute kidney injury lack specificity for identifying patients at risk of adverse renal outcomes. The objective was to develop a model that analyses hourly urine output values in real time to identify those at risk of developing severe oliguria. Design: This was a retrospective cohort study utilizing prospectively collected data. Setting: A cardiac ICU in the United Kingdom. Patients: Patients undergoing cardiac surgery between January 2013 and November 2017. Interventions: None. Measurement and Main Results: Patients were randomly assigned to development (n = 981) and validation (n = 2,389) datasets. A patient-specific, dynamic Bayesian model was developed to predict future urine output on an hourly basis. Model discrimination and calibration for predicting severe oliguria ( 0.8) were identified and their outcomes were compared with those for low-risk patients and for patients who met the Kidney Disease: Improving Global Outcomes urine output criterion for acute kidney injury. Model discrimination was excellent at all time points (area under the curve > 0.9 for all). Calibration of the model’s predictions was also excellent. After adjustment using multivariable logistic regression, patients in the high-risk group were more likely to require renal replacement therapy (odds ratio, 10.4; 95% CI, 5.9–18.1), suffer prolonged hospital stay (odds ratio, 4.4; 95% CI, 3.0–6.4), and die in hospital (odds ratio, 6.4; 95% CI, 2.8–14.0) (p < 0.001 for all). Outcomes for those identified as high risk by the model were significantly worse than for patients who met the Kidney Disease: Improving Global Outcomes urine output criterion. Conclusions: This novel, patient-specific model identifies patients at increased risk of severe oliguria. Classification according to model predictions outperformed the Kidney Disease: Improving Global Outcomes urine output criterion. As the new model identifies patients at risk before severe oliguria develops it could potentially facilitate intervention to improve patient outcomes

Contextual factors among indiscriminate or larger attacks on food or water supplies, 1946-2015

This research updates previous inventories of malicious attacks on food and water to include data from 1946 through mid-2015. A systematic search of news reports, databases and previous inventories of poisoning events was undertaken. Incidents that threatened or were intended to achieve direct harm to humans, and that were either relatively large (number of victims > 4 or indiscriminate in intent or realisation were included. Agents could be chemical, biological or radio-nuclear. Reports of candidate incidents were subjected to systematic inclusion and exclusion criteria as well as validity analysis (not always clearly undertaken in previous inventories of such attacks). We summarise contextual aspects of the attacks that may be important for scenario prioritisation, modelling and defensive preparedness. Opportunity is key to most realised attacks, particularly access to dangerous agents. The most common motives and relative success rate in causing harm were very different between food and water attacks. The likelihood that people were made ill or died also varied by food/water mode, and according to motive and opportunity for delivery of the hazardous agent. Deaths and illness associated with attacks during food manufacture and prior to sale have been fewer than those in some other contexts. Valuable opportunities for food defence improvements are identified in other contexts, especially food prepared in private or community settings