Reduced healthcare utilisation following successful HCV treatment in HIV co-infected patients with mild liver disease

New direct-acting antivirals (DAA) for hepatitis C virus (HCV) infection have achieved high cure rates in many patient groups previously considered difficult-to-treat, including those HIV/HCV co-infected. The high price of these medications is likely to limit access to treatment, at least in the short term. Early treatment priority is likely to be given to those with advanced disease, but a more detailed understanding of the potential benefits in treating those with mild disease is needed. We hypothesized that successful HCV treatment within a co-infected population with mild liver disease would lead to a reduction in the use and costs of healthcare services in the 5 years following treatment completion. We performed a retrospective cohort study of HIV/HCV-co-infected patients without evidence of fibrosis/cirrhosis who received a course of HCV therapy between 2004 and 2013. Detailed analysis of healthcare utilization up to 5 years following treatment for each patient using clinical and electronic records was used to estimate healthcare costs. Sixty-three patients were investigated, of whom 48 of 63 (76.2%) achieved sustained virological response 12 weeks following completion of therapy (SVR12). Individuals achieving SVR12 incurred lower health utilization costs (£5000 per-patient) compared to (£10 775 per-patient) non-SVR patients in the 5 years after treatment. Healthcare utilization rates and costs in the immediate 5 years following treatment were significantly higher in co-infected patients with mild disease that failed to achieve SVR12. These data suggest additional value to achieving cure beyond the prevention of complications of disease

InP homojunction solar cell performance on the LIPS 3 flight experiment

Performance data for the NASA Lewis Research Center indium phosphide n+p homojunction solar cell module on the LIPS 3 Flight Experiment is presented. The objective of the experiment is to measure the performance of InP cells in the natural radiation environment of the 1100 km altitude, 60+ deg inclination orbit. Analysis of flight data indicates that the performance of the four cells throughout the first year is near expected values. No degradation in short-circuit current was seen, as was expected from radiation tolerance studies of similar cells. Details of the cell structure and flight module design are discussed. The results of the temperature dependency and radiation tolerance studies necessary for normalization and analysis of the data are included

Exploiting formyl peptide receptor 2 to promote microglial resolution: a new approach to Alzheimer's disease treatment.

Alzheimer’s disease and dementia are among the most significant current healthcare challenges given the rapidly growing elderly population, and the almost total lack of effective therapeutic interventions. Alzheimer’s disease pathology has long been considered in terms of accumulation of amyloid beta and hyperphosphorylated tau, but the importance of neuroinflammation in driving disease has taken greater precedence over the last 15–20 years. Inflammatory activation of the primary brain immune cells, the microglia, has been implicated in Alzheimer’s pathogenesis through genetic, preclinical, imaging and postmortem human studies, and strategies to regulate microglial activity may hold great promise for disease modification. Neuroinflammation is necessary for defence of the brain against pathogen invasion or damage but is normally self-limiting due to the engagement of endogenous pro-resolving circuitry that terminates inflammatory activity, a process that appears to fail in Alzheimer’s disease. Here, we discuss the potential for a major regulator and promoter of resolution, the receptor FPR2, to restrain pro-inflammatory microglial activity, and propose that it may serve as a valuable target for therapeutic investigation in Alzheimer’s disease

Allocation in Practice

How do we allocate scarcere sources? How do we fairly allocate costs? These are two pressing challenges facing society today. I discuss two recent projects at NICTA concerning resource and cost allocation. In the first, we have been working with FoodBank Local, a social startup working in collaboration with food bank charities around the world to optimise the logistics of collecting and distributing donated food. Before we can distribute this food, we must decide how to allocate it to different charities and food kitchens. This gives rise to a fair division problem with several new dimensions, rarely considered in the literature. In the second, we have been looking at cost allocation within the distribution network of a large multinational company. This also has several new dimensions rarely considered in the literature.Comment: To appear in Proc. of 37th edition of the German Conference on Artificial Intelligence (KI 2014), Springer LNC

Hybrid analytical and numerical approach for modeling fluid flow in simplified three-dimensional fracture networks

<jats:p>Modeling fluid flow in three-dimensional fracture networks is required in a wide variety of applications related to fractured rocks. Numerical approaches developed for this purpose rely on either simplified representations of the physics of the considered problem using mesh-free methods at the fracture scale or complex meshing of the studied systems resulting in considerable computational costs. Here, we derive an alternative approach that does not rely on a full meshing of the fracture network yet maintains an accurate representation of the modeled physical processes. This is done by considering simplified fracture networks in which the fractures are represented as rectangles that are divided into rectangular subfractures such that the fracture intersections are defined on the borders of these subfractures. Two-dimensional analytical solutions for the Darcy-scale flow problem are utilized at the subfracture scale and coupled at the fracture-network scale through discretization nodes located on the subfracture borders. We investigate the impact of parameters related to the location and number of the discretization nodes on the results obtained, and we compare our results with those calculated using reference solutions, which are an analytical solution for simple configurations and a standard finite-element modeling approach for complex configurations. This work represents a first step towards the development of 3D hybrid analytical and numerical approaches where the impact of the surrounding matrix will be eventually considered.</jats:p&gt

Characterizing near-surface fractured-rock aquifers: Insights provided by the numerical analysis of electrical resistivity experiments

Fractured-rock aquifers represent an important part of the groundwater that is used for domestic, agricultural, and industrial purposes. In these natural systems, the presence and properties of fractures control both the quantity and quality of water extracted, meaning that knowledge about the fractures is critical for effective water resource management. Here, we explore through numerical modeling whether electrical resistivity (ER) geophysical measurements, acquired from the Earth’s surface, may potentially be used to identify and provide information about shallow bedrock fractures. To this end, we conduct a systematic numerical modeling study whereby we evaluate the effect of a single buried fracture on ER-profiling data, examining how the corresponding anomaly changes as a function of the fracture and domain characteristics. Two standard electrode configurations, the Wenner-Schlumberger (WS) and dipole-dipole (DD) arrays, are considered in our analysis, with three different spacing factors. Depending on the considered electrode array, we find that the fracture dip angle and length will impact the resistivity anomaly curves differently, with the WS array being better adapted for distinguishing between sub-horizontal and sub-vertical fractures, but the DD array leading to larger overall anomaly magnitudes. We also find that, unsurprisingly, the magnitude of the resistivity anomaly, and thus fracture detectability, is strongly affected by the depth of overburden and its electrical resistivity, as well as the fracture aperture and contrast between the fracture and bedrock resistivities. Further research into the electrical properties of fractures, both above and below the water table, is deemed necessary