531 research outputs found

    Vector continued fraction algorithms.

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    We consider the construction of rational approximations to given power series whose coefficients are vectors. The approximants are in the form of vector-valued continued fractions which may be used to obtain vector Padeapproximants using recurrence relations. Algorithms for the determination of the vector elements of these fractions have been established using Clifford algebras. We devise new algorithms based on these which involve operations on vectors and scalars only β€” a desirable characteristic for computations involving vectors of large dimension. As a consequence, we are able to form new expressions for the numerator and denominator polynomials of these approximants as products of vectors, thus retaining their Clifford nature

    Genetic Diversity and Antimicrobial Resistance of Escherichia coli from Human and Animal Sources Uncovers Multiple Resistances from Human Sources

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    Escherichia coli are widely used as indicators of fecal contamination, and in some cases to identify host sources of fecal contamination in surface water. Prevalence, genetic diversity and antimicrobial susceptibility were determined for 600 generic E. coli isolates obtained from surface water and sediment from creeks and channels along the middle Santa Ana River (MSAR) watershed of southern California, USA, after a 12 month study. Evaluation of E. coli populations along the creeks and channels showed that E. coli were more prevalent in sediment compared to surface water. E. coli populations were not significantly different (Pβ€Š=β€Š0.05) between urban runoff sources and agricultural sources, however, E. coli genotypes determined by pulsed-field gel electrophoresis (PFGE) were less diverse in the agricultural sources than in urban runoff sources. PFGE also showed that E. coli populations in surface water were more diverse than in the sediment, suggesting isolates in sediment may be dominated by clonal populations.Twenty four percent (144 isolates) of the 600 isolates exhibited resistance to more than one antimicrobial agent. Most multiple resistances were associated with inputs from urban runoff and involved the antimicrobials rifampicin, tetracycline, and erythromycin. The occurrence of a greater number of E. coli with multiple antibiotic resistances from urban runoff sources than agricultural sources in this watershed provides useful evidence in planning strategies for water quality management and public health protection

    What Can a Pilot Congestive Heart Failure Disease Management Program Tell Us about Likely Return on Investment?: A Case Study from a Program Offered to Federal Employees

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    In 1999, the Blue Cross and Blue Shield Federal Employee Program (FEP) implemented a pilot disease management program to manage congestive heart failure (CHF) among members. The purpose of this project was to estimate the financial return on investment in the pilot CHF program, prior to a full program rollout. A cohort of 457 participants from the state of Maryland was matched to a cohort of 803 nonparticipants from a neighboring state where the CHF program was not offered. Each cohort was followed for 12 months before the program began and 12 months afterward. The outcome measures of primary interest were the differences over time in medical care expenditures paid by FEP and by all payers. Independent variables included indicators of program participation, type of heart disease, comorbidity measures, and demographics. From the perspective of the funding organization (FEP), the estimated return on investment for the pilot CHF disease management program was a savings of 1.08inmedicalexpenditureforeverydollarspentontheprogram.Addingsavingstootherpayersaswell,thereturnoninvestmentwasasavingsof1.08 in medical expenditure for every dollar spent on the program. Adding savings to other payers as well, the return on investment was a savings of 1.15 in medical expenditures per dollar spent on the program. The amount of savings depended upon CHF risk levels. The value of a pilot initiative and evaluation is that lessons for larger-scale efforts can be learned prior to full-scale rollout. (Disease Management 2005;8:346-360)Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63402/1/dis.2005.8.346.pd

    Towards a Social Trust-Aware Recommender for Teachers

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    Fazeli, S., Drachsler, H., Brouns, F., & Sloep, P. B. (2014). Towards a Social Trust-aware Recommender for Teachers. In N. Manouselis, H. Drachsler, K. Verbert & O. C. Santos (Eds.), Recommender Systems for Technology Enhanced Learning (pp. 177-194): Springer New York.Online communities and networked learning provide teachers with social learning opportunities, allowing them to interact and collaborate with others in order to develop their personal and professional skills. However, with the large number of learning resources produced everyday, teachers need to find out what are the most suitable ones for them. In this paper, we introduce recommender systems as a potential solution to this . The setting is the Open Discovery Space (ODS) project. Unfortunately, due to the sparsity of the educational datasets most educational recommender systems cannot make accurate recommendations. To overcome this problem, we propose to enhance a trust-based recommender algorithm with social data obtained from monitoring the activities of teachers within the ODS platform. In this article, we outline the re-quirements of the ODS recommender system based on experiences reported in related TEL recommender system studies. In addition, we provide empirical ev-idence from a survey study with stakeholders of the ODS project to support the requirements identified from a literature study. Finally, we present an agenda for further research intended to find out which recommender system should ul-timately be deployed in the ODS platform.NELLL, EU 7th framework Open Discovery Spac

    Platypus globin genes and flanking loci suggest a new insertional model for beta-globin evolution in birds and mammals

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    Background: Vertebrate alpha (Ξ±)- and beta (Ξ²)-globin gene families exemplify the way in which genomes evolve to produce functional complexity. From tandem duplication of a single globin locus, the Ξ±- and Ξ²-globin clusters expanded, and then were separated onto different chromosomes. The previous finding of a fossil Ξ²-globin gene (Ο‰) in the marsupial Ξ±-cluster, however, suggested that duplication of the Ξ±-Ξ² cluster onto two chromosomes, followed by lineage-specific gene loss and duplication, produced paralogous Ξ±- and Ξ²-globin clusters in birds and mammals. Here we analyse genomic data from an egg-laying monotreme mammal, the platypus (Ornithorhynchus anatinus), to explore haemoglobin evolution at the stem of the mammalian radiation. Results: The platypus Ξ±-globin cluster (chromosome 21) contains embryonic and adult Ξ±- globin genes, a Ξ²-like Ο‰-globin gene, and the GBY globin gene with homology to cytoglobin, arranged as 5'-ΞΆ-ΞΆ'-Ξ±D-Ξ±3-Ξ±2-Ξ±1-Ο‰-GBY-3'. The platypus Ξ²-globin cluster (chromosome 2) contains single embryonic and adult globin genes arranged as 5'-Ξ΅-Ξ²-3'. Surprisingly, all of these globin genes were expressed in some adult tissues. Comparison of flanking sequences revealed that all jawed vertebrate Ξ±-globin clusters are flanked by MPG-C16orf35 and LUC7L, whereas all bird and mammal Ξ²-globin clusters are embedded in olfactory genes. Thus, the mammalian Ξ±- and Ξ²-globin clusters are orthologous to the bird Ξ±- and Ξ²-globin clusters respectively. Conclusion: We propose that Ξ±- and Ξ²-globin clusters evolved from an ancient MPG-C16orf35-Ξ±-Ξ²-GBY-LUC7L arrangement 410 million years ago. A copy of the original Ξ² (represented by Ο‰ in marsupials and monotremes) was inserted into an array of olfactory genes before the amniote radiation (>315 million years ago), then duplicated and diverged to form orthologous clusters of Ξ²-globin genes with different expression profiles in different lineages.Vidushi S. Patel, Steven J.B. Cooper, Janine E. Deakin, Bob Fulton, Tina Graves, Wesley C. Warren, Richard K. Wilson and Jennifer A.M. Grave

    Quantifying Cost-Effectiveness of Controlling Nosocomial Spread of Antibiotic-Resistant Bacteria: The Case of MRSA

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    BACKGROUND: The costs and benefits of controlling nosocomial spread of antibiotic-resistant bacteria are unknown. METHODS: We developed a mathematical algorithm to determine cost-effectiveness of infection control programs and explored the dynamical interactions between different epidemiological variables and cost-effectiveness. The algorithm includes occurrence of nosocomial infections, attributable mortality, costs and efficacy of infection control and how antibiotic-resistant bacteria affect total number of infections: do infections with antibiotic-resistant bacteria replace infections caused by susceptible bacteria (replacement scenario) or occur in addition to them (addition scenario). Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia was used for illustration using observational data on S. aureus bacteremia (SAB) in our hospital (n = 189 between 2001-2004, all being methicillin-susceptible S. aureus [MSSA]). RESULTS: In the replacement scenario, the costs per life year gained range from 45,912 euros to 6590 euros for attributable mortality rates ranging from 10% to 50%. Using 20,000 euros per life year gained as a threshold, completely preventing MRSA would be cost-effective in the replacement scenario if attributable mortality of MRSA is > or = 21%. In the addition scenario, infection control would be cost saving along the entire range of estimates for attributable mortality. CONCLUSIONS: Cost-effectiveness of controlling antibiotic-resistant bacteria is highly sensitive to the interaction between infections caused by resistant and susceptible bacteria (addition or replacement) and attributable mortality. In our setting, controlling MRSA would be cost saving for the addition scenario but would not be cost-effective in the replacement scenario if attributable mortality would be < 21%

    Cost-minimization analysis in a blind randomized trial on small-incision versus laparoscopic cholecystectomy from a societal perspective: sick leave outweighs efforts in hospital savings

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    Background: After its introduction, laparoscopic cholecystectomy rapidly expanded around the world and was accepted the procedure of choice by consensus. However, analysis of evidence shows no difference regarding primary outcome measures between laparoscopic and small-incision cholecystectomy. In absence of clear clinical benefit it may be interesting to focus on the resource use associated with the available techniques, a secondary outcome measure. This study focuses on a difference in costs between laparoscopic and small-incision cholecystectomy from a societal perspective with emphasis on internal validity and generalisability Methods: A blinded randomized single-centre trial was conducted in a general teaching hospital in The Netherlands. Patients with reasonable to good health diagnosed with symptomatic cholecystolithiasis scheduled for cholecystectomy were included. Patients were randomized between laparoscopic and small-incision cholecystectomy. Total costs were analyzed from a societal perspective. Results: Operative costs were higher in the laparoscopic group using reusable laparoscopic instruments (difference 203 euro; 95% confidence interval 147 to 259 euro). There were no significant differences in the other direct cost categories (outpatient clinic and admittance related costs), indirect costs, and total costs. More than 60% of costs in employed patients were caused by sick leave. Conclusion: Based on differences in costs, small-incision cholecystectomy seems to be the preferred operative technique over the laparoscopic technique both from a hospital and societal cost perspective. Sick leave associated with convalescence after cholecystectomy in employed patients results in considerable costs to society

    An Individual-Oriented Model on the Emergence of Support in Fights, Its Reciprocation and Exchange

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    Complex social behaviour of primates has usually been attributed to the operation of complex cognition. Recently, models have shown that constraints imposed by the socio-spatial structuring of individuals in a group may result in an unexpectedly high number of patterns of complex social behaviour, resembling the dominance styles of egalitarian and despotic species of macaques and the differences between them. This includes affiliative patterns, such as reciprocation of grooming, grooming up the hierarchy, and reconciliation. In the present study, we show that the distribution of support in fights, which is the social behaviour that is potentially most sophisticated in terms of cognitive processes, may emerge in the same way. The model represents the spatial grouping of individuals and their social behaviour, such as their avoidance of risks during attacks, the self-reinforcing effects of winning and losing their fights, their tendency to join in fights of others that are close by (social facilitation), their tendency to groom when they are anxious, the reduction of their anxiety by grooming, and the increase of anxiety when involved in aggression. Further, we represent the difference in intensity of aggression apparent in egalitarian and despotic macaques. The model reproduces many aspects of support in fights, such as its different types, namely, conservative, bridging and revolutionary, patterns of choice of coalition partners attributed to triadic awareness, those of reciprocation of support and β€˜spiteful acts’ and of exchange between support and grooming. This work is important because it suggests that behaviour that seems to result from sophisticated cognition may be a side-effect of spatial structure and dominance interactions and it shows that partial correlations fail to completely omit these effects of spatial structure. Further, the model is falsifiable, since it results in many patterns that can easily be tested in real primates by means of existing data
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