On automatic derivation of first order conditions in dynamic stochastic optimisation problems

This note presents an algorithm for deriving first order conditions applicable to the most common optimisation problems encountered in dynamic stochastic models automatically. Given a symbolic library or a computer algebra system one can efficiently derive first order conditions which can then be used for solving models numerically (steady state, linearisation)

Following the rules of the correct blood pressure measurement by hypertensive patients in the practice of Self-Blood Pressure Monitoring (SBPM)

Wstęp Przestrzeganie zasad prawidłowego pomiaru ciśnienia tętniczego jest warunkiem uzyskania wiarygodnych wyników samodzielnych pomiarów domowych ciśnienia tętniczego (SBPM, self-blood pressure monitoring). Celem pracy była ocena znajomości i przestrzegania powyższych zasad przez chorych na nadciśnienie tętnicze stosujących SBPM. Materiał i metody Grupę losowo dobranych 201 chorych na nadciśnienie tętnicze (101 — pacjenci ZPOZ, 100 — pacjenci Poradni Nadciśnienia Tętniczego przy Klinice Kardiologii, średni wiek: 57,80 ± 12,51 lat, 53,7% kobiet), którzy regularnie stosują SBPM, poddano ankiecie utworzonej na podstawie zaleceń European Society of Hypertension (2005,2003) dotyczących pomiarów ciśnienia krwi. Wyniki Aż 20,9% respondentów używa aparatów nadgarstkowych. Spośród pacjentów użytkujących aparaty z mankietem na ramię (79,1% ogółu) tylko 45,3% sprawdziło, czy rozmiar mankietu ich ciśnieniomierza jest dla nich odpowiedni. W ciągu godziny przed pomiarem 26,3% badanych zdarza się spożywać obfity posiłek, 22,9% — wykonywać ciężką/męczącą pracę fizyczną, 18,9% — pić kawę, 3,5% — pić alkohol. Pięciominutowego odpoczynku przed pomiarem nie stosuje 20,4% ankietowanych. Co 3 chory mierzy ciśnienie wkrótce po zażyciu leków hipotensyjnych. Niewielu badanych uwzględnia czynniki podnoszące ciśnienie krwi, takie jak wypełnienie pęcherza moczowego, gorączka, zbyt wysoka lub zbyt niska temperatura otoczenia (11,4%). Pacjenci poradni przyklinicznej oraz osoby lepiej wykształcone mają nieco większą wiedzę na temat czynników zwiększających ciśnienie tętnicze. Długość terapii nadciśnienia tętniczego pozostawała bez wpływu na poziom wiedzy dotyczącej prawidłowych zasad prowadzenia pomiarów ciśnienia krwi. Wnioski Wybór sfigmomanometru w SBPM jest często niewłaściwy, a dobór odpowiedniego rozmiaru mankietu zaniedbywany. Wiedza pacjentów odnośnie do warunków prawidłowego pomiaru ciśnienia krwi jest niekompletna.Background An appropriate blood pressure (BP) measurement technique is crucial in obtaining reliable results in Self-Blood Pressure Monitoring (SBPM). The aim of the study was to assess to what extent hypertensive patients who perform SBPM know and follow the rules of the correct blood pressure measurement. Material and methods A random group of 201 hypertensive individuals (100 primary care patients and 101 high reference ambulatory patients, aged 57.80 ± 12.51 years, 53.7% female) who regularly perform SBPM have undergone an inquiry study based on the European Society of Hypertension 2005 and 2003 recommendations for blood pressure (BP) measurement. Results As many as 20.9% respondents use wrist devices. Among patients using sphygmomanometers with arm cuff system (79.1% of all) only 45.3% check if the cuff size matches their arm circumference. In the hour preceding BP measurement 26.3% of the studied individuals happen to eat an abundant meal, 22.9% perform strenuous exercise, 18.9% drink coffee, 3.5% consume alcohol. Fiveminute resting before taking BP is not practiced by 20.4% of the enquired. One in three patients takes their BP soon after antihypertensive drug intake. Few responders identify bladder distension, fever, too high or too low temperature of the surrounding (11.4%–22.9%) with the impact on the blood pressure. High reference patients and higher educated ones are slightly better informed on the factors increasing BP. Hypertension therapy duration did not influence the knowledge of the rules of correctly performed SBPM. Conclusions Sphygmomanometer selection for SBPM is often inappropriate and correct cuff size matching neglected. Patients’ knowledge about the rules of proper BP measurement is incomplete

Following the rules of the correct blood pressure measurement by hypertensive patients in the practice of Self-Blood Pressure Monitoring (SBPM)

Wstęp Przestrzeganie zasad prawidłowego pomiaru ciśnienia tętniczego jest warunkiem uzyskania wiarygodnych wyników samodzielnych pomiarów domowych ciśnienia tętniczego (SBPM, self-blood pressure monitoring). Celem pracy była ocena znajomości i przestrzegania powyższych zasad przez chorych na nadciśnienie tętnicze stosujących SBPM. Materiał i metody Grupę losowo dobranych 201 chorych na nadciśnienie tętnicze (101 - pacjenci ZPOZ, 100 - pacjenci Poradni Nadciśnienia Tętniczego przy Klinice Kardiologii, średni wiek: 57,80 ± 12,51 lat, 53,7% kobiet), którzy regularnie stosują SBPM, poddano ankiecie utworzonej na podstawie zaleceń European Society of Hypertension (2005, 2003) dotyczących pomiarów ciśnienia krwi. Wyniki Aż 20,9% respondentów używa aparatów nadgarstkowych. Spośród pacjentów użytkujących aparaty z mankietem na ramię (79,1% ogółu) tylko 45,3% sprawdziło, czy rozmiar mankietu ich ciśnieniomierza jest dla nich odpowiedni. W ciągu godzi ny przed pomiarem 26,3% badanych zdarza się spożywać obfity posiłek, 22,9% - wykonywać ciężką/ /męczącą pracę fizyczną, 18,9% - pić kawę, 3,5% - pić alkohol. Pięciominutowego odpoczynku przed pomiarem nie stosuje 20,4% ankietowanych. Co 3 chory mierzy ciśnienie wkrótce po zażyciu leków hipotensyjnych. Niewielu badanych uwzględnia czynniki podnoszące ciśnienie krwi, takie jak wypełnienie pęcherza moczowego, gorączka, zbyt wysoka lub zbyt niska temperatura otoczenia (11,4%). Pacjenci poradni przyklinicznej oraz osoby lepiej wykształcone mają nieco większą wiedzę na temat czynników zwiększających ciśnienie tętnicze. Długość terapii nadciśnienia tętniczego pozostawała bez wpływu na poziom wiedzy dotyczącej prawidłowych zasad prowadzenia pomiarów ciśnienia krwi. Wnioski Wybór sfigmomanometru w SBPM jest często niewłaściwy, a dobór odpowiedniego rozmiaru mankietu zaniedbywany. Wiedza pacjentów odnośnie do warunków prawidłowego pomiaru ciśnienia krwi jest niekompletna.Background An appropriate blood pressure (BP) measurement technique is crucial in obtaining reliable results in Self-Blood Pressure Monitoring (SBPM). The aim of the study was to assess to what extent hypertensive patients who perform SBPM know and follow the rules of the correct blood pressure measurement. Material and methods A random group of 201 hypertensive individuals (100 primary care patients and 101 high reference ambulatory patients, aged 57.80 ± 12.51 years, 53.7% female) who regularly perform SBPM have undergone an inquiry study based on the European Society of Hypertension 2005 and 2003 recommendations for blood pressure (BP) measurement. Results As many as 20.9% respondents use wrist devices. Among patients using sphygmomanometers with arm cuff system (79.1% of all) only 45.3% check if the cuff size matches their arm circumference. In the hour preceding BP measurement 26.3% of the studied individuals happen to eat an abundant meal, 22.9% perform strenuous exercise, 18.9% drink coffee, 3.5% consume alcohol. Fiveminute resting before taking BP is not practiced by 20.4% of the enquired. One in three patients takes their BP soon after antihypertensive drug intake. Few responders identify bladder distension, fever, too high or too low temperature of the surrounding (11.4%-22.9%) with the impact on the blood pressure. High reference patients and higher educated ones are slightly better informed on the factors increasing BP. Hypertension therapy duration did not influence the knowledge of the rules of correctly performed SBPM. Conclusions Sphygmomanometer selection for SBPM is often inappropriate and correct cuff size matching neglected. Patients’ knowledge about the rules of proper BP measurement is incomplete

A living drug: application of CAR-T therapy for lymphoid malignancies and beyond

The ongoing development of novel personalized cancer therapies has resulted in the implementation of T cells enriched with synthetic chimeric antigen receptors, known as chimeric antigen receptors T cell (CAR-T) cells, into clinical practice. CAR-T cells are able to recognize and bind specific antigens present on the surface of target cells — so-called tumor-associated antigens. This innovative method has been approved for the treatment of hematological malignancies and may also serve as a bridge to hematopoietic stem cell transplantation. The production of the drug containing modified T cells consists of several steps — leukapheresis, T cell activation, transduction and expansion of the final CAR-T cells. Activation of CAR-T cells occurs through a pathway independent of the major histocompatibility complex, which is often associated with uncontrolled responses from the immune system and adverse reactions such as cytokine release syndrome. CAR-T therapy can only be performed in certified centers, and requires close cooperation between experienced specialists of different medical disciplines. This is what determines its effectiveness. Every step from collection and cryopreservation, through transport and modification, to thawing and infusion is strictly controlled because it has a critical impact on the quality and efficiency of the drug. Despite its proven benefits, CAR-T therapy remains available only to patients who meet well-defined criteria. These however are liable to change with the emergence of new indications

Smets-Wouters '03 model revisited - an implementation in gEcon

This paper presents an implementation of the well-known Smets-Wouters 2003 model for Euro Area using the gEcon package - what we call the ``third generation'' DSGE modelling toolbox. Our exercise serves three goals. First, we show how gEcon can be used to implement an important - from both applications and historical perspective - model. Second, through rigorous exposition enforced by the gEcon’s block-agent paradigm we analyse all the Smets-Wouters model’s building blocks. Last, but not least, the implementation presented here serves as a natural starting point for important from applications point of view extensions, like opening the economy, introducing non-lump-sum taxes, or adding sectors to the model economy. Full model implementation is attached

Penilaian Kinerja Keuangan Koperasi di Kabupaten Pelalawan

This paper describe development and financial performance of cooperative in District Pelalawan among 2007 - 2008. Studies on primary and secondary cooperative in 12 sub-districts. Method in this stady use performance measuring of productivity, efficiency, growth, liquidity, and solvability of cooperative. Productivity of cooperative in Pelalawan was highly but efficiency still low. Profit and income were highly, even liquidity of cooperative very high, and solvability was good

Juxtaposing BTE and ATE – on the role of the European insurance industry in funding civil litigation

One of the ways in which legal services are financed, and indeed shaped, is through private insurance arrangement. Two contrasting types of legal expenses insurance contracts (LEI) seem to dominate in Europe: before the event (BTE) and after the event (ATE) legal expenses insurance. Notwithstanding institutional differences between different legal systems, BTE and ATE insurance arrangements may be instrumental if government policy is geared towards strengthening a market-oriented system of financing access to justice for individuals and business. At the same time, emphasizing the role of a private industry as a keeper of the gates to justice raises issues of accountability and transparency, not readily reconcilable with demands of competition. Moreover, multiple actors (clients, lawyers, courts, insurers) are involved, causing behavioural dynamics which are not easily predicted or influenced. Against this background, this paper looks into BTE and ATE arrangements by analysing the particularities of BTE and ATE arrangements currently available in some European jurisdictions and by painting a picture of their respective markets and legal contexts. This allows for some reflection on the performance of BTE and ATE providers as both financiers and keepers. Two issues emerge from the analysis that are worthy of some further reflection. Firstly, there is the problematic long-term sustainability of some ATE products. Secondly, the challenges faced by policymakers that would like to nudge consumers into voluntarily taking out BTE LEI

Search for stop and higgsino production using diphoton Higgs boson decays

Results are presented of a search for a "natural" supersymmetry scenario with gauge mediated symmetry breaking. It is assumed that only the supersymmetric partners of the top-quark (stop) and the Higgs boson (higgsino) are accessible. Events are examined in which there are two photons forming a Higgs boson candidate, and at least two b-quark jets. In 19.7 inverse femtobarns of proton-proton collision data at sqrt(s) = 8 TeV, recorded in the CMS experiment, no evidence of a signal is found and lower limits at the 95% confidence level are set, excluding the stop mass below 360 to 410 GeV, depending on the higgsino mass

Severe early onset preeclampsia: short and long term clinical, psychosocial and biochemical aspects

Preeclampsia is a pregnancy specific disorder commonly defined as de novo hypertension and proteinuria after 20 weeks gestational age. It occurs in approximately 3-5% of pregnancies and it is still a major cause of both foetal and maternal morbidity and mortality worldwide1. As extensive research has not yet elucidated the aetiology of preeclampsia, there are no rational preventive or therapeutic interventions available. The only rational treatment is delivery, which benefits the mother but is not in the interest of the foetus, if remote from term. Early onset preeclampsia (<32 weeks’ gestational age) occurs in less than 1% of pregnancies. It is, however often associated with maternal morbidity as the risk of progression to severe maternal disease is inversely related with gestational age at onset2. Resulting prematurity is therefore the main cause of neonatal mortality and morbidity in patients with severe preeclampsia3. Although the discussion is ongoing, perinatal survival is suggested to be increased in patients with preterm preeclampsia by expectant, non-interventional management. This temporising treatment option to lengthen pregnancy includes the use of antihypertensive medication to control hypertension, magnesium sulphate to prevent eclampsia and corticosteroids to enhance foetal lung maturity4. With optimal maternal haemodynamic status and reassuring foetal condition this results on average in an extension of 2 weeks. Prolongation of these pregnancies is a great challenge for clinicians to balance between potential maternal risks on one the eve hand and possible foetal benefits on the other. Clinical controversies regarding prolongation of preterm preeclamptic pregnancies still exist – also taking into account that preeclampsia is the leading cause of maternal mortality in the Netherlands5 - a debate which is even more pronounced in very preterm pregnancies with questionable foetal viability6-9. Do maternal risks of prolongation of these very early pregnancies outweigh the chances of neonatal survival? Counselling of women with very early onset preeclampsia not only comprises of knowledge of the outcome of those particular pregnancies, but also knowledge of outcomes of future pregnancies of these women is of major clinical importance. This thesis opens with a review of the literature on identifiable risk factors of preeclampsia