On the Volume of Boolean expressions of Large Congruent Balls

We consider the volume of a Boolean expression of some congruent balls about a given system of centers in the d-dimensional Euclidean space. When the radius r of the balls is large, this volume can be approximated by a polynomial of r, which will be computed up to an O(r^{d−3}) error term. We study how the top coefficients of this polynomial depend on the set of the centers. It is known that in the case of the union of the balls, the top coefficients are some constant multiples of the intrinsic volumes of the convex hull of the centers. Thus, the coefficients in the general case lead to generalizations of the intrinsic volumes, in particular, to a generalization of the mean width of a set. Some known results on the mean width, along with the theorem on its monotonicity under contractions are extended to the "Boolean analogues" of the mean width

Funding models in palliative care: lessons from international experience

Background:Funding models influence provision and development of palliative care services. As palliative care integrates into mainstream health care provision, opportunities to develop funding mechanisms arise. However, little has been reported on what funding models exist or how we can learn from them.Aim:To assess national models and methods for financing and reimbursing palliative care.Design:Initial literature scoping yielded limited evidence on the subject as national policy documents are difficult to identify, access and interpret. We undertook expert consultations to appraise national models of palliative care financing in England, Germany, Hungary, Republic of Ireland, New Zealand, The Netherlands, Norway, Poland, Spain, Sweden, Switzerland, the United States and Wales. These represent different levels of service development and a variety of funding mechanisms.Results:Funding mechanisms reflect country-specific context and local variations in care provision. Patterns emerging include the following:Provider payment is rarely linked to population need and often perpetuates existing inequitable patterns in service provision.Funding is frequently characterised as a mixed system of charitable, public and private payers.The basis on which providers are paid for services rarely reflects individual care input or patient needs.Conclusion:Funding mechanisms need to be well understood and used with caution to ensure best practice and minimise perverse incentives. Before we can conduct cross-national comparisons of costs and impact of palliative care, we need to understand the funding and policy context for palliative care in each country of interest

A prevalent mutation with founder effect in Spanish Recessive Dystrophic Epidermolysis Bullosa families

<p>Abstract</p> <p>Background</p> <p>Recessive Dystrophic Epidermolysis Bullosa (RDEB) is a genodermatosis caused by more than 500 different mutations in the <it>COL7A1 </it>gene and characterized by blistering of the skin following a minimal friction or mechanical trauma.</p> <p>The identification of a cluster of RDEB pedigrees carrying the c.6527insC mutation in a specific area raises the question of the origin of this mutation from a common ancestor or as a result of a hotspot mutation. The aim of this study was to investigate the origin of the c.6527insC mutation.</p> <p>Methods</p> <p>Haplotypes were constructed by genotyping nine single nucleotides polymorphisms (SNPs) throughout the <it>COL7A1 </it>gene. Haplotypes were determined in RDEB patients and control samples, both of Spanish origin.</p> <p>Results</p> <p>Sixteen different haplotypes were identified in our study. A single haplotype cosegregated with the c.6527insC mutation.</p> <p>Conclusion</p> <p>Haplotype analysis showed that all alleles carrying the c.6527insC mutation shared the same haplotype cosegregating with this mutation (<b><it>CCGCTCAAA_6527insC</it></b>), thus suggesting the presence of a common ancestor.</p

Pharmacovigilance in hospice/palliative care: the net immediate and short-term effects of dexamethasone for anorexia

Objectives Loss of appetite is prevalent in palliative care and distressing for patients and families. Therapies include corticosteroids or progestogens. This study explores the net effect of dexamethasone on anorexia. Methods Prospective data were collected when dexamethasone was started for anorexia as part of routine care. The National Cancer Institute’s Common Toxicity Criteria for Adverse Events (NCICTCAE) Likert scales assessed severity of anorexia and immediate and short-term harms at 2 time points: baseline and 7 days. Results This study (41 sites, 8 countries) collected data (July 2013 to July 2014) from 114 patients (mean age 71 (SD 11), 96% with cancer). Median Australian-modified Karnofsky Performance Scale was 50% (range 20–70). Mean baseline NCICTCAE anorexia score was 2.7 (SD 0.6; median 3). 6 patients died by day 7. Of 108 evaluable patients, 74 (68.5%; 95% CI 59.0% to 76.7%) reported ≥1 reduction anorexia scores by day 7, of whom 30 were 0. Mean dexamethasone dose on day 7 was 4.1 mg/day (SD 3.4; median 4; range 0–46 mg). 24 patients reported ≥1 harms (32.4% CI 22.6% to 44.1%; insomnia n=10, depression n=7, euphoria n=7 and hyperglycaemia n=7). Of 24 patients with no benefit, 10 reported ≥1 harms. Conclusions This study shows positive and negative effects of 7 days of dexamethasone as an appetite stimulant in patients with advanced life-limiting illnesses. Identifying clinicodemographic characteristics of people most at risk of harms with no benefit is a crucial next step. Longer term follow-up will help to understand longer term and cumulative harms

Pattern Recognition Based Speed Forecasting Methodology for Urban Traffic Network

A full methodology of short-term traffic prediction is proposed for urban road traffic network via Artificial Neural Network (ANN). The goal of the forecasting is to provide speed estimation forward by 5, 15 and 30 min. Unlike similar research results in this field, the investigated method aims to predict traffic speed for signalized urban road links and not for highway or arterial roads. The methodology contains an efficient feature selection algorithm in order to determine the appropriate input parameters required for neural network training. As another contribution of the paper, a built-in incomplete data handling is provided as input data (originating from traffic sensors or Floating Car Data (FCD)) might be absent or biased in practice. Therefore, input data handling can assure a robust operation of speed forecasting also in case of missing data. The proposed algorithm is trained, tested and analysed in a test network built-up in a microscopic traffic simulator by using daily course of real-world traffic

Novel mutations in the ATP2C1 gene in two patients with Hailey-Hailey disease

Benign familial chronic pemphigus (Hailey-Hailey disease, HHD) is a rare hereditary condition characterized by development of blisters at sites of friction and in the intertriginous areas. Mutations in the ATP2C1 gene, which encodes the human secretory pathway calcium ATPase 1 (hSPCA1), have been identified as possible causative mutations. Studying Hungarian patients with HHD, we found two novel, distinct, heterozygous mutations. In a 65-year-old man with a 41-year history of severe recurrent symptoms, a single nucleotide insertion, 1085insA, was detected. In a patient whose symptoms were induced by environmental contact allergens, we found a nonsense mutation, Q506X, in exon 17. Our study further illustrates the diversity of mutational events in the pathogenesis of HHD

A POTENTIAL DUAL APICAL PATHWAY IN POLARIZED REGENERATIVE CELLS OF THE MIDGUT OF MANDUCA SEXTA

Two novel proteins with apparent molecular weight of 38 (Manduca sexta midgut MsM38) and 46kDa (MsM46) were isolated from midgut homogenates in wandering stage Manduca sexta larvae and both of them were found to be present exclusively in this tissue on Western blots. Immunocytochemical studies revealed that both proteins are expressed in the regenerative cells however, their distribution pattern is clearly different. MsM38 is localized in the cytoplasm of resting regenerative cells during the feeding period, and is accumulated in the calcospherits at the beginning of the wandering period. Along with the delamination of the larval epithelium, this protein is released apically from these vesicles. The antiserum labels an additional 76 kDa protein in the wandering larval midgut homogenates. The appearance of this 76 kDa protein coincides with the accumulation of the immunopositive material in the calcospherits. MsM46 is similarly distributed during the feeding period in the cytoplasm of regenerative cells. At the beginning of the wandering period it accumulates around the newly forming large apical vacuoles, that are released at the time of complete delamination of the larval epithelium. In parallel with this process MsM46, and another 40 kDa protein, that becomes labeled from this period on Western blots appeares on the apical microvillar projections. Thus both isolated proteins are directed apically from different compartments, that raises the possibility of a dual apical routing pathway in regenerative cells

THE IMMUNOPROTEIN SCOLEXIN AND ITS SYNTHESIZING SITES Ś THE MIDGUT EPITHELIUM AND THE EPIDERMIS

Scolexin is one of the bacterial induced hemolymph proteins of tobacco hornworm (Manduca sexta) lar- vae, that has hemocyte coagulation-provoking activity. The 72 kDa scolexin complex is composed of two 36 kDa subunits. To examine the protein secretory pathways in insect epithelia a polyclonal antibody was raised against the 36 kDa hemolymph protein. This MsH36 antibody recognised a 36 and a 72 kDa pro- tein in tissue homogenates. On the basis of the characteristic labelling pattern observed on immunoblots and immunocytochemical sections we concluded that the 36 kDa protein in the hemolymph, in the midgut and in the epidermis was identical with the scolexin subunit. In present paper we report a labelling shift in the midgut epithelium between goblet and columnar cells that may be controlled by the hormonal system. A 72 kDa protein showed similar epitops and molecular weight to the scolexin com- plex and was detected in epidermis and in cuticle under both reducing and non-reducing conditions. Tissue localization of 36 kDa and 72 kDa MsH36 antibody labelling proteins indicated the possibility that the epidermal cells produce two kinds of scolexin-like proteins. The complex composed of 36 kDa subunits are transported basolaterally into the circulation and display hemocyte coagulation inducing activity while the 72 kDa form contains two subunits linked covalently secreted apically into the cuticle