What is the impact of duplicate coverage on the demand for health care in Germany?

Duplicate coverage involves those individuals who hold public health insurance, and purchase additional private coverage. Using data from the German Institute for Economic Research, we try to investigate the impact of duplicate coverage on the demand for healthcare (measured in number of visits to doctors). Given the simultaneity of the choices to take out additional private health insurance coverage, we estimate a negative binomial model to measure this impact. We also estimate a a Full Information Maximun Loglikelihood (FIML), known as Endogenous Switching Poisson Count Model and we compare these results with the standard maximum log likelihood (ML) estimators of the negative binomial model. The Results show that, there is a positive difference on the level of health services demanded when there is a duplicate coverage. We found also that there is evidence to think that in Germany there is a feedback between duplicate coverage and the demand of health services.Health care services demand, health insurance

Non-equilibrium gas flow and heat transfer in a bottom heated square microcavity

This paper was presented at the 4th Micro and Nano Flows Conference (MNF2014), which was held at University College, London, UK. The conference was organised by Brunel University and supported by the Italian Union of Thermofluiddynamics, IPEM, the Process Intensification Network, the Institution of Mechanical Engineers, the Heat Transfer Society, HEXAG - the Heat Exchange Action Group, and the Energy Institute, ASME Press, LCN London Centre for Nanotechnology, UCL University College London, UCL Engineering, the International NanoScience Community, www.nanopaprika.eu.The flow of a rarefied gas in a square enclosure with a bottom wall at high temperature and the other three walls at the same low temperature is investigated. The flow configuration is simulated both deterministically, using the non-linear Shakhov kinetic model and stochastically, using the DSMC method. Excellent agreement between the two approaches is obtained. The flow is characterized by the reference Knudsen number and the temperature ratio. It is found that along the side walls the velocity of the gas is not necessarily from cold-to-hot regions due to thermal creep, but from hot-to-cold as well. The effect of the flow parameters to this configuration, including the not well theoretically defined flow from hot-to-cold, is investigated and results are provided in the whole range of the Knudsen number for small, moderate and large temperature differences

What is the impact of duplicate coverage on the demand for health care in Germany?

Duplicate coverage involves those individuals who hold public health insurance, and purchase additional private coverage. Using data from the German Institute for Economic Research, we try to investigate the impact of duplicate coverage on the demand for healthcare (measured in number of visits to doctors). Given the simultaneity of the choices to take out additional private health insurance coverage, we estimate a negative binomial model to measure this impact. We also estimate a a Full Information Maximun Loglikelihood (FIML), known as Endogenous Switching Poisson Count Model and we compare these results with the standard maximum log likelihood (ML) estimators of the negative binomial model. The Results show that, there is a positive difference on the level of health services demanded when there is a duplicate coverage. We found also that there is evidence to think that in Germany there is a feedback between duplicate coverage and the demand of health services

What is the impact of duplicate coverage on the demand for health care in Germany?

Duplicate coverage involves those individuals who hold public health insurance, and purchase additional private coverage. Using data from the German Institute for Economic Research, we try to investigate the impact of duplicate coverage on the demand for healthcare (measured in number of visits to doctors). Given the simultaneity of the choices to take out additional private health insurance coverage, we estimate a negative binomial model to measure this impact. We also estimate a a Full Information Maximun Loglikelihood (FIML), known as Endogenous Switching Poisson Count Model and we compare these results with the standard maximum log likelihood (ML) estimators of the negative binomial model. The Results show that, there is a positive difference on the level of health services demanded when there is a duplicate coverage. We found also that there is evidence to think that in Germany there is a feedback between duplicate coverage and the demand of health services

The Effects of an Adaptive and Distributed Transmission Power Control on the Performance of Energy Harvesting Sensor Networks

The design of routing protocols for wireless sensor networks (WSNs) has been traditionally tackled by assuming battery-powered sensors, in which minimizing the power consumption was the main objective. Advances in technology and the ability to harvest energy from the environment has enabled self-sustaining systems and thus diminish the significance of network lifetime considerations in the design of WSNs. Although WSNs operated by energy-harvesting sensors are not limited by network lifetime, they still pose new design challenges due to the unstable and uncertain amount of energy that can be harvested from the environment. In this paper, we propose a new protocol for energy-harvesting sensor networks that uses adaptive transmission power to maintain the network connectivity, and distributes the traffic load on the network. Based on local information, each node dynamically adjusts its transmission power in order to maximize the network’s end-to-end performance. The simulation results indicate that the proposed protocol keeps the network connected at most of the times by using an efficient power management, outperforming greedy forwarding and dynamic duty cycle protocols in terms of packet delivery ratio, delay, and power management

Plasmonically Enhanced Reflectance of Heat Radiation from Low-Bandgap Semiconductor Microinclusions

Increased reflectance from the inclusion of highly scattering particles at low volume fractions in an insulating dielectric offers a promising way to reduce radiative thermal losses at high temperatures. Here, we investigate plasmonic resonance driven enhanced scattering from microinclusions of low-bandgap semiconductors (InP, Si, Ge, PbS, InAs and Te) in an insulating composite to tailor its infrared reflectance for minimizing thermal losses from radiative transfer. To this end, we compute the spectral properties of the microcomposites using Monte Carlo modeling and compare them with results from Fresnel equations. The role of particle size-dependent Mie scattering and absorption efficiencies, and, scattering anisotropy are studied to identify the optimal microinclusion size and material parameters for maximizing the reflectance of the thermal radiation. For composites with Si and Ge microinclusions we obtain reflectance efficiencies of 57 - 65% for the incident blackbody radiation from sources at temperatures in the range 400 - 1600 {\deg}C. Furthermore, we observe a broadbanding of the reflectance spectra from the plasmonic resonances due to charge carriers generated from defect states within the semiconductor bandgap. Our results thus open up the possibility of developing efficient high-temperature thermal insulators through use of the low-bandgap semiconductor microinclusions in insulating dielectrics.Comment: Main article (8 Figures and 2 Tables) + Supporting Information (8 Figures

Orally active antischistosomal early leads identified from the open access malaria box.

BACKGROUND: Worldwide hundreds of millions of schistosomiasis patients rely on treatment with a single drug, praziquantel. Therapeutic limitations and the threat of praziquantel resistance underline the need to discover and develop next generation drugs. METHODOLOGY: We studied the antischistosomal properties of the Medicines for Malaria Venture (MMV) malaria box containing 200 diverse drug-like and 200 probe-like compounds with confirmed in vitro activity against Plasmodium falciparum. Compounds were tested against schistosomula and adult Schistosoma mansoni in vitro. Based on in vitro performance, available pharmacokinetic profiles and toxicity data, selected compounds were investigated in vivo. PRINCIPAL FINDINGS: Promising antischistosomal activity (IC50: 1.4-9.5 µM) was observed for 34 compounds against schistosomula. Three compounds presented IC50 values between 0.8 and 1.3 µM against adult S. mansoni. Two promising early leads were identified, namely a N,N'-diarylurea and a 2,3-dianilinoquinoxaline. Treatment of S. mansoni infected mice with a single oral 400 mg/kg dose of these drugs resulted in significant worm burden reductions of 52.5% and 40.8%, respectively. CONCLUSIONS/SIGNIFICANCE: The two candidates identified by investigating the MMV malaria box are characterized by good pharmacokinetic profiles, low cytotoxic potential and easy chemistry and therefore offer an excellent starting point for antischistosomal drug discovery and development

Swab-yourself trial with economic monitoring and testing for infections collectively (SYSTEMATIC): Part 2. A diagnostic accuracy, and cost-effectiveness, study comparing rectal, pharyngeal and urogenital samples analysed individually, versus as a pooled specimen, for the diagnosis of gonorrhoea and chlamydia

This is the author accepted manuscript. The final version is available from Oxford University Press via the DOI in this recordBACKGROUND: Sexual history does not accurately identify those with extragenital Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) so universal extragenital sampling is recommended. Nucleic acid amplification tests (NAATs) are expensive. If urogenital, plus rectal and pharyngeal, samples are analysed the diagnostic cost is trebled. Pooling samples into one NAAT container would cost the same as urogenital samples alone. We compared clinician triple samples analysed individually with self-taken pooled samples for diagnostic accuracy, and cost, in MSM and females. METHODS: Prospective, convenience, sample in UK sexual health clinic. Randomised order of clinician and self-samples from pharynx, rectum, plus first catch urine (FCU) in MSM and vulvovaginal swabs (VVS) in females, for NG and CT detection. RESULTS: Of 1793 participants (1284 females, 509 MSM), 116 had NG detected (75 urogenital, 83 rectum, 72 pharynx). 276 had CT detected (217 urogenital, 249 rectum, 63 pharynx).There was no difference in sensitivities between clinician triple samples and self-pooled specimens for NG (99.1%, 98.3%) but clinician samples analysed individually identified 3% more chlamydia infections than pooled (99.3%, 96.0%; p=0.027). However, pooled specimens identified more infections than VVS/FCU alone. Pooled specimens missed 2 NG and 11 CT infections, whereas VVS/FCU missed 41 NG and 58 CT infections. Self-taken pooled specimens were the most cost-effective. CONCLUSIONS: Just FCU/VVS testing missed many infections. Self-taken pooled samples were as sensitive as clinician triple samples for identifying NG, but clinician samples analysed individually identified 3% more CT infections than pooled. The extragenital sampling was achievable at no additional diagnostic cost to the FCU/VVS. TRIAL REGISTRATION: ClinicalTrials.gov NCT02371109.National Institute for Health Research (NIHR

Phenoloxidase activity acts as a mosquito innate immune response against infection with semliki forest virus

Several components of the mosquito immune system including the RNA interference (RNAi), JAK/STAT, Toll and IMD pathways have previously been implicated in controlling arbovirus infections. In contrast, the role of the phenoloxidase (PO) cascade in mosquito antiviral immunity is unknown. Here we show that conditioned medium from the Aedes albopictus-derived U4.4 cell line contains a functional PO cascade, which is activated by the bacterium Escherichia coli and the arbovirus Semliki Forest virus (SFV) (Togaviridae; Alphavirus). Production of recombinant SFV expressing the PO cascade inhibitor Egf1.0 blocked PO activity in U4.4 cell- conditioned medium, which resulted in enhanced spread of SFV. Infection of adult female Aedes aegypti by feeding mosquitoes a bloodmeal containing Egf1.0-expressing SFV increased virus replication and mosquito mortality. Collectively, these results suggest the PO cascade of mosquitoes plays an important role in immune defence against arboviruses