1,511 research outputs found
Defining the cost of the Egyptian lymphatic filariasis elimination programme
BACKGROUND: Lymphatic filariasis (LF) is targeted for global elimination. LF elimination programmes in different countries, including Egypt, are supported financially by national and international agencies. The national programme in Egypt is based on mass drug administration (MDA) of an annual dose of a combination of 2 drugs (DEC and albendazole) to all endemic villages. This study aimed primarily to estimate the Total and Government costs of two rounds of MDA conducted in Egypt in 2000 and 2001, the average cost per person treated, and the cost share of the different programme partners. METHODS: The Total costs reflect the overall annual costs of the MDA programme, and we defined Government costs as those expenditures made by the Egyptian government to develop, implement and sustain the MDA programmes. We used a generic protocol developed in coordination with the Emory Lymphatic Filariasis Support Center. Our study was concerned with all costs to the government, donors and other implementing parties. Cost data were retrospectively gathered from local, regional and national Ministry of Health and Population records. The total estimates for each governorate were based on data from a representative district for the governorate; these were combined with national programme data for a national estimate. RESULTS: The overall Total and Government costs for treating approximately 1,795,553 individuals living in all endemic villages in the year 2000 were US 2,412,000, respectively. In 2001, the number of persons treated increased (29%) and the Total costs were US 2,331,000. In 2000, the average Total and Government costs per treated subject were US 1.34, respectively, however, these costs decreased to US 1.00, respectively in 2001. The coverage rate was 86.0% in 2000 and it increased to 88.0% in 2001. CONCLUSION: The Egyptian government provided 75.8% of all resources, as reflected in the Total cost estimates, and international agencies contributed the rest. Such data highlight both the commitment of the Egyptian government and the significance of the contributions of international bodies toward the LF elimination programme
The problem of shot selection in basketball
In basketball, every time the offense produces a shot opportunity the player
with the ball must decide whether the shot is worth taking. In this paper, I
explore the question of when a team should shoot and when they should pass up
the shot by considering a simple theoretical model of the shot selection
process, in which the quality of shot opportunities generated by the offense is
assumed to fall randomly within a uniform distribution. I derive an answer to
the question "how likely must the shot be to go in before the player should
take it?", and show that this "lower cutoff" for shot quality depends
crucially on the number of shot opportunities remaining (say, before the
shot clock expires), with larger demanding that only higher-quality shots
should be taken. The function is also derived in the presence of a
finite turnover rate and used to predict the shooting rate of an
optimal-shooting team as a function of time. This prediction is compared to
observed shooting rates from the National Basketball Association (NBA), and the
comparison suggests that NBA players tend to wait too long before shooting and
undervalue the probability of committing a turnover.Comment: 7 pages, 2 figures; comparison to NBA data adde
Velocity Correlations in Driven Two-Dimensional Granular Media
Simulations of volumetrically forced granular media in two dimensions produce
s tates with nearly homogeneous density. In these states, long-range velocity
correlations with a characteristic vortex structure develop; given sufficient
time, the correlations fill the entire simulated area. These velocity
correlations reduce the rate and violence of collisions, so that pressure is
smaller for driven inelastic particles than for undriven elastic particles in
the same thermodynamic state. As the simulation box size increases, the effects
of veloc ity correlations on the pressure are enhanced rather than reduced.Comment: 12 pages, 6 figures, 21 reference
Electronic health records to facilitate clinical research
Electronic health records (EHRs) provide opportunities to enhance patient care, embed performance measures in clinical practice, and facilitate clinical research. Concerns have been raised about the increasing recruitment challenges in trials, burdensome and obtrusive data collection, and uncertain generalizability of the results. Leveraging electronic health records to counterbalance these trends is an area of intense interest. The initial applications of electronic health records, as the primary data source is envisioned for observational studies, embedded pragmatic or post-marketing registry-based randomized studies, or comparative effectiveness studies. Advancing this approach to randomized clinical trials, electronic health records may potentially be used to assess study feasibility, to facilitate patient recruitment, and streamline data collection at baseline and follow-up. Ensuring data security and privacy, overcoming the challenges associated with linking diverse systems and maintaining infrastructure for repeat use of high quality data, are some of the challenges associated with using electronic health records in clinical research. Collaboration between academia, industry, regulatory bodies, policy makers, patients, and electronic health record vendors is critical for the greater use of electronic health records in clinical research. This manuscript identifies the key steps required to advance the role of electronic health records in cardiovascular clinical research
Multiple etiologies of axonal sensory motor polyneuropathy in a renal transplant recipient: a case report
<p>Abstract</p> <p>Introduction</p> <p>Neurological complications leading to morbidity and mortality are not frequent in renal transplant recipients. Here, we report a renal transplant recipient who presented with diminished strength in his limbs probably due to multiple etiologies of axonal sensorimotor polyneuropathy, which resolved with intravenous immunoglobulin.</p> <p>Case presentation</p> <p>A 49-year-old Iranian male renal transplant recipient with previous history of autosomal dominant polycystic kidney disease presented with diminished strength in his limbs one month after surgery. Our patient was on cyclosporine A, mycophenolate mofetil and prednisone. Although a detected hypophosphatemia was corrected with supplemental phosphate, the loss of strength was still slowly progressive and diffuse muscular atrophy was remarkable in his trunk, upper limb and pelvic girdle. Meanwhile, his cranial nerves were intact. Post-transplant diabetes mellitus was diagnosed and insulin therapy was initiated. In addition, as a high serum cyclosporine level was detected, the dose of cyclosporine was reduced. Our patient was also put on intravenous ganciclovir due to positive serum cytomegalovirus immunoglobulin M antibody. Despite the reduction of oral cyclosporine dose along with medical therapy for the cytomegalovirus infection and diabetes mellitus, his muscular weakness and atrophy did not improve. One week after administration of intravenous immunoglobulin, a significant improvement was noted in his muscular weakness.</p> <p>Conclusion</p> <p>A remarkable response to intravenous immunoglobulin is compatible with an immunological basis for the present condition (post-transplant polyneuropathy). In cases of post-transplant polyneuropathy with a high clinical suspicion of immunological origin, administration of intravenous immunoglobulin may be recommended.</p
Phase-slip induced dissipation in an atomic Bose-Hubbard system
Phase slips play a primary role in dissipation across a wide spectrum of
bosonic systems, from determining the critical velocity of superfluid helium to
generating resistance in thin superconducting wires. This subject has also
inspired much technological interest, largely motivated by applications
involving nanoscale superconducting circuit elements, e.g., standards based on
quantum phase-slip junctions. While phase slips caused by thermal fluctuations
at high temperatures are well understood, controversy remains over the role of
phase slips in small-scale superconductors. In solids, problems such as
uncontrolled noise sources and disorder complicate the study and application of
phase slips. Here we show that phase slips can lead to dissipation for a clean
and well-characterized Bose-Hubbard (BH) system by experimentally studying
transport using ultra-cold atoms trapped in an optical lattice. In contrast to
previous work, we explore a low velocity regime described by the 3D BH model
which is not affected by instabilities, and we measure the effect of
temperature on the dissipation strength. We show that the damping rate of
atomic motion-the analogue of electrical resistance in a solid-in the confining
parabolic potential fits well to a model that includes finite damping at zero
temperature. The low-temperature behaviour is consistent with the theory of
quantum tunnelling of phase slips, while at higher temperatures a cross-over
consistent with the transition to thermal activation of phase slips is evident.
Motion-induced features reminiscent of vortices and vortex rings associated
with phase slips are also observed in time-of-flight imaging.Comment: published in Nature 453, 76 (2008
Can Broader Diffusion of Value-Based Insurance Design Increase Benefits from US Health Care without Increasing Costs? Evidence from a Computer Simulation Model
Using a computer simulation based on US data, R. Scott Braithwaite and colleagues calculate the benefits of value-based insurance design, in which patients pay less for highly cost-effective services
The cometary composition of a protoplanetary disk as revealed by complex cyanides
Observations of comets and asteroids show that the Solar Nebula that spawned
our planetary system was rich in water and organic molecules. Bombardment
brought these organics to the young Earth's surface, seeding its early
chemistry. Unlike asteroids, comets preserve a nearly pristine record of the
Solar Nebula composition. The presence of cyanides in comets, including 0.01%
of methyl cyanide (CH3CN) with respect to water, is of special interest because
of the importance of C-N bonds for abiotic amino acid synthesis. Comet-like
compositions of simple and complex volatiles are found in protostars, and can
be readily explained by a combination of gas-phase chemistry to form e.g. HCN
and an active ice-phase chemistry on grain surfaces that advances
complexity[3]. Simple volatiles, including water and HCN, have been detected
previously in Solar Nebula analogues - protoplanetary disks around young stars
- indicating that they survive disk formation or are reformed in situ. It has
been hitherto unclear whether the same holds for more complex organic molecules
outside of the Solar Nebula, since recent observations show a dramatic change
in the chemistry at the boundary between nascent envelopes and young disks due
to accretion shocks[8]. Here we report the detection of CH3CN (and HCN and
HC3N) in the protoplanetary disk around the young star MWC 480. We find
abundance ratios of these N-bearing organics in the gas-phase similar to
comets, which suggests an even higher relative abundance of complex cyanides in
the disk ice. This implies that complex organics accompany simpler volatiles in
protoplanetary disks, and that the rich organic chemistry of the Solar Nebula
was not unique.Comment: Definitive version of the manuscript is published in Nature, 520,
7546, 198, 2015. This is the author's versio
Dopaminergic modulation of appetitive trace conditioning: the role of D1 receptors in medial prefrontal cortex
Rationale: Trace conditioning may provide a behavioural model suitable to examine the maintenance of ‘on line’ information and its underlying neural substrates.
Objectives: Experiment la was run to establish trace conditioning in a shortened procedure which would be suitable to test the effects of dopamine (DA) D1 receptor agents administered by microinjection directly into the brain. Experiment lb examined the effects of the DA D1 agonist SKF81297 and the DA D1 antagonist SCH23390 following systemic administration in pre-trained animals. Experiment 2 went on to test the effects of systemically administered SKF81297 on the acquisition of trace conditioning. In experiment 3, SKF81297 was administered directly in prelimbic (PL) and infralimbic (IL) sub-regions of medial prefrontal cortex (mPFC) to compare the role of different mPFC sub-regions.
Results: Whilst treatment with SCH23390 impaired motor responding and/or motivation, SKF81297 had relatively little effect in the pre-trained animals tested in experiment 1b. However, systemic SKF81297 depressed the acquisition function at the 2-s trace interval in experiment 2. Similarly, in experiment 3, SKF81297 (0.1 μg in 1.0 μl) microinjected into either PL or IL mPFC impaired appetitive conditioning at the 2-s trace interval.
Conclusions: Impaired trace conditioning under SKF81297 is likely to be mediated in part (but not exclusively) within the IL and PL mPFC sub-regions. The finding that trace conditioning was impaired rather than enhanced under SKF81297 provides further evidence for the inverse U-function which has been suggested to be characteristic of mPFC DA function
Preserving ovarian function in patients receiving cyclophosphamide
Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68327/2/10.1191_096120399678847335.pd
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