21,389 research outputs found
The systematic use of cost-effectiveness criteria to inform decisions about the removal of items from publicly-financed 'benefits packages'. A report commissioned by the Department of Health and prepared by the London School of Hygiene and Tropical Medicine
The regulation of competition between publicly-financed hospitals. A rapid review commissioned by the Department of Health and prepared by the London School of Hygiene and Tropical Medicine
A review of the role and responsibilities of national ministries of health in five countries. A report commissioned by the Department of Health and prepared by the London School of Hygiene and Tropical Medicine
Grain boundary melting in ice
We describe an optical scattering study of grain boundary premelting in water
ice. Ubiquitous long ranged attractive polarization forces act to suppress
grain boundary melting whereas repulsive forces originating in screened Coulomb
interactions and classical colligative effects enhance it. The liquid enhancing
effects can be manipulated by adding dopant ions to the system. For all
measured grain boundaries this leads to increasing premelted film thickness
with increasing electrolyte concentration. Although we understand that the
interfacial surface charge densities and solute concentrations can
potentially dominate the film thickness, we can not directly measure them
within a given grain boundary. Therefore, as a framework for interpreting the
data we consider two appropriate dependent limits; one is dominated by
the colligative effect and one is dominated by electrostatic interactions.Comment: 6 pages, 5 figure
Calculation of Elastic Green's Functions for Lattices with Cavities
In this Brief Report, we present an algorithm for calculating the elastic
Lattice Greens Function of a regular lattice, in which defects are created by
removing lattice points. The method is computationally efficient, since the
required matrix operations are on matrices that scale with the size of the
defect subspace, and not with the size of the full lattice. This method allows
the treatment of force fields with multi-atom interactions.Comment: 3 pages. RevTeX, using epsfig.sty. One figur
Extremely low long‐term erosion rates around the Gamburtsev Mountains in interior East Antarctica
The high elevation and rugged relief (>3 km) of the Gamburtsev Subglacial Mountains (GSM) have long been considered enigmatic. Orogenesis normally occurs near plate boundaries, not cratonic interiors, and large‐scale tectonic activity last occurred in East Antarctica during the Pan‐African (480–600 Ma). We sampled detrital apatite from Eocene sands in Prydz Bay at the terminus of the Lambert Graben, which drained a large pre‐glacial basin including the northern Gamburtsev Mountains. Apatite fission‐track and (U‐Th)/He cooling ages constrain bedrock erosion rates throughout the catchment. We double‐dated apatites to resolve individual cooling histories. Erosion was very slow, averaging 0.01–0.02 km/Myr for >250 Myr, supporting the preservation of high elevation in interior East Antarctica since at least the cessation of Permian rifting. Long‐term topographic preservation lends credence to postulated high‐elevation mountain ice caps in East Antarctica since at least the Cretaceous and to the idea that cold‐based glaciation can preserve tectonically inactive topography
Sensitivity-analysis method for inverse simulation application
An important criticism of traditional methods of inverse simulation that are based on the Newton–Raphson algorithm is that they suffer from numerical problems. In this paper these problems are discussed and a new method based on sensitivity-analysis theory is developed and evaluated. The Jacobian matrix may be calculated by solving a sensitivity equation and this has advantages over the approximation methods that are usually applied when the derivatives of output variables with respect to inputs cannot be found analytically. The methodology also overcomes problems of input-output redundancy that arise in the traditional approaches to inverse simulation. The sensitivity- analysis approach makes full use of information within the time interval over which key quantities are compared, such as the difference between calculated values and the given ideal maneuver after each integration step. Applications to nonlinear HS125 aircraft and Lynx helicopter models show that, for this sensitivity-analysis method, more stable and accurate results are obtained than from use of the traditional Newton–Raphson approach
A direct optical method for the study of grain boundary melting
The structure and evolution of grain boundaries underlies the nature of
polycrystalline materials. Here we describe an experimental apparatus and light
reflection technique for measuring disorder at grain boundaries in optically
clear material, in thermodynamic equilibrium. The approach is demonstrated on
ice bicrystals. Crystallographic orientation is measured for each ice sample.
The type and concentration of impurity in the liquid can be controlled and the
temperature can be continuously recorded and controlled over a range near the
melting point. The general methodology is appropriate for a wide variety of
materials.Comment: 8 pages, 8 figures, updated with minor changes made to published
versio
Reduced healthcare utilisation following successful HCV treatment in HIV co-infected patients with mild liver disease
New direct-acting antivirals (DAA) for hepatitis C virus (HCV) infection have achieved high cure rates in many patient groups previously considered difficult-to-treat, including those HIV/HCV co-infected. The high price of these medications is likely to limit access to treatment, at least in the short term. Early treatment priority is likely to be given to those with advanced disease, but a more detailed understanding of the potential benefits in treating those with mild disease is needed. We hypothesized that successful HCV treatment within a co-infected population with mild liver disease would lead to a reduction in the use and costs of healthcare services in the 5 years following treatment completion. We performed a retrospective cohort study of HIV/HCV-co-infected patients without evidence of fibrosis/cirrhosis who received a course of HCV therapy between 2004 and 2013. Detailed analysis of healthcare utilization up to 5 years following treatment for each patient using clinical and electronic records was used to estimate healthcare costs. Sixty-three patients were investigated, of whom 48 of 63 (76.2%) achieved sustained virological response 12 weeks following completion of therapy (SVR12). Individuals achieving SVR12 incurred lower health utilization costs (£5000 per-patient) compared to (£10 775 per-patient) non-SVR patients in the 5 years after treatment. Healthcare utilization rates and costs in the immediate 5 years following treatment were significantly higher in co-infected patients with mild disease that failed to achieve SVR12. These data suggest additional value to achieving cure beyond the prevention of complications of disease
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