What Does It Take for a Family to Afford to Pay for Health Care?

Addresses how much Californians can afford to pay for health care based on their current insurance premiums and out-of-pocket expenses as well as other basic necessities, such as housing, child care, transportation, food, and taxes

Phase II Proof-of-Concept Trial of the Orexin Receptor Antagonist Filorexant (MK-6096) in Patients with Major Depressive Disorder.

BackgroundWe evaluated the orexin receptor antagonist filorexant (MK-6096) for treatment augmentation in patients with major depressive disorder.MethodsWe conducted a 6-week, double-blind, placebo-controlled, parallel-group, Phase II, proof-of-concept study. Patients with major depressive disorder (partial responders to ongoing antidepressant therapy) were randomized 1:1 to once-daily oral filorexant 10 mg or matching placebo.ResultsDue to enrollment challenges, the study was terminated early, resulting in insufficient statistical power to detect a prespecified treatment difference; of 326 patients planned, 129 (40%) were randomized and 128 took treatment. There was no statistically significant difference in the primary endpoint of change from baseline to week 6 in Montgomery Asberg Depression Rating Scale total score; the estimated treatment difference for filorexant-placebo was -0.7 (with negative values favoring filorexant) (P=.679). The most common adverse events were somnolence and suicidal ideation.ConclusionsThe interpretation of the results is limited by the enrollment, which was less than originally planned, but the available data do not suggest efficacy of orexin receptor antagonism with filorexant for the treatment of depression. (Clinical Trial Registry: clinicaltrials.gov: NCT01554176)

queue: Customized large-scale clock frequency scaling

Abstract-We examine the scalability of a set of techniques related to Dynamic Voltage-Frequency Scaling (DVFS) on HPC systems to reduce the energy consumption of scientific applications through an application-aware analysis and runtime framework, Green Queue. Green Queue supports making CPU clock frequency changes in response to intra-node and internode observations about application behavior. Our intra-node approach reduces CPU clock frequencies and therefore power consumption while CPUs lacks computational work due to inefficient data movement. Our inter-node approach reduces clock frequencies for MPI ranks that lack computational work. We investigate these techniques on a set of large scientific applications on 1024 cores of Gordon, an Intel Sandybridgebased supercomputer at the San Diego Supercomputer Center. Our optimal intra-node technique showed an average measured energy savings of 10.6% and a maximum of 21.0% over regular application runs. Our optimal inter-node technique showed an average 17.4% and a maximum of 31.7% energy savings

Zoonotic causes of febrile illness in malaria endemic countries:a systematic review

Fever is one of the most common reasons for seeking health care globally and most human pathogens are zoonotic. We conducted a systematic review to describe the occurrence and distribution of zoonotic causes of human febrile illness reported in malaria endemic countries. We included data from 53 (48·2%) of 110 malaria endemic countries and 244 articles that described diagnosis of 30 zoonoses in febrile people. The majority (17) of zoonoses were bacterial, with nine viruses, three protozoa, and one helminth also identified. Leptospira species and non-typhoidal salmonella serovars were the most frequently reported pathogens. Despite evidence of profound data gaps, this Review reveals widespread distribution of multiple zoonoses that cause febrile illness. Greater understanding of the epidemiology of zoonoses in different settings is needed to improve awareness about these pathogens and the management of febrile illness

High-frequency simulations of global seismic wave propagation using SPECFEM3D_GLOBE on 62K processors

SPECFEM3D_GLOBE is a spectral element application enabling the simulation of global seismic wave propagation in 3D anelastic, anisotropic, rotating and self-gravitating Earth models at unprecedented resolution. A fundamental challenge in global seismology is to model the propagation of waves with periods between 1 and 2 seconds, the highest frequency signals that can propagate clear across the Earth. These waves help reveal the 3D structure of the Earth's deep interior and can be compared to seismographic recordings. We broke the 2 second barrier using the 62K processor Ranger system at TACC. Indeed we broke the barrier using just half of Ranger, by reaching a period of 1.84 seconds with sustained 28.7 Tflops on 32K processors. We obtained similar results on the XT4 Franklin system at NERSC and the XT4 Kraken system at University of Tennessee Knoxville, while a similar run on the 28K processor Jaguar system at ORNL, which has better memory bandwidth per processor, sustained 35.7 Tflops (a higher flops rate) with a 1.94 shortest period. Thus we have enabled a powerful new tool for seismic wave simulation, one that operates in the same frequency regimes as nature; in seismology there is no need to pursue periods much smaller because higher frequency signals do not propagate across the entire globe. We employed performance modeling methods to identify performance bottlenecks and worked through issues of parallel I/O and scalability. Improved mesh design and numbering results in excellent load balancing and few cache misses. The primary achievements are not just the scalability and high teraflops number, but a historic step towards understanding the physics and chemistry of the Earth's interior at unprecedented resolution

Joint Inference in Weakly-Annotated Image Datasets via Dense Correspondence

We present a principled framework for inferring pixel labels in weakly-annotated image datasets. Most previous, example-based approaches to computer vision rely on a large corpus of densely labeled images. However, for large, modern image datasets, such labels are expensive to obtain and are often unavailable. We establish a large-scale graphical model spanning all labeled and unlabeled images, then solve it to infer pixel labels jointly for all images in the dataset while enforcing consistent annotations over similar visual patterns. This model requires significantly less labeled data and assists in resolving ambiguities by propagating inferred annotations from images with stronger local visual evidences to images with weaker local evidences. We apply our proposed framework to two computer vision problems, namely image annotation with semantic segmentation, and object discovery and co-segmentation (segmenting multiple images containing a common object). Extensive numerical evaluations and comparisons show that our method consistently outperforms the state-of-the-art in automatic annotation and semantic labeling, while requiring significantly less labeled data. In contrast to previous co-segmentation techniques, our method manages to discover and segment objects well even in the presence of substantial amounts of noise images (images not containing the common object), as typical for datasets collected from Internet search

Sociocultural and Health System Factors Associated With Mortality Among Febrile Inpatients in Tanzania: A Prospective Social Biopsy Cohort Study

Introduction Communicable diseases are the leading causes of death in Tanzania despite the existence of effective treatment tools. We aimed to assess the sociocultural and health system factors associated with mortality from febrile illness in northern Tanzania. Methods We interviewed febrile inpatients to determine prevalence of barriers in seeking or receiving care and grouped these barriers using the Three Delays model (delays at home, in transport and at healthcare facilities). We assessed 6-week mortality and, after matching on age, gender and severity of illness, measured the association between delays and mortality using conditional logistic regression. Results We enrolled 475 children, of whom 18 (3.8%) died, and 260 adults, of whom 34 (13.0%) died. For children, home delays were not associated with mortality. Among adults, a delay in care-seeking due to not recognising severe symptoms was associated with mortality (OR: 3.01; 95% CI 1.24 to 7.32). For transport delays, taking \u3e1 hour to reach a facility increased odds of death in children (OR: 3.27; 95% CI 1.11 to 9.66) and adults (OR: 3.03; 95% CI 1.32 to 6.99). For health system delays, each additional facility visited was associated with mortality for children (OR: 1.59; 95% CI 1.06 to 2.38) and adults (OR: 2.00; 95% CI 1.17 to 3.41), as was spending \u3e4 days between the first facility visit and reaching tertiary care (OR: 4.39; 95% CI 1.49 to 12.93). Conclusion Our findings suggest that delays at home, in transport and in accessing tertiary care are risk factors for mortality from febrile illness in northern Tanzania. Interventions that may reduce mortality include community education regarding severe symptoms, expanding transportation infrastructure and streamlining referrals to tertiary care for the sickest patients