Introducing Diagnosis-Related Groups in Kazakhstan: Evolution, achievements, and challenges.

In 2012, Kazakhstan introduced Diagnosis-Related Groups (DRGs), as part of a package of reforms which sought to contain costs and to improve efficiency and transparency in the health system; but the main challenge was to design and implement a DRG system in just one year. In 2011-2012, Kazakhstan developed its own DRG system. Initially 180 DRGs were defined to group inpatient cases but this number was subsequently expanded to more than 400. Because of time limits, the cost weights had to be derived in the absence of existing standard hospital cost accounting systems, and a national patient data transfer system also needed developing. Most importantly, huge efforts were needed to develop a regulatory framework and build up DRG capabilities at a national level. The implementation of DRGs was facilitated by strong political will for their introduction as part of a coherent package of health reforms, and consolidated efforts to build capacity. DRGs are now the key payment mechanism for hospitals. However the reforms are not fully institutionalized: the DRG structure is continuously being refined in a context of data limitations, and the revision of cost weights is most affected by insufficient data and the lack of standardized reporting mechanisms. Capacity around DRG coding is also still being developed. Countries planning to introduce DRG systems should be aware of the challenges in moving too quickly to implement DRGs as the main hospital reimbursement mechanism

First measurement of kaonic helium-3 X-rays

The first observation of the kaonic 3He 3d - 2p transition was made using slow K- mesons stopped in a gaseous 3He target. The kaonic atom X-rays were detected with large-area silicon drift detectors using the timing information of the K+K- pairs of phi-meson decays produced by the DAFNE e+e- collider. The strong interaction shift of the kaonic 3He 2p state was determined to be -2+-2 (stat)+-4 (syst) eV.Comment: Accepted for publication in Phys. Lett.

Pressure induced high-spin to low-spin transition in FeS evidenced by x-ray emission spectroscopy

We report the observation of the pressure-induced high-spin to low-spin transition in FeS using new high-pressure synchrotron x-ray emission spectroscopy techniques. The transition is evidenced by the disappearance of the low-energy satellite in the Fe K$\beta$ emission spectrum of FeS. Moreover, the phase transition is reversible and closely related to the structural phase transition from a manganese phosphide-like phase to a monoclinic phase. The study opens new opportunities for investigating the electronic properties of materials under pressure.Comment: ReVTeX, 4 pages, 3 figures inserted with epsfig. minor modifications before submission to PR

Characterization of low temperature metallic magnetic calorimeters having gold absorbers with implanted 163^{163}Ho ions

For the first time we have investigated the behavior of fully micro-fabricated low temperature metallic magnetic calorimeters (MMCs) after undergoing an ion-implantation process. This experiment had the aim to show the possibility to perform a high precision calorimetric measurement of the energy spectrum following the electron capture of $^{163}$Ho using MMCs having the radioactive $^{163}$Ho ions implanted in the absorber. The implantation of $^{163}$Ho ions was performed at ISOLDE-CERN. The performance of a detector that underwent an ion-implantation process is compared to the one of a detector without implanted ions. The results show that the implantation dose of ions used in this experiment does not compromise the properties of the detector. In addition an optimized detector design for future $^{163}$Ho experiments is presented

SARS-CoV-2 Wastewater Genomic Surveillance: Approaches, Challenges, and Opportunities

During the SARS-CoV-2 pandemic, wastewater-based genomic surveillance (WWGS) emerged as an efficient viral surveillance tool that takes into account asymptomatic cases and can identify known and novel mutations and offers the opportunity to assign known virus lineages based on the detected mutations profiles. WWGS can also hint towards novel or cryptic lineages, but it is difficult to clearly identify and define novel lineages from wastewater (WW) alone. While WWGS has significant advantages in monitoring SARS-CoV-2 viral spread, technical challenges remain, including poor sequencing coverage and quality due to viral RNA degradation. As a result, the viral RNAs in wastewater have low concentrations and are often fragmented, making sequencing difficult. WWGS analysis requires advanced computational tools that are yet to be developed and benchmarked. The existing bioinformatics tools used to analyze wastewater sequencing data are often based on previously developed methods for quantifying the expression of transcripts or viral diversity. Those methods were not developed for wastewater sequencing data specifically, and are not optimized to address unique challenges associated with wastewater. While specialized tools for analysis of wastewater sequencing data have also been developed recently, it remains to be seen how they will perform given the ongoing evolution of SARS-CoV-2 and the decline in testing and patient-based genomic surveillance. Here, we discuss opportunities and challenges associated with WWGS, including sample preparation, sequencing technology, and bioinformatics methods.Comment: V Munteanu and M Saldana contributed equally to this work A Smith and S Mangul jointly supervised this work For correspondence: [email protected]

Instabilities in the wake of an inclined prolate spheroid

We investigate the instabilities, bifurcations and transition in the wake behind a 45-degree inclined 6:1 prolate spheroid, through a series of direct numerical simulations (DNS) over a wide range of Reynolds numbers (Re) from 10 to 3000. We provide a detailed picture of how the originally symmetric and steady laminar wake at low Re gradually looses its symmetry and turns unsteady as Re is gradually increased. Several fascinating flow features have first been revealed and subsequently analysed, e.g. an asymmetric time-averaged flow field, a surprisingly strong side force etc. As the wake partially becomes turbulent, we investigate a dominating coherent wake structure, namely a helical vortex tube, inside of which a helical symmetry alteration scenario was recovered in the intermediate wake, together with self-similarity in the far wake.Comment: Book chapter in "Computational Modeling of Bifurcations and Instabilities in Fluid Dynamics (A. Gelfgat ed.)", Springe

Measurements of the strong-interaction widths of the kaonic 3He and 4He 2p levels

The kaonic 3He and 4He X-rays emitted in the 3d-2p transitions were measured in the SIDDHARTA experiment. The widths of the kaonic 3He and 4He 2p states were determined to be Gamma_2p(3He) = 6 \pm 6 (stat.) \pm 7 (syst.) eV, and Gamma_2p(4He) = 14 \pm 8 (stat.) \pm 5 (syst.) eV, respectively. Both results are consistent with the theoretical predictions. The width of kaonic 4He is much smaller than the value of 55 \pm 34 eV determined by the experiments performed in the 70's and 80's, while the width of kaonic 3He was determined for the first time.Comment: Accepted in Phys. Lett.

Divergent Roles of Salmonella Pathogenicity Island 2 and Metabolic Traits during Interaction of S. enterica Serovar Typhimurium with Host Cells

The molecular mechanisms of virulence of the gastrointestinal pathogen Salmonella enterica are commonly studied using cell culture models of infection. In this work, we performed a direct comparison of the interaction of S. enterica serovar Typhimurium (S. Typhimurium) with the non-polarized epithelial cell line HeLa, the polarized cell lines CaCo2, T84 and MDCK, and macrophage-like RAW264.7 cells. The ability of S. Typhimurium wild-type and previously characterized auxotrophic mutant strains to enter host cells, survive and proliferate within mammalian cells and deploy the Salmonella Pathogenicity Island 2-encoded type III secretion system (SPI2-T3SS) was quantified. We found that the entry of S. Typhimurium into polarized cells was much more efficient than entry into non-polarized cells or phagocytic uptake. While SPI2-T3SS dependent intracellular proliferation was observed in HeLa and RAW cells, the intracellular replication in polarized cells was highly restricted and not affected by defective SPI2-T3SS. The contribution of aromatic amino acid metabolism and purine biosynthesis to intracellular proliferation was distinct in the various cell lines investigated. These observations indicate that the virulence phenotypes of S. Typhimurium are significantly affected by the cell culture model applied