Outcomes and costs of blunt trauma in England and Wales

Background Trauma represents an important public health concern in the United Kingdom, yet the acute costs of blunt trauma injury have not been documented and analysed in detail. Knowledge of the overall costs of trauma care, and the drivers of these costs, is a prerequisite for a cost-conscious approach to improvement in standards of trauma care, including evaluation of the cost-effectiveness of new healthcare technologies. Methods Using the Trauma Audit Research Network database, we examined patient records for persons aged 18 years and older hospitalised for blunt trauma between January 2000 and December 2005. Patients were stratified by the Injury Severity Score (ISS). Results A total of 35,564 patients were identified; 60% with an ISS of 0 to 9, 17% with an ISS of 10 to 16, 12% with an ISS of 17 to 25, and 11% with an ISS of 26 to 75. The median age was 46 years and 63% of patients were men. Falls were the most common cause of injury (50%), followed by road traffic collisions (33%). Twenty-nine percent of patients were admitted to critical care for a median length of stay of 4 days. The median total hospital length of stay was 9 days, and 69% of patients underwent at least one surgical procedure. Seven percent of the patients died before discharge, with the highest proportion of deaths among those in the ISS 26–75 group (32%). The mean hospital cost per person was £9,530 (± 11,872). Costs varied significantly by Glasgow Coma Score, ISS, age, cause of injury, type of injury, hospital mortality, grade and specialty of doctor seen in the accident and emergency department, and year of admission. Conclusion The acute treatment costs of blunt trauma in England and Wales vary significantly by injury severity and survival, and public health initiatives that aim to reduce both the incidence and severity of blunt trauma are likely to produce significant savings in acute trauma care. The largest component of acute hospital cost is determined by the length of stay, and measures designed to reduce length of admissions are likely to be the most effective in reducing the costs of blunt trauma care

The National Health Accounts of the Philippines: Continuing Development and New Findings

For more than a decade now, the national health accounts (NHA) of the Philippines has been providing data that are important for health policymaking. At present, the NHA not only continues to be important for health policymaking. It has also become indispensable as a tool for monitoring and tracking outcomes of health sector policies. To further expand its usefulness, the Philippine NHA underwent major restructuring, specifically in the classification of health expenditures by uses of funds. The revised NHA now includes several types of breakdown by uses of funds. Analysis of preliminary 2003 estimates of the revised NHA matrices reveals new details of the manner by which health funds are utilized in the Philippines--data that are not available in the original NHA.health sector, national health accounts, health funds

The National Health Accounts of the Philippines: Continuing Development and New Findings

For more than a decade now, the national health accounts (NHA) of the Philippines has been providing data that are important for health policymaking. At present, the NHA not only continues to be important for health policymaking. It has also become indispensable as a tool for monitoring and tracking outcomes of health sector policies. To further expand its usefulness, the Philippine NHA underwent major restructuring, specifically in the classification of health expenditures by uses of funds. The revised NHA now includes several types of breakdown by uses of funds. Analysis of preliminary 2003 estimates of the revised NHA matrices reveals new details of the manner by which health funds are utilized in the Philippines--data that are not available in the original NHA.health sector, national health accounts, health funds

Cumulate causes for the low contents of sulfide-loving elements in the continental crust

Despite the economic importance of chalcophile (sulfide-loving) and siderophile (metal-loving) elements (CSEs), it is unclear how they become enriched or depleted in the continental crust, compared with the oceanic crust. This is due in part to our limited understanding of the partitioning behaviour of the CSEs. Here I compile compositional data for mid-ocean ridge basalts and subduction-related volcanic rocks. I show that the mantle-derived melts that contribute to oceanic and continental crust formation rarely avoid sulfide saturation during cooling in the crust and, on average, subduction-zone magmas fractionate sulfide at the base of the continental crust prior to ascent. Differentiation of mantle-derived melts enriches lower crustal sulfide- and silicate-bearing cumulates in some CSEs compared with the upper crust. This storage predisposes the cumulate-hosted compatible CSEs (such as Cu and Au) to be recycled back into the mantle during subduction and delamination, resulting in their low contents in the bulk continental crust and potentially contributing to the scarcity of ore deposits in the upper continental crust. By contrast, differentiation causes the upper oceanic and continental crust to become enriched in incompatible CSEs (such as W) compared with the lower oceanic and continental crust. Consequently, incompatible CSEs are predisposed to become enriched in subduction-zone magmas that contribute to continental crust formation and are less susceptible to removal from the continental crust via delamination compared with the compatible CSEs

Fairly Allocating Contiguous Blocks of Indivisible Items

In this paper, we study the classic problem of fairly allocating indivisible items with the extra feature that the items lie on a line. Our goal is to find a fair allocation that is contiguous, meaning that the bundle of each agent forms a contiguous block on the line. While allocations satisfying the classical fairness notions of proportionality, envy-freeness, and equitability are not guaranteed to exist even without the contiguity requirement, we show the existence of contiguous allocations satisfying approximate versions of these notions that do not degrade as the number of agents or items increases. We also study the efficiency loss of contiguous allocations due to fairness constraints.Comment: Appears in the 10th International Symposium on Algorithmic Game Theory (SAGT), 201

Nutrigenetic Effect of Moringa oleifera Seed Meal on the Biological Growth Programme of Young Broiler Chickens.

A Nutrigenetic study of the effects of graded levels (0%, 5% and 10%) of undecorticated undefatted Moringa oleifera Seed Meal (UUMOSM) on the biological growth programme of 48 young broilers of two genotypes (Marshall and Arbor Acres) was conducted. Rates of change (%) of Body Weight (WTR), Length (BLR) and Girth (BGR), and Lengths of Shank (SLR), Thigh (TLR), Wing (WLR) and Keel (KLR) between 1 and 4 weeks age were measured. The effect of Genotype and Diet on growth rate was defined by fitting a univariate General Linear Model, while the strength of relationship between traits was examined by use of Pearson's bivariate correlation method. Only BLR was significantly (P<0.05) affected by genotype, while diet significantly (P<0.05) determined WTR, BGR, TLR, WLR, and KLR. Significant (P<0.05) effects of Genotype x Diet interaction on WTR, BLR, BGR, WLR and KLR were observed. The level of correlation between trait rates varied with increasing levels of UUMOSM in both genotypes; exhibiting a direct, inverse, parabola or inverted parabola shaped relationship curve. These results showed that subtle variations in dietary levels of UUMOSM significantly influence the biological growth programme of young broilers, with implications for size and interrelationship of body parts, including shape/conformation. They further showed that substructures within populations such as clusters with non-overlapping nutritional habits (voluntary or forced) influence overall population estimates of inter-trait relationships. The transcriptomic (gene expression) and metabonomic correlates of the phenomenon reported here will be examined in further studies and should yield evidence of underlying mechanisms.Keywords: Moringa oleifera seed meal, Broiler, Growth rate, Correlationand Regression

Improving the robustness to input errors on touch-based self-service kiosks and transportation apps

acceptedVersio

Clinical predictors of low CD4 count among HIV-infected pulmonary tuberculosis clients: A health facility-based survey

Objectives. The study aimed to determine the clinical and laboratory predictors of a low CD4+ cell count

Scalable and Interpretable One-class SVMs with Deep Learning and Random Fourier features

One-class support vector machine (OC-SVM) for a long time has been one of the most effective anomaly detection methods and extensively adopted in both research as well as industrial applications. The biggest issue for OC-SVM is yet the capability to operate with large and high-dimensional datasets due to optimization complexity. Those problems might be mitigated via dimensionality reduction techniques such as manifold learning or autoencoder. However, previous work often treats representation learning and anomaly prediction separately. In this paper, we propose autoencoder based one-class support vector machine (AE-1SVM) that brings OC-SVM, with the aid of random Fourier features to approximate the radial basis kernel, into deep learning context by combining it with a representation learning architecture and jointly exploit stochastic gradient descent to obtain end-to-end training. Interestingly, this also opens up the possible use of gradient-based attribution methods to explain the decision making for anomaly detection, which has ever been challenging as a result of the implicit mappings between the input space and the kernel space. To the best of our knowledge, this is the first work to study the interpretability of deep learning in anomaly detection. We evaluate our method on a wide range of unsupervised anomaly detection tasks in which our end-to-end training architecture achieves a performance significantly better than the previous work using separate training.Comment: Accepted at European Conference on Machine Learning and Principles and Practice of Knowledge Discovery in Databases (ECML-PKDD) 201

Genetic Inactivation of ANGPTL4 Improves Glucose Homeostasis and Reduces Risk of Type 2 Diabetes

Abstract Angiopoietin-like 4 (ANGPTL4) is an endogenous inhibitor of lipoprotein lipase that modulates lipid levels, coronary atherosclerosis risk, and nutrient partitioning. We hypothesize that loss of ANGPTL4 function might improve glucose homeostasis and decrease risk of type 2 diabetes (T2D). We investigate protein-altering variants in ANGPTL4 among 58,124 participants in the DiscovEHR human genetics study, with follow-up studies in 82,766 T2D cases and 498,761 controls. Carriers of p.E40K, a variant that abolishes ANGPTL4’s ability to inhibit lipoprotein lipase, have lower odds of T2D (odds ratio 0.89, 95% confidence interval 0.85-0.92, p=6.3x10-10), lower fasting glucose, and greater insulin sensitivity. Predicted loss-of-function variants are associated with lower odds of T2D among 32,015 cases and 84,006 controls (odds ratio 0.71, 95% confidence interval 0.49-0.99, p=0.041). Functional studies in Angptl4-deficient mice confirm improved insulin sensitivity and glucose homeostasis. In conclusion, genetic inactivation of ANGPTL4 is associated with improved glucose homeostasis and reduced risk of T2D