Treatment for congenital toxoplasmosis: finding out what works

Evidence for the effectiveness of prenatal or postnatal treatment for congenital toxoplasmosis will be critical to guide policy about prenatal and neonatal screening over the next 10 years, let alone the next 100. Randomised controlled trials are needed to address questions about treatment effectiveness, although cohort studies are also needed to provide information on prognosis, especially disability. Nowhere are such studies needed more than in South America where congenital toxoplasmosis is a major public health problem

A Monte Carlo model checker for probabilistic LTL with numerical constraints

We define the syntax and semantics of a new temporal logic called probabilistic LTL with numerical constraints (PLTLc). We introduce an efficient model checker for PLTLc properties. The efficiency of the model checker is through approximation using Monte Carlo sampling of finite paths through the model’s state space (simulation outputs) and parallel model checking of the paths. Our model checking method can be applied to any model producing quantitative output – continuous or stochastic, including those with complex dynamics and those with an infinite state space. Furthermore, our offline approach allows the analysis of observed (real-life) behaviour traces. We find in this paper that PLTLc properties with constraints over free variables can replace full model checking experiments, resulting in a significant gain in efficiency. This overcomes one disadvantage of model checking experiments which is that the complexity depends on system granularity and number of variables, and quickly becomes infeasible. We focus on models of biochemical networks, and specifically in this paper on intracellular signalling pathways; however our method can be applied to a wide range of biological as well as technical systems and their models. Our work contributes to the emerging field of synthetic biology by proposing a rigourous approach for the structured formal engineering of biological systems

Heparin bonded lines offer a solution that is difficult to implement Rapid Response to Dobson,R "Half the cases of bacteraemia in hospitals in England are linked to devices)

[Full text] The BMJ news report[1] that devices, particularly central venous lines, are linked to over half the cases of hospital acquired bacteraemia has long been a source of concern to clinicians in intensive care. Unfortunately, one simple, effective and low-cost intervention is not being used because of restrictions on licensing and supply. A systematic review[2] of heparin bonding (1 trial) or heparin infusion (3 trials) versus no anti-thrombotic prophylaxis for central venous lines showed a strong trend for a reduction in bacteraemia (pooled RR 0.26; 95% CI: 007, 1.03). Our updated searches found one subsequent trial[3] (200 children), conducted at Great Ormond Street Hospital (GOSH) without commercial funding, in which heparin bonded lines reduced the risk of bacteraemia from 33% to 4% (risk difference 29%; 19%, 39%). As heparin bonded central venous lines are not licensed for use in the UK, GOSH has been able to maintain their supply only by agreeing to take full legal responsibility should problems arise. This means that lines can be used but only on a named-patient basis with their use audited. It is therefore not surprising that a recent survey of 36 consultant and specialist trainee anaesthetists from across the south east of England found that no other trust was using heparin bonded lines. Policy regarding heparin bonded lines undoubtedly requires more and better quality studies[4,5]. However, satisfactory alternatives are few. Heparin infusion requires staff time, additional equipment, and provides the opportunity for drug errors. In contrast, adverse effects of heparin bonded lines remain theoretical. Although heparin bonded lines are licensed and widely used in the USA, the UK licensing authority requires further studies which the company appears to be reluctant to pursue. Focused commercial and research efforts are required to resolve this impasse. Reference List 1. Dobson R. Half the cases of bacteraemia in hospitals in England are linked to devices. BMJ 2003;326:10. 2. Randolph AG, Cook DJ, Gonzales CA, Andrew M. Benefit of heparin in central venous and pulmonary artery catheters: a meta-analysis of randomized controlled trials. Chest 1998;113:165-71. 3. Pierce CM, Wade A, Mok Q. Heparin-bonded central venous lines reduce thrombotic and infective complications in critically ill children. Intensive Care Med. 2000;26:967-72. 4. Randolph AG, Cook DJ, Gonzales CA, Andrew M. Benefit of heparin in peripheral venous and arterial catheters: systematic review and meta- analysis of randomised controlled trials. BMJ 1998;316:969-75. 5. Shah PS, Ng E, Sinha AK. Heparin for prolonging peripheral intravenous catheter use in neonates (Cochrane Review). Cochrane Database.Syst.Rev. 2002;CD00277

Implications of annual examinations for the Bank Insurance Fund

Deposit insurance ; Bank failures ; Bank examination

Effects of interest on demand deposits: implications of compensating balances

Bank deposits ; Interest ; Bank loans

Recent changes in handling bank failures and their effects on the banking industry

Banks and banking ; Bank failures ; Federal Deposit Insurance Corporation

Effectiveness of state reserve requirements

Bank reserves ; Banks and banking