Assessing the Economic Gains of Free Market Access for the Least Developed Countries in the QUAD

The Least Developed Countries (LDCs) are the poorest countries in the world. Their share of world trade has declined from 0.8% in 1980 to less than 0.5% today. The purpose of this study is to evaluate the impact on the LDCs of getting duty- and quota-free access to their main export markets. Our conclusion is that the aggregate benefits are likely to be modest. The main reasons are (1) that most LDCs presently enjoy quite liberal market access in important export markets, and (2) that the ability of LDCs to take advantage of trade preferences is limited, due to supply constraints and restrictive rules of origin.

Monte-Carlo Simulation Based on Patient-Individual Distributions for Supporting Intensive Care Occupancy Management

Managing Intensive Care Units (ICUs) in hospitals is a highly challenging endeavor. In particular, decisions such as admitting elective patients and discharging patients from the ICU have to be taken under a high level of uncertainty since the occupancy of ICUs does not only depend on these decisions but also on unknown parameters such emergency patient arrivals and lengths of stay of the patients in the ICU. In this paper, we develop a framework for supporting ICU occupation management by quantifying the impact of admission and discharge decisions on the probability of reaching critical ICU occupancy levels in a given planning horizon. A key component of this framework is the use of data-driven approaches for obtaining probability distributions for the parameters affected by uncertainty. In particular, we use standardized treatment and patient health state data to create patient-specific length-of-stay distributions with a Machine Learning approach. These patient-individual distributions are then validated and/or adjusted by medical experts. The validated distributions form the input to a Monte-Carlo Simulation that is used to approximate the probability distributions of the daily ICU occupancy levels resulting from ICU admission and discharge decisions. We experimentally evaluate our framework in a counterfactual simulation based on one year of historical data from 2019 from a medium-sized ICU in a German hospital. In that evaluation, we use a simple ICU management policy based on the probabilistic occupancy forecasts aiming at reducing the risk of running out of ICU capacity. The results show that following this policy would have avoided hitting critical occupancy levels by around 70% and would have had a smoothing effect on ICU occupancy levels

Strengthening Medical Care for Young People in the Netherlands:A Reflection

To improve medical care for young people in the Netherlands, various professional groups representing physicians who provide medical care to children have developed a vision called ‘strengthening medical care for young people’. The purpose of this viewpoint is to reflect on the implementation of proposals to augment cooperation and coordination between the professional groups involved. Our reflection demonstrates that additional action regarding cooperation and coordination is still necessary to strengthen this care for young people. First, regarding the practical implementation of collaboration, the guidelines are unclear, and many are out-of-date. Second, adequate structured interdisciplinary training and intervision are lacking for physicians frequently collaborating in the care of young people. Third, interdisciplinary access to patient files is too complex and time-consuming. We recommend structured monitoring of the implementation of all improvement proposals, regarding both processes and outcomes. In addition, we recommend collaboration with physicians treating mentally disabled individuals to improve medical care for this group

Strengthening Medical Care for Young People in the Netherlands:A Reflection

To improve medical care for young people in the Netherlands, various professional groups representing physicians who provide medical care to children have developed a vision called ‘strengthening medical care for young people’. The purpose of this viewpoint is to reflect on the implementation of proposals to augment cooperation and coordination between the professional groups involved. Our reflection demonstrates that additional action regarding cooperation and coordination is still necessary to strengthen this care for young people. First, regarding the practical implementation of collaboration, the guidelines are unclear, and many are out-of-date. Second, adequate structured interdisciplinary training and intervision are lacking for physicians frequently collaborating in the care of young people. Third, interdisciplinary access to patient files is too complex and time-consuming. We recommend structured monitoring of the implementation of all improvement proposals, regarding both processes and outcomes. In addition, we recommend collaboration with physicians treating mentally disabled individuals to improve medical care for this group.</p

Statistical and ecological challengesof monitoring parasitic salmon lice infestationsin wild salmonid fish stocks

-Ecological monitoring programmes should provide precise data to inform management, but the data quality is often limited by methodological challenges and the need for cost-effective sampling. Parasite infestations are particularly challenging to monitor due to complex interactions among hosts, parasites and the environment. In Norway, salmon lice infestations on wild salmonid fish have been monitored since 1992 to survey the potential transmission between farmed and wild salmonids. Here, we compared spatiotemporal variation in salmon lice levels with variations in local fjord conditions, including salinity, temperature and infestation pressure from salmon farms (measured as mean abundance of mature female lice × number of farmed fish). We tested 3 different measures of infestation with different statistical properties. Our results confirm that, even after correcting for temperature and salinity effects, in - festation pressure from salmon farms significantly increases the probability of lice infestation in wild salmonids. The probability of infestation increases with fish body length, salmon farm infestation pressure and tem perature, and decreases with increasing freshwater influence. Furthermore, we found a significant interaction between temperature and infestation pressure from salmon farms. When the infestation pressure from farms is low, temperature has a strong increasing effect on the probability of infestation, but as the infestation pressure from farms increases, temperature gradually becomes less important. The exact results vary somewhat depending on the measure of lice infestations used, but the same trend can be seen in all models. We discuss the statistical and biological complexities that make monitoring of salmon lice in wild populations challenging

The OCareCloudS project: toward organizing care through trusted cloud services

The increasing elderly population and the shift from acute to chronic illness makes it difficult to care for people in hospitals and rest homes. Moreover, elderly people, if given a choice, want to stay at home as long as possible. In this article, the methodologies to develop a cloud-based semantic system, offering valuable information and knowledge-based services, are presented. The information and services are related to the different personal living hemispheres of the patient, namely the daily care-related needs, the social needs and the daily life assistance. Ontologies are used to facilitate the integration, analysis, aggregation and efficient use of all the available data in the cloud. By using an interdisciplinary research approach, where user researchers, (ontology) engineers, researchers and domain stakeholders are at the forefront, a platform can be developed of great added value for the patients that want to grow old in their own home and for their caregivers

Complete chloroplast genome sequences of Hordeum vulgare, Sorghum bicolor and Agrostis stolonifera, and comparative analyses with other grass genomes

Comparisons of complete chloroplast genome sequences of Hordeum vulgare, Sorghum bicolor and Agrostis stolonifera to six published grass chloroplast genomes reveal that gene content and order are similar but two microstructural changes have occurred. First, the expansion of the IR at the SSC/IRa boundary that duplicates a portion of the 5′ end of ndhH is restricted to the three genera of the subfamily Pooideae (Agrostis, Hordeum and Triticum). Second, a 6 bp deletion in ndhK is shared by Agrostis, Hordeum, Oryza and Triticum, and this event supports the sister relationship between the subfamilies Erhartoideae and Pooideae. Repeat analysis identified 19-37 direct and inverted repeats 30 bp or longer with a sequence identity of at least 90%. Seventeen of the 26 shared repeats are found in all the grass chloroplast genomes examined and are located in the same genes or intergenic spacer (IGS) regions. Examination of simple sequence repeats (SSRs) identified 16–21 potential polymorphic SSRs. Five IGS regions have 100% sequence identity among Zea mays, Saccharum officinarum and Sorghum bicolor, whereas no spacer regions were identical among Oryza sativa, Triticum aestivum, H. vulgare and A. stolonifera despite their close phylogenetic relationship. Alignment of EST sequences and DNA coding sequences identified six C–U conversions in both Sorghum bicolor and H. vulgare but only one in A. stolonifera. Phylogenetic trees based on DNA sequences of 61 protein-coding genes of 38 taxa using both maximum parsimony and likelihood methods provide moderate support for a sister relationship between the subfamilies Erhartoideae and Pooideae

Mutations in POLE and survival of colorectal cancer patients – link to disease stage and treatment

Recent molecular profiling studies reported a new class of ultramutated colorectal cancers (CRCs), which are caused by exonuclease domain mutations (EDMs) in DNA polymerase ϵ (POLE). Data on the clinical implications of these findings as to whether these mutations define a unique CRC entity with distinct clinical outcome are lacking. We performed Sanger sequencing of the POLE exonuclease domain in 431 well-characterized patients with microsatellite stable (MSS) CRCs of a population-based patient cohort. Mutation data were analyzed for associations with major epidemiological, clinical, genetic, and pathological parameters including overall survival (OS) and disease-specific survival (DSS). In 373 of 431 MSS CRC, all exons of the exonuclease domain were analyzable. Fifty-four mutations were identified in 46 of these samples (12.3%). Besides already reported EDMs, we detected many new mutations in exons 13 and 14 (corresponding to amino acids 410–491) as well as in exon 9 and exon 11 (corresponding to aa 268–303 and aa 341–369). However, we did not see any significant associations of EDMs with clinicopathological parameters, including sex, age, tumor location and tumor stage, CIMP, KRAS, and BRAF mutations. While with a median follow-up time of 5.0 years, survival analysis of the whole cohort revealed nonsignificantly different adjusted hazard ratios (HRs) of 1.35 (95% CI: 0.82–2.25) and 1.44 (0.81–2.58) for OS and DSS indicating slightly impaired survival of patients with EDMs, subgroup analysis for patients with stage III/IV disease receiving chemotherapy revealed a statistically significantly increased adjusted HR (1.87; 95%CI: 1.02–3.44). In conclusion, POLE EDMs do not appear to define an entirely new clinically distinct disease entity in CRC but may have prognostic or predictive implications in CRC subgroups, whose significance remains to be investigated in future studies

Linking heart rate variability to psychological health and brain structure in adolescents with and without conduct disorder

AimsHeart rate variability (HRV) measures have been suggested in healthy individuals as a potential index of self-regulation skills, which include both cognitive and emotion regulation aspects. Studies in patients with a range of psychiatric disorders have however mostly focused on the potential association between abnormally low HRV at rest and specifically emotion regulation difficulties. Emotion regulation deficits have been reported in patients with Conduct Disorder (CD) however, the association between these emotion regulation deficits and HRV measures has yet to be fully understood. This study investigates (i) the specificity of the association between HRV and emotion regulation skills in adolescents with and without CD and (ii) the association between HRV and grey matter brain volumes in key areas of the central autonomic network which are involved in self-regulation processes, such as insula, lateral/medial prefrontal cortices or amygdala.MethodsRespiratory sinus arrhythmia (RSA) measures of HRV were collected from adolescents aged between 9–18 years (693 CD (427F)/753 typically developing youth (TD) (500F)), as part of a European multi-site project (FemNAT-CD). The Inverse Efficiency Score, a speed-accuracy trade-off measure, was calculated to assess emotion and cognitive regulation abilities during an Emotional Go/NoGo task. The association between RSA and task performance was tested using multilevel regression models. T1-weighted structural MRI data were included for a subset of 577 participants (257 CD (125F); 320 TD (186F)). The CerebroMatic toolbox was used to create customised Tissue Probability Maps and DARTEL templates, and CAT12 to segment brain images, followed by a 2 × 2 (sex × group) full factorial ANOVA with RSA as regressor of interest.ResultsThere were no significant associations between RSA and task performance, neither during emotion regulation nor during cognitive regulation trials. RSA was however positively correlated with regional grey matter volume in the left insula (pFWE = 0.011) across all subjects.ConclusionRSA was related to increased grey matter volume in the left insula across all subjects. Our results thus suggest that low RSA at rest might be a contributing or predisposing factor for potential self-regulation difficulties. Given the insula’s role in both emotional and cognitive regulation processes, these brain structural differences might impact either of those

Community-driven dispersal in an individual-based predator-prey model

We present a spatial, individual-based predator-prey model in which dispersal is dependent on the local community. We determine species suitability to the biotic conditions of their local environment through a time and space varying fitness measure. Dispersal of individuals to nearby communities occurs whenever their fitness falls below a predefined tolerance threshold. The spatiotemporal dynamics of the model is described in terms of this threshold. We compare this dynamics with the one obtained through density-independent dispersal and find marked differences. In the community-driven scenario, the spatial correlations in the population density do not vary in a linear fashion as we increase the tolerance threshold. Instead we find the system to cross different dynamical regimes as the threshold is raised. Spatial patterns evolve from disordered, to scale-free complex patterns, to finally becoming well-organized domains. This model therefore predicts that natural populations, the dispersal strategies of which are likely to be influenced by their local environment, might be subject to complex spatiotemporal dynamics.Comment: 43 pages, 7 figures, vocabulary modifications, discussion expanded, references added, Ecological Complexity accepte