Simulating Migration In The Pensim2 Dynamic Microsimulation Model

Modelling migration is fundamentally important to maintaining the appropriate population structure in a dynamic microsimulation model. It is particularly important as it is faster changing than other demographic processes such as fertility and mortality and so can impact upon the structure of the population quickly. In this paper we review methods that have been used by other models and describe the choices and methods used in the Pensim2 dynamic microsimulation model. In particular we model immigration flows, emigration flows and the overseas population. We divide our method into modelling how many migrate using external macro data and who emigrates, based upon micro processes.Migration, Dynamic Microsimulation

Design Requirements for a Patient Administered Personal Electronic Health Record

Published version of a chapter in the book: Biomedical engineering, trends in electronics, communications and software. Intech, 2011 Open Acces

The economic contribution of recreational fishing: Waterville, Co. Kerry. ESRI Research Bulletin 2017/11

This research evaluates the local economic benefit arising from recreational angling tourism in Waterville, Co. Kerry. Tourism is vital to the local economy, and fishing is an important tourist attraction. Fishing opportunities include sea fish angling for bass, pollack, mullet, etc., as well as lake and river angling for salmon, sea trout and brown trout. Other sporting and cultural attractions also exist locally and the area benefits from it situation on the ‘Ring of Kerry’. Waterville Lakes and Rivers Trust undertook a survey of anglers between February and June 2015. This research is based on that survey data but focuses on visiting tourist anglers and their expenditures in the local area, both anglingrelated (e.g. ghillie and boat hire, fishing tackle, bait, etc.) and non-angling expenditures (e.g. accommodation, meals, drinks and groceries, gifts, etc.). The survey includes both tourists where the sole focus of the trip was fishing and where fishing was only one component of a trip that included other tourist activities

Possible detection of two giant extrasolar planets orbiting the eclipsing polar UZ Fornacis

We present new high-speed, multi-observatory, multi-instrument photometry of the eclipsing polar UZ For in order to measure precise mid-eclipse times with the aim of detecting any orbital period variations. When combined with published eclipse times and archival data spanning ~27 years, we detect departures from a linear and quadratic trend of ~60 s. The departures are strongly suggestive of two cyclic variations of 16(3) and 5.25(25) years. The two favoured mechanisms to drive the periodicities are either two giant extrasolar planets as companions to the binary (with minimum masses of 6.3(1.5)M(Jupiter) and 7.7(1.2)M(Jupiter)) or a magnetic cycle mechanism (e.g. Applegate's mechanism) of the secondary star. Applegate's mechanism would require the entire radiant energy output of the secondary and would therefore seem to be the least likely of the two, barring any further refinements in the effect of magnetic fieilds (e.g. those of Lanza et al.). The two planet model can provide realistic solutions but it does not quite capture all of the eclipse times measurements. A highly eccentric orbit for the outer planet would fit the data nicely, but we find that such a solution would be unstable. It is also possible that the periodicities are driven by some combination of both mechanisms. Further observations of this system are encouraged.Comment: 10 pages, 4 figures, 2 table

The Dwarf Novae of Shortest Period

We present observations of the dwarf novae GW Lib, V844 Her, and DI UMa. Radial velocities of H-alph yield orbital periods of 0.05332 +- 0.00002 d (= 76.78 m) for GW Lib and and 0.054643 +- 0.000007 d (= 78.69 m) for V844 Her. Recently, the orbital period of DI UMa was found to be only 0.054564 +- 0.000002 d (= 78.57 m) by Fried et al. (1999), so these are the three shortest orbital periods among dwarf novae with normal-abundance secondaries. GW Lib has attracted attention as a cataclysmic binary showing apparent ZZ Ceti-type pulsations of the white dwarf primary. Its spectrum shows sharp Balmer emission flanked by strong, broad Balmer absorption, indicating a dominant contribution by white-dwarf light. Analysis of the Balmer absorption profiles is complicated by the unknown residual accretion luminosity and lack of coverage of the high Balmer lines. Our best-fit model atmospheres are marginally hotter than the ZZ Ceti instability strip, in rough agreement with recent ultraviolet results from HST. The spectrum and outburst behavior of GW Lib make it a near twin of WZ Sge, and we estimate it to have a quiescent V absolute magnitude 12. Comparison with archival data reveals proper motion of 65 +- 12 mas/yr. The mean spectrum of V844 Her is typical of SU UMa dwarf novae. We detected superhumps in the 1997 May superoutburst with superhump period = 0.05597 +- 0.00005 d. The spectrum of DI UMa appears normal for a dwarf nova near minimum light. These three dwarf novae have nearly identical short periods but completely dissimilar outburst characteristics. We discuss possible implications.Comment: Accepted for publication in Publications of the Astronomical Society of the Pacific; 16 pages, 6 figure

Utility of Phase Angle to Identify Cachexia and Assess Mortality in End-Stage Renal Disease

© 2020 American Society for Nutrition. Published by Elsevier Inc. This is an Open access article under the CC-BY-NC-ND license. https://creativecommons.org/licenses/by-nc-nd/4.0/Objectives This cross-sectional analysis sought to identify cachexia and assess survival using phase angle (PA) in patients with end-stage renal disease (ESRD) receiving haemodialysis. Methods Patients receiving haemodialysis (n = 87, mean age 65.9 +/– 13.0) completed a Phase Angle (PA; 50 khz) measurement using bioelectrical impedance analysis. Cachexia variables were recorded according to Evans et al. definition (2008) including nutritional and functional measures (weight, Body Mass Index (BMI), Hand Grip Strength (HGS), Lean Tissue Mass (LTM), C-Reative Protein (CRP), serum albumin, haemoglobin, appetite (Functional Assessment of Anorexia/Cachexia Treatment (FAACT)) and fatigue (Functional Assessment of Chronic Illness Therapy (FACIT)). Survival was assessed at 12 months. Mann Whitney-U and Spearman correlation coefficient were conducted. Results The majority of patients completed follow up (n = 76). Eleven patients had died. Mean PA was not statistically different between those identified as cachectic and non-cachectic according to Evans et al. (2008) definition or between those patients that survived and died. However, patients that survived had better mean scores of weight, BMI, HGS, CRP, serum albumin and fatigue (FACIT). In addition, LTM scores were significantly better in patients that survived (P < .01). Appetite scores were also significantly better in patients that survived (P < .01) and those without cachexia (P = .01). Conclusions This study was part of a larger effort to clarity a phenotype of cachexia in ESRD. Unlike previous research, this study did not find PA useful in identifying patients at a higher risk of cachexia or death. However overall these patients had a very low mean PA. FAACT did discriminate between groups indicating self-reporting measurement tools of nutritional status were useful in identifying patients at a higher risk of cachexia and death. A larger sample and longer follow up is required to balance the limitations of this small study. Timing the administration of PA also requires consideration in future studies. Funding Sources Public Health Agency; Northern Ireland Kidney Research Fund.Peer reviewe

Phenotypic Responses to a Lifestyle Intervention Do Not Account for Inter-Individual Variability in Glucose Tolerance for Individuals at High Risk of Type 2 Diabetes

Background: Lifestyle interventions have been shown to delay or prevent the onset of type 2 diabetes among high risk adults. A better understanding of the variability in physiological responses would support the matching of individuals with the best type of intervention in future prevention programmes, in order to optimize risk reduction. The purpose of this study was to determine if phenotypic characteristics at baseline or following a 12 weeks lifestyle intervention could explain the inter-individual variability in change in glucose tolerance in individuals with high risk for type 2 diabetes.Methods: In total, 285 subjects with normal glucose tolerance (NGT, FINDRISC score &gt; 12), impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) were recruited for a 12 weeks lifestyle intervention. Glucose tolerance, insulin sensitivity, anthropometric characteristics and aerobic fitness were measured. Variability of responses was examined by grouping participants by baseline glycemic status, by cluster analysis based on the change in glucose tolerance and by Principal Component Analysis (PCA).Results: In agreement with other studies, the mean response to the 12 weeks intervention was positive for the majority of parameters. Overall, 89% improved BMI, 80% waist circumference, and 81% body fat while only 64% improved fasting plasma glucose and 60% 2 h glucose. The impact of the intervention by glycaemic group did not show any phenotypic differences in response between NGT, IFG, and IGT. A hierarchical cluster analysis of change in glucose tolerance identified four sub-groups of “responders” (high and moderate) and “non-responders” (no response or deteriorated) but there were few differences in baseline clincal and physiological parameters or in response to the intervention to explain the overall variance. A further PCA analysis of 19 clinical and physiological univariables could explain less than half (48%) of total variability.Conclusion: We found that phenotypic characteristics from standard clinical and physiological parameters were not sufficient to account for the inter-individual variability in glucose tolerance following a 12 weeks lifestyle intervention in inidivuals at high risk for type 2 diabetes. Further work is required to identify biomarkers that complement phenotypic traits and better predict the response to glucose tolerance

Predictors of change in social networks, support and satisfaction following a first episode psychosis: A cohort study

Background Diminished social networks are common in psychosis but few studies have measured these comprehensively and prospectively to determine how networks and support evolve during the early phase. There is little information regarding perceived support in the early phase of illness. The aim of this study was to describe social support, networks and perceived satisfaction, explore the clinical correlates of these outcomes and examine whether phases of untreated psychosis are linked with social network variables to determine potential opportunities for intervention. Methods During the study period, we assessed 222 people with first-episode psychosis at entry into treatment using valid and reliable measures of diagnosis, positive and negative symptoms, periods of untreated psychosis and prodrome and premorbid adjustment. For follow-up we contacted participants to conduct a second assessment (n = 158). There were 97 people who participated which represented 61% of those eligible. Social network and support information obtained at both time points included the number of friends, self-reported satisfaction with support and social network size and clinician’s evaluation of the degree of support received through networks. Mixed effects modelling determined the contribution of potential explanatory variables to social support measured. Results A number of clinical variables were linked with social networks, support and perceived support and satisfaction. The size of networks did not change over time but those with no friends and duration of untreated psychosis was significantly longer for those with no friends at entry into treatment (n = 129, Median = 24.5mths, IQR = 7.25 – 69.25; Mann-Whitney U = 11.78, p = 0.008). Social support at baseline and at one year was predicted by homelessness (t = -2.98, p = 0.001, CI -4.74 to -1.21), duration of untreated psychosis (t = -0.86, p = 0.031, CI - 1.65 to -0.08) and premorbid adjustment (t = -2.26, p = 0.017, CI -4.11 to -0.42). Social support improved over time but the duration of untreated psychosis was not linked with the rate of improvement in this outcome. Conclusions Improved social support could indicate greater reliance on social support or becoming more adept at mobilising resources to meet social needs. Particularly vulnerable groups with very long duration of untreated psychosis confirm the need for earlier intervention or targeted social network interventions to preserve social connectedness

Protocol for a national cohort study to explore the long-term clinical and patient-reported outcomes and cost-effectiveness of implant-based and autologous breast reconstruction after mastectomy for breast cancer: The Brighter Study

Introduction Breast reconstruction (BR) is offered to improve quality of life for women with breast cancer undergoing mastectomy. As most women will be long-Term breast cancer survivors, high-quality information regarding the long-Term outcomes of different BR procedures is essential to support informed decision-making. As different techniques vary considerably in cost, policymakers also require high-quality cost-effectiveness evidence to inform care. The Brighter study aims to explore the long-Term clinical and patient-reported outcomes (PROs) of implant-based and autologous BR and use health economic modelling to compare the long-Term cost-effectiveness of different reconstructive techniques. Methods and analysis Women undergoing mastectomy and/or BR following a diagnosis of breast cancer between 1 January 2008 and 31 March 2009 will be identified from hospital episode statistics (HES). Surviving women will be contacted and invited to complete validated PRO measures including the BREAST-Q, EQ-5D-5L and ICECAP-A, or opt out of having their data included in the HES analysis. Long-Term clinical outcomes will be explored using HES data. The primary outcome will be rates of revisional surgery between implant-based and autologous procedures. Secondary outcomes will include rates of secondary reconstruction and reconstruction failure. The long-Term PROs of implant-based and autologous reconstruction will be compared using BREAST-Q, EQ-5D-5L and ICECAP-A scores. Multivariable regression will be used to examine the relationship between long-Term outcomes, patient comorbidities, sociodemographic and treatment factors. A Markov model will be developed using HES and PRO data and published literature to compare the relative long-Term cost-effectiveness of implant-based and autologous BR. Ethics and dissemination The Brighter study has been approved by the South-West-Central Bristol Research Ethics Committee (20/SW/0020), and the Confidentiality Advisory Group (20/CAG/0021). Results will be published in peer-reviewed journals and presented at national meetings. We will work with the professional associations, charities and patient groups to disseminate the results

Formation of m2G6 in Methanocaldococcus jannaschii tRNA catalyzed by the novel methyltransferase Trm14

The modified nucleosides N2-methylguanosine and N22-dimethylguanosine in transfer RNA occur at five positions in the D and anticodon arms, and at positions G6 and G7 in the acceptor stem. Trm1 and Trm11 enzymes are known to be responsible for several of the D/anticodon arm modifications, but methylases catalyzing post-transcriptional m2G synthesis in the acceptor stem are uncharacterized. Here, we report that the MJ0438 gene from Methanocaldococcus jannaschii encodes a novel S-adenosylmethionine-dependent methyltransferase, now identified as Trm14, which generates m2G at position 6 in tRNACys. The 381 amino acid Trm14 protein possesses a canonical RNA recognition THUMP domain at the amino terminus, followed by a γ-class Rossmann fold amino-methyltransferase catalytic domain featuring the signature NPPY active site motif. Trm14 is associated with cluster of orthologous groups (COG) 0116, and most closely resembles the m2G10 tRNA methylase Trm11. Phylogenetic analysis reveals a canonical archaeal/bacterial evolutionary separation with 20–30% sequence identities between the two branches, but it is likely that the detailed functions of COG 0116 enzymes differ between the archaeal and bacterial domains. In the archaeal branch, the protein is found exclusively in thermophiles. More distantly related Trm14 homologs were also identified in eukaryotes known to possess the m2G6 tRNA modification