Applying economic principles to health care.

Applying economic thinking to an understanding of resource use in patient care is challenging given the complexities of delivering health care in a hospital. Health-care markets lack the characteristics needed to determine a "market" price that reflects the economic value of resources used. However, resource allocation in a hospital can be analyzed by using production theory to determine efficient resource use. The information provided by hospital epidemiologists is critical to understanding health-care production processes used by a hospital and developing economic incentives to promote antibiotic effectiveness and infection control

Approximate N3^{3}LO Parton Distribution Functions with Theoretical Uncertainties: MSHT20aN3^3LO PDFs

We present the first global analysis of parton distribution functions (PDFs) at approximate N$^{3}$LO in the strong coupling constant $\alpha_{s}$, extending beyond the current highest NNLO achieved in PDF fits. To achieve this, we present a general formalism for the inclusion of theoretical uncertainties from missing higher orders (MHOs) into a PDF fit. We demonstrate how using the currently available knowledge surrounding the next highest order (N$^{3}$LO) in $\alpha_{s}$ can provide consistent, justifiable and explainable approximate N$^{3}$LO (aN$^{3}$LO) PDFs, including estimates for missing higher order uncertainties (MHOUs). Specifically, we approximate the splitting functions, transition matrix elements, coefficient functions and $K$-factors for multiple processes to N$^{3}$LO. Crucially, these are constrained to be consistent with the wide range of already available information about N$^{3}$LO to match the complete result at this order as accurately as possible. Using this approach we perform a fully consistent approximate N$^{3}$LO global fit within the MSHT framework. This relies on an expansion of the Hessian procedure used in previous MSHT fits to allow for sources of theoretical uncertainties. These are included as nuisance parameters in a global fit, controlled by knowledge and intuition based prior distributions. We analyse the differences between our aN$^{3}$LO PDFs and the standard NNLO PDF set, and study the impact of using aN$^{3}$LO PDFs on the LHC production of a Higgs boson at this order. Finally, we provide guidelines on how these PDFs should be be used in phenomenological investigations.Comment: 150 pages, 48 figures, 20 tables. Updated LHAPDF Grids available which include a correction of a minor bug in the non-singlet splitting function leading to very small changes in fit quality and PDFs, but with no significant changes to any results or conclusion

Probing the Pulsar Wind Nebula of PSR B0355+54

We present XMM-Newton and Chandra X-ray observations of the middle-aged radio pulsar PSR B0355+54. Our X-ray observations reveal emission not only from the pulsar itself, but also from a compact diffuse component extending ~50'' in the opposite direction to the pulsar's proper motion. There is also evidence for the presence of fainter diffuse emission extending ~5' from the point source. The compact diffuse feature is well-fitted with a power-law, the index of which is consistent with the values found for other pulsar wind nebulae. The morphology of the diffuse component is similar to the ram-pressure confined pulsar wind nebulae detected for other sources. The X-ray emission from the pulsar itself is described well by a thermal plus power-law fit, with the thermal emission most likely originating in a hot polar cap.Comment: 9 pages (uses emulateapj.cls), 8 figures, 2 tables, accepted for publication in Ap

Perspectives on Highly Adaptive or Morphing Aircraft

The ability to adapt to different flight conditions has been fundamental to aircraft design since the Wright Brothers first flight. Over a hundred years later, unconventional aircraft adaptability, often called aircraft morphing has become a topic of considerable renewed interest. In the past two decades, this interest has been largely fuelled by advancements in multi-functional or smart materials and structures. However, highly adaptive or morphing aircraft is certainly a cross-discipline challenge that stimulates a wide range of design possibilities. This paper will review some of the history of morphing aircraft including recent research programs and discuss some perspectives on this work

Examining the effectiveness of place-based interventions to improve public health and reduce health inequalities: an umbrella review.

BackgroundLocally delivered, place-based public health interventions are receiving increasing attention as a way of improving health and reducing inequalities. However, there is limited evidence on their effectiveness. This umbrella review synthesises systematic review evidence of the health and health inequalities impacts of locally delivered place-based interventions across three elements of place and health: the physical, social, and economic environments.MethodsSystematic review methodology was used to identify recent published systematic reviews of the effectiveness of place-based interventions on health and health inequalities (PROGRESS+) in high-income countries. Nine databases were searched from 1st January 2008 to 1st March 2020. The quality of the included articles was determined using the Revised Assessment of Multiple Systematic Reviews tool (R-AMSTAR).ResultsThirteen systematic reviews were identified - reporting 51 unique primary studies. Fifty of these studies reported on interventions that changed the physical environment and one reported on changes to the economic environment. Only one primary study reported cost-effectiveness data. No reviews were identified that assessed the impact of social interventions. Given heterogeneity and quality issues, we found tentative evidence that the provision of housing/home modifications, improving the public realm, parks and playgrounds, supermarkets, transport, cycle lanes, walking routes, and outdoor gyms - can all have positive impacts on health outcomes - particularly physical activity. However, as no studies reported an assessment of variation in PROGRESS+ factors, the effect of these interventions on health inequalities remains unclear.ConclusionsPlace-based interventions can be effective at improving physical health, health behaviours and social determinants of health outcomes. High agentic interventions indicate greater improvements for those living in greater proximity to the intervention, which may suggest that in order for interventions to reduce inequalities, they should be implemented at a scale commensurate with the level of disadvantage. Future research needs to ensure equity data is collected, as this is severely lacking and impeding progress on identifying interventions that are effective in reducing health inequalities.Trial registrationPROSPERO CRD42019158309

Screening the medicines for Malaria Venture "Malaria Box" against the Plasmodium falciparum aminopeptidases, M1, M17 and M18

Malaria is a parasitic disease that remains a global health burden. The ability of the parasite to rapidly develop resistance to therapeutics drives an urgent need for the delivery of new drugs. The Medicines for Malaria Venture have compounds known for their antimalarial ac- tivity, but not necessarily the molecular targets. In this study, we assess the ability of the “MMV 400” compounds to inhibit the activity of three metalloaminopeptidases from Plasmo- dium falciparum, PfA-M1, PfA-M17 and PfM18 AAP. We have developed a multiplex assay system to allow rapid primary screening of compounds against all three metalloaminopepti- dases, followed by detailed analysis of promising compounds. Our results show that there were no PfM18AAP inhibitors, whereas two moderate inhibitors of the neutral aminopepti- dases PfA-M1 and PfA-M17 were identified. Further investigation through structure-activity relationship studies and molecular docking suggest that these compounds are competitive inhibitors with novel binding mechanisms, acting through either non-classical zinc coordina- tion or independently of zinc binding altogether. Although it is unlikely that inhibition of PfA- M1 and/or PfA-M17 is the primary mechanism responsible for the antiplasmodial activity re- ported for these compounds, their detailed characterization, as presented in this work, pave the way for their further optimization as a novel class of dual PfA-M1/PfA-M17 inhibitors uti- lising non-classical zinc binding groups

XMM-Newton Observations of PSR B1706-44

We report on the XMM-Newton observations of the young, 102 ms pulsar PSR B1706-44. We have found that both a blackbody plus power-law and a magnetized atmospheric model plus power-law provide an excellent fit to the EPIC spectra. The two scenarios are therefore indistinguishable on a statistical basis, although we are inclined to prefer the latter on physical grounds. In this case, assuming a source distance of ~2.3 kpc, the size of the region responsible for the thermal emission is R~13 km, compatible with the surface of a neutron star. A comparison of the surface temperature of PSR B1706-44 obtained from this fit with cooling curves favor a medium mass neutron star with M~1.45 solar masses or M~1.59 solar masses, depending on two different models of proton superfluidity in the interior. The large collecting area of XMM-Newton allows us to resolve a substructure in the broad soft X-ray modulation detected by Chandra, revealing the presence of two separate peaks with pulsed fractions of 7 +/- 4% and 15 +/- 3%, respectively.Comment: 21 pages, 5 figures, 2 tables, accepted for publication in Ap

The ROTSE-III Robotic Telescope System

The observation of a prompt optical flash from GRB990123 convincingly demonstrated the value of autonomous robotic telescope systems. Pursuing a program of rapid follow-up observations of gamma-ray bursts, the Robotic Optical Transient Search Experiment (ROTSE) has developed a next-generation instrument, ROTSE-III, that will continue the search for fast optical transients. The entire system was designed as an economical robotic facility to be installed at remote sites throughout the world. There are seven major system components: optics, optical tube assembly, CCD camera, telescope mount, enclosure, environmental sensing & protection and data acquisition. Each is described in turn in the hope that the techniques developed here will be useful in similar contexts elsewhere.Comment: 19 pages, including 4 figures. To be published in PASP in January, 2003. PASP Number IP02-11