An efficient approach to noise analysis through multidimensional physics-based models

IEEE TRANS. EL. DEV

Modelling the Dynamics of a Public Health Care System: Evidence from Time-Series Data

The English National Health Service was established in 1948, and has therefore yielded some long time series data on health system performance. Waiting times for inpatient care have been a persistent cause of policy concern since the creation of the NHS. This paper develops a theoretical model of the dynamic interaction between key indicators of health system performance. It then investigates empirically the relationship between hospital activity, waiting times and population characteristics using aggregate time-series data for the NHS over the period 1952-2005. Structural Vector Auto-Regression suggests that in the long run: a) higher activity is associated with lower waiting times (elasticity = -0.9%); b) a higher proportion of old population is associated with higher waiting times (elasticity = 1.6%). In the short run, higher lagged waiting time leads to higher activity (elasticity = 0.2%). We also find that shocks in waiting times are countered by higher activity, so the effect is only temporary, while shocks in activity have a permanent effect. We conclude that policies to reduce waiting times should focus on initiatives that increase hospital activity.Waiting times, Dynamics, Vector Auto-Regression.

Effective coverage and systems effectiveness for malaria case management in sub-saharan african countries

Scale-up of malaria preventive and control interventions over the last decade resulted in substantial declines in mortality and morbidity from the disease in sub-Saharan Africa and many other parts of the world. Sustaining these gains will depend on the health system performance. Treatment provides individual benefits by curing infection and preventing progression to severe disease as well as community-level benefits by reducing the infectious reservoir and averting emergence and spread of drug resistance. However many patients with malaria do not access care, providers do not comply with treatment guidelines, and hence, patients do not necessarily receive the correct regimen. Even when the correct regimen is administered some patients will not adhere and others will be treated with counterfeit or substandard medication leading to treatment failures and spread of drug resistance. We apply systems effectiveness concepts that explicitly consider implications of health system factors such as treatment seeking, provider compliance, adherence, and quality of medication to estimate treatment outcomes for malaria case management. We compile data for these indicators to derive estimates of effective coverage for 43 high-burden Sub-Saharan African countries. Parameters are populated from the Demographic and Health Surveys and other published sources. We assess the relative importance of these factors on the level of effective coverage and consider variation in these health systems indicators across countries. Our findings suggest that effective coverage for malaria case management ranges from 8% to 72% in the region. Different factors account for health system inefficiencies in different countries. Significant losses in effectiveness of treatment are estimated in all countries. The patterns of inter-country variation suggest that these are system failures that are amenable to change. Identifying the reasons for the poor health system performance and intervening to tac them become key priority areas for malaria control and elimination policies in the region

Modelling the Dynamics of a Public Health Care System: Evidence from Time-Series Data

The English National Health Service was established in 1948, and has therefore yielded some long time series data on health system performance. Waiting times for inpatient care have been a persistent cause of policy concern since the creation of the NHS. This paper develops a theoretical model of the dynamic interaction between key indicators of health system performance. It then investigates empirically the relationship between hospital activity, waiting times and population characteristics using aggregate time-series data for the NHS over the period 1952— 2005. Structural Vector Auto-Regression suggests that in the long run: a) higher activity is associated with lower waiting times (elasticity = -0.9%); b) a higher proportion of old population is associated with higher waiting times (elasticity = 1.6%). In the short run, higher lagged waiting time leads to higher activity (elasticity = 0.2%). We also find that shocks in waiting times are countered by higher activity, so the effect is only temporary, while shocks in activity have a permanent effect. We conclude that policies to reduce waiting times should focus on initiatives that increase hospital activity.Waiting Times, Dynamics, Vector Auto-Regression

BeppoSAX Observations of the Maser Sy2 Galaxy: ESO103-G35

We have made BeppoSAX observations of the Seyfert 2/1.9 galaxy ESO103-G35, which contains a nuclear maser source and is known to be heavily absorbed in the X-rays. Analysis of the X-ray spectra observed by SAX in October 1996 and 1997 yields a spectral index 0.74+/-0.07, typical of Seyfert galaxies and consistent with earlier observations of this source. The strong, soft X-ray absorption has column density 1.79E(23)/cm^2, again consistent with earlier results. The best fitting spectrum is that of a power law with a high energy cutoff at 29+/-10 keV, a cold, marginally resolved Fe Kalpha line with EW 290 eV (1996) and a mildly ionized Fe K-edge at 7.37 keV. The Kalpha line and cold absorption are consistent with origin in a accretion disk/torus through which our line-of-sight passes at a radial distance of $\sim 50$ pc. The Fe K-edge is mildly ionized suggesting the presence of ionized gas probably in the inner accretion disk, close to the central source or in a separate warm absorber. The data quality is too low to distinguish between these possibilities but the edge-on geometry implied by the water maser emission favors the former. Comparison with earlier observations of ESO103-G35 shows little/no change in spectral parameters while the flux changes by factors of a few on timescales of a few months. The 2--10 keV flux decreased by a factor of 2.7 between Oct 1996 and Oct 1997 with no detectable change in the count rate >20 keV suggesting a constant or delayed response reflection component. The high energy cutoff is lower than the typical 300keV values seen in Seyfert galaxies. A significant subset of similar sources would affect current models of the AGN contribution to the cosmic X-ray background which generally assume a high energy cutoff of 300 keV.Comment: 22 pages, postscript file, accepted for publication in Ap

Anomalous RR Lyrae stars(?). III. CM Leonis

Time series of B,V,I CCD photometry and radial velocity measurements from high resolution spectroscopy (R=30,000) covering the full pulsation cycle are presented for the field RR Lyrae star CM Leonis. The photometric data span a 6 year interval from 1994 to 1999, and allow us to firmly establish the pulsation mode and periodicity of the variable. The derived period P=0.361699 days (+/- 0.000001) is very close to the value published in the Fourth Edition of the General Catalogue of Variable Stars (P=0.361732 days). However, contrary to what was previously found, the amplitude and shape of the light curve qualify CM Leo as a very regular first overtone pulsator with a prominent hump on the rising branch of its multicolour light curves. According to an abundace analysis performed on three spectra taken near minimum light (0.42 < phase < 0.61), CM Leo is a metal-poor star with metal abundance [Fe/H]=-1.93 +/- 0.20. The photometric and radial velocity curves of CM Leo have been compared with the predictions of suitable pulsational models to infer tight constraints on the stellar mass, effective temperature, and distance modulus of the star. We derive a true distance modulus of CM Leo of (m-M)0=13.11 +/- 0.02 mag and a corresponding absolute magnitude of Mv=0.47 +/- 0.04. This absolute magnitude, once corrected for evolutionary and metallicity effects, leads to a true distance modulus of the Large Magellanic Cloud of (m-M)0=18.43 +/- 0.06 mag, in better agreement with the long astronomical distance scale.Comment: 14 pages, 10 figures, accepted for publication in MNRA

Simulation of the cost-effectiveness of malaria vaccines

<p>Abstract</p> <p>Background</p> <p>A wide range of possible malaria vaccines is being considered and there is a need to identify which vaccines should be prioritized for clinical development. An important element of the information needed for this prioritization is a prediction of the cost-effectiveness of potential vaccines in the transmission settings in which they are likely to be deployed. This analysis needs to consider a range of delivery modalities to ensure that clinical development plans can be aligned with the most appropriate deployment strategies.</p> <p>Methods</p> <p>The simulations are based on a previously published individual-based stochastic model for the natural history and epidemiology of <it>Plasmodium falciparum </it>malaria. Three different vaccine types: pre-erythrocytic vaccines (PEV), blood stage vaccines (BSV), mosquito-stage transmission-blocking vaccines (MSTBV), and combinations of these, are considered each delivered via a range of delivery modalities (Expanded Programme of Immunization – EPI-, EPI with booster, and mass vaccination combined with EPI). The cost-effectiveness ratios presented are calculated for four health outcomes, for assumed vaccine prices of US$2 or US$ 10 per dose, projected over a 10-year period.</p> <p>Results</p> <p>The simulations suggest that PEV will be more cost-effective in low transmission settings, while BSV at higher transmission settings. Combinations of BSV and PEV are more efficient than PEV, especially in moderate to high transmission settings, while compared to BSV they are more cost-effective in moderate to low transmission settings. Combinations of MSTBV and PEV or PEV and BSV improve the effectiveness and the cost-effectiveness compared to PEV and BSV alone only when applied with EPI and mass vaccinations. Adding booster doses to the EPI is unlikely to be a cost-effective alternative to delivering vaccines via the EPI for any vaccine, while mass vaccination improves effectiveness, especially in low transmission settings, and is often a more efficient alternative to the EPI. However, the costs of increasing the coverage of mass vaccination over 50% often exceed the benefits.</p> <p>Conclusion</p> <p>The simulations indicate malaria vaccines might be efficient malaria control interventions, and that both transmission setting and vaccine delivery modality are important to their cost-effectiveness. Alternative vaccine delivery modalities to the EPI may be more efficient than the EPI. Mass vaccination is predicted to provide substantial health benefits at low additional costs, although achieving high coverage rates can lead to substantial incremental costs.</p

Methane emissions from rice paddies globally: A quantitative statistical review of controlling variables and modelling of emission factors

Funding Information: This work was funded by Climate Change, Agriculture and Food Security (CCAFS), Kellogg's and the University of Aberdeen . We are grateful for the help and advice from modellers, stakeholders, the cool farm alliance (CFA) and those who by their publications on GHG emissions from rice paddies have made this work possible. Special thanks to the cool farm alliance, stakeholders, experts, and modellers who have helped us improve our understanding and guided us in the right direction when needed given the Covid pandemic restrictions, making project engagement between those involved limited to online engagement. Publisher Copyright: © 2023Peer reviewedPublisher PD

Measurement of N2O emissions over the whole year is necessary for estimating reliable emission factors

We thank Dali Nayak, Thomas Cornulier and Arindam Datta for data collection and helpful discussions during the development of this analysis. This work was supported by the National Natural Science Foundation of China (41671464). P.S. and M.A. acknowledge support from the UK-China Virtual Joint Centre, N-Circle (grant number BB/N013484/1). Z.S. appreciates the financial support from the China Scholarship Council (201706010406) to support her study in the UKPeer reviewedPostprin