Assessing the utility of public health surveillance using specificity, sensitivity, and lives saved

In modern surveillance of public health, data may be reported in a timely fashion, and include spatial data on cases in addition to the time of their occurrence. This has lead to many recent developments in statistical methods to detect events of public health importance. However, there has been relatively little work into methods to identify how to compare such methods. One powerful rationale for performing surveillance is earlier detection of events of public health significance; previous evaluation tools have focused on metrics which include the timeliness of detection in addition to sensitivity and specificity. However, such metrics have not accounted for the number of persons affected by the events. We re-examine the rationale for this surveillance and conclude that earlier detection is preferred because it can prevent additional morbidity and mortality. Based on this observation, we propose evaluating the number of cases prevented by each detection method, and include this information in assessing the value of different detection methods. Using this approach incorporates more information about the events and the detection and provides a sound basis for making decisions about which detection methods to employ

Heuristische Optimierung der globalen Zielfunktion im dynamischen Ridesharing

LOUD ist ein Ridesharing-Algorithmus, welcher Fahrtanfragen zu dem Zeitpunkt, an dem sie eintreffen, in die Route eines Fahrzeuges aus einer begrenzten Menge an Fahrzeugen einfügt. Dafür betrachtet LOUD den Umweg, den ein Fahrzeug machen muss, um die Fahrtanfrage abzuarbeiten. Dem Fahrzeug, welches den kleinsten Umweg für die Fahrtanfrage machen muss, weist LOUD die Fahrtanfrage zu. Dadurch soll eine globale Zielfunktion, die durchschnittliche Gesamtfahrzeit eines Fahrzeuges, minimiert werden. LOUD berücksichtigt dabei nicht, ob ein Fahrzeug von Bedeutung für zukünftige Fahrtanfragen ist, aber durch die Zuweisung der aktuellen Fahrtanfrage an das Fahrzeug für die zukünftige Fahrtanfrage nicht mehr zur Verfügung steht. In dieser Arbeit befassen wir uns mit der strategischen Planung für das Ridesharing-Problem. Dabei bestimmen wir heuristisch die Fahrzeuge, die von Bedeutung für zukünftige Fahrtanfragen sind und benachteiligen diese bei der Auswahl eines Fahrzeuges für eine Fahrtanfrage. Dadurch sollen die Fahrzeuge derart positioniert werden, dass sich der Umweg, welches ein Fahrzeug für eine zukünftige Fahrtanfrage machen muss verringert und damit die globale Zielfunktion weiter minimiert werden kann. Wir konnten zeigen, dass mit diesem Ansatz die durchschnittliche Gesamtfahrzeit, sowie die Reisezeit der Fahrgäste im 95%-Quantil reduziert werden kann

Simulation Modelling in Ophthalmology : Application to Cost Effectiveness of Ranibizumab and Aflibercept for the Treatment of Wet Age-Related Macular Degeneration in the United Kingdom

Previously developed models in ophthalmology have generally used a Markovian structure. There are a number of limitations with this approach, most notably the ability to base patient outcomes on best-corrected visual acuity (BCVA) in both eyes, which may be overcome using a different modelling structure. Simulation modelling allows for this to be modelled more precisely, and therefore may provide more accurate and relevant estimates of the cost effectiveness of ophthalmology interventions

Planar cell polarity-mediated induction of neural stem cell expansion during axolotl spinal cord regeneration

Axolotls are uniquely able to mobilize neural stem cells to regenerate all missing regions of the spinal cord. How a neural stem cell under homeostasis converts after injury to a highly regenerative cell remains unknown. Here, we show that during regeneration, axolotl neural stem cells repress neurogenic genes and reactivate a transcriptional program similar to embryonic neuroepithelial cells. This dedifferentiation includes the acquisition of rapid cell cycles, the switch from neurogenic to proliferative divisions, and the re-expression of planar cell polarity (PCP) pathway components. We show that PCP induction is essential to reorient mitotic spindles along the anterior-posterior axis of elongation, and orthogonal to the cell apical-basal axis. Disruption of this property results in premature neurogenesis and halts regeneration. Our findings reveal a key role for PCP in coordinating the morphogenesis of spinal cord outgrowth with the switch from a homeostatic to a regenerative stem cell that restores missing tissue.Fil: Rodrigo Albors, Aida. Deutsche Forschungsgemeinschaft; Alemania. Max Planck Institute of Molecular Cell Biology and Genetics; Alemania. Technische Universitat Dresden; AlemaniaFil: Tazaky, Akira. Deutsche Forschungsgemeinschaft; Alemania. Max Planck Institute of Molecular Cell Biology and Genetics; Alemania. Technische Universitat Dresden; AlemaniaFil: Rost, Fabian. Technische Universitat Dresden; AlemaniaFil: Nowoshilow, Sergej. Deutsche Forschungsgemeinschaft; Alemania. Max Planck Institute of Molecular Cell Biology and Genetics; Alemania. Technische Universitat Dresden; AlemaniaFil: Chara, Osvaldo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Física de Líquidos y Sistemas Biológicos. Universidad Nacional de La Plata. Facultad de Ciencias Exactas. Instituto de Física de Líquidos y Sistemas Biológicos; Argentina. Technische Universitat Dresden; AlemaniaFil: Tanaka, Elly M. Deutsche Forschungsgemeinschaft; Alemania. Max Planck Institute of Molecular Cell Biology and Genetics; Alemania. Technische Universitat Dresden; Alemani

Pseudo-Foster Kennedy Syndrome due to unilateral optic nerve hypoplasia: a case report

<p>Abstract</p> <p>Introduction</p> <p>Pseudo-Foster Kennedy Syndrome is described as unilateral optic disc swelling with contralateral optic atrophy in the absence of an intracranial mass causing compression of the optic nerve. This occurs typically due to bilateral sequential optic neuritis or ischaemic optic neuropathy.</p> <p>Case Presentation</p> <p>We describe a case of pseudo-Foster Kennedy Syndrome in a two year old boy with unilateral papilloedema due to a congenital optic disc anomaly in one eye preventing transmission of raised intracranial pressure to the optic nerve.</p> <p>Conclusion</p> <p>From our findings we conclude that congenital optic nerve hypoplasia is a cause of pseudo-Foster Kennedy Syndrome.</p

Amorphous alloys of magnetic transmitters of power transformers for power source of induction installation

In the article are considered the advantages of using transformers with magnetic cores from amorphous alloys in comparison with transformers with conventional magnetic cores of electrotechnical steels. Provides information about the comparison of the average no-load losses for power transformers with magnetic core of transformer steel and a magnetic core made of amorphous alloy. The most promising way of reducing the cost production and operation of distribution transformers is the use of magnetic cores made of amorphous (nanocrystalline) alloys, this provides a more than fivefold reduction of losses of idling of transformers compared with traditional magnetic circuits of electrical steel. Development of new highly effective power supplies for electrotechnological installations with induction heating, it is necessary to use the new coordinating high-frequency transformers on the basis of magnetic conductors from amorphous alloys.В статье рассмотрены преимущества применения трансформаторов с магнитопроводами из аморфных сплавов, по сравнению с трансформаторами с традиционными магнитопроводами из электротехнических сталей. Приведены сведения о сравнении усредненных потерь холостого хода для силовых трансформаторов с магнитопроводом из трансформаторной стали и с магнитопроводом из аморфного сплава. Наиболее перспективный путь снижения затрат на производство и эксплуатацию распределительных трансформаторов – это применение магнитопроводов из аморфных (нанокристаллических) сплавов, при этом обеспечивается более чем пятикратное снижение потерь холостого хода трансформаторов по сравнению с традиционными магнитопроводами из электротехнической стали. Разработка новых высокоэффективных источников питания для электротехнологических установок с индукционным нагревом, необходимо использовать новые согласующие высокочастотные трансформаторы на базе магнитопроводов из аморфных сплавов

Time trends in referrals to child and adolescent gender identity services : a study in four Nordic countries and in the UK

Purpose: To explore whether the increase observed in referrals to child and adolescent gender identity services (GIDSs) has been similar in four Nordic countries and in the UK. Materials and methods: Numbers of referrals per year in 2011–2017 were obtained from all GIDS in Denmark, Finland, Norway, Sweden and the UK and related to population aged <18. Results: A similar pattern of increase in referral rates was observed across countries, resulting in comparable population adjusted rates in 2017. In children, male:female birth sex ratio was even; in adolescents, a preponderance of females (birth sex) was observed, particularly in Finland. Conclusions: The demand for GIDSs has evolved similarly across Nordic countries and the UK. The reasons for the increase are not known but increased awareness of gender identity issues, service availability, destigmatization as well as social and media influences may play a role

Are carriers of CYP21A2 mutations less vulnerable to psychological stress? A population-based national cohort study

Background Congenital adrenal hyperplasia (CAH) is one of the most common monogenic autosomal recessive disorders with an incidence of one in 15 000. About one in 70 individuals in the general population are carriers of a severe CYP21A2 mutation. It has been suggested that this confers a survival advantage, perhaps as a result of increased activity in the hypothalamic–pituitary–adrenal axis. We investigated vulnerability to psychological stress in obligate carriers. Method The Swedish CAH Registry encompasses more than 600 patients. Parents, that is obligate carriers of the CYP21A2 mutation, were identified through the Multigeneration Register. The diagnosis of the child was used as the psychological stressor. Psychiatric diagnoses before and after the birth of a child with CAH were compared to those of controls derived from (i) the general population, (ii) parents of children with hypospadias and (iii) parents of children with diabetes mellitus type 1 (T1DM). Results Parents of children with CAH had less risk of being diagnosed with any psychiatric disorder (OR, 0 6), an affective disorder (OR, 0 5) or substance misuse (OR, 0 5) after the diagnosis of the child, compared to the general population. Their risk was also decreased compared to parents of a child with hypospadias (OR, 0 6, 0 4 and 0 2, respectively) and parents of a child with T1DM (OR 0 7, 0 6 and 0 2, respectively). The CYP21A2 carriers had a lower risk of developing mood and stress-related disorders after the diagnosis of the child. Conclusion Obligate CYP21A2 carriers had a reduced risk of a psychiatric diagnosis and were less vulnerable to a psychologically stressful situation, at least with respect to receiving a psychiatric diagnosis. This indicates a better ability to cope with psychological stress among heterozygous carriers of severe CYP21A2 mutations, which may contribute to the apparent survival advantageNoneAccepte