Reslizumab in patients with inadequately controlled late-onset asthma and elevated blood eosinophils

INTRODUCTION: Asthma with adult onset and elevated blood eosinophils is a difficult-to-treat subgroup. This post hoc analysis evaluated reslizumab, an anti-interleukin-5 monoclonal antibody, in patients with late-onset eosinophilic asthma. METHODS: Data from two 52-week placebo-controlled trials of reslizumab IV 3 mg/kg every 4 weeks in patients aged 12-75 years with inadequately controlled asthma, ≥1 asthma exacerbation within 12 months, and screening blood eosinophils ≥400/μL (NCT01287039/NCT01285323) were stratified by age of asthma onset (<40 or ≥40 years). Annual clinical asthma exacerbation rates, change in lung function, and patient-reported outcomes were analyzed. RESULTS: 273 patients with late-onset asthma (placebo, n = 130; reslizumab, n = 143) and 658 with early-onset asthma (placebo, n = 336; reslizumab, n = 322) were included. Baseline demographics were similar between groups. The interaction between age at onset of asthma and effect of reslizumab on asthma exacerbations was statistically significant (p = 0.0083). Compared with placebo, reslizumab produced a 75% relative reduction in asthma exacerbations in patients with late-onset asthma (rate ratio [RR] 0.25; 95% confidence interval [CI], 0.16, 0.40), substantially larger than the reduction in earlier onset patients (RR 0.58; 95% CI, 0.44, 0.76). Similar findings were observed for other measures of asthma, including forced expiratory volume in 1 s (FEV1). The adverse event profile of reslizumab was similar in patients with early- or late-onset asthma. CONCLUSIONS: Compared with placebo, reslizumab produced larger reductions in asthma exacerbations and larger improvements in lung function in patients with late versus early-onset asthma

Measure Preserving Diffeomorphisms of the Torus are Unclassifiable

The isomorphism problem in ergodic theory was formulated by von Neumann in 1932 in his pioneering paper Zur Operatorenmethode in der klassischen Mechanik (Ann. of Math. (2), 33(3):587--642, 1932). The problem has been solved for some classes of transformations that have special properties, such as the collection of transformations with discrete spectrum or Bernoulli shifts. This paper shows that a general classification is impossible (even in concrete settings) by showing that the collection $E$ of pairs of ergodic, Lebesgue measure preserving diffeomorphisms $(S,T)$ of the 2-torus that are isomorphic is a complete analytic set in the $C^\infty$- topology (and hence not Borel).Comment: 97 pages, 4 figure

Ebola Contact Tracing Study data

The collection contains four datasets captured in the Ebola Contact Tracing Study: [1] 'summary_data_cases' contains details of the 41 confirmed Ebola cases included in the study; [2] 'app_data_contacts' contains details of the 646 Ebola contacts registered on the Ebola Contact Tracing App (ECT) smartphone app. These originate from 18 Ebola cases (16 were laboratory confirmed and 2 were “secret burials” that were not confirmed); [3] 'paper_data_contacts' describes 408 Ebola contacts who were identified from 25 Ebola cases for monitoring using the standard paper-based system for contact tracing; and [4] 'main_analysis_dataset' contains information on 804 Ebola contacts and their contact tracing monitoring status collected using both the ECT app and paper-based system

Forecast Errors Before and After the Great Moderation

This paper investigates the change in private-sector and Federal Reserve forecasts before and after the Great Moderation. We view the Great Moderation as a natural experiment. Using forecasts produced by the Survey of Professional Forecasters and the Federal Reserve (Greenbook forecasts) we investigate four questions: 1) How large was the decline in forecast errors? 2) Did forecast accuracy improve relative to the decline in volatility of growth and inflation? 3) Did forecasters respond to the Great Moderation? 4) What are the potential benefits to monetary policymakers of smaller forecast errors? We find that the absolute median error as well as the cross-sectional volatility of forecast errors decreased significantly. Forecasters appeared to have narrowed the dispersion of their forecasts in response to the Great Moderation. Forecast accuracy did not improve relative to the reduction in the volatility of the economy. To the extent that the Fed is forward-looking when it sets its federal funds rate target, improvements in forecast accuracy imply substantial improvements in the Fed’s ability to reach its optimum federal funds rate target.forecast errors, Greenbook, Survey of Professional Forecasters, Great Moderation

Why do people not attend for treatment for trachomatous trichiasis in Ethiopia? A study of barriers to surgery.

BACKGROUND: Trachomatous trichiasis (TT) surgery is provided free or subsidised in most trachoma endemic settings. However, only 18-66% of TT patients attend for surgery. This study analyses barriers to attendance among TT patients in Ethiopia, the country with the highest prevalence of TT in the world. METHODOLOGY/PRINCIPAL FINDINGS: Participants with previously un-operated TT were recruited at 17 surgical outreach campaigns in Amhara Region, Ethiopia. An interview was conducted to ascertain why they had not attended for surgery previously. A trachoma eye examination was performed by an ophthalmologist. 2591 consecutive individuals were interviewed. The most frequently cited barriers to previous attendance for surgery were lack of time (45.3%), financial constraints (42.9%) and lack of an escort (35.5% in females, 19.6% in males). Women were more likely to report a fear of surgery (7.7% vs 3.2%, p<0.001) or be unaware of how to access services (4.5% vs 1.0% p<0.001); men were more frequently asymptomatic (19.6% vs 10.1%, p<0.001). Women were also less likely to have been previously offered TT surgery than men (OR = 0.70, 95%CI 0.53-0.94). CONCLUSIONS/SIGNIFICANCE: The major barriers to accessing surgery from the patients' perspective are the direct and indirect costs of surgery. These can to a large extent be reduced or overcome through the provision of free or low cost surgery at the community level. TRIAL REGISTRATION: ClinicalTrials.gov NCT00522860 and NCT00522912

Dielectric Elastomer Actuated Systems and Methods

The system of the present invention includes an actuator having at least two electrodes, an elastomeric dielectric film disposed between the two electrodes, and a frame attached to the elastomeric dielectric film. The frame provides a linear actuation force characteristic over a displacement range. The displacement range is preferably the stroke of the actuator. The displacement range can be about 5 mm and greater. Further, the frame can include a plurality of configurations, for example, at least a rigid members coupled to a flexible member wherein the frame provides an elastic restoring force. In preferred embodiments, the rigid member can be, but is not limited to, curved beams, parallel beams, rods and plates. In a preferred embodiment the actuator can further include a passive element disposed between two flexible members such as, for example, links to tune a stiffness characteristic of the actuator. The passive element can be a bi-stable element. Further, the actuator can include a plurality of layers of the elastomeric dielectric film integrated into the frame. The elastomeric film can be made of different materials such as, for example, acrylic, silicone and latex

A synthetic Escherichia coli predator–prey ecosystem

We have constructed a synthetic ecosystem consisting of two Escherichia coli populations, which communicate bi-directionally through quorum sensing and regulate each other's gene expression and survival via engineered gene circuits. Our synthetic ecosystem resembles canonical predator–prey systems in terms of logic and dynamics. The predator cells kill the prey by inducing expression of a killer protein in the prey, while the prey rescue the predators by eliciting expression of an antidote protein in the predator. Extinction, coexistence and oscillatory dynamics of the predator and prey populations are possible depending on the operating conditions as experimentally validated by long-term culturing of the system in microchemostats. A simple mathematical model is developed to capture these system dynamics. Coherent interplay between experiments and mathematical analysis enables exploration of the dynamics of interacting populations in a predictable manner