1,004 research outputs found
The adaptation of an English spellchecker for Japanese writers
It has been pointed out that the spelling errors made by second-language writers writing in English have features that are to some extent characteristic of their first language, and the suggestion has been made that a spellchecker could be adapted to take account of these features. In the work reported here, a corpus of spelling errors made by Japanese writers writing in English was compared with a corpus of errors made by native speakers. While the great majority of errors were common to the two corpora, some distinctively Japanese error patterns were evident against this common background, notably a difficulty in deciding between the letters b and v, and the letters l and r, and a tendency to add syllables. A spellchecker that had been developed for native speakers of English was adapted to cope with these errors. A brief account is given of the spellchecker’s mode of operation to indicate how it lent itself to modifications of this kind. The native-speaker spellchecker and the Japanese-adapted version were run over the error corpora and the results show that these adaptations produced a modest but worthwhile improvement to the spellchecker’s performance in correcting Japanese-made errors
Managing healthcare budgets in times of austerity: the role of program budgeting and marginal analysis
Given limited resources, priority setting or choice making will remain a reality at all levels of publicly funded healthcare across countries for many years to come. The pressures may well be even more acute as the impact of the economic crisis of 2008 continues to play out but, even as economies begin to turn around, resources within healthcare will be limited, thus some form of rationing will be required. Over the last few decades, research on healthcare priority setting has focused on methods of implementation as well as on the development of approaches related to fairness and legitimacy and on more technical aspects of decision making including the use of multi-criteria decision analysis. Recently, research has led to better understanding of evaluating priority setting activity including defining ‘success’ and articulating key elements for high performance. This body of research, however, often goes untapped by those charged with making challenging decisions and as such, in line with prevailing public sector incentives, decisions are often reliant on historical allocation patterns and/or political negotiation. These archaic and ineffective approaches not only lead to poor decisions in terms of value for money but further do not reflect basic ethical conditions that can lead to fairness in the decision-making process. The purpose of this paper is to outline a comprehensive approach to priority setting and resource allocation that has been used in different contexts across countries. This will provide decision makers with a single point of access for a basic understanding of relevant tools when faced with having to make difficult decisions about what healthcare services to fund and what not to fund. The paper also addresses several key issues related to priority setting including how health technology assessments can be used, how performance can be improved at a practical level, and what ongoing resource management practice should look like. In terms of future research, one of the most important areas of priority setting that needs further attention is how best to engage public members
Using economic evidence to set healthcare priorities in low-income and lower-middle-income countries: a systematic review of methodological frameworks
Policy makers in low-income and lower-middle-income countries (LMICs) are increasingly looking to develop 'evidence-based' frameworks for identifying priority health interventions. This paper synthesises and appraises the literature on methodological frameworks - which incorporate economic evaluation evidence - for the purpose of setting healthcare priorities in LMICs. A systematic search of Embase, MEDLINE, Econlit and PubMed identified 3968 articles with a further 21 articles identified through manual searching. A total of 36 papers were eligible for inclusion. These covered a wide range of health interventions with only two studies including health systems strengthening interventions related to financing, governance and human resources. A little under half of the studies (39%) included multiple criteria for priority setting, most commonly equity, feasibility and disease severity. Most studies (91%) specified a measure of 'efficiency' defined as cost per disability-adjusted life year averted. Ranking of health interventions using multi-criteria decision analysis and generalised cost-effectiveness were the most common frameworks for identifying priority health interventions. Approximately a third of studies discussed the affordability of priority interventions. Only one study identified priority areas for the release or redeployment of resources. The paper concludes by highlighting the need for local capacity to conduct evaluations (including economic analysis) and empowerment of local decision-makers to act on this evidence
Comparison of small intestinal contrast ultrasound with magnetic resonance enterography in pediatric Crohn's disease
Aim To compare the diagnostic yield of small intestinal contrast ultrasonography (SICUS) with magnetic resonance enterography (MRE) in routine clinical practice in a cohort of pediatric patients investigated for Crohn's disease (CD) attending a UK tertiary center. Methods and Results Patients with suspected or established CD who underwent SICUS were identified retrospectively. SICUS was compared to conventional transabdominal ultrasound (TUS), ileocolonoscopy (IC), and MRE. The accuracy and agreement of SICUS in detecting small bowel lesions and CD‐related complications were assessed using kappa (κ) coefficient statistics. A total of 93 patients (median age 15 years, range 2–17, 49 male) underwent SICUS; 58 had suspected and 35 had established CD. In suspected CD, sensitivity and specificity of SICUS in detecting CD small bowel lesions were 81.8 and 100% and for TUS 85.7 and 87.5%, respectively. In established CD, sensitivity and specificity of SICUS were 98.7 and 100% and TUS 80 and 100%, respectively. Agreement between SICUS and IC was substantial for the presence of lesions (κ = 0.73) but fair in TUS (κ = 0.31). Agreement between SICUS and IC was almost perfect for detecting strictures (κ = 0.84), with a sensitivity of 100% and specificity of 97.6%. When comparing SICUS and TUS with MRE, agreement for the presence of lesions was substantial (κ = 0.63) and moderate (κ = 0.53), respectively. Agreement between SICUS and MRE was substantial for detecting strictures (κ = 0.77) and dilatation (κ = 0.68). Conclusions SICUS offers a radiation‐free alternative for assessing pediatric small bowel CD, with diagnostic accuracy that is comparable to MRE and IC, supporting its wider use in routine practice
Complex population dynamics as a competition between multiple time-scale phenomena
The role of the selection pressure and mutation amplitude on the behavior of
a single-species population evolving on a two-dimensional lattice, in a
periodically changing environment, is studied both analytically and
numerically. The mean-field level of description allows to highlight the
delicate interplay between the different time-scale processes in the resulting
complex dynamics of the system. We clarify the influence of the amplitude and
period of the environmental changes on the critical value of the selection
pressure corresponding to a phase-transition "extinct-alive" of the population.
However, the intrinsic stochasticity and the dynamically-built in correlations
among the individuals, as well as the role of the mutation-induced variety in
population's evolution are not appropriately accounted for. A more refined
level of description, which is an individual-based one, has to be considered.
The inherent fluctuations do not destroy the phase transition "extinct-alive",
and the mutation amplitude is strongly influencing the value of the critical
selection pressure. The phase diagram in the plane of the population's
parameters -- selection and mutation is discussed as a function of the
environmental variation characteristics. The differences between a smooth
variation of the environment and an abrupt, catastrophic change are also
addressesd.Comment: 15 pages, 12 figures. Accepted for publication in Phys. Rev.
No detection of large-scale magnetic fields at the surfaces of Am and HgMn stars
We investigate the magnetic dichotomy between Ap/Bp and other A-type stars by
carrying out a deep spectropolarimetric study of Am and HgMn stars. Using the
NARVAL spectropolarimeter at the Telescope Bernard Lyot (Observatoire du Pic du
Midi, France), we obtained high-resolution circular polarisation spectroscopy
of 12 Am stars and 3 HgMn stars. Using Least Squares Deconvolution (LSD), no
magnetic field is detected in any of the 15 observed stars. Uncertaintiies as
low as 0.3 G (respectively 1 G) have been reached for surface-averaged
longitudinal magnetic field measurements for Am (respectively HgMn) stars.
Associated with the results obtained previously for Ap/Bp stars, our study
confirms the existence of a magnetic dichotomy among A-type stars. Our data
demonstrate that there is at least one order of magnitude difference in field
strength between Zeeman detected stars (Ap/Bp stars) and non Zeeman detected
stars (Am and HgMn stars). This result confirms that the
spectroscopically-defined Ap/Bp stars are the only A-type stars harbouring
detectable large-scale surface magnetic fields.Comment: 6 pages, 3 figures, accepted for publication in A&
Using Economic Evidence to Set Healthcare Priorities in Low-Income and Lower-Middle-Income Countries: A Systematic Review of Methodological Frameworks.
Policy makers in low-income and lower-middle-income countries (LMICs) are increasingly looking to develop 'evidence-based' frameworks for identifying priority health interventions. This paper synthesises and appraises the literature on methodological frameworks--which incorporate economic evaluation evidence--for the purpose of setting healthcare priorities in LMICs. A systematic search of Embase, MEDLINE, Econlit and PubMed identified 3968 articles with a further 21 articles identified through manual searching. A total of 36 papers were eligible for inclusion. These covered a wide range of health interventions with only two studies including health systems strengthening interventions related to financing, governance and human resources. A little under half of the studies (39%) included multiple criteria for priority setting, most commonly equity, feasibility and disease severity. Most studies (91%) specified a measure of 'efficiency' defined as cost per disability-adjusted life year averted. Ranking of health interventions using multi-criteria decision analysis and generalised cost-effectiveness were the most common frameworks for identifying priority health interventions. Approximately a third of studies discussed the affordability of priority interventions. Only one study identified priority areas for the release or redeployment of resources. The paper concludes by highlighting the need for local capacity to conduct evaluations (including economic analysis) and empowerment of local decision-makers to act on this evidence
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Linkage and sequence analysis indicate that CCBE1 is mutated in recessively inherited generalised lymphatic dysplasia
Generalised lymphatic dysplasia (GLD) is characterised by extensive peripheral lymphoedema with visceral involvement. In some cases, it presents in utero with hydrops fetalis. Autosomal dominant and recessive inheritance has been reported. A large, non-consanguineous family with three affected siblings with generalised lymphatic dysplasia is presented. One child died aged 5 months, one spontaneously miscarried at 17 weeks gestation, and the third has survived with extensive lymphoedema. All three presented with hydrops fetalis. There are seven other siblings who are clinically unaffected. Linkage analysis produced two loci on chromosome 18, covering 22 Mb and containing 150 genes, one of which is CCBE1. A homozygous cysteine to serine change in CCBE1 has been identified in the proband, in a residue that is conserved across species. High density SNP analysis revealed homozygosity (a region of 900 kb) around the locus for CCBE1 in all three affected cases. This indicates a likely ancestral mutation that is common to both parents; an example of a homozygous mutation representing Identity by Descent (IBD) in this pedigree. Recent studies in zebrafish have shown this gene to be required for lymphangiogenesis and venous sprouting and are therefore supportive of our findings. In view of the conserved nature of the cysteine, the nature of the amino acid change, the occurrence of a homozygous region around the locus, the segregation within the family, and the evidence from zebrafish, we propose that this mutation is causative for the generalised lymphatic dysplasia in this family, and may be of relevance in cases of non-immune hydrops fetalis
The Affective Impact of Financial Skewness on Neural Activity and Choice
Few finance theories consider the influence of “skewness” (or large and asymmetric but unlikely outcomes) on financial choice. We investigated the impact of skewed gambles on subjects' neural activity, self-reported affective responses, and subsequent preferences using functional magnetic resonance imaging (FMRI). Neurally, skewed gambles elicited more anterior insula activation than symmetric gambles equated for expected value and variance, and positively skewed gambles also specifically elicited more nucleus accumbens (NAcc) activation than negatively skewed gambles. Affectively, positively skewed gambles elicited more positive arousal and negatively skewed gambles elicited more negative arousal than symmetric gambles equated for expected value and variance. Subjects also preferred positively skewed gambles more, but negatively skewed gambles less than symmetric gambles of equal expected value. Individual differences in both NAcc activity and positive arousal predicted preferences for positively skewed gambles. These findings support an anticipatory affect account in which statistical properties of gambles—including skewness—can influence neural activity, affective responses, and ultimately, choice
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