84 resultados para Value analysis (Cost control)
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We formed the GEnetics of Nephropathy–an International Effort (GENIE) consortium to examine previously reported genetic associations with diabetic nephropathy (DN) in type 1 diabetes. GENIE consists of 6,366 similarly ascertained participants of European ancestry with type 1 diabetes, with and without DN, from the All Ireland-Warren 3-Genetics of Kidneys in Diabetes U.K. and Republic of Ireland (U.K.-R.O.I.) collection and the Finnish Diabetic Nephropathy Study (FinnDiane), combined with reanalyzed data from the Genetics of Kidneys in Diabetes U.S. Study (U.S. GoKinD). We found little evidence for the association of the EPO promoter polymorphism, rs161740, with the combined phenotype of proliferative retinopathy and end-stage renal disease in U.K.-R.O.I. (odds ratio [OR] 1.14, P = 0.19) or FinnDiane (OR 1.06, P = 0.60). However, a fixed-effects meta-analysis that included the previously reported cohorts retained a genome-wide significant association with that phenotype (OR 1.31, P = 2 × 10-9). An expanded investigation of the ELMO1 locus and genetic regions reported to be associated with DN in the U.S. GoKinD yielded only nominal statistical significance for these loci. Finally, top candidates identified in a recent meta-analysis failed to reach genome-wide significance. In conclusion, we were unable to replicate most of the previously reported genetic associations for DN, and significance for the EPO promoter association was attenuated.
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The Kyoto Protocol and the European Energy Performance of Buildings Directive put an onus on governments
and organisations to lower carbon footprint in order to contribute towards reducing global warming. A key
parameter to be considered in buildings towards energy and cost savings is its indoor lighting that has a major
impact on overall energy usage and Carbon Dioxide emissions. Lighting control in buildings using Passive
Infrared sensors is a reliable and well established approach; however, the use of only Passive Infrared does not
offer much savings towards reducing carbon, energy, and cost. Accurate occupancy monitoring information can
greatly affect a building’s lighting control strategy towards a greener usage. This paper presents an approach for
data fusion of Passive Infrared sensors and passive Radio Frequency Identification (RFID) based occupancy
monitoring. The idea is to have efficient, need-based, and reliable control of lighting towards a green indoor
environment, all while considering visual comfort of occupants. The proposed approach provides an estimated
13% electrical energy savings in one open-plan office of a University building in one working day. Practical
implementation of RFID gateways provide real-world occupancy profiling data to be fused with Passive
Infrared sensing towards analysis and improvement of building lighting usage and control.
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Introduction Product standardisation involves promoting the prescribing of pre-selected products within a particular category across a healthcare region and is designed to improve patient safety by promoting continuity of medicine use across the primary/secondary care interface, in addition to cost containment without compromising clinical care (i.e. maintaining safety and efficacy). Objectives To examine the impact of product standardisation on the prescribing of compound alginate preparations within primary care in Northern Ireland. Methods Data were obtained on alginate prescribing from the Northern Ireland Central Services Agency (Prescription Pricing Branch), covering a period of 43 months. Two standardisation promotion interventions were carried out at months 18 and 33. In addition to conventional statistical analyses, a simple interrupted time series analysis approach, using graphical interpretation, was used to facilitate interpretation of the data. Results There was a significant increase in the prescribed share of the preferred alginate product in each of the four health boards in Northern Ireland and a decrease in the cost per Defined Daily Dose for alginate liquid preparations overall. Compliance with the standardisation policy was, however, incomplete and was influenced to a marked degree by the activities of the pharmaceutical industry. The overall economic impact of the prescribing changes during the study was small (3.1%). Conclusion The findings suggested that product standardisation significantly influenced the prescribing pattern for compound alginate liquid preparations within primary care across Northern Ireland. © 2012 The Authors. IJPP © 2012 Royal Pharmaceutical Society.
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This paper presents a new methodology for solving the multi-vehicle formation control problem. It employs a unique extension-decomposition-aggregation scheme to transform the overall complex formation control problem into a group of subproblems, which work via boundary interactions or disturbances. Thus, it is proved that the overall formation system is exponentially stable in the sense of Lyapunov, if all the individual augmented subsystems (IASs) are stable. Linear matrix inequality-based H8 control methodology is employed to design the decentralized formation controllers to reject the impact of the formation changes being treated as boundary disturbances and guarantee the stability of all the IASs, consequently maintaining the stability of the overall formation system. Simulation studies are performed to verify the stability, performance, and effectiveness of the proposed strategy.
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Aim: To study the long-term outcome of deep sclerectomy in patients with open angle glaucoma. Methods: Prospective consecutive series of 43 eyes (38 patients) with medically uncontrolled open-angle glaucoma undergoing deep sclerectomy. All patients underwent clinical assessment before and after surgery at day 7 and at months 1, 3, 6, 12, 18, 24, 36. Surgical success was considered if the patient's intraocular pressure (IOP)>22 mmHg and the IOP was lowered by more than 20% without the use of any medication. Kaplan-Meier survival curves were used to evaluate the success rate. Results: The mean follow-up time was 28.1±8.2 months. Mean IOP decreased significantly from a preoperative value of 24.6±5.5 mmHg to a postoperative value of 18.5±4.6 mmHg at 36 months (P>0.001). Microperforation of TDM occurred in three cases (7.0%) and ciliary body prolapse in one case (2.3%) but did not prevent completion of the operation. Postoperatively, hyphaema was detected in one case and shallow anterior chamber in another case and both were treated conservatively. Bleb encapsulation with elevation of IOP occurred in two cases (4.7%) and was treated with 5-fluorouracil subconjunctival injection. Goniopuncture with neodymium : YAG laser was performed in two cases (4.7%). There were no other late complications with the exception of failure of the operation. On the life-table analysis the success rate at 12, 24, and 30 months were 61.4, 36.6, and 18.9%, respectively. Conclusion: Deep sclerectomy reduced the IOP temporarily while minimising the risk of postoperative complications commonly encountered with standard trabeculectomy. However, after long-term follow-up surgery failed to maintain a low IOP. © 2006 Nature Publishing Group. All rights reserved.
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Recently, two fast selective encryption methods for context-adaptive variable length coding and context-adaptive binary arithmetic coding in H.264/AVC were proposed by Shahid et al. In this paper, it was demonstrated that these two methods are not as efficient as only encrypting the sign bits of nonzero coefficients. Experimental results showed that without encrypting the sign bits of nonzero coefficients, these two methods can not provide a perceptual scrambling effect. If a much stronger scrambling effect is required, intra prediction modes, and the sign bits of motion vectors can be encrypted together with the sign bits of nonzero coefficients. For practical applications, the required encryption scheme should be customized according to a user's specified requirement on the perceptual scrambling effect and the computational cost. Thus, a tunable encryption scheme combining these three methods is proposed for H.264/AVC. To simplify its implementation and reduce the computational cost, a simple control mechanism is proposed to adjust the control factors. Experimental results show that this scheme can provide different scrambling levels by adjusting three control factors with no or very little impact on the compression performance. The proposed scheme can run in real-time and its computational cost is minimal. The security of the proposed scheme is also discussed. It is secure against the replacement attack when all three control factors are set to one.
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Microalbuminuria is a common diagnosis in the clinical care of patients with type 1 diabetes mellitus. Long-term outcomes after the development of microalbuminuria are variable.
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Multi-vehicle cooperative formation control problem is an important and typical topic of research on multi-agent system. This paper presents a formation stability conjecture to conceive a new methodology for solving the decentralised multi-vehicle formation control problem. It employs the “extension-decomposition-aggregation” scheme to transform the complex multi-agent control problem into a group of sub-problems which is able to be solved conveniently. Based on this methodology, it is proved that if all the individual augmented subsystems can be stabilised by using any approach, the overall formation system is not only asymptotically but also exponentially stable in the sense of Lyapunov within a neighbourhood of the desired formation. Simulation study on 6-DOF aerial vehicles (Aerosonde UAVs) has been performed to verify the achieved formation stability result. The proposed multi-vehicle formation control strategy can be conveniently extended to other cooperative control problems of multi-agent systems.
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Reliable detection of JAK2-V617F is critical for accurate diagnosis of myeloproliferative neoplasms (MPNs); in addition, sensitive mutation-specific assays can be applied to monitor disease response. However, there has been no consistent approach to JAK2-V617F detection, with assays varying markedly in performance, affecting clinical utility. Therefore, we established a network of 12 laboratories from seven countries to systematically evaluate nine different DNA-based quantitative PCR (qPCR) assays, including those in widespread clinical use. Seven quality control rounds involving over 21,500 qPCR reactions were undertaken using centrally distributed cell line dilutions and plasmid controls. The two best-performing assays were tested on normal blood samples (n=100) to evaluate assay specificity, followed by analysis of serial samples from 28 patients transplanted for JAK2-V617F-positive disease. The most sensitive assay, which performed consistently across a range of qPCR platforms, predicted outcome following transplant, with the mutant allele detected a median of 22 weeks (range 6-85 weeks) before relapse. Four of seven patients achieved molecular remission following donor lymphocyte infusion, indicative of a graft vs MPN effect. This study has established a robust, reliable assay for sensitive JAK2-V617F detection, suitable for assessing response in clinical trials, predicting outcome and guiding management of patients undergoing allogeneic transplant.