A model to assess the cost effectiveness of statins in achieving the UK National Service Framework target cholesterol levels

Background: Coronary heart disease (CHD) is a public health priority in the UK. The National Service Framework (NSF) has set standards for the prevention, diagnosis and treatment of CHD, which include the use of cholesterol-lowering agents aimed at achieving targets of blood total cholesterol (TC) < 5.0 mmol/L and low density lipoprotein-cholesterol (LDL-C) < 3.0 mmol/L. In order to achieve these targets cost effectively, prescribers need to make an informed choice from the range of statins available. Aim: To estimate the average and relative cost effectiveness of atorvastatin, fluvastatin, pravastatin and simvastatin in achieving the NSF LDL-C and TC targets. Design: Model-based economic evaluation. Methods: An economic model was constructed to estimate the number of patients achieving the NSF targets for LDL-C and TC at each dose of statin, and to calculate the average drug cost and incremental drug cost per patient achieving the target levels. The population baseline LDL-C and TC, and drug efficacy and drug costs were taken from previously published data. Estimates of the distribution of patients receiving each dose of statin were derived from the UK national DIN-LINK database. Results: The estimated annual drug cost per 1000 patients treated with atorvastatin was £289 000, with simvastatin £315 000, with pravastatin £333 000 and with fluvastatin £167 000. The percentages of patients achieving target are 74.4%, 46.4%, 28.4% and 13.2% for atorvastatin, simvastatin, pravastatin and fluvastatin, respectively. Incremental drug cost per extra patient treated to LDL-C and TC targets compared with fluvastafin were £198 and £226 for atorvastatin, £443 and £567 for simvastatin and £1089 and £2298 for pravastatin, using 2002 drug costs. Conclusions: As a result of its superior efficacy, atorvastatin generates a favourable cost-effectiveness profile as measured by drug cost per patient treated to LDL-C and TC targets. For a given drug budget, more patients would achieve NSF LDL-C and TC targets with atorvastatin than with any of the other statins examined.

Approximate Model Checking of Real-Time Systems for Linear Duration Invariants

Real-time systems are usually modelled with timed automata and real-time requirements relating to the state durations of the system are often specifiable using Linear Duration Invariants, which is a decidable subclass of Duration Calculus formulas. Various algorithms have been developed to check timed automata or real-time automata for linear duration invariants, but each needs complicated preprocessing and exponential calculation. To the best of our knowledge, these algorithms have not been implemented. In this paper, we present an approximate model checking technique based on a genetic algorithm to check real-time automata for linear durration invariants in reasonable times. Genetic algorithm is a good optimization method when a problem needs massive computation and it works particularly well in our case because the fitness function which is derived from the linear duration invariant is linear. ACM Computing Classification System (1998): D.2.4, C.3.

Accent Recognition for Noisy Audio Signals

It is well established that accent recognition can be as accurate as up to 95% when the signals are noise-free, using feature extraction techniques such as mel-frequency cepstral coefficients and binary classifiers such as discriminant analysis, support vector machine and k-nearest neighbors. In this paper, we demonstrate that the predictive performance can be reduced by as much as 15% when the signals are noisy. Specifically, in this paper we perturb the signals with different levels of white noise, and as the noise become stronger, the out-of-sample predictive performance deteriorates from 95% to 80%, although the in-sample prediction gives overly-optimistic results. ACM Computing Classification System (1998): C.3, C.5.1, H.1.2, H.2.4., G.3.

Fragments of a Samaritan Targum : edited from a Bodleian Ms. : with an introduction, containing a sketch of Samaritan history, dogma, and literature

by John W. Nutt, M.A., Fellow of All Souls' College, Grinfield reader on the LXX, sub-librarian of the Bodleian Library, Oxford

Die Papyrusurkunden der jüdischen Gemeinde in Elephantine in ihrer Bedeutung für jüdische Religion und Geschichte

von August Freiherr von Gall, Lic.theol., Dr.phil., Professor am Gymn. und Privatdozent a.d. Univ. in Gießen

Die jüdischen Exulanten in Babylonien

von Erich Klamroth, Lic.theol.

Griechentum und Judentum im letzten Jahrhundert vor Christus

von Dr. Paul Heinisch, Universitätsprofessor aus Straßburg, z.Zt. Breslau

Desenvolvimento de pastas cimentantes contendo nanossílica como material estendedor para aplicação em fases iniciais, de poços petrolíferos, submetidas à baixa temperatura (5°c ± 3ºc)

The improved performance of hydraulic binders, the base of Portland cement, consists in the careful selection and application of materials that promote greater durability and reduced maintenance costs There is a wide variety of chemical additives used in Portland cement slurries for cementing oil wells. These are designed to work in temperatures below 0 ° C (frozen areas of land) to 300 ° C (thermal recovery wells and geothermal); pressure ranges near ambient pressure (in shallow wells) to greater than 200 MPa (in deep wells). Thus, additives make possible the adaptation of the cement slurries for application under various conditions. Among the materials used in Portland cement slurry, for oil wells, the materials with nanometer scale have been applied with good results. The nanossílica, formed by a dispersion of SiO2 particles, in the nanometer scale, when used in cement systems improves the plastic characteristics and mechanical properties of the hardened material. This dispersion is used commercially as filler material, modifier of rheological properties and / or in recovery processes construction. It is also used in many product formulations such as paints, plastics, synthetic rubbers, adhesives, sealants and insulating materials Based on the above, this study aims to evaluate the performance of nanossílica as extender additive and improver of the performance of cement slurries subjected to low temperatures (5 ° C ± 3 ° C) for application to early stages of marine oil wells. Cement slurries were formulated, with densities 11.0;12.0 and 13.0 ppg, and concentrations of 0; 0.5, 1.0 and 1.5%. The cement slurries were subjected to cold temperatures (5 ° C ± 3 ° C), and its evaluation performed by tests rheological stability, free water and compressive strength in accordance with the procedures set by API SPEC 10A. Thermal characterization tests (TG / DTA) and crystallographic (XRD) were also performed. The use of nanossílica promoted reduction of 30% of the volume of free water and increased compression resistance value of 54.2% with respect to the default cement slurry. Therefore, nanossílica presented as a promising material for use in cement slurries used in the early stages of low-temperature oil wells

The Samaritans : their history, doctrines, and literature

by Moses Gaster, Ph.D.

Zustand der Nation im Exilio

Schriftenreihe des Originals: Sammlung theologischer Schriften ; 35

Geschichte der Regenten von Juda nach dem Exilio

von dem Verfasser der Geschichte Jesu

Morphometrics of seagrasses at species level, Moreton Bay, Australia determined from core samples collected in 2012-2013

Seagrass meadows are important marine carbon sinks, yet they are threatened and declining worldwide. Seagrass management and conservation requires adequate understanding of the physical and biological factors determining carbon content in seagrass sediments. Here, we identified key factors that influence carbon content in seagrass meadows across several environmental gradients in Moreton Bay, SE Queensland. Sampling was conducted in two regions: (1) Canopy Complexity, 98 sites on the Eastern Banks, where seagrass canopy structure and species composition varied while turbidity was consistently low; and (2) Turbidity Gradient, 11 locations across the entire bay, where turbidity varied among sampling locations. Sediment organic carbon content and seagrass structural complexity (shoot density, leaf area, and species specific characteristics) were measured from shallow sediment and seagrass biomass cores at each location, respectively. Environmental data were obtained from empirical measurements (water quality) and models (wave height). The key factors influencing carbon content in seagrass sediments were seagrass structural complexity, turbidity, water depth, and wave height. In the Canopy Complexity region, carbon content was higher for shallower sites and those with higher seagrass structural complexity. When turbidity varied along the Turbidity Gradient, carbon content was higher at sites with high turbidity. In both regions carbon content was consistently higher in sheltered areas with lower wave height. Seagrass canopy structure, water depth, turbidity, and hydrodynamic setting of seagrass meadows should therefore be considered in conservation and management strategies that aim to maximize sediment carbon content.

(Table 1) Bulk geochemistry of sediment cores KH-79-3_L3 and KH-79-3_C3

The organic and isotopic geochemical study of two sediment cores (KH-79-3, L-3, and KH-79-3, C-3) from the Oki Ridge in the Japan Sea has revealed that total organic carbon (TOC) mass accumulation rates are extremely high in the 12-11 ka (calendar age) interval and TOC in the sections in the 24-17 ka interval is depleted in 13C by 3.5? relative to Holocene sediments. Alkenone sea surface temperature (SST) shows a decrease from 18° to 14°C from 17.5 to 11.6 ka and a sharp increase from 14° to 19°C from 11.6 to 11.1 ka. The SST changes are associated with the inflow of cold seawater with the vertical water mixing and the inflowof warm Tsushima Current into the Japan Sea. The d13C values for both 24-methylcholesta-5,22-dien-3?-ol (diatom marker) and dinosterol (dinoflagellate marker), are at their minimum from 24 to 17 ka, while those for long-chain alkenones are not. The theoretical considerations on d13C for biomarkers suggest low photosynthetic carbon demand of diatoms and dinoflagellates from 24 to 17 ka.

Studies in asymmetric and heterocyclic synthesis: I. chiral ketones II. Quinolones III. Trifluoromethylated pyrones

This thesis is split into three sections based on three different areas of research. In the first section, investigations into the α-alkylation of ketones using a novel chiral auxiliary is reported. This chiral auxiliary was synthesised containing a pyrrolidine ring in the chiral arm and was applied in the preparation of α-alkylated ketones which were obtained in up to 92% ee and up to 63% yield over two steps. Both 3-pentanone and propiophenone based ketones were used in the investigation with a variety of both alkyl and benzyl based electrophiles. The novel chiral auxiliary was also successful when applied to Michael and aldol reactions. A diamine precursor en route to the chiral auxiliary was also applied as an organocatalyst in a Michael reaction, with the product obtained in excellent enantioselectivity. In the second section, investigations into potential anti-quorum sensing molecules are reported. The bacteria Pseudomonas aeruginosa is an antibiotic-resistant pathogen that demonstrates cooperative behaviours and communicates using small chemical molecules in a process termed quorum sensing. A variety of C-3 analogues of the quorum sensing molecules used by P. aeruginosa were synthesised. Expanding upon previous research within the group, investigations were carried out into alternative protecting group strategies of 2-heptyl-4-(1H)- quinolone with the aim of improving the yields of products of cross-coupling reactions. In the third section, investigations into fluorination and trifluoromethylation of 2-pyrones, pyridones and quinolones is reported. The incorporation of a fluorine atom or a trifluoromethyl group into a molecule is important in pharmaceutical drug discovery programmes as it can lead to increased lipophilicity and bioavailability, however late-stage incorporation is rarely reported. Both direct fluorination and trifluoromethylation were attempted. Eight trifluoromethylated 2-pyrones, five trifluoromethylated 2-pyridones and a trifluoromethylated 2-quinolone were obtained in a late-stage synthesis from their respective iodinated precursors using methyl fluorosulfonyldifluoroacetate as a trifluoromethylating reagent.