Analytical and Monte Carlo approaches to evaluate probability distributions of interruption duration

Regulatory authorities in many countries, in order to maintain an acceptable balance between appropriate customer service qualities and costs, are introducing a performance-based regulation. These regulations impose penalties-and, in some cases, rewards-that introduce a component of financial risk to an electric power utility due to the uncertainty associated with preserving a specific level of system reliability. In Brazil, for instance, one of the reliability indices receiving special attention by the utilities is the maximum continuous interruption duration (MCID) per customer.This parameter is responsible for the majority of penalties in many electric distribution utilities. This paper describes analytical and Monte Carlo simulation approaches to evaluate probability distributions of interruption duration indices. More emphasis will be given to the development of an analytical method to assess the probability distribution associated with the parameter MCID and the correspond ng penalties. Case studies on a simple distribution network and on a real Brazilian distribution system are presented and discussed.

Transandean railroads: the interruption of service and prospects for resumption

Building the infrastructure and then operating a railroad which starts on the Pacific coast of South America and which, a few score kilometres inland, must climb close to 4,000 metres above sea level in the Andes mountains has always presented challenges both for the civil engineers responsible for its construction and for the managers in charge of its operation.As at mid-2001, two of the four transandean railroads that ran 20 years ago are out of service, owing to adverse weather conditions, and a third is not operating as a result of institutional problems.Nevertheless, two of the three railroads that are now shut down could resume service soon. Furthermore, there is a possibility that a new transandean railroad could be built that would cross the Andes mountains further south, at an altitude of less than 1,750 meters.

Supplementary corpora lutea monitoring allows progestin treatment interruption on day 70 of pregnancy in non-cyclic recipient mares

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Impacts of interruption of the Agulhas leakage on the tropical Atlantic in coupled ocean-atmosphere simulations

In this paper we use a coupled ocean-atmosphere model to investigate the impact of the interruption of Agulhas leakage of Indian ocean water on the tropical Atlantic, a region where strong coupled ocean-atmosphere interactions occur. The effect of a shut down of leakage of Indian ocean water is isolated from the effect of a collapse of the MOC. In our experiments, the ocean model is forced with boundary conditions in the southeastern corner of the domain that correspond to no interocean exchange of Indian ocean water into the Atlantic. The southern boundary condition is taken from the Levitus data and ensures an MOC in the Atlantic. Within this configuration, instead of warm and salty Indian ocean water temperature (cold) and salinity (fresh) anomalies of southern ocean origin propagate into the South Atlantic and eventually reach the equatorial region, mainly in the thermocline. This set up mimics the closure of the ""warm water path"" in favor of the ""cold water path"". As part of the atmospheric response, there is a northward shift of the intertropical convergence zone (ITCZ). The changes in trade winds lead to reduced Ekman pumping in the equatorial region. This leads to a freshening and warming of the surface waters along the equator. Especially in the Cold Tongue region, the cold and fresh subsurface anomalies do not reach the surface due to the reduced upwelling. The anomaly signals are transported by the equatorial undercurrent and spread away from the equator within the thermocline. Part of the anomaly eventually reaches the Tropical North Atlantic, where it affects the Guinea Dome. Surprisingly, the main effect at the surface is small on the equator and relatively large at the Guinea Dome. In the atmosphere, the northward shift of the ITCZ is associated with a band of negative precipitation anomalies and higher salinities over the Tropical South Atlantic. An important implication of these results is that the modified water characteristics due to a shut down of the Agulhas leakage remain largely unaffected when crossing the equatorial Atlantic and therefore can affect the deepwater formation in the North Atlantic. This supports the hypothesis that the Agulhas leakage is an important source region for climate change and decadal variability of the Atlantic.

Evaluation of HIV-1 resistance to antiretroviral drugs among 150 patients after six months of therapeutic interruption

Most of the antiretroviral (ARV) studies in Brazil have been reported in treatment-experienced and naive patients rather than in the setting of treatment interruption (TI). In this study, we analysed reasons given for TI and resistance mutations occurring in 150 HIV-1-infected patients who underwent TI. Of the patients analysed, 110 (73.3%) experienced TI following medical advice, while the remaining patients stopped antiretroviral therapy (ART) of their own accord. The main justifications for TI were: ARV-related toxicities (38.7%), good laboratory parameters (30%) and poor adherence (20%). DNA sequencing of the partial pol gene was successful in 137 (91.3%) patients, of whom 38 (27.7%) presented mutations conferring ARV resistance. A higher viral load prior to TI correlated with drug resistance (P < 0.05). Our results demonstrate that there are diverse rationales for TI and that detection of resistant strains during TI most likely indicates a fitter virus than the wild type. High viral loads coupled with unprotected sex in this group could increase the likelihood of transmission of drug-resistant virus. Thus, treating physicians should be alerted to this problem when the use of ARVs is interrupted.

HIV-1 Proviral DNA Loads (as Determined by Quantitative PCR) in Patients Subjected to Structured Treatment Interruption after Antiretroviral Therapy Failure

The impact of Structured Treatment Interruption (STI) in peripheral blood mononuclear cell (PBMC) proviral reservoirs in 41 highly active antiretroviral therapy (HAART)-treated viremic individuals at baseline and 12 weeks after STI was determined using quantitative PCR (qPCR). Viral load increased 0.7 log(10) and CD4 decreased 97.5 cells/mm(3) after 12 weeks. A total of 28 of the 41 individuals showed an increased proviral load, 19 with a statistically significant increase above 10%. An increase in active viral replication is an important factor in the replenishment of the proviral reservoir even for short time periods.

Early antiretroviral therapy during primary HIV-1 infection results in a transient reduction of the viral setpoint upon treatment interruption

Long-term benefits of combination antiretroviral therapy (cART) initiation during primary HIV-1 infection are debated.

HLA-Bw4 identifies a population of HIV-infected patients with an increased capacity to control viral replication after structured treatment interruption

After structured treatment interruption (STI) of treatment for HIV-1, a fraction of patients maintain suppressed viral loads. Prospective identification of such patients might improve HIV-1 treatment, if selected patients are offered STI.

Determinants of CD4 cell count decline after treatment interruption

Patients who had started HAART (Highly Active Anti-Retroviral Treatment) under previous aggressive DHHS guidelines (1997) underwent a life-long continuous HAART that was associated with many short term as well as long term complications. Many interventions attempted to reduce those complications including intermittent treatment also called pulse therapy. Many studies were done to study the determinants of rate of fall in CD4 count after interruption as this data would help guide treatment interruptions. The data set used here was a part of a cohort study taking place at the Johns Hopkins AIDS service since January 1984, in which the data were collected both prospectively and retrospectively. The patients in this data set consisted of 47 patients receiving via pulse therapy with the aim of reducing the long-term complications. ^ The aim of this project was to study the impact of virologic and immunologic factors on the rate of CD4 loss after treatment interruption. The exposure variables under investigation included CD4 cell count and viral load at treatment initiation. The rates of change of CD4 cell count after treatment interruption was estimated from observed data using advanced longitudinal data analysis methods (i.e., linear mixed model). Using random effects accounted for repeated measures of CD4 per person after treatment interruption. The regression coefficient estimates from the model was then used to produce subject specific rates of CD4 change accounting for group trends in change. The exposure variables of interest were age, race, and gender, CD4 cell counts and HIV RNA levels at HAART initiation. ^ The rate of fall of CD4 count did not depend on CD4 cell count or viral load at initiation of treatment. Thus these factors may not be used to determine who can have a chance of successful treatment interruption. CD4 and viral load were again studied by t-tests and ANOVA test after grouping based on medians and quartiles to see any difference in means of rate of CD4 fall after interruption. There was no significant difference between the groups suggesting that there was no association between rate of fall of CD4 after treatment interruption and above mentioned exposure variables. ^