We consider certain elliptic modular graph functions that arise in the asymptotic expansion around the non--separating node of genus two string invariants that appear in the integrand of the \(D^8 ...R^4\) interaction in the low momentum expansion of the four graviton amplitude in type II superstring theory. These elliptic modular graphs have links given by the Green function, as well its holomorphic and anti--holomorphic derivatives. Using appropriate auxiliary graphs at various intermediate stages of the analysis, we show that each graph can be expressed solely in terms of graphs with links given only by the Green function and not its derivatives. This results in a reduction in the number of basis elements in the space of elliptic modular graphs.
We obtain Poisson equations satisfied by elliptic modular graph functions with four links. Analysis of these equations leads to a non--trivial algebraic relation between the various graphs.
Results of randomized controlled trials (RCTs) provide valuable comparisons of 2 or more interventions to inform health care decision making; however, many more comparisons are required than ...available time and resources to conduct them. Moreover, RCTs have limited generalizability. Comparative effectiveness research (CER) using real-world evidence (RWE) can increase generalizability and is important for decision making, but use of nonrandomized designs makes their evaluation challenging. Several tools are available to assist. In this study, we comparatively characterize 5 tools used to evaluate RWE studies in the context of making health care adoption decision making: (1) Good Research for Comparative Effectiveness (GRACE) Checklist, (2) IMI GetReal RWE Navigator (Navigator), (3) Center for Medical Technology Policy (CMTP) RWE Decoder, (4) CER Collaborative tool, and (5) Real World Evidence Assessments and Needs Guidance (REAdi) tool. We describe each and then compare their features along 8 domains: (1) objective/user/context, (2) development/scope, (3) platform/presentation, (4) user design, (5) study-level internal/external validity of evidence, (6) summarizing body of evidence, (7) assisting in decision making, and (8) sharing results/making improvements. Our summary suggests that the GRACE Checklist aids stakeholders in evaluation of the quality and applicability of individual CER studies. Navigator is a collection of educational resources to guide demonstration of effectiveness, a guidance tool to support development of medicines, and a directory of authoritative resources for RWE. The CMTP RWE Decoder aids in the assessment of relevance and rigor of RWE. The CER Collaborative tool aids in the assessment of credibility and relevance. The REAdi tool aids in refinement of the research question, study retrieval, quality assessment, grading the body of evidence, and prompts with questions to facilitate coverage decisions. All tools specify a framework, were designed with stakeholder input, assess internal validity, are available online, and are easy to use. They vary in their complexity and comprehensiveness. The RWE Decoder, CER Collaborative tool, and REAdi tool synthesize evidence and were specifically designed to aid formulary decision making. This study adds clarity on what the tools provide so that the user can determine which best fits a given purpose.
This work was supported by the Health Tech Fund, which was provided to the University of Washington School of Pharmacy by its Corporate Advisory Board. This consortium of pharmaceutical and biotech companies supports the research program of the University of Washington School of Pharmacy across the competitive space. The sponsors seeded the idea for the project and contributed to study design and improvement. The authors had full control of all content development, manuscript drafting, and submission for publication. The REAdi tool was developed by the authors. Chen, Bansal, Barthold, Carlson, Veenstra, Basu, Devine, Yun, Ta, and Beal were supported by a training grant from the University of Washington-Allergan Fellowship, unrelated to this work. Basu reports personal fees from Salutis Consulting, unrelated to this work. Graff is an employee of the National Pharmaceutical Council, which was a partner in the development of the CER Collaborative and funding partner for the CMTP RWE Decoder and the GRACE Checklist. A previous version of this work was presented as an invited workshop at AMCP Nexus 2018; October 22-25, 2018; Orlando, FL.
Background. Cost-effectiveness analyses measure quality of life by associating utilities with specific health states. Utilities are often defined by single health states, such as incontinence or ...impotence in the case of prostate cancer treatments. Health conditions often occur simultaneously, yielding joint health states (e.g., impotence with incontinence). Given the combinatorial mathematics involved, even a small number of conditions can result in large numbers of potential joint states, complicating utility elicitation for all relevant states. Analytic predictions for joint-state utilities have been based on 3 theoretical models: 1) multiplicative, 2) additive, and 3) minimum models. These models' empirical accuracy for joint-state utility prediction has been minimally examined. The authors compared these 3 models for predicting joint-state utilities from single-state utilities in men at the time of prostate biopsies. Methods. Utilities were collected using time tradeoff in 2 university-based prostate biopsy clinics (N = 147). Single-state utilities were elicited for impotence, incontinence, watchful waiting, and post-prostatectomy. Joint-state utilities were elicited for states combining impotence with 1) incontinence, 2) postprostatectomy, or 3) watchful waiting. Testing 3 prediction models of joint-state utilities for bias and consistency, the predictions were compared against directly elicited joint-state utilities. Results. All 3 models are biased. The minimum model is preferred, being the least biased and most efficient. Conclusions. No current model accurately predicts joint-state utility using the component single-state utilities. When possible, joint-state utilities should be elicited. If not possible, the minimum model is recommended. Research to identify better models is needed.
Japanese encephalitis (JE) is one of the most dreaded mosquito-borne viral encephalitis known to afflict humans. The Japanese encephalitis virus (JEV) is a neurotropic flavivirus that affects the ...CNS, causing extensive damage that may lead to fatality in about one third of patients. Half of the survivors suffer from severe neuropshychiatric sequelae. With nearly 3 billion people living under the current JE-endemic region, recurring incidents of epidemic are being reported at regular intervals. With no established antiviral therapies against JE available, vaccination has been the only way of preventing JE. Two types of JE vaccines are currently in vogue although the safety of administering them is questionable, in certain individuals. Thus, there is a need to develop a safe, affordable and potent JE vaccine and this review addresses the current efforts in this direction. This review also focuses on the pathophysiology of JE and efforts towards a possible breakthrough in anti-JEV therapy.
Statins reduce morbidity and mortality among patients with diabetes, but their use remains suboptimal. Understanding trends in statin use may inform strategies for improvement.
We enrolled a ...national, retrospective cohort of 899,664 veterans aged≥40years with diabetes in 2003. We followed them through 2011, dividing the nine-year follow-up into 90-day periods. For each period, we determined statin use, defined as possession of ≥30-day supply. We examine factors associated with statin uptake among baseline non-users with a multivariate model.
Baseline prevalence of statin use was 43%, increased by 1.8% per period (p for trend<0.001), and reached a maximum of ~59%. Statin use among non-Hispanic racial/ethnic minorities lagged behind their white counterparts. Among baseline non-users, statin use was 9% after Year 1 and reached 36% by Year 9. Factors associated with statin uptake included use of hypoglycemic agents, HbA1c between 7 and 8.9% (53–74mmol/mol), hypertension, heart failure, peripheral vascular disease, and Hispanic ethnicity.
Statin use is slowly increasing among patients with diabetes, and at varying rates within subgroups of this population. Policies that prioritize these subgroups for statin promotion may help guide future, intervention-based research to increase compliance with current guidelines.
•Less than 60% of patients with diabetes are using a statin•Among those not using a cholesterol medication at baseline, uptake was slow•Comorbid cardiovascular disease, HbA1c >7%, and Hispanic ethnicity were associated with an increased odds of statin uptake
Chemokines and their receptors are important elements for the selective attraction and activation of various subsets of leukocytes. Interferon-gamma inducible protein (IP-10 or CXCL-10) is a potent ...chemoattractant and has been suggested to enhance the severity of virus infection and neuronal injury. In order to assess functional importance of this chemokine in viral encephalitis, we have exploited an experimental model of Japanese encephalitis. We report for the first time that in Japanese encephalitis, astrocytes are the predominant source of IP-10. A progressive increase in IP-10 induction following viral infection is concomitant with the increase in IFN-γ a known inducer of IP-10. However, this increase in IFN-γ level is not sufficient to confer protection as animals eventually succumb to the infection.
Time-sequence data is high dimensional and con- tains a lot of information, which can be utilized in various fields, such as insurance, finance, and advertising. Personal data including time-sequence ...data is often converted to anonymized datasets, which need to strike a balance between both privacy and utility. In this paper, we consider low-rank matrix decomposition as one of the anonymization methods and evaluate its efficiency. We convert time-sequence datasets to matrices and evaluate both privacy and utility. The record IDs in time-sequence data are changed at regular intervals to reduce re-identification risk. However, since individuals tend to behave in a similar fashion over periods of time, there remains a risk of record linkage even if record IDs are different. Hence, we evaluate the re- identification and linkage risks as privacy risks of time-sequence data. Our experimental results show that matrix decomposition is a viable anonymization method and it can achieve better utility than existing anonymization methods.
▶ TNF-α was expressed in 32% patients with TBM, IL-6, IL-10, IL-1β and IL-8 were significantly expressed in patients compared to controls and declined after 3 months of antitubercular therapy. ▶ ...Levels of IL-6 was increased in patients who had worsening of exudates and tuberculoma. ▶ The cytokine levels however did not significantly correlate with stage of meningitis, outcome and radiological deterioration or improvement.
There is paucity of studies on cytokines in tuberculous meningitis (TBM) and their relation with clinical and radiological changes; therefore this study was undertaken. 16 TBM patients diagnosed on the basis of clinical, CSF and radiological criteria were included. They were subjected to TNF-α, IL-6, IL-8, IL-10, IL-1β, and IL-12p70 estimation in CSF. The cytokine levels were also estimated in 10 controls. Initial clinical examination, stage of TBM and MRI findings (infarct, hydrocephalus, tuberculoma and exudates) were recorded. The patients were treated with 4 drugs antitubercular (RHZE) therapy and after 3 months clinical examination, cytokine levels, and radiological studies were repeated. Outcome was defined by Barthel index score at 3 months into poor, partial and complete recovery. The patient's age ranged between 10 and 50 years, 5 were females. At 3 months, all the patients were clinically followed up and 14 underwent repeat MRI. 10 patients improved, 1 remained stable and 5 deteriorated. There was worsening with respect to tuberculoma in 3, infarction in 2 and exudate in 1 patient. TNF-α was expressed in 32% patients, IL-6, IL-10, IL-1β and IL-8 were significantly expressed in patients and declined after 3 months following treatment. The cytokine levels did not correlate with stage of meningitis, outcome and radiological deterioration or improvement.
PDF
