2,616 research outputs found
India’s new Asia-Pacific strategy: Modi acts East
Get PDFIn this Lowy Institute Analysis, Danielle Rajendram examines India’s Look East Policy, and argues that the Modi Government will prioritise even closer engagement with the Asia-Pacific.
Key findings
India’s Look East Policy has shaped its engagement with the Asia-Pacific for over two decades, and, in recent years, has been driven by an external balancing strategy against China’s influence in the Indian Ocean, as well as India’s desire for a greater global role.
The BJP’s overwhelming electoral mandate will provide Prime Minister Modi with the opportunity to transform India into a serious strategic player in East and Southeast Asia.
The Modi Government will pursue a greater role in the Asia-Pacific in line with India’s growing economic and strategic interests, based on practical partnerships with Japan, Vietnam, Australia, and ASEAN
An updated cost-effectiveness analysis of pazopanib versus sunitinib as first-line treatment for locally advanced or metastatic renal cell carcinoma in Italy
Get PDFObjective: To assess the cost-effectiveness of pazopanib versus sunitinib as a first-line treatment for patients with metastatic renal cell carcinoma (mRCC) from an Italian National Health Service perspective, considering the evolving Italian landscape in terms of new reimbursement agreements trend. Methods: This analysis is an update of the previously published cost-effectiveness analysis to incorporate recent 2019 costs and additional changes regarding drug discounting. A partitioned-survival analysis model with three different health states (progression-free survival, post-progression survival, and dead) was utilized. Outcomes included progression-free life years, post-progression life years, overall life years, quality-adjusted life years (QALYs), and costs calculated for both treatments. Cost-effectiveness was assessed in terms of incremental costs per QALY gained and the net monetary benefit (NMB) of pazopanib versus sunitinib. In the base case analysis, a time horizon of 5 years was used and future costs and QALYs were discounted at a 3% annual discount rate. An impact of methodological and parameter uncertainly on base case results was evaluated using probabilistic and deterministic sensitivity analyses. Results: In the base case, pazopanib had higher QALYs (+0.060) at lower costs (−€5,857) versus sunitinib, hence it dominated sunitinib. At willingness-to-pay thresholds of €30,000 and €50,000 per QALY, the NMB with pazopanib were €7,647 and €8,841 per patient, respectively, versus sunitinib. The probability that pazopanib is cost-effective versus sunitinib was estimated to be 97.5% at a cost-effectiveness threshold of €20,000, 95.4% at a threshold of €30,000, and 90.2% at a threshold of €50,000 per QALY. Cost-effectiveness results were robust to changes in key parameter values and assumptions as demonstrated by deterministic sensitivity analyses. Conclusions: Pazopanib is likely to represent a cost-effective treatment option compared with sunitinib as a first-line treatment for patients with metastatic RCC in Italy
Atlante Paremiologico Italiano (API): Questionario e metodi di Ricerca sul Campo
No full textS. Trovato (a c. d.), Proverbi, locuzioni e modi di dire nel dominio linguistico italiano, Atti del I Convegno dell’Atlante Paremiologico Italiano, Il Calamo, Roma
Psychological treatments in schizophrenia: II. Meta-analyses of randomized controlled trials of social skills training and cognitive remediation
No full textBackground. Social skills training and cognitive remediation are psychological techniques with considerable face validity for the treatment of negative symptoms of schizophrenia and their consequences. This paper provides a meta-analytical review of these treatments. It includes an appreciable number of randomized controlled trials, using comparisons against both standard care and other active interventions. However, the assessment of particular outcomes sometimes had to be based on single studies.Method. A detailed search strategy was used to identify randomized controlled trials of social skills training and cognitive remediation, primarily employing electronic databases. Randomized controlled trials (RCTs) that met predefined criteria were then subjected to meta-analysis on a variety of outcome measures.Results. There was no clear evidence for any benefits of social skills training on relapse rate, global adjustment, social functioning, quality of life or treatment compliance. Cognitive remediation had no benefit on attention, verbal memory, visual memory, planning, cognitive flexibility or mental state.Conclusions. Social skills training and cognitive remediation do not appear to confer reliable benefits for patients with schizophrenia and cannot be recommended for clinical practice
Successful extraction of insect DNA from recent copal inclusions: limits and perspectives
Get PDFInsects entombed in copal, the sub-fossilized resin precursor of amber, represent a potential source of genetic data for extinct and extant, but endangered or elusive, species. Despite several studies demonstrated that it is not possible to recover endogenous DNA from insect inclusions, the preservation of biomolecules in fossilized resins samples is still under debate. In this study, we tested the possibility of obtaining endogenous ancient DNA (aDNA) molecules from insects preserved in copal, applying experimental protocols specifically designed for aDNA recovery. We were able to extract endogenous DNA molecules from one of the two samples analyzed, and to identify the taxonomic status of the specimen. Even if the sample was found well protected from external contaminants, the recovered DNA was low concentrated and extremely degraded, compared to the sample age. We conclude that it is possible to obtain genomic data from resin-entombed organisms, although we discourage aDNA analysis because of the destructive method of extraction protocols and the non-reproducibility of the results
Trump and Modi: Seeking a Global Partnership?
No full textThe visit of the Indian Prime Minister to Washington DC provides an opportunity for the US and India to set aside some of the uncertainties that have set into the relationship. President Trump and Prime Minister Modi must be ambitious and spell out a vision befitting a global partnership
The Multi-State Epigenetic Pacemaker enables the identification of combinations of factors that influence DNA methylation
No full textEpigenetic clocks, DNA methylation-based predictive models of chronological age, are often utilized to study aging associated biology. Despite their widespread use, these methods do not account for other factors that also contribute to the variability of DNA methylation data. For example, many CpG sites show strong sex-specific or cell-type-specific patterns that likely impact the predictions of epigenetic age. To overcome these limitations, we developed a multidimensional extension of the Epigenetic Pacemaker, the Multi-state Epigenetic Pacemaker (MSEPM). We show that the MSEPM is capable of accurately modeling multiple methylation-associated factors simultaneously, while also providing site-specific models that describe the per site relationship between methylation and these factors. We utilized the MSEPM with a large aggregate cohort of blood methylation data to construct models of the effects of age-, sex-, and cell-type heterogeneity on DNA methylation. We found that these models capture a large faction of the variability at thousands of DNA methylation sites. Moreover, this approach allows us to identify sites that are primarily affected by aging and no other factors. An analysis of these sites reveals that those that lose methylation over time are enriched for CTCF transcription factor chip peaks, while those that gain methylation over time are associated with bivalent promoters of genes that are not expressed in blood. These observations suggest mechanisms that underlie age-associated methylation changes and suggest that age-associated increases in methylation may not have strong functional consequences on cell states. In conclusion, the MSEPM is capable of accurately modeling multiple methylation-associated factors, and the models produced can illuminate site-specific combinations of factors that affect methylation dynamics
Open and closed distal anastomosis for acute type A aortic dissection repair
No full textOBJECTIVES The current consensus favours an open distal anastomosis for aortic dissection repair. A small number of experiences have compared early and long-term outcomes between closed and open distal anastomosis in the setting of acute aortic dissection. METHODS We reviewed our experience in 204 patients who underwent repair of spontaneous acute type A aortic dissection between January 2000 and December 2013. Open distal repair was performed in 109 patients, whereas 95 patients received a closed anastomosis. The clinical presentation, anatomical characteristics of aortic dissection, surgical techniques and the outcomes were analysed in the overall population and in the subgroup of patients (n = 100; open = 39, closed = 61) with Type 1 DeBakey dissection and a proximal intimal tear. Twenty-six preoperative and operative variables were studied to determine their impact on hospital mortality and postoperative neurological deficits. Imaging follow-up was available in 83 patients. RESULTS A more extensive involvement of the aortic arch characterized the open repair group. No differences in terms of mortality, morbidity and survival rates were observed between the two groups of patients. Open repair with cerebral perfusion was associated with a better neurological outcome. Patients who underwent an open distal anastomosis showed a significant higher rate of complete thrombosis of the false lumen. CONCLUSIONS An open repair does not increase the risk of early mortality and positively affect the evolution of the false lumen in distal unresected aortic segments. The use of cerebral perfusion reduces the risk of perioperative neurological injury
Acute type A aortic dissection repair in elderly patients
No full textOBJECTIVES: We evaluated our experience in acute type A aortic dissection (ATAAD) repair in elderly patients. The role of clinical presentation and surgical strategies in determining patients' outcome was further assessed. METHODS: A retrospective analysis of patients over 75 years who underwent emergency repair of ATAAD at our institution during 2000-13 was performed. Forty-five patients (mean age = 79 ± 3 years; 26 females) were identified. Aortic dissection was complicated in 17 (37%) patients with new neurological deficit (n = 5), cardiac tamponade (n = 12), acute myocardial infarction (n = 5) and acute renal failure (n = 2). The ascending aorta was replaced in all patients and hypothermic circulatory arrest was employed in 22 patients. The aortic replacement needed extension to the hemiarch in 11 patients and the aortic valve was replaced in 9 patients; in 3 cases, full root replacement was performed. RESULTS: The in-hospital mortality rate was 15% (n = 7). Preoperative acute neurological deficit was the only independent risk factor for mortality (P = 0.03). Age >80 years old per se was not associated with a poor outcome. Surgical strategies and extension of aortic wall resection did not affect the operative mortality. The postoperative course was complicated in 23 (52%) patients. During the median follow-up of 57 months, there were 4 late deaths. The cumulative 1-, 5- and 8-year survival rates were 82, 76 and 67%, respectively. CONCLUSIONS: Emergency surgical repair of ATAAD in elderly patients resulted in an acceptable early mortality rate and satisfactory intermediate survival. Preoperative acute neurological deficit predicts a worse outcome. Advanced age alone should not be considered as a contraindication to AAD repair
Behavioral Simulation of Biological Neuron Systems in SystemC
No full textThe investigation of neuron structures is an incredibly difficult and complex task that yields relatively low rewards in terms of information from biological forms (either animals or tissue). The structures and connectivity of even the simplest invertebrates are almost impossible to establish with standard laboratory techniques. Recent work has shown how a simplified behavioural approach to modeling neurons can allow “virtual” experiments to be carried out that map the behaviour of a simulated structure onto a hypothetical biological one, with correlation of behaviour rather than underlying connectivity. The problems with such approaches are twofold. The first is the difficulty of simulating realistic aggregates efficiently, and the second is making sense of the results. In this paper we describe a method of modeling neuron aggregates using SystemC (a language developed for hardware design), and also a design interface to enable structures and connection maps to be developed, with simulations carried out leading to animated visualization of the result
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