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"Evans, B G"
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An undisciplined economist : Robert G. Evans on health economics, health care policy, and population health
\"For the past four decades Robert Evans has been Canada's foremost health policy analyst and commentator, in the process playing a leadership role in the development of both health economics and population health at home and internationally. In this book the editors have assembled sixteen of Evans' most important contributions, including several seminal works and two new, previously unpublished articles. The topics addressed range widely, from the peculiar structure of the health care 'industry' to the social determinants of the health of entire populations to the misleading role that economists have sometimes played in health policy debates. Few academics write with Evans' clarity, candour or wit, while unabashedly exposing health policy myths and the interests that lie behind them. Claims that public health insurance is unsustainable, that the health care costs of an aging population will bankrupt us, that user charges will make the health care system more efficient, or that health care is the most important determinant of a population's health, are refuted with piercing analysis and supporting data. For those familiar with Evans' work, this will be a prized collection. For those new to the fields of health economics, health policy, or population health, there could be no better or more lucid introduction. For everyone, this collection is important reading and a fitting tribute to an outstanding scholar.\"-- Provided by publisher.
Allosteric conformational change of a cyclic nucleotide-gated ion channel revealed by DEER spectroscopy
by
Zagotta, William N.
,
Evans, Eric G. B.
,
Stoll, Stefan
in
Agonists
,
Allosteric properties
,
Allosteric Site - physiology
2020
Cyclic nucleotide-gated (CNG) ion channels are essential components of mammalian visual and olfactory signal transduction. CNG channels open upon direct binding of cyclic nucleotides (cAMP and/or cGMP), but the allosteric mechanism by which this occurs is incompletely understood. Here, we employed double electron-electron resonance (DEER) spectroscopy to measure intersubunit distance distributions in SthK, a bacterial CNG channel from Spirochaeta thermophila. Spin labels were introduced into the SthK C-linker, a domain that is essential for coupling cyclic nucleotide binding to channel opening. DEER revealed an agonistdependent conformational change in which residues of the B′-helix displayed outward movement with respect to the symmetry axis of the channel in the presence of the full agonist cAMP, but not with the partial agonist cGMP. This conformational rearrangement was observed both in detergent-solubilized SthK and in channels reconstituted into lipid nanodiscs. In addition to outwardmovement of the B′-helix, DEER-constrained Rosetta structural models suggest that channel activation involves upward translation of the cytoplasmic domain and formation of state-dependent interactions between the C-linker and the transmembrane domain. Our results demonstrate a previously unrecognized structural transition in a CNG channel and suggest key interactions that may be responsible for allosteric gating in these channels.
Journal Article
The risk of cancer in HIV-infected people in southeast England: a cohort study
by
Møller, H
,
Newnham, A
,
Evans, H S
in
Acquired immune deficiency syndrome
,
Acquired Immunodeficiency Syndrome - complications
,
Acquired Immunodeficiency Syndrome - epidemiology
2005
This study used data from the Communicable Disease Surveillance Centre's national HIV database and the Thames Cancer Registry to assess the risk of cancer in HIV-infected people in southeast England. Among 26 080 HIV-infected men with 158 660 person-years follow-up, 1851 cancers, and among 7110 HIV-infected women (31 098 person-years), 171 cancers were identified. The standardised incidence ratio (SIR) for all non-AIDS-defining cancers was significantly increased in HIV-infected men (2.8, 95% confidence interval (CI) 2.6–3.1) but was nonsignificant in HIV-infected women (1.1, 95% CI 0.8–1.6). Most of the cancers observed were in men (
n
=1559) and women (
n
=127) with AIDS, and among them, the SIR for all non-AIDS-defining cancers was significantly increased in men (8.2, 95% CI 7.2–9.2) and women (2.8, 95% CI 1.6–4.6). The SIR for all non-AIDS-defining cancers was only just significantly increased in men with HIV-infection but not AIDS (1.2, 95% CI 1.0–1.5) and was nonsignificant in such women (0.8, 95% CI 0.5–1.2).
Journal Article
Improved single frequency estimation with wide acquisition range
by
Awoseyila, A.B.
,
Evans, B.G.
,
Kasparis, C.
in
Applied sciences
,
Detection, estimation, filtering, equalization, prediction
,
Exact sciences and technology
2008
An improved method for estimating the frequency of a single complex sinusoid in complex additive white Gaussian noise is proposed. The method uses a modified version of the weighted linear predictor to achieve optimal accuracy at low/moderate SNR while retaining its speed and wide acquisition range. Consequently, it has an advantage over known methods that use the weighted phase averager since they suffer from an increased threshold effect at frequencies approaching the full estimation range.
Journal Article
Emerging trends in the epidemiology of invasive mycoses in England and Wales (1990–9)
2001
Invasive fungal infections are becoming an increasing public health problem owing to the growth in numbers of susceptible individuals. Despite this, the profile of mycoses remains low and there is no surveillance system specific to fungal infections currently existing in England and Wales. We analysed laboratory reports of deep-seated mycoses made to the Communicable Disease Surveillance Centre between 1990 and 1999 from England and Wales. A substantial rise in candidosis was seen during this period (6·76–13·70 reports per million population/year), particularly in the older age groups. Rates of cryptococcosis in males fluctuated over the decade but fell overall (1·05–0·66 per million population/year), whereas rates of female cases gradually rose up until 1998 (0·04–0·41 per million population/year). Reports of Pneumocystis carinii in men reduced substantially between 1990 and 1999 (2·77–0·42 per million population/year) but showed little change in women. Reports of aspergillosis fluctuated up until 1996, after which reports of male and female cases rose substantially (from 0·08 for both in 1996 to 1·92 and 1·69 per million population/year in 1999 for males and females respectively), largely accounted for by changes in reporting practice from one laboratory. Rates of invasive mycoses were generally higher in males than females, with overall male-to-female rate ratios of 1·32 (95% CI 1·25–1·40) for candidosis, 1·30 (95% CI 1·05–1·60) for aspergillosis, 3·99 (95% CI 2·93–5·53) for cryptococcosis and 4·36 (95% CI 3·47–5·53) for Pneumocystis carinii. The higher male than female rates of reports is likely to be a partial reflection of HIV epidemiology in England and Wales, although this does not fully explain the ratio in infants and older age groups. Lack of information on underlying predisposition prevents further identification of risk groups affected. Whilst substantial under-reporting of Pneumocystis carinii and Cryptococcus species was apparent, considerable numbers of superficial mycoses were mis-reported indicating a need for clarification of reporting guidelines. Efforts to enhance comprehensive laboratory reporting should be undertaken to maximize the utility of this approach for surveillance of deep-seated fungal infections.
Journal Article
Constant log-MAP decoding algorithm for duo-binary turbo codes
by
Sweeney, P.
,
Papaharalabos, S.
,
Evans, B.G.
in
Applied sciences
,
Coding, codes
,
Exact sciences and technology
2006
The constant log-MAP decoding algorithm suitable for duo-binary turbo codes. Motivated by an existing algorithm approach, an efficient algorithm is presented, which is superior in terms of frame/bit error rate performance and has approximately the same computational complexity. Compared with log-MAP decoding, the proposed algorithm has negligible performance degradation, exactly as for binary turbo codes.
Journal Article
Recent trends in HIV and other STIs in the United Kingdom: data to the end of 2002
by
Thomas, D
,
Fenton, K A
,
Parry, J V
in
Acquired immune deficiency syndrome
,
African Continental Ancestry Group
,
AIDS
2004
Sexual health in the United Kingdom has deteriorated in recent years with further increases in HIV and other sexually transmitted infections (STIs) reported in 2002. This paper describes results from the available surveillance data in the United Kingdom from the Health Protection Agency and its national collaborators. The data sources range from voluntary reports of HIV/AIDS from clinicians, CD4 cell count monitoring, a national census of individuals living with HIV, and the Unlinked Anonymous Programme, to statutory reports of STIs from genitourinary medicine (GUM) clinics and enhanced STI surveillance systems. In 2002, an estimated 49 500 adults aged over 15 years were living with HIV in the United Kingdom, of whom 31% were unaware of their infection. Diagnoses of new HIV infections have doubled from 1997 to 2002, mainly driven by heterosexuals who acquired their infection abroad. HIV transmission also continues within the United Kingdom, particularly among homo/bisexual men who, in 2002, accounted for 80% of all newly diagnosed HIV infections acquired in the United Kingdom. New diagnoses of syphilis have increased eightfold, and diagnoses of chlamydia and gonorrhoea have doubled from 1997 to 2002 overall; STI rates disproportionately affect homo/bisexual men and young people. Effective surveillance is essential in the provision of timely information on the changing epidemiology of HIV and other STIs; this information is necessary for the targeting of prevention efforts and through providing baseline information against which progress towards targets can be monitored.
Journal Article
Epidemiology of HIV among black and minority ethnic men who have sex with men in England and Wales
2005
Objectives: To examine the epidemiology of HIV among black and minority ethnic (BME) men who have sex with men (MSM) in England and Wales (E&W). Methods: Ethnicity data from two national HIV/AIDS surveillance systems were reviewed (1997–2002 inclusive), providing information on new HIV diagnoses and those accessing NHS HIV treatment and care services. In addition, undiagnosed HIV prevalence among MSM attending 14 genitourinary medicine (GUM) clinics participating in the Unlinked Anonymous Prevalence Monitoring Programme and having routine syphilis serology was examined by world region of birth. Results: Between 1997 and 2002, 1040 BME MSM were newly diagnosed with HIV in E&W, representing 12% of all new diagnoses reported among MSM. Of the 1040 BME MSM, 27% were black Caribbean, 12% black African, 10% black other, 8% Indian/Pakistani/Bangladeshi, and 44% other/mixed. Where reported (n = 395), 58% of BME MSM were probably infected in the United Kingdom. An estimated 7.4% (approximate 95% CI: 4.4% to 12.5%) of BME MSM aged 16–44 in E&W were living with diagnosed HIV in 2002 compared with 3.2% (approximate 95% CI: 2.6% to 3.9%) of white MSM (p<0.001). Of Caribbean born MSM attending GUM clinics between 1997 and 2002, the proportion with undiagnosed HIV infection was 15.8% (95% CI: 11.7% to 20.8%), while among MSM born in other regions it remained below 6.0%. Conclusions: Between 1997–2002, BME MSM accounted for just over one in 10 new HIV diagnoses among MSM in E more than half probably acquired their infection in the United Kingdom. In 2002, the proportion of BME MSM living with diagnosed HIV in E&W was significantly higher than white MSM. Undiagnosed HIV prevalence in Caribbean born MSM was high. These data confirm the need to remain alert to the sexual health needs and evolving epidemiology of HIV among BME MSM in E&W.
Journal Article
Recent trends in diagnoses of HIV and other sexually transmitted infections in England and Wales among men who have sex with men
2004
Objectives: To examine trends in rates of diagnoses of HIV and other sexually transmitted infections (STIs) in men who have sex with men (MSM) in England and Wales between 1997 and 2002. Methods: Estimates of the MSM population living in England and Wales, London and the rest of England and Wales were applied to surveillance data, providing rates of diagnoses of HIV and STIs and age group specific rates for HIV and uncomplicated gonorrhoea. Results: Between 1997 and 2002, rates of diagnoses of HIV and acute STIs in MSM increased substantially. Rates in London were higher than elsewhere. Rises in acute STIs were similar throughout England and Wales, except for uncomplicated gonorrhoea and infectious syphilis, with greater increases outside London. Rates of gonorrhoea diagnoses doubled between 1999 and 2001 (661/100 000, 1271/100 000, p<0.001) in England and Wales followed by a slight decline to 1210/100 000 (p = 0.03) in 2002—primarily the result of a decline in diagnoses among men aged 25–34 (1340/100 000, 1128/100 000, p<0.001) and 35–44 (924/100 000, 863/100 000, p = 0.03) in London. HIV was the third most common STI diagnosed in MSM in England and Wales and the second in London, with the highest rate (1286/100 000) found among men aged 35–44 in London in 2002. Conclusions: Rates of diagnosis of HIV and other STIs have increased substantially among MSM in England and Wales. Increases show heterogeneity by infection, geography, and age over time. Rates in London were twice those seen elsewhere, with greatest changes over time. The observed changes reflect concomitant increases in high risk behaviour documented in behavioural surveillance survey programmes.
Journal Article