Decision-analytic cost-effectiveness model to compare prostate cryotherapy to androgen deprivation therapy for treatment of radiation recurrent prostate cancer

Objective: To determine the cost-effectiveness of salvage cryotherapy (SC) in men with radiation recurrent prostate cancer (RRPC). Design: Cost-utility analysis using decision analytic modelling by a Markov model. Setting and methods: Compared SC and androgen deprivation therapy (ADT) in a cohort of patients with RRPC (biopsy proven local recurrence, no evidence of metastatic disease). A literature review captured published data to inform the decision model, and resource use data were from the Scottish Prostate Cryotherapy Service. The model was run in monthly cycles for RRPC men, mean age of 70 years. The model was run over the patient lifetime, to assess changes in patient health states and the associated quality of life, survival and cost impacts. Results are reported in terms of the discounted incremental costs and discounted incremental quality-adjusted life years (QALYs) gained between the 2 alternative interventions. Probabilistic sensitivity analysis used a 10 000 iteration Monte Carlo simulation. Results: SC has a high upfront treatment cost, but delays the ongoing monthly cost of ADT. SC is the dominant strategy over the patient lifetime; it is more effective with an incremental 0.56 QALY gain (95% CI 0.28 to 0.87), and less costly with a reduced lifetime cost of £29 719 (€37 619) (95% CI −51 985 to −9243). For a ceiling ratio of £30 000, SC has a 100% probability to be cost-effective. The cost neutral point was at 3.5 years, when the upfront cost of SC (plus any subsequent cumulative cost of side effects and ADT) equates the cumulative cost in the ADT arm. Limitations of our model may arise from its insensitivity to parameter or structural uncertainty. Conclusions: The platform for SC versus ADT cost-effective analysis can be employed to evaluate other treatment modalities or strategies in RRPC. SC is the dominant strategy, costing less over a patient's lifetime with improvements in QALYs

Unification of bulk and interface electroresistive switching in oxide systems

We demonstrate that the physical mechanism behind electroresistive switching in oxide Schottky systems is electroformation, as in insulating oxides. Negative resistance shown by the hysteretic current-voltage curves proves that impact ionization is at the origin of the switching. Analyses of the capacitance-voltage and conductance-voltage curves through a simple model show that an atomic rearrangement is involved in the process. Switching in these systems is a bulk effect, not strictly confined at the interface but at the charge space region.Comment: 4 pages, 3 figures, accepted in PR

Multi-wavelength emissions from the millisecond pulsar binary PSR J1023+0038 during an accretion active state

Recent observations strongly suggest that the millisecond pulsar binary PSR J1023+0038 has developed an accretion disk since 2013 June. We present a multi-wavelength analysis of PSR J1023+0038, which reveals that 1) its gamma-rays suddenly brightened within a few days in June/July 2013 and has remained at a high gamma-ray state for several months; 2) both UV and X-ray fluxes have increased by roughly an order of magnitude, and 3) the spectral energy distribution has changed significantly after the gamma-ray sudden flux change. Time variabilities associated with UV and X-rays are on the order of 100-500 seconds and 50-100 seconds, respectively. Our model suggests that a newly formed accretion disk due to the sudden increase of the stellar wind could explain the changes of all these observed features. The increase of UV is emitted from the disk, and a new component in gamma-rays is produced by inverse Compton scattering between the new UV component and pulsar wind. The increase of X-rays results from the enhancement of injection pulsar wind energy into the intra-binary shock due to the increase of the stellar wind. We also predict that the radio pulses may be blocked by the evaporated winds from the disk and the pulsar is still powered by rotation.Comment: 8 pages, 3 figures; accepted for publication in Ap

Droplets in the coexistence region of the two-dimensional Ising model

The two-dimensional Ising model with fixed magnetization is studied using Monte Carlo techniques. At the coexistence line, the macroscopic, extensive droplet of minority spins becomes thermally unstable by breaking up into microscopic clusters. Intriguing finite--size effects as well as singularities of thermal and cluster properties associated with the transition are discussed.Comment: 7 pages, 3 figures included, submitted to J. Phys. A: Math. Ge

Perturbative Approach to the Quasinormal Modes of Dirty Black Holes

Using a recently developed perturbation theory for uasinormal modes (QNM's), we evaluate the shifts in the real and imaginary parts of the QNM frequencies due to a quasi-static perturbation of the black hole spacetime. We show the perturbed QNM spectrum of a black hole can have interesting features using a simple model based on the scalar wave equation.Comment: Published in PR

Sorptivity of self-compacting concrete containing fly ash and silica fume

This paper presents the surface water absorption of self-compacting concrete (SCC) containing fly ash and silica fume using sorptivity test. Ordinary Portland cement was partially replaced by various combinations of fly ash and silica fume. Test results show that the presence of fly ash and silica fume significantly reduce the surface water absorption of self-compacting concrete at a water-binder ratio of 0.38. When only fly ash is used to partially replace Ordinary Portland cement, a more noticeable reduction in sorptivity is found when the fly ash content is greater than 20%

Ocular and Extraocular Expression of Opsins in the Rhopalium of Tripedalia cystophora (Cnidaria: Cubozoa)

A growing body of work on the neuroethology of cubozoans is based largely on the capabilities of the photoreceptive tissues, and it is important to determine the molecular basis of their light sensitivity. The cubozoans rely on 24 special purpose eyes to extract specific information from a complex visual scene to guide their behavior in the habitat. The lens eyes are the most studied photoreceptive structures, and the phototransduction in the photoreceptor cells is based on light sensitive opsin molecules. Opsins are photosensitive transmembrane proteins associated with photoreceptors in eyes, and the amino acid sequence of the opsins determines the spectral properties of the photoreceptors. Here we show that two distinct opsins (Tripedalia cystophora-lens eye expressed opsin and Tripedalia cystophora-neuropil expressed opsin, or Tc-leo and Tc-neo) are expressed in the Tripedalia cystophora rhopalium. Quantitative PCR determined the level of expression of the two opsins, and we found Tc-leo to have a higher amount of expression than Tc-neo. In situ hybridization located Tc-leo expression in the retinal photoreceptors of the lens eyes where the opsin is involved in image formation. Tc-neo is expressed in a confined part of the neuropil and is probably involved in extraocular light sensation, presumably in relation to diurnal activity