New findings from the time trade-off for income approach to elicit willingness to pay for a quality adjusted life year

In this paper we empirically investigate how to appropriately model utility of wealth and health. We use a recently proposed alternative approach to value willingness to pay (WTP) for health, making use of trade-offs between income and life years or quality of life, which we extend to allow for a more realistic multiplicative utility function over health and money. Moreover, we show how reference-dependency can be incorporated into this model and derive its predictions for WTP elicitation. We propose three experimental elicitation procedures and test these in a feasibility study, analysing the responses under different assumptions about the discount rate. Several interesting results are reported: first, the data are highly skewed, but if we trim the 5% lowest and highest values, we obtain plausible WTP estimates. Second, the results differ considerably between procedures, indicating that WTP estimates are sensitive to the assumed utility function. Third, respondents appear to be loss averse for both health and money, which is consistent with assumptions from prospect theory. Finally, our results also indicate that respondents are more willing to trade quality of life than life years

Global-fidelity limits of state-dependent cloning of mixed states

By relevant modifications, the known global-fidelity limits of state-dependent cloning are extended to mixed quantum states. We assume that the ancilla contains some a priori information about the input state. As it is shown, the obtained results contribute to the stronger no-cloning theorem. An attainability of presented limits is discussed.Comment: 8 pages, ReVTeX, 1 figure. In revised form an attainability of presented limits is discussed. Detected errors are corrected. Elucidative figure is added. Minor grammatical changes are made. More explanation

The corrective approach: policy implications of recent developments in QALY measurement based on prospect theory

Background and Objectives Common health state valuation methodology, such as time tradeoff (TTO) and standard gamble (SG), is typically applied under several descriptively invalid assumptions, for example, related to linear quality-adjusted life years (QALYs) or expected utility (EU) theory. Hence, the current use of results from health state valuation exercises may lead to biased QALY weights, which may in turn affect decisions based on economic evaluations using such weights. Methods have been proposed to correct responses for the biases associated with different health state valuation techniques. In this article we outline the relevance of prospect theory (PT), which has become the dominant descriptive alternative to EU, for health state valuations and economic evaluations. Methods and Results We provide an overview of work in this field, which aims to remove biases from QALY weights. We label this “the corrective approach.” By quantifying PT parameters, such as loss aversion, probability weighting, and nonlinear utility, it may be possible to correct TTO and SG responses for biases in an attempt to produce more valid estimates of preferences for health states. Through straightforward examples, this article illustrates the effects of this corrective approach and discusses several unresolved issues that currently limit the relevance of corrected weights for policy. Conclusions Suggestions for research addressing these issues are provided. Nonetheless, if validly corrected health state valuations become available, we argue in favor of using these in economic evaluations

CYP17A1 deficient XY mice display susceptibility to atherosclerosis, altered lipidomic profile and atypical sex development

CYP17A1 is a cytochrome P450 enzyme with 17-alpha-hydroxylase and C17,20-lyase activities. CYP17A1 genetic variants are associated with coronary artery disease, myocardial infarction and visceral and subcutaneous fat distribution; however, the underlying pathological mechanisms remain unknown. We aimed to investigate the function of CYP17A1 and its impact on atherosclerosis in mice. At 4-6 months, CYP17A1-deficient mice were viable, with a KO:Het:WT ratio approximating the expected Mendelian ratio of 1:2:1. All Cyp17a1 knockout (KO) mice were phenotypically female; however, 58% were Y chromosome-positive, resembling the phenotype of human CYP17A1 deficiency, leading to 46,XY differences/disorders of sex development (DSD). Both male and female homozygous KO mice were infertile, due to abnormal genital organs. Plasma steroid analyses revealed a complete lack of testosterone in XY-KO mice and marked accumulation of progesterone in XX-KO mice. Elevated corticosterone levels were observed in both XY and XX KO mice. In addition, Cyp17a1 heterozygous mice were also backcrossed onto an Apoe KO atherogenic background and fed a western-type diet (WTD) to study the effects of CYP17A1 on atherosclerosis. Cyp17a1 x Apoe double KO XY mice developed more atherosclerotic lesions than Apoe KO male controls, regardless of diet (standard or WTD). Increased atherosclerosis in CYP17A1 XY KO mice lacking testosterone was associated with altered lipid profiles. In mice, CYP17A1 deficiency interferes with sex differentiation. Our data also demonstrate its key role in lipidomic profile, and as a risk factor in the pathogenesis of atherosclerosis

A QALY loss is a QALY loss is a QALY loss

Evidence has accumulated documenting loss aversion for monetary and, recently, for health outcomes—meaning that, generally, losses carry more weight than equally sized gains. In the conventional Quality-Adjusted Life Year (QALY) models, which comprise utility for quality and length of life, loss aversion is not taken into account. When measuring elements of the QALY model, commonly, the (implicit) assumption is that utility for length and quality of life are independent. First attempts to quantify loss aversion for QALYs typically measured loss aversion in the context of life duration, keeping quality of life constant (or vice versa). However, given that QALYs are multi-attribute utilities, it may be possible that the degree of loss aversion is dependent on, or inseparable from, quality of life and non-constant. We test this assumption using non-parametric methodology to quantify loss aversion, under different levels of quality of life. We measure utility of life duration for four health states within subjects, and present the results of a robustness test of loss aversion within the QALY model. We find loss aversion coefficients to be stable at the aggregate level, albeit with considerable heterogeneity at the individual level. Implications for applied work on prospect theory within health economics are discussed

Trust me; I know what I am doing

One core assumption of standard economic theory is that an individual’s preferences are stable, irrespective of the method used to elicit them. This assumption may be violated if preference reversals are observed when comparing different methods to elicit people’s preferences. People may then prefer A over B using one method while preferring B over A using another. Such preference reversals pose a significant problem for theoretical and applied research. We used a sample of medical and economics students to investigate preference reversals in the health and financial domain when choosing patients/clients. We explored whether preference reversals are associated with domain-relevant training and tested whether using guided ‘choice list’ elicitation reduces reversals. Our findings suggest that preference reversals were more likely to occur for medical students, within the health domain, and for open-ended valuation questions. Familiarity with a domain reduced the likelihood of preference reversals in that domain. Although preference reversals occur less frequently within specialist domains, they remain a significant theoretical and practical problem. The use of clearer valuation procedures offers a promising approach to reduce preference reversals

Oblique triangular antiferromagnetic phase in CsCu1−x_{1-x}Cox_xCl3_3

The spin-1/2 stacked triangular antiferromagnet CsCu$_{1-x}$Co$_x$Cl$_3$ with $0.015<x<0.032$ undergoes two phase transitions at zero field. The low-temperature phase is produced by the small amount of Co$^{2+}$ doping. In order to investigate the magnetic structures of the two ordered phases, the neutron elastic scattering experiments have been carried out for the sample with $x\approx 0.03$. It is found that the intermediate phase is identical to the ordered phase of CsCuCl$_3$, and that the low-temperature phase is an oblique triangular antiferromagnetic phase in which the spins form a triangular structure in a plane tilted from the basal plane. The tilting angle which is 42$^{\circ}$ at $T=1.6$ K decreases with increasing temperature, and becomes zero at $T_{\rm N2} =7.2$ K. An off-diagonal exchange term is proposed as the origin of the oblique phase.Comment: 6 pages, 7 figure

Soliton Lattices in the Incommensurate Spin-Peierls Phase: Local Distortions and Magnetizations

It is shown that nonadiabatic fluctuations of the soliton lattice in the spin-Peierls system CuGeO_3 lead to an important reduction of the NMR line widths. These fluctuations are the zero-point motion of the massless phasonic excitations. Furthermore, we show that the discrepancy of X-ray and NMR soliton widths can be understood as the difference between a distortive and a magnetic width. Their ratio is controlled by the frustration of the spin system. By this work, theoretical and experimental results can be reconciled in two important points.Comment: 9 pages, 5 figures included, Revtex submitted to Physical Review

Gravitational Lensing by Black Holes

We review the theoretical aspects of gravitational lensing by black holes, and discuss the perspectives for realistic observations. We will first treat lensing by spherically symmetric black holes, in which the formation of infinite sequences of higher order images emerges in the clearest way. We will then consider the effects of the spin of the black hole, with the formation of giant higher order caustics and multiple images. Finally, we will consider the perspectives for observations of black hole lensing, from the detection of secondary images of stellar sources and spots on the accretion disk to the interpretation of iron K-lines and direct imaging of the shadow of the black hole.Comment: Invited article for the GRG special issue on lensing (P. Jetzer, Y. Mellier and V. Perlick Eds.). 31 pages, 12 figure

Chaos in a double driven dissipative nonlinear oscillator

We propose an anharmonic oscillator driven by two periodic forces of different frequencies as a new time-dependent model for investigating quantum dissipative chaos. Our analysis is done in the frame of statistical ensemble of quantum trajectories in quantum state diffusion approach. Quantum dynamical manifestation of chaotic behavior, including the emergence of chaos, properties of strange attractors, and quantum entanglement are studied by numerical simulation of ensemble averaged Wigner function and von Neumann entropy.Comment: 9 pages, 18 figure