Cost-effectiveness analysis in R using a multi-state modelling survival analysis framework: a tutorial

This tutorial provides a step-by-step guide to performing cost-effectiveness analysis using a multi-state modelling approach. Alongside the tutorial we provide easy-to-use functions in the statistics package R. We argue this multi-state modelling approach using a package such as R has advantages over approaches where models are built in a spreadsheet package. In particular, using a syntax-based approach means there is a written record of what was done and the calculations are transparent. Reproducing the analysis is straightforward as the syntax just needs to be run again. The approach can be thought of as an alternative way to build a Markov decision analytic model, which also has the option to use a state-arrival extended approach if the Markov property does not hold. In the state-arrival extended multi-state model a covariate that represents patients’ history is included allowing the Markov property to be tested. We illustrate the building of multi-state survival models, making predictions from the models and assessing fits. We then proceed to perform a cost-effectiveness analysis including deterministic and probabilistic sensitivity analyses. Finally, we show how to create two common methods of visualising the results, namely cost-effectiveness planes and cost-effectiveness acceptability curves. The analysis is implemented entirely within R. It is based on adaptions to functions in the existing R package mstate, to accommodate parametric multi-state modelling which facilitates extrapolation of survival curves

Identifying "communities" within energy landscapes

Potential energy landscapes can be represented as a network of minima linked by transition states. The community structure of such networks has been obtained for a series of small Lennard-Jones clusters. This community structure is compared to the concept of funnels in the potential energy landscape. Two existing algorithms have been used to find community structure, one involving removing edges with high betweenness, the other involving optimization of the modularity. The definition of the modularity has been refined, making it more appropriate for networks such as these where multiple edges and self-connections are not included. The optimization algorithm has also been improved, using Monte Carlo methods with simulated annealing and basin hopping, both often used successfully in other optimization problems. In addition to the small clusters, two examples with known heterogeneous landscapes, LJ_13 with one labelled atom and LJ_38, were studied with this approach. The network methods found communities that are comparable to those expected from landscape analyses. This is particularly interesting since the network model does not take any barrier heights or energies of minima into account. For comparison, the network associated with a two-dimensional hexagonal lattice is also studied and is found to have high modularity, thus raising some questions about the interpretation of the community structure associated with such partitions.Comment: 13 pages, 11 figure

Power-law distributions for the areas of the basins of attraction on a potential energy landscape

Energy landscape approaches have become increasingly popular for analysing a wide variety of chemical physics phenomena. Basic to many of these applications has been the inherent structure mapping, which divides up the potential energy landscape into basins of attraction surrounding the minima. Here, we probe the nature of this division by introducing a method to compute the basin area distribution and applying it to some archetypal supercooled liquids. We find that this probability distribution is a power law over a large number of decades with the lower-energy minima having larger basins of attraction. Interestingly, the exponent for this power law is approximately the same as that for a high-dimensional Apollonian packing, providing further support for the suggestion that there is a strong analogy between the way the energy landscape is divided into basins, and the way that space is packed in self-similar, space-filling hypersphere packings, such as the Apollonian packing. These results suggest that the basins of attraction provide a fractal-like tiling of the energy landscape, and that a scale-free pattern of connections between the minima is a general property of energy landscapes.Comment: 4 pages, 3 figure

Shifting family bilingualism: two South African case studies

This ethnographic, sociolinguistic study describes the home language practices of two Afrikaans/English bilingual families, living in two middle-class English-dominant neighbourhoods, with the youngest children attending an English-medium primary school. In this study, I investigate if these families maintain their existing Afrikaans-dominant bilingualism, or shift towards greater use of English. According to the sociolinguistic literature, there is an on-going relationship between the processes of language maintenance and shift. Factors that influence these processes include bilingualism, marriage patterns, socio-economic status, prestige of dominant languages, domains, educational environment, school peer group and attitudes as well as perceptions about languages and language use. The database consists of naturalistic observations, interviews and language diaries. Conversations between family members in their respective homes were audio-recorded (32 hours of observations in total) and open-ended interviews were conducted with family members about their language use and attitudes. The children completed language diaries where they self-reported their language use at home and at school. The findings are as follows: both families speak English, Afrikaans as well as varieties of English and Afrikaans characterised by code-switching, code-mixing and borrowings in the home. The Petersen family presents with intergenerational transmission and maintenance of Afrikaans from the mother and brothers to the younger daughters. ‘Teaching moments’ in this family, characterised by an active interrelationship between English and Afrikaans, result in the transmission and use of Afrikaans and English between the family members. As a result of the domestic Afrikaans maintenance, the two daughters continue to speak Afrikaans and express a positive attitude toward the language in general and their bilingual identity in particular

Effect of oil palm sustainability certification on deforestation and fire in Indonesia.

Many major corporations and countries have made commitments to purchase or produce only "sustainable" palm oil, a commodity responsible for substantial tropical forest loss. Sustainability certification is the tool most used to fulfill these procurement policies, and around 20% of global palm oil production was certified by the Roundtable on Sustainable Palm Oil (RSPO) in 2017. However, the effect of certification on deforestation in oil palm plantations remains unclear. Here, we use a comprehensive dataset of RSPO-certified and noncertified oil palm plantations (∼188,000 km2) in Indonesia, the leading producer of palm oil, as well as annual remotely sensed metrics of tree cover loss and fire occurrence, to evaluate the impact of certification on deforestation and fire from 2001 to 2015. While forest loss and fire continued after RSPO certification, certified palm oil was associated with reduced deforestation. Certification lowered deforestation by 33% from a counterfactual of 9.8 to 6.6% y-1 Nevertheless, most plantations contained little residual forest when they received certification. As a result, by 2015, certified areas held less than 1% of forests remaining within Indonesian oil palm plantations. Moreover, certification had no causal impact on forest loss in peatlands or active fire detection rates. Broader adoption of certification in forested regions, strict requirements to avoid all peat, and routine monitoring of clearly defined forest cover loss in certified and RSPO member-held plantations appear necessary if the RSPO is to yield conservation and climate benefits from reductions in tropical deforestation

Fluxes and distribution of dissolved iron in the eastern (sub-) tropical North Atlantic Ocean

Aeolian dust transport from the Saharan/Sahel desert regions is considered the dominant external input of iron (Fe) to the surface waters of the eastern (sub-) tropical North Atlantic Ocean. To test this hypothesis, we investigated the sources of dissolved Fe (DFe) and quantified DFe fluxes to the surface ocean in this region. In winter 2008, surface water DFe concentrations varied between <0.1 nM and 0.37 nM, with an average of 0.13 ± 0.07 nM DFe (n = 194). A strong correlation between mixed layer averaged concentrations of dissolved aluminum (DAl), a proxy for dust input, and DFe indicated dust as a source of DFe to the surface ocean. The importance of Aeolian nutrient input was further confirmed by an increase of 0.1 nM DFe and 0.05 ?M phosphate during a repeat transect before and after a dust event. An exponential decrease of DFe with increasing distance from the African continent, suggested that continental shelf waters were a source of DFe to the northern part of our study area. Relatively high Fe:C ratios of up to 3 × 10?5 (C derived from apparent oxygen utilization (AOU)) indicated an external source of Fe to these African continental shelf waters. Below the wind mixed layer along 12°N, enhanced DFe concentrations (>1.5 nM) correlated positively with apparent oxygen utilization (AOU) and showed the importance of organic matter remineralization as an DFe source. As a consequence, vertical diffusive mixing formed an important Fe flux to the surface ocean in this region, even surpassing that of a major dust event

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Thesis (Ed.M.)--Boston Universit