Allocating Vote: Health — ‘Needs Assessment’ and an Economics-Based Approach

This paper critiques 'needs assessment' as a basis for allocating public funding of health and disability services and discusses an alternative economics-based approach. In essence, the former approach ignores the effects on health outcomes of health care spending at the margin while the latter focuses explicitly on these considerations. A simple diagrammatic model is introduced that illustrates at a conceptual level the (micro) economic constraints and choices available to policy-makers. Finally, some practical steps and unresolved issues in implementing the economics approach are considered.

LOWER BODY PEAK FORCE BUT NOT POWER IS AN IMPORTANT DISCRIMINATOR OF ELITE SENIOR RUGBY LEAGUE PLAYERS

This investigation determined differences in lower body strength and power between elite junior (17-20 years) and elite senior (open-aged) rugby league athletes. Twenty junior and 25 senior athletes performed an isometric mid-thigh pull, countermovement jump, repeated jump, and broad jump tests during a National Rugby League pre-season. The effects of age (junior vs. senior) and position (adjustables vs. hit-up forwards vs. outside backs) on test results were investigated using a two-way analysis of variance. Cohen’s d effect sizes (ES) and 95% confidence intervals were calculated for pairwise comparisons. Isometric mid-thigh pull absolute peak force was greater for senior players compared to junior players (ES=0.88, p<.05). Countermovement jump absolute peak power was greater for outside backs (ES=1.12) and hit-up forwards (ES=1.23) compared to adjustables (p<.05), greater for senior outside backs compared to junior outside backs (ES=1.53, p<.05), and greater for junior hit-up forwards compared to senior hit-up forwards (ES=1.00, p<.05). This research demonstrated the differences in strength and power of rugby league athletes between playing age and position. Improving lower body strength should be prioritised for athletic development of junior rugby league athletes, with consideration given to requirements across different playing positions

Progressive promoter element combinations classify conserved orthogonal plant circadian gene expression modules

We aimed to test the proposal that progressive combinations of multiple promoter elements acting in concert may be responsible for the full range of phases observed in plant circadian output genes. In order to allow reliable selection of informative phase groupings of genes for our purpose, intrinsic cyclic patterns of expression were identified using a novel, non-biased method for the identification of circadian genes. Our non-biased approach identified two dominant, inherent orthogonal circadian trends underlying publicly available microarray data from plants maintained under constant conditions. Furthermore, these trends were highly conserved across several plant species. Four phase-specific modules of circadian genes were generated by projection onto these trends and, in order to identify potential combinatorial promoter elements that might classify genes into these groups, we used a Random Forest pipeline which merged data from multiple decision trees to look for the presence of element combinations. We identified a number of regulatory motifs which aggregated into coherent clusters capable of predicting the inclusion of genes within each phase module with very high fidelity and these motif combinations changed in a consistent, progressive manner from one phase module group to the next, providing strong support for our hypothesis

A Simple Deep Learning Architecture for City-scale Vehicle Re-identification

The task of vehicle re-identification aims to identify a vehicle across different cameras with non overlapping fields of view and it is a challenging research problem due to viewpoint orientation, scene occlusions and intrinsic inter-class similarity of the data. In this paper, we propose a simplistic approach for one-shot vehicle re-identification based on a siamese/triple convolutional architecture for feature representation. Our method involves learning a feature space in which the vehicles of the same identities are projected closer to one another compared to those with different identities. Moreover, we provide an extensive evaluation of loss functions, including a novel combination of triplet loss with classification loss, and other network parameters applied to our vehicle re-identification system. Compared to most existing state-of-the-art approaches, our approach is simpler and more straightforward for training, utilizing only identity-level annotations. The proposed method is evaluated on the large-scale CityFlow-ReID dataset

Preparatory study for the revaluation of the EQ-5D tariff: methodology report.

BACKGROUND: EQ-5D is a widely used generic measure of health with a 'tariff', or preference weights, obtained from the general population, using time trade-off (TTO). PRET (Preparatory study for the Re-valuation of the EQ-5D Tariff project) contributes towards the methodology for its revaluation. METHODS: Stage 1 examined key assumptions typically involved in health-state valuations through a series of binary choice exercises, namely that health-state preferences are independent of (1) duration of the state; (2) whose health it is (i.e. perspective); (3) length of 'lead time' (a mechanism to value all states on the same scale, including those who are worse than being dead); (4) when health events take place (time preference); and (5) satisfaction associated with the state. Further topics addressed were (6) exhaustion of lead time in the worst state; (7) health-state valuation using discrete choice experiments (DCEs) with a duration attribute; and (8) binary choice administration of lead time - time trade-off (LT-TTO). Stage 1 consisted of an online survey with 6000 respondents. Stage 2 compared the results above to those of an identical survey conducted in 200 face-to-face computer-assisted personal interviews (CAPIs), covering topics (1) to (7). Stages 3 and 4 examined - in more detail and depth - issues taken from stage 1. Stage 3 consisted of CAPI surveys of a representative UK sample of 300, using examples of TTO, LT-TTO, and DCE with duration, each followed by extensive feedback questions. Stage 4 was a more intensive exercise involving a qualitative analysis of people's thought processes during both binary choice and iterative health-state valuation exercises. Data were collected through 'think-aloud' methods in 30 interviews of a convenience sample. RESULTS: Stage 1 found that health-state values are not independent of (1) duration of the state but there is no clear pattern; (2) whose health it is; (3) the duration of 'lead time' but there was no clear pattern; (4) when health events take place; or (5) satisfaction associated with the state. Furthermore, (6) exhaustion of lead time in the worst state was subject to substantial framing effects; (7) the five-level version of the EQ-5D (EQ-5D-5L) can be valued using DCE with duration as an attribute; and (8) binary choice LT-TTO can be administered in an online environment. Stage 2 found that although online surveys and CAPI surveys resulted in different compositions of respondents, at the aggregate, their responses to the experimental questions covering (1) to (7) above were not statistically significantly different from each other. Stages 3 and 4 found that TTO and LT-TTO were easier than DCE with duration; respondents did not necessarily trade across all attributes of EQ-5D; some respondents found it difficult to distinguish between the two worst levels of EQ-5D-5L, and some respondents may be thinking about the impact of their ill health on their family. CONCLUSIONS: In order for the National Institute for Health and Care Excellence to make the most appropriate decisions, the EQ-5D tariff needs to incorporate the latest understanding of health-state preferences. PRET contributed to the knowledge base on the conduct of health-state valuation studies. FUNDING: The Medical Research Council (MRC)-National Institute for Health Research (NIHR) Methodology Research Programme funded the PRET project (MRC ref. G0901500), and the EuroQol Group funded the PRET-AS project (Preparatory study for the Re-valuation of the EQ-5D Tariff project - Additional Sample) as an extension to the PRET project with formal agreement from the MRC

Commercial processing of Oriental lilies affects bud opening and metabolic dynamics

Lilies are a high value cut flower typically producing 4–5 flowers per stem, but the opening of young buds of Oriental hybrid lilies is often affected in cut flowers. Commercial treatment includes harvesting of the stem when the oldest bud is closed and at turning colour, approximately 2 ds before it would open on the plant. Stems are then rehydrated, stored chilled for up to 72 h and transported dry. To understand the effect of commercial treatment on the nutrient status metabolomes were compared throughout bud opening from different positions on the stem. At each developmental stage the metabolomic profile was affected by bud position and commercial treatment. Starch accumulated as long as buds remain closed; upon bud opening starch content declined. Reciprocally, sugar levels rose during flower opening and were affected by edge/ midrib location and commercial treatment. Glucose, fructose and sucrose levels remained higher in opened flowers still on the plant. AMY2 (amylase) transcript levels rose as did those of two sugar transporters (MST6 and SWEET7). Commercial processing therefore impacts on the metabolome and the ability to accumulate sugars in the opening flower bud. Commercial treatment delayed bud opening and the effect was dependent on the position of the bud on the stem. However, it had little impact on the rate of cell expansion during flower opening. Cell expansion in the different areas of the adaxial epidermis was unaffected by the commercial treatment. Furthermore, edge and adaxial tepal cells expanded faster during opening. Expression of cell expansion related genes (EXPA1 and LoPIP1) fell as flowers opened. This differential cell expansion in the tepal sectors could underpin the transition of a convex to a concave tepal shape during opening. In conclusion, commercial processing mainly affects the early stages of bud opening. Sugar and metabolite accumulation is compromised by commercial treatment, but this did not affect the capacity for cell expansion in the tepal. Furthermore, our data indicate that differential cell expansion in the different sectors of the tepals is important in lily flower opening, and that this is associated with starch breakdown and sugar accumulation