Issues in evaluating the costs and cost-effectiveness of Cognitive Behavioural Therapy for overweight/obese adolescents, CHERE Working Paper 2009/1

Economic evaluation is the systematic assessment of the costs and consequences of alternative courses of action. In health and healthcare, the results can be used to inform clinicians and policy makers about the relative cost-effectiveness of options under consideration [1]. Many economic evaluations are undertaken alongside randomised controlled trials (RCTs); the advantages of this approach are that i) prospective, accurate data can be collected on costs and effects and ii) appropriate outcome measures for use in economic evaluation can be chosen. The outcome of an economic evaluation is usually described as a ratio of the costs and effects ? often called the incremental cost-effectiveness ratio (ICER). The ICER is determined by calculating the differences in the costs and effects of both intervention and control groups and dividing the former by the latter. In designing an economic evaluation, the important questions to resolve are: which costs should be included and which outcome measures are most appropriate for estimating the cost-effectiveness ratio? In 2005, the Australian Technology Network of Universities funded the Centre for Metabolic Fitness (CMF) through a competitive, peer-reviewed process. The aims of the centre are to develop and evaluate diet and exercise interventions to counteract metabolic syndrome and assess their acceptability by target community groups. Metabolic syndrome is a cluster of metabolically determined risk factors associated with obesity (e.g. hypertension, impaired blood glucose etc). A number of collaborative projects have been developed within the centre, one of which is the CHOOSE HEALTH project. As part of this project, the effectiveness of cognitive behavioural therapy (CBT) as an intervention for overweight or obese adolescents has been trialled at the University of RMIT by Leah Brennan and the University of South Australia by Margarita Tsiros, as part of their post-graduate studies1. Subsequently, it has been decided to add an economic component to this work. Trials of the effectiveness and cost-effectiveness of different means of delivering cognitive behaviourally based weight management programs are planned2. This paper reports the results of investigations into the two questions which need to be addressed prior to undertaking a formal economic evaluation of the CHOOSE HEALTH program: i) what costs should be included and ii) which measures of outcome are suitable for estimating an ICER in this context. The paper is organised in four sections. Following the introduction (section 1) and brief descriptions of the background to and context in which the program was planned (section 2), details of the RMIT trial design and results are provided in section 3. In the final section (section 4), a cost model is presented and the implications of the outcomes used in the initial trials of the effectiveness are discussed in relation to designing a prospective economic evaluation of the CHOOSE HEALTH program.costs, economic evaluation, cognitive behavioural therapy (CBT), adolescent obesity, Australia

A new twist to an old story: HE 0450-2958, and the ULIRG→\to (optically bright QSO) transition hypothesis

We report on interferometric imaging of the CO J=1--0 and J=3--2 line emission from the controversial QSO/galaxy pair HE 0450--2958. {\it The detected CO J=1--0 line emission is found associated with the disturbed companion galaxy not the luminous QSO,} and implies $\rm M_{gal}(H_2)\sim (1-2)\times 10^{10} M_{\odot}$, which is \ga 30% of the dynamical mass in its CO-luminous region. Fueled by this large gas reservoir this galaxy is the site of an intense starburst with $\rm SFR\sim 370 M_{\odot} yr^{-1}$, placing it firmly on the upper gas-rich/star-forming end of Ultra Luminous Infrared Galaxies (ULIRGs, $\rm L_{IR}>10^{12} L_{\odot}$). This makes HE 0450--2958 the first case of extreme starburst and powerful QSO activity, intimately linked (triggered by a strong interaction) but not coincident. The lack of CO emission towards the QSO itself renews the controversy regarding its host galaxy by making a gas-rich spiral (the typical host of Narrow Line Seyfert~1 AGNs) less likely. Finally, given that HE 0450--2958 and similar IR-warm QSOs are considered typical ULIRG$\to$(optically bright QSO) transition candidates, our results raise the possibility that some may simply be {\it gas-rich/gas-poor (e.g. spiral/elliptical) galaxy interactions} which ``activate'' an optically bright unobscured QSO in the gas-poor galaxy, and a starburst in the gas-rich one. We argue that such interactions may have gone largely unnoticed even in the local Universe because the combination of tools necessary to disentagle the progenitors (high resolution and S/N optical {\it and} CO imaging) became available only recently.Comment: 25 pages, 5 figures, accepted for publication by The Astrophysical Journa

Binary Neutron Stars with Arbitrary Spins in Numerical Relativity

We present a code to construct initial data for binary neutron star systems in which the stars are rotating. Our code, based on a formalism developed by Tichy, allows for arbitrary rotation axes of the neutron stars and is able to achieve rotation rates near rotational breakup. We compute the neutron star angular momentum through quasi-local angular momentum integrals. When constructing irrotational binary neutron stars, we find a very small residual dimensionless spin of $\sim 2\times 10^{-4}$. Evolutions of rotating neutron star binaries show that the magnitude of the stars' angular momentum is conserved, and that the spin- and orbit-precession of the stars is well described by post-Newtonian approximation. We demonstrate that orbital eccentricity of the binary neutron stars can be controlled to $\sim 0.1\%$. The neutron stars show quasi-normal mode oscillations at an amplitude which increases with the rotation rate of the stars.Comment: 20 pages, 22 figure

A Machine Learning Technique to Identify Transit Shaped Signals

We describe a new metric that uses machine learning to determine if a periodic signal found in a photometric time series appears to be shaped like the signature of a transiting exoplanet. This metric uses dimensionality reduction and k-nearest neighbors to determine whether a given signal is sufficiently similar to known transits in the same data set. This metric is being used by the Kepler Robovetter to determine which signals should be part of the Q1–Q17 DR24 catalog of planetary candidates. The Kepler Mission reports roughly 20,000 potential transiting signals with each run of its pipeline, yet only a few thousand appear to be sufficiently transit shaped to be part of the catalog. The other signals tend to be variable stars and instrumental noise. With this metric, we are able to remove more than 90% of the non-transiting signals while retaining more than 99% of the known planet candidates. When tested with injected transits, less than 1% are lost. This metric will enable the Kepler mission and future missions looking for transiting planets to rapidly and consistently find the best planetary candidates for follow-up and cataloging

Workshop Report: Container Based Analysis Environments for Research Data Access and Computing

Report of the first workshop on Container Based Analysis Environments for Research Data Access and Computing supported by the National Data Service and Data Exploration Lab and held at the National Center for Supercomputing Applications (NCSA) at the University of Illinois at Urbana-Champaign

Kepler Data Release 4 Notes

The Data Analysis Working Group have released long and short cadence materials, including FFIs and Dropped Targets for the Public. The Kepler Science Office considers Data Release 4 to provide "browse quality" data. These notes have been prepared to give Kepler users of the Multimission Archive at STScl (MAST) a summary of how the data were collected and prepared, and how well the data processing pipeline is functioning on flight data. They will be updated for each release of data to the public archive and placed on MAST along with other Kepler documentation, at http://archive.stsci.edu/kepler/documents.html. Data release 3 is meant to give users the opportunity to examine the data for possibly interesting science and to involve the users in improving the pipeline for future data releases. To perform the latter service, users are encouraged to notice and document artifacts, either in the raw or processed data, and report them to the Science Office

Masses, radii, and orbits of small Kepler planets : The transition from gaseous to rocky planets

We report on the masses, sizes, and orbits of the planets orbiting 22 Kepler stars. There are 49 planet candidates around these stars, including 42 detected through transits and 7 revealed by precise Doppler measurements of the host stars. Based on an analysis of the Kepler brightness measurements, along with high-resolution imaging and spectroscopy, Doppler spectroscopy, and (for 11 stars) asteroseismology, we establish low false-positive probabilities (FPPs) for all of the transiting planets (41 of 42 have an FPP under 1%), and we constrain their sizes and masses. Most of the transiting planets are smaller than three times the size of Earth. For 16 planets, the Doppler signal was securely detected, providing a direct measurement of the planet's mass. For the other 26 planets we provide either marginal mass measurements or upper limits to their masses and densities; in many cases we can rule out a rocky composition. We identify six planets with densities above 5 g cm-3, suggesting a mostly rocky interior for them. Indeed, the only planets that are compatible with a purely rocky composition are smaller than 2 R ⊕. Larger planets evidently contain a larger fraction of low-density material (H, He, and H2O).Peer reviewedFinal Accepted Versio

Proteomic Analysis of Anti-Tumor Effects of 11-Dehydrosinulariolide on CAL-27 Cells

The anti-tumor effects of 11-dehydrosinulariolide, an active ingredient isolated from soft coral Sinularia leptoclados, on CAL-27 cells were investigated in this study. In the MTT assay for cell proliferation, increasing concentrations of 11-dehydrosinulariolide decreased CAL-27 cell viability. When a concentration of 1.5 μg/mL of 11-dehydrosinulariolide was applied, the CAL-27 cells viability was reduced to a level of 70% of the control sample. The wound healing function decreased as the concentration of 11-dehydrosinulariolide increased. The results in this study indicated that treatment with 11-dehydrosinulariolide for 6 h significantly induced both early and late apoptosis of CAL-27 cells, observed by flow cytometric measurement and microscopic fluorescent observation. A comparative proteomic analysis was conducted to investigate the effects of 11-dehydrosinulariolide on CAL-27 cells at the molecular level by comparison between the protein profiling (revealed on a 2-DE map) of CAL-27 cells treated with 11-dehydrosinulariolide and that of CAL-27 cells without the treatment. A total of 28 differential proteins (12 up-regulated and 16 down-regulated) in CAL-27 cells treated with 11-dehydrosinulariolide have been identified by LC-MS/MS analysis. Some of the differential proteins are associated with cell proliferation, apoptosis, protein synthesis, protein folding, and energy metabolism. The results of this study provided clues for the investigation of biochemical mechanisms of the anti-tumor effects of 11-dehydrosinulariolide on CAL-27 cells and could be valuable information for drug development and progression monitoring of oral squamous cell carcinoma (OSCC)