The credibility of health economic models for health policy decision-making: the case of population screening for abdominal aortic aneurysm

<i>Objectives</i>: To review health economic models of population screening for abdominal aortic aneurysm (AAA) among elderly males and assess their credibility for informing decision-making. <i>Methods</i>: A literature review identified health economic models of ultrasound screening for AAA. For each model focussing on population screening in elderly males, model structure and input parameter values were critically appraised using published good practice guidelines for decision analytic models. <i>Results</i>: Twelve models published between 1989 and 2003 were identified. Converting costs to a common currency and base year, substantial variability in cost-effectiveness results were revealed. Appraisals carried out for the nine models focusing on population screening showed differences in their complexity, with the simpler models generating results most favourable to screening. Eight of the nine models incorporated two or more simplifying structural assumptions favouring screening; uncertainty surrounding these assumptions was not investigated by any model. Quality assessments on a small number of parameters revealed input values varied between models, methods used to identify and incorporate input data were often not described, and few sensitivity analyses were reported. <i>Conclusions</i>: Large variation exists in the cost-effectiveness results generated by AAA screening models. The substantial number of factors potentially contributing to such disparities means that reconciliation of model results is impossible. In addition, poor reporting of methods makes it difficult to identify the most plausible and thus most useful model of those developed

Poultry producer\u27s willingness to invest in on-farm carcass disposal

Foreign animal diseases (FAD) can cause substantial economic losses in production, consumption, and the supply chain. These diseases are typically highly pathogenic and lead to disruptions in normal business practices and to demands for higher investment in biosecurity practices. For poultry producers this can lead to changes in bird pick-ups, chick placements, and length of out time on farms as well as changes in day-to-day operations. When an FAD is reported, poultry producers that rely on off-premises carcass disposal (e.g., renderers or landfills) may be required to develop on-farm disposal capacity (e.g., incinerators or burial) rapidly if their operation falls within movement restriction zones. While preemptive planning is suggested, not all producers have an environmentally approved plan given disruptions in business continuity. This study estimated poultry producers’ willingness to pay (WTP) for on-farm carcass disposal methods for routine, non-catastrophic mortality during an FAD outbreak to understand what factors contribute to the investment decision. Poultry producers were surveyed about their operations’ characteristics, their disease perceptions, and were presented with a hypothetical disease scenario. The estimated mean WTP for additional disposal capacity was $15,651. Besides indicating that a market for on-farm carcass disposal exists, our findings also provide information that can be used when creating policy to simultaneously incentivize farm-level biosecurity and carcass disposal protocols while continuing to encourage disease reporting, which together, improves overall livestock disease management in the United States

Exploring the feasibility and acceptability of the contents, design, and functionalities of an online intervention promoting mental health, wellbeing, and study skills in Higher Education students

Background: Substantial numbers of students in Higher Education (HE) are reporting mental health difficulties, such as mild to moderate symptoms of depression and anxiety. Coupled with academic skills challenges, these difficulties can lead to decreased academic performance, low levels of study satisfaction, and eventually drop out. Student support services are facing budget cuts and can only attend to limited numbers of students, usually the ones who present with more severe mental health problems. Moreover, face-to-face contact may not appeal to those students who feel embarrassed by their problems or are afraid of being stigmatised. To address this important problem, an online psychological wellbeing and study skills support system called MePlusMe, has been developed to provide personalised support to its users. In the present study we investigated the feasibility and acceptability of the contents, design, and functionalities of the system. Methods: An offline version of the system was introduced to 13 postgraduate and undergraduate students (mean age = 31.3 years, SD = 10.25 years; 4 males) in a UK HE Institution, who presented with mild or moderate mental health difficulties. The participants evaluated the design of the system, its functionalities, and contents at Baseline and at Weeks 2, 4, and 8. Results: Participants found the system easy to use, professional, and efficient and its contents non-judgemental and informative. Participants stated that engaging with and practicing the techniques targeted at mental health difficulties led to improvements in positive thinking and self-confidence, while the study skills techniques were practical. Suggestions for further improvement included the development of an app and an option for direct engagement with professionals. Conclusions: The findings confirmed the acceptability of the contents, design and functionalities of the system, while providing useful information to inform its further development. Next steps include a feasibility study, which will test and quantify the effects on everyday functioning, mood, mental wellbeing, and academic self-efficacy after using the system, and subsequently a randomized controlled trial, which will evaluate its effectiveness

The Structural Basis of Actin Organization by Vinculin and Metavinculin

Vinculin is an essential adhesion protein that links membrane-bound integrin and cadherin receptors through their intracellular binding partners to filamentous actin, facilitating mechanotransduction. Here we present an 8.5-Å-resolution cryo-electron microscopy reconstruction and pseudo-atomic model of the vinculin tail (Vt) domain bound to F-actin. Upon actin engagement, the N-terminal "strap" and helix 1 are displaced from the Vt helical bundle to mediate actin bundling. We find that an analogous conformational change also occurs in the H1' helix of the tail domain of metavinculin (MVt) upon actin binding, a muscle-specific splice isoform that suppresses actin bundling by Vt. These data support a model in which metavinculin tunes the actin bundling activity of vinculin in a tissue-specific manner, providing a mechanistic framework for understanding metavinculin mutations associated with hereditary cardiomyopathies

Measuring Transit Signal Recovery in the Kepler Pipeline II: Detection Efficiency as Calculated in One Year of Data

The Kepler planet sample can only be used to reconstruct the underlying planet occurrence rate if the detection efficiency of the Kepler pipeline is known, here we present the results of a second experiment aimed at characterising this detection efficiency. We inject simulated transiting planet signals into the pixel data of ~10,000 targets, spanning one year of observations, and process the pixels as normal. We compare the set of detections made by the pipeline with the expectation from the set of simulated planets, and construct a sensitivity curve of signal recovery as a function of the signal-to-noise of the simulated transit signal train. The sensitivity curve does not meet the hypothetical maximum detection efficiency, however it is not as pessimistic as some of the published estimates of the detection efficiency. For the FGK stars in our sample, the sensitivity curve is well fit by a gamma function with the coefficients a = 4.35 and b = 1.05. We also find that the pipeline algorithms recover the depths and periods of the injected signals with very high fidelity, especially for periods longer than 10 days. We perform a simplified occurrence rate calculation using the measured detection efficiency compared to previous assumptions of the detection efficiency found in the literature to demonstrate the systematic error introduced into the resulting occurrence rates. The discrepancies in the calculated occurrence rates may go some way towards reconciling some of the inconsistencies found in the literature.Comment: 13 pages, 7 figures, 1 electronic table, accepted by Ap

Measuring Transit Signal Recovery in the Kepler Pipeline. III. Completeness of the Q1-Q17 DR24 Planet Candidate Catalogue, with Important Caveats for Occurrence Rate Calculations

With each new version of the Kepler pipeline and resulting planet candidate catalogue, an updated measurement of the underlying planet population can only be recovered with an corresponding measurement of the Kepler pipeline detection efficiency. Here, we present measurements of the sensitivity of the pipeline (version 9.2) used to generate the Q1-Q17 DR24 planet candidate catalog (Coughlin et al. 2016). We measure this by injecting simulated transiting planets into the pixel-level data of 159,013 targets across the entire Kepler focal plane, and examining the recovery rate. Unlike previous versions of the Kepler pipeline, we find a strong period dependence in the measured detection efficiency, with longer (>40 day) periods having a significantly lower detectability than shorter periods, introduced in part by an incorrectly implemented veto. Consequently, the sensitivity of the 9.2 pipeline cannot be cast as a simple one-dimensional function of the signal strength of the candidate planet signal as was possible for previous versions of the pipeline. We report on the implications for occurrence rate calculations based on the Q1-Q17 DR24 planet candidate catalog and offer important caveats and recommendations for performing such calculations. As before, we make available the entire table of injected planet parameters and whether they were recovered by the pipeline, enabling readers to derive the pipeline detection sensitivity in the planet and/or stellar parameter space of their choice.Comment: 8 pages, 5 figures, full electronic version of Table 1 available at the NASA Exoplanet Archive; accepted by ApJ May 2nd, 201

Cyclotron modeling phase-resolved infrared spectroscopy of polars I: EF Eridani

We present phase-resolved low resolution infrared spectra of the polar EF Eridani obtained over a period of 2 years with SPEX on the IRTF. The spectra, covering the wavelength range 0.8 to 2.4 microns, are dominated by cyclotron emission at all phases. We use a ``Constant Lambda'' prescription to attempt to model the changing cyclotron features seen in the spectra. A single cyclotron emission component with B = 12.6 MG, and a plasma temperature of kT = 5.0 keV, does a reasonable job in matching the features seen in the H and K bands, but fails to completely reproduce the morphology shortward of 1.6 microns. We find that a two component model, where both components have similar properties, but whose contributions differ with viewing geometry, provides an excellent fit to the data. We discuss the implications of our models and compare them with previously published results. In addition, we show that a cyclotron model with similar properties to those used for modeling the infrared spectra, but with a field strength of B = 115 MG, can explain the GALEX observations of EF Eri.Comment: 25 pages, 5 figures, to appear in Ap

Vegetation and peat characteristics of restiad bogs on Chatham Island (Rekohu), New Zealand

Restiad bogs dominated by Sporadanthus traversii on Chatham Island, New Zealand, were sampled to correlate vegetation patterns and peat properties, and to compare with restiad systems dominated by Sporadanthus ferrugineus and Empodisma minus in the Waikato region, North Island, New Zealand. Classification and ordination resulted in five groups that reflected a disturbance gradient. The largest S. traversii group, which comprised plots from central, relatively intact bogs, had the lowest levels of total nitrogen (mean 1.20 mg cm-3), total phosphorus (mean 0.057 mg cm-3), total potassium (mean 0.083 mg cm-3), and available phosphorus (mean 18.6 μg cm-3). Modification by drainage, stock, and fires resulted in a decline of S. traversii and an increase of Gleichenia dicarpa fern cover, together with elevated peat nutrient levels and higher bulk density. Compared with peat dominated by Sporadanthus ferrugineus or Empodisma minus in relatively unmodified Waikato restiad bogs, Chatham Island peat under S. traversii has significantly higher total potassium, total nitrogen, available phosphorus, bulk density, and von Post decomposition indices, and significantly lower pH. Sporadanthus traversii and Empodisma minus have similar ecological roles in restiad bog development, occupying a relatively wide nutrient range, and regenerating readily from seed after fire. Despite differences in root morphology, S. traversii and E. minus are the major peat formers in raised restiad bogs on Chatham Island and in Waikato, respectively, and could be regarded as ecological equivalents

A Structural Model for Vinculin Insertion into PIP 2 -Containing Membranes and the Effect of Insertion on Vinculin Activation and Localization

Vinculin, a scaffolding protein that localizes to focal adhesions (FAs) and adherens junctions, links the actin cytoskeleton to the adhesive super-structure. While vinculin binds to a number of cytoskeletal proteins, it can also associate with phosphatidylinositol 4,5-bisphosphate (PIP2) to drive membrane association. To generate a structural model for PIP2-dependent interaction of vinculin with the lipid bilayer, we conducted lipid-association, nuclear magnetic resonance, and computational modeling experiments. We find that two basic patches on the vinculin tail drive membrane association: the basic collar specifically recognizes PIP2, while the basic ladder drives association with the lipid bilayer. Vinculin mutants with defects in PIP2-dependent liposome association were then expressed in vinculin knockout murine embryonic fibroblasts. Results from these analyses indicate that PIP2 binding is not required for localization of vinculin to FAs or FA strengthening, but is required for vinculin activation and turnover at FAs to promote its association with the force transduction FA nanodomain

Resonance and frequency-locking phenomena in spatially extended phytoplankton-zooplankton system with additive noise and periodic forces

In this paper, we present a spatial version of phytoplankton-zooplankton model that includes some important factors such as external periodic forces, noise, and diffusion processes. The spatially extended phytoplankton-zooplankton system is from the original study by Scheffer [M Scheffer, Fish and nutrients interplay determines algal biomass: a minimal model, Oikos \textbf{62} (1991) 271-282]. Our results show that the spatially extended system exhibit a resonant patterns and frequency-locking phenomena. The system also shows that the noise and the external periodic forces play a constructive role in the Scheffer's model: first, the noise can enhance the oscillation of phytoplankton species' density and format a large clusters in the space when the noise intensity is within certain interval. Second, the external periodic forces can induce 4:1 and 1:1 frequency-locking and spatially homogeneous oscillation phenomena to appear. Finally, the resonant patterns are observed in the system when the spatial noises and external periodic forces are both turned on. Moreover, we found that the 4:1 frequency-locking transform into 1:1 frequency-locking when the noise intensity increased. In addition to elucidating our results outside the domain of Turing instability, we provide further analysis of Turing linear stability with the help of the numerical calculation by using the Maple software. Significantly, oscillations are enhanced in the system when the noise term presents. These results indicate that the oceanic plankton bloom may partly due to interplay between the stochastic factors and external forces instead of deterministic factors. These results also may help us to understand the effects arising from undeniable subject to random fluctuations in oceanic plankton bloom.Comment: Some typos errors are proof, and some strong relate references are adde