Gender differences in health-related quality of life following total laryngectomy

Background: The impact of a total laryngectomy on an individual's life has primarily been measured from a male viewpoint reflecting the demographics of a diagnosis of laryngeal cancer. A small number of studies have looked specifically at females, but very few are comparison studies. Consequently, there is little consistent research regarding any potential gender differences. Aims: To investigate whether there are gender differences in perceptions of health-related quality of life and functional abilities following total laryngectomy. Methods & Procedures: A total of 43 participants (22 males, 21 females), who had undergone a total laryngectomy procedure at least one year previously, took part in the study. They completed The European Organisation for Research and Treatment of Cancer Core Questionnaire Version 3.0 (EORTC QLQ-C30) in conjunction with the disease-specific Head & Neck Cancer Module (QLQ-H&N35). Outcomes & Results: There were no significant differences between males and females on demographic and disease-related variables, except for the following: significantly more females lived alone and changed their employment status following surgery. Males had a significantly higher global health status/quality of life than females (p < 0.05) and significantly higher levels of physical (p = 0.01), emotional (p < 0.01), cognitive (p < 0.05) and social functioning (p < 0.05). After adjusting for differences in living arrangements and change in employment status, differences in emotional and social functioning remained significant. There was a general trend for females to have higher symptom/impairment levels and to report more treatment-related problems, but the majority of these differences were not significant. Conclusions & Implications: Following total laryngectomy, females appear to be worsely affected in aspects of quality of life than males. Emotional and social functioning are particularly vulnerable. The findings imply that rehabilitation programmes after total laryngectomy need to evaluate quality of life and address these specific areas in order to improve patient-reported long-term outcomes

Reference pricing with elastic demand for pharmaceuticals

In this paper, we re‐examine the properties of two commonly adopted government reimbursement schemes for pharmaceuticals: reference pricing and fixed percentage reimbursement. We depart from the previous literature by assuming that the individual demand is price‐sensitive and depends on the copayment rate (i.e., the part paid by each consumer). We obtain two novel results under reference pricing: first, as the copayment rate increases, so do pharmaceutical prices; second, this increase in pharmaceutical prices reduces social welfare. Whilst reference pricing does emerge as a preferable reimbursement scheme, demand elasticities and the copayment rate interact in complex ways. This leads (unexpectedly) to the possibility that a higher copayment rate (lower reimbursement rate) results in higher government expenditure.info:eu-repo/semantics/acceptedVersio

Unsupervised cross-lingual speaker adaptation for HMM-based speech synthesis using two-pass decision tree construction

This paper demonstrates how unsupervised cross-lingual adaptation of HMM-based speech synthesis models may be performed without explicit knowledge of the adaptation data language. A two-pass decision tree construction technique is deployed for this purpose. Using parallel translated datasets, cross-lingual and intralingual adaptation are compared in a controlled manner. Listener evaluations reveal that the proposed method delivers performance approaching that of unsupervised intralingual adaptation

Snakes and ladders: localized solutions of plane Couette flow

We demonstrate the existence of a large number of exact solutions of plane Couette flow, which share the topology of known periodic solutions but are localized in space. Solutions of different size are organized in a snakes-and-ladders structure strikingly similar to that observed for simpler pattern-forming PDE systems. These new solutions are a step towards extending the dynamical systems view of transitional turbulence to spatially extended flows.Comment: submitted to Physics Review Letter

Colour analysis of degraded parchment

Multispectral imaging was employed to collect data on the degradation of an 18th century parchment by a series of physical and chemical treatments. Each sample was photographed before and after treatment by a monochrome digital camera with 21 narrow-band filters. A template-matching technique was used to detect the circular holes in each sample and a four-point projective transform to register the 21 images. Colour accuracy was verified by comparison of reconstructed spectra with measurements by spectrophotometer

A Gaussian process framework for modelling instrumental systematics: application to transmission spectroscopy

Transmission spectroscopy, which consists of measuring the wavelength-dependent absorption of starlight by a planet's atmosphere during a transit, is a powerful probe of atmospheric composition. However, the expected signal is typically orders of magnitude smaller than instrumental systematics, and the results are crucially dependent on the treatment of the latter. In this paper, we propose a new method to infer transit parameters in the presence of systematic noise using Gaussian processes, a technique widely used in the machine learning community for Bayesian regression and classification problems. Our method makes use of auxiliary information about the state of the instrument, but does so in a non-parametric manner, without imposing a specific dependence of the systematics on the instrumental parameters, and naturally allows for the correlated nature of the noise. We give an example application of the method to archival NICMOS transmission spectroscopy of the hot Jupiter HD 189733, which goes some way towards reconciling the controversy surrounding this dataset in the literature. Finally, we provide an appendix giving a general introduction to Gaussian processes for regression, in order to encourage their application to a wider range of problems.Comment: 6 figures, 1 table, accepted for publication in MNRA

International consensus (ICON) on treatment of Ménière's disease

Objective: To present the international consensus for recommendations for Ménière's disease (MD) treatment. Methods: Based on a literature review and report of 4 experts from 4 continents, the recommendations have been presented during the 21st IFOS congress in Paris, in June 2017 and are presented in this work. Results: The recommendation is to change the lifestyle, to use the vestibular rehabilitation in the intercritic period and to propose psychotherapy. As a conservative medical treatment of first line, the authors recommend to use diuretics and Betahistine or local pressure therapy. When medical treatment fails, the recommendation is to use a second line treatment, which consists in the intratympanic injection of steroids. Then as a third line treatment, depending on the hearing function, could be either the endolymphatic sac surgery (when hearing is worth being preserved) or the intratympanic injection of gentamicin (with higher risks of hearing loss). The very last option is the destructive surgical treatment labyrinthectomy, associated or not to cochlear implantation or vestibular nerve section (when hearing is worth being preserved), which is the most frequent option

Assembly and force measurement with SPM-like probes in holographic optical tweezers

We report a high fidelity tomographic reconstruction of the quantum state of photon pairs generated by parametric down-conversion with orbital angular momentum (OAM) entanglement. Our tomography method allows us to estimate an upper and lower bound for the entanglement between the down-converted photons. We investigate the two-dimensional state subspace defined by the OAM states ±ℓ and superpositions thereof, with ℓ=1, 2, ..., 30. We find that the reconstructed density matrix, even for OAMs up to around ℓ=20, is close to that of a maximally entangled Bell state with a fidelity in the range between F=0.979 and F=0.814. This demonstrates that, although the single count-rate diminishes with increasing ℓ, entanglement persists in a large dimensional state space