Modelling the cost-effectiveness of a newborn hearing screening programme:Usability and pitfalls

Objective: The EUSCREEN project concerns the study of European vision and hearing screening programmes. Part of the project was the development of a cost-effectiveness model to analyse such programmes. We describe the development and usability of an online tool to enable stakeholders to design, analyse or modify a newborn hearing screening (NHS) programme. Design: Data from literature, from existing NHS programmes, and observations by users were used to develop and refine the tool. Required inputs include prevalence of the hearing impairment, test sequence and its timing, attendance, sensitivity, and specificity of each screening step. Outputs include the number of cases detected and the costs of screening and diagnostics. Study sample: Eleven NHS programmes with reliable data. Results: Three analyses are presented, exploring the effect of low attendance, number of screening steps, testing in the maternity ward, or screening at a later age, on the benefits and costs of the programme. Knowledge of the epidemiology of a staged screening programme is crucial when using the tool. Conclusions: This study presents a tool intended to aid stakeholders to design a new or analyse an existing hearing screening programme in terms of benefits and costs.</p

Schroedingers equation with gauge coupling derived from a continuity equation

We consider a statistical ensemble of particles of mass m, which can be described by a probability density \rho and a probability current \vec{j} of the form \rho \nabla S/m. The continuity equation for \rho and \vec{j} implies a first differential equation for the basic variables \rho and S. We further assume that this system may be described by a linear differential equation for a complex state variable \chi. Using this assumptions and the simplest possible Ansatz \chi(\rho,S) Schroedingers equation for a particle of mass m in an external potential V(q,t) is deduced. All calculations are performed for a single spatial dimension (variable q) Using a second Ansatz \chi(\rho,S,q,t) which allows for an explict q,t-dependence of \chi, one obtains a generalized Schroedinger equation with an unusual external influence described by a time-dependent Planck constant. All other modifications of Schroeodingers equation obtained within this Ansatz may be eliminated by means of a gauge transformation. Thus, this second Ansatz may be considered as a generalized gauging procedure. Finally, making a third Ansatz, which allows for an non-unique external q,t-dependence of \chi, one obtains Schroedingers equation with electromagnetic potentials \vec{A}, \phi in the familiar gauge coupling form. A possible source of the non-uniqueness is pointed out.Comment: 25 pages, no figure

Generalised quantum weakest preconditions

Generalisation of the quantum weakest precondition result of D'Hondt and Panangaden is presented. In particular the most general notion of quantum predicate as positive operator valued measure (POVM) is introduced. The previously known quantum weakest precondition result has been extended to cover the case of POVM playing the role of a quantum predicate. Additionally, our result is valid in infinite dimension case and also holds for a quantum programs defined as a positive but not necessary completely positive transformations of a quantum states.Comment: 7 pages, no figures, added references, changed conten

Horizontal Branch Stars: The Interplay between Observations and Theory, and Insights into the Formation of the Galaxy

We review HB stars in a broad astrophysical context, including both variable and non-variable stars. A reassessment of the Oosterhoff dichotomy is presented, which provides unprecedented detail regarding its origin and systematics. We show that the Oosterhoff dichotomy and the distribution of globular clusters (GCs) in the HB morphology-metallicity plane both exclude, with high statistical significance, the possibility that the Galactic halo may have formed from the accretion of dwarf galaxies resembling present-day Milky Way satellites such as Fornax, Sagittarius, and the LMC. A rediscussion of the second-parameter problem is presented. A technique is proposed to estimate the HB types of extragalactic GCs on the basis of integrated far-UV photometry. The relationship between the absolute V magnitude of the HB at the RR Lyrae level and metallicity, as obtained on the basis of trigonometric parallax measurements for the star RR Lyrae, is also revisited, giving a distance modulus to the LMC of (m-M)_0 = 18.44+/-0.11. RR Lyrae period change rates are studied. Finally, the conductive opacities used in evolutionary calculations of low-mass stars are investigated. [ABRIDGED]Comment: 56 pages, 22 figures. Invited review, to appear in Astrophysics and Space Scienc

H-ATLAS/GAMA: magnification bias tomography. Astrophysical constraints above ~1 arcmin

An unambiguous manifestation of the magnification bias is the cross-correlation between two source samples with non-overlapping redshift distributions. In this work we measure and study the cross-correlation signal between a foreground sample of GAMA galaxies with spectroscopic redshifts in the range 0.2<z<0.8, and a background sample of H-ATLAS galaxies with photometric redshifts gsim1.2. It constitutes a substantial improvement over the cross-correlation measurements made by Gonzalez-Nuevo et al. (2014) with updated catalogues and wider area (with S/Ngsim 5 below 10 arcmin and reaching S/N~ 20 below 30 arcsec). The better statistics allow us to split the sample in different redshift bins and to perform a tomographic analysis (with S/Ngsim 3 below 10 arcmin and reaching S/N~ 15 below 30 arcsec). Moreover, we implement a halo model to extract astrophysical information about the background galaxies and the deflectors that are producing the lensing link between the foreground (lenses) and background (sources) samples. In the case of the sources, we find typical mass values in agreement with previous studies: a minimum halo mass to host a central galaxy, Mmin~ 1012.26 M⊙, and a pivot halo mass to have at least one sub-halo satellite, M1~ 1012.84 M⊙. However, the lenses are massive galaxies or even galaxy groups/clusters, with minimum mass of Mminlens~ 1013.06 M⊙. Above a mass of M1lens~ 1014.57 M⊙ they contain at least one additional satellite galaxy which contributes to the lensing effect. The tomographic analysis shows that, while M1lens is almost redshift independent, there is a clear evolution of increase Mminlens with redshift in agreement with theoretical estimations. Finally, the halo modeling allows us to identify a strong lensing contribution to the cross-correlation for angular scales below 30 arcsec. This interpretation is supported by the results of basic but effective simulations

Assessment of hearing screening programmes across 47 countries or regions III: provision of childhood hearing screening after the newborn period

Objective: To inventory provision and features of childhood hearing screening after the newborn period (CHS), primarily in Europe. Design: From each participating country or region, experts provided information through an extensive questionnaire: implementation year, age at screening, test method, pass criteria, screening location, screener profession, and quality indicators: coverage, referral, follow-up and detection rates, supplemented by literature sources. Study sample: Forty-two European countries or regions, plus Russia, Malawi, Rwanda, India, and China. Results: CHS was performed universally with pure-tone audiometry screening (PTS) in 17 countries or regions, whereas non-universal CHS was performed in eight with PTS or whisper tests. All participating countries with universal PTS had newborn hearing screening. Coverage rate was provided from three countries, detection rate from one, and referral and follow-up rate from two. In four countries, universal PTS was performed at two ages. Earliest universal PTS was performed in a (pre)school setting by nurses (n = 9, median age: 5 years, range: 3–7), in a healthcare setting by doctors and nurses (n = 7, median age: 4.5 years, range: 4–7), or in both (n = 1). Conclusions: Within universal CHS, PTS was mostly performed at 4–6 years by nurses. Insufficient collection of data and monitoring with quality indicators impedes evaluation of screening

Assessment of hearing screening programmes across 47 countries or regions II: coverage, referral, follow-up and detection rates from newborn hearing screening

Objectives: To assess the performance of newborn hearing screening (NHS) programmes, through selected quality measures and their relationship to protocol design. Design: NHS coverage, referral, follow-up and detection rates were aggregated. Referral rates were compared to age at screening step 1, number of steps, and test method: OAE or aABR. Study sample: A questionnaire on existing hearing screening was completed by experts from countries in Europe, plus Russia, Malawi, Rwanda, India and China. Results: Out of 47 countries or regions, NHS coverage rates were reported from 26, referral rates from 23, follow up from 12 and detection rates from 13. Median coverage rate for step 1 was 96%. Referral rate from step 1 was 6–22% where screening may be performed 24 h, and 4% for >72 h. Referral rates to diagnostic assessment averaged 2.1% after one to two steps using OAE only, 1.7% after two steps including aABR, and 0.8% after three to four steps including aABR. Median detection rate for bilateral permanent hearing impairment ≥40dB was 1 per 1000 infants. Conclusion: Referral rates were related to age, test method and number of screening steps. Quality measures were not available for many NHS programmes

Identification and characterization of genes controlled by the sporulation-regulatory gene spo0H in Bacillus subtilis.

We describe a general strategy for the identification of genes that are controlled by a specific regulatory factor in vivo and the use of this strategy to identify genes in Bacillus subtilis that are controlled by spo0H, a regulatory gene required for the initiation of sporulation. The general strategy makes use of a cloned regulatory gene fused to an inducible promoter to control expression of the regulatory gene and random gene fusions to a reporter gene to monitor expression in the presence and absence of the regulatory gene product. spo0H encodes a sigma factor of RNA polymerase, sigma H, and is required for the extensive reprograming of gene expression during the transition from growth to stationary phase and during the initiation of sporulation. We identified 18 genes that are controlled by sigma H (csh genes) in vivo by monitoring expression of random gene fusions to lacZ, made by insertion mutagenesis with the transposon Tn917lac, in the presence and absence of sigma H. These genes had lower levels of expression in the absence of sigma H than in the presence of sigma H. Patterns of expression of the csh genes during growth and sporulation in wild-type and spo0H mutant cells indicated that other regulatory factors are probably involved in controlling expression of some of these genes. Three of the csh::Tn917lac insertion mutations caused noticeable phenotypes. One caused a defect in vegetative growth, but only in combination with a spo0H mutation. Two others caused a partial defect in sporulation. One of these also caused a defect in the development of genetic competence. Detailed characterization of some of the csh genes and their regulatory regions should help define the role of spo0H in the regulation of gene expression during the transition from growth to stationary phase and during the initiation of sporulation