Evaluation of the incremental cost to the National Health Service of prescribing analogue insulin

Introduction Insulin analogues have become increasingly popular despite their greater cost compared with human insulin. The aim of this study was to calculate the incremental cost to the National Health Service (NHS) of prescribing analogue insulin preparations instead of their human insulin alternatives. Methods Open-source data from the four UK prescription pricing agencies from 2000 to 2009 were analysed. Cost was adjusted for inflation and reported in UK pounds at 2010 prices. Results Over the 10-year period, the NHS spent a total of £2732 million on insulin. The total annual cost increased from £156 million to £359 million, an increase of 130%. The annual cost of analogue insulin increased from £18.2 million (12% of total insulin cost) to £305 million (85% of total insulin cost), whereas the cost of human insulin decreased from £131 million (84% of total insulin cost) to £51 million (14% of total insulin cost). If it is assumed that all patients using insulin analogues could have received human insulin instead, the overall incremental cost of analogue insulin was £625 million. Conclusion Given the high marginal cost of analogue insulin, adherence to prescribing guidelines recommending the preferential use of human insulin would have resulted in considerable financial savings over the period

Survival of Radio-Marked Versus Leg-Banded Northern Bobwhite in Kentucky

Understanding the impact of radiomarking northern bobwhite (Colinus virginianus) survival is essential because of the widespread reliance on radiotelemetry to assess vital population parameters. We conducted an assessment of bobwhite populations within the Central Hardwoods Bird Conservation Region using leg banding and radiotelemetry on Peabody Wildlife Management Area, a 3,330-ha reclaimed surface mine in western Kentucky. We captured bobwhites using baited funnel traps during a 112-day period (23 Jul-11 Nov 2010) and marked 180 with necklace-style radio-transmitters (6 g) and 256 birds with only leg bands. Eighty-five birds were opportunistically recaptured in funnel traps, of which 81 were used in developing survival estimates. We used the Cormack-Jolly-Seber model in Program MARK to estimate periodic survival rates (PSR) of both sample groups. Candidate models which included body mass as a covariate explained the most variability in survival. The estimated PSR was 0.309 6 0.109 based on the best approximating model and was 0.302 6 0.108 from model averaging. We calculated a point of inflection for this model, which suggested a mass ‘threshold’ of 131g, above which survival improved at a decreasing rate. The model including only the radio-transmitter effect had a DAICc .3 and was considered to be non-plausible. Further research with larger samples is needed to develop more robust survival models to fully assess the effects of radiomarking bobwhites. It does not appear, based on our study, that radio transmitters adversely affect survival of northern bobwhite

Northern Bobwhite Survival Related to Movement on a Reclaimed Surface Coal Mine

Reclaimed coal mines represent opportunity to provide large tracts of early succession habitat essential to northern bobwhite (Colinus virginianus) populations. However, little research has been conducted to explore the potential of reclaimed mine sites and examine bobwhite ecology on these unique areas. Reclaimed mines in Kentucky were planted to non-native species, such as sericea lespedeza (Lespedeza cuneata) and tall fescue (Festuca arundinacea), which do not provide suitable structure for northern bobwhite brood-rearing and movement. Fallow disking (in blocks and linear firebreaks) and planting food plots are part of current management efforts to improve food availability and habitat structure for broods. We trapped and radiomarked 266 northern bobwhites between April 2010 and September 2011 on Peabody Wildlife Management Area, a 3,330-ha reclaimed coal mine in western Kentucky, USA to investigate the effects of current management practices on movement and survival. We calculated seasonal daily movement as the Euclidean distance from a location on day 1 to day 2. Breeding season (1 Apr-30 Sep) movement averaged 128 m in 2010 and 147 m in 2011. Daily movement averaged 163 m during the 2010–2011 non-breeding (1 Oct-31 Mar) season. Multiple regression analysis indicated annual food plots, disk blocks, firebreaks, and roads did not explain variation within daily movement regardless of season (R2 0.04). Individual bird/covey, precipitation, hours between locations, and average temperature also poorly explained movement variation. We used Program MARK to model the effect of season, year, mean daily movement, mean distance to annual food plots, disk blocks, firebreaks, and roads on survival. The season (breeding/non-breeding) model explained 81% of the variation in survival, and the year model explained 13%, suggesting management was not driving survival. We do not believe disking should be discontinued, although it did not influence movement, as it can improve vegetation structure important to nest-site selection and broods

Heterogeneous Shallow-Shelf Carbonate Buildups in the Paradox Basin, Utah and Colorado: Targets for Increased Oil Production and Reserves Using Horizontal Drilling Techniques

The Paradox Basin of Utah, Colorado, Arizona, and New Mexico contains nearly 100 small oil fields producing from carbonate buildups within the Pennsylvanian (Desmoinesian) Paradox Formation. These fields typically have one to 10 wells with primary production ranging from 700,000 to 2,000,000 barrels (111,300-318,000 m{sup 3}) of oil per field and a 15 to 20 percent recovery rate. At least 200 million barrels (31.8 million m{sup 3}) of oil will not be recovered from these small fields because of inefficient recovery practices and undrained heterogeneous reservoirs. Several fields in southeastern Utah and southwestern Colorado are being evaluated as candidates for horizontal drilling and enhanced oil recovery from existing vertical wells based upon geological characterization and reservoir modeling case studies. Geological characterization on a local scale is focused on reservoir heterogeneity, quality, and lateral continuity, as well as possible reservoir compartmentalization, within these fields. This study utilizes representative cores, geophysical logs, and thin sections to characterize and grade each field's potential for drilling horizontal laterals from existing development wells. The results of these studies can be applied to similar fields elsewhere in the Paradox Basin and the Rocky Mountain region, the Michigan and Illinois Basins, and the Midcontinent region. This report covers research activities for the first half of the fourth project year (April 6 through October 5, 2003). The work included (1) analysis of well-test data and oil production from Cherokee and Bug fields, San Juan County, Utah, and (2) diagenetic evaluation of stable isotopes from the upper Ismay and lower Desert Creek zones of the Paradox Formation in the Blanding sub-basin, Utah. Production ''sweet spots'' and potential horizontal drilling candidates were identified for Cherokee and Bug fields. In Cherokee field, the most productive wells are located in the thickest part of the mound facies of the upper Ismay zone, where microporosity is well developed. In Bug field, the most productive wells are located structurally downdip from the updip porosity pinch out in the dolomitized lower Desert Creek zone, where micro-box-work porosity is well developed. Microporosity and micro-box-work porosity have the greatest hydrocarbon storage and flow capacity, and potential horizontal drilling target in these fields. Diagenesis is the main control on the quality of Ismay and Desert Creek reservoirs. Most of the carbonates present within the lower Desert Creek and Ismay have retained a marine-influenced carbon isotope geochemistry throughout marine cementation as well as through post-burial recycling of marine carbonate components during dolomitization, stylolitization, dissolution, and late cementation. Meteoric waters do not appear to have had any effect on the composition of the dolomites in these zones. Light oxygen values obtained from reservoir samples for wells located along the margins or flanks of Bug field may be indicative of exposure to higher temperatures, to fluids depleted in {sup 18}O relative to sea water, or to hypersaline waters during burial diagenesis. The samples from Bug field with the lightest oxygen isotope compositions are from wells that have produced significantly greater amounts of hydrocarbons. There is no significant difference between the oxygen isotope compositions from lower Desert Creek dolomite samples in Bug field and the upper Ismay limestones and dolomites from Cherokee field. Carbon isotopic compositions for samples from Patterson Canyon field can be divided into two populations: isotopically heavier mound cement and isotopically lighter oolite and banded cement. Technology transfer activities consisted of exhibiting a booth display of project materials at the annual national convention of the American Association of Petroleum Geologists, a technical presentation, a core workshop, and publications. The project home page was updated on the Utah Geological Survey Internet web site

Phosphomimetic Mutation of Ser-187 of SNAP-25 Increases both Syntaxin Binding and Highly Ca2+-sensitive Exocytosis

The phosphorylation targets that mediate the enhancement of exocytosis by PKC are unknown. PKC phosporylates the SNARE protein SNAP-25 at Ser-187. We expressed mutants of SNAP-25 using the Semliki Forest Virus system in bovine adrenal chromaffin cells and then directly measured the Ca2+ dependence of exocytosis using photorelease of caged Ca2+ together with patch-clamp capacitance measurements. A flash of UV light used to elevate [Ca2+]i to several μM and release the highly Ca2+-sensitive pool (HCSP) of vesicles was followed by a train of depolarizing pulses to elicit exocytosis from the less Ca2+-sensitive readily releasable pool (RRP) of vesicles. Carbon fiber amperometry confirmed that the amount and kinetics of catecholamine release from individual granules were similar for the two phases of exocytosis. Mimicking PKC phosphorylation with expression of the S187E SNAP-25 mutant resulted in an approximately threefold increase in the HCSP, whereas the response to depolarization increased only 1.5-fold. The phosphomimetic S187D mutation resulted in an ∼1.5-fold increase in the HCSP but a 30% smaller response to depolarization. In vitro binding assays with recombinant SNARE proteins were performed to examine shifts in protein–protein binding that may promote the highly Ca2+-sensitive state. The S187E mutant exhibited increased binding to syntaxin but decreased Ca2+-independent binding to synaptotagmin I. Mimicking phosphorylation of the putative PKA phosphorylation site of SNAP-25 with the T138E mutation decreased binding to both syntaxin and synaptotagmin I in vitro. Expressing the T138E/ S187E double mutant in chromaffin cells demonstrated that enhancing the size of the HCSP correlates with an increase in SNAP-25 binding to syntaxin in vitro, but not with Ca2+-independent binding of SNAP-25 to synaptotagmin I. Our results support the hypothesis that exocytosis triggered by lower Ca2+ concentrations (from the HCSP) occurs by different molecular mechanisms than exocytosis triggered by higher Ca2+ levels

MAJOR OIL PLAYS IN UTAH AND VICINITY

Utah oil fields have produced over 1.2 billion barrels (191 million m{sup 3}). However, the 13.7 million barrels (2.2 million m{sup 3}) of production in 2002 was the lowest level in over 40 years and continued the steady decline that began in the mid-1980s. The Utah Geological Survey believes this trend can be reversed by providing play portfolios for the major oil-producing provinces (Paradox Basin, Uinta Basin, and thrust belt) in Utah and adjacent areas in Colorado and Wyoming. Oil plays are geographic areas with petroleum potential caused by favorable combinations of source rock, migration paths, reservoir rock characteristics, and other factors. The play portfolios will include: descriptions and maps of the major oil plays by reservoir; production and reservoir data; case-study field evaluations; summaries of the state-of-the-art drilling, completion, and secondary/tertiary techniques for each play; locations of major oil pipelines; descriptions of reservoir outcrop analogs; and identification and discussion of land use constraints. All play maps, reports, databases, and so forth, produced for the project will be published in interactive, menu-driven digital (web-based and compact disc) and hard-copy formats. This report covers research activities for the fourth quarter of the first project year (April 1 through June 30, 2003). This work included describing outcrop analogs to the Jurassic Nugget Sandstone and Pennsylvanian Paradox Formation, the major oil producers in the thrust belt and Paradox Basin, respectively. Production-scale outcrop analogs provide an excellent view, often in three dimensions, of reservoir-facies characteristics and boundaries contributing to the overall heterogeneity of reservoir rocks. They can be used as a ''template'' for evaluation of data from conventional core, geophysical and petrophysical logs, and seismic surveys. The Nugget Sandstone was deposited in an extensive dune field that extended from Wyoming to Arizona. Outcrop analogs are found in the stratigraphically equivalent Navajo Sandstone of southern Utah which displays large-scale dunal cross-strata with excellent reservoir properties and interdunal features such as oases, wadi, and playa lithofacies with poor reservoir properties. Hydrocarbons in the Paradox Formation are stratigraphically trapped in carbonate buildups (or phylloid-algal mounds). Similar carbonate buildups are exposed in the Paradox along the San Juan River of southeastern Utah. Reservoir-quality porosity may develop in the types of facies associated with buildups such as troughs, detrital wedges, and fans, identified from these outcrops. When combined with subsurface geological and production data, these outcrop analogs can improve (1) development drilling and production strategies such as horizontal drilling, (2) reservoir-simulation models, (3) reserve calculations, and (4) design and implementation of secondary/tertiary oil recovery programs and other best practices used in the oil fields of Utah and vicinity. During this quarter, technology transfer activities consisted of exhibiting the project plans, objectives, and products at a booth at the 2003 annual convention of the American Association of Petroleum Geologists. The project home page was updated on the Utah Geological Survey Internet web site

Monitoring Northern Bobwhite Breeding Populations in the Central Hardwoods Bird Conservation Region

Monitoring northern bobwhite (Colinus virginianus) breeding populations is an important component of the National Bobwhite Conservation Initiative as a means of evaluating success of achieving population goals. Northern bobwhite populations declined by 3.8% from 1980 to 2006 in the Central Hardwoods Bird Conservation Region (CHBCR). Northern bobwhite research in the CHBCR is limited and population trend estimates are based on North American Breeding Bird Survey (BBS) data. Monitoring northern bobwhite populations and developing accurate population estimates by incorporating detection functions and occupancy estimates are important components of the conservation initiative in this region. We documented northern bobwhite abundance throughout the CHBCR via a roadside-based removal and distance sampling survey method, and assessed differences in detection with respect to observer, northern bobwhite relative abundance, and land cover. We also addressed the potential for a roadside survey bias to ascertain if there was a seasonal, or site effect on northern bobwhite detection and occupancy through repeated surveys. Finally, we measured northern bobwhite calling rates by time of day and day of the breeding season to assess bobwhite availability for detection with radiotelemetry data. The spatially-balanced, roadside, monitoring strategy used counties as basic sampling units within bobwhite focal areas in the CHBCR (n 1⁄4 37 counties). We randomly located 5, 15-km monitoring routes in each focal county along secondary roads. We conducted 5-min unlimited distance point counts along each route (30 counts/route) from May through July, 2008–2011. We conducted off-road and radiotelemetry surveys on Peabody Wildlife Management Area (PWMA), and additional off-road surveys on Fort Campbell Military Base, Tennessee-Kentucky and on private lands in Livingston County, Kentucky from May through July, 2010–2011.We detected 6,440 individual northern bobwhite on roadside survey routes; .95% of the survey routes had at least 1 northern bobwhite detection. We developed a suite of 17 a priori removal models in Program MARK to estimate roadside survey detection probabilities. The best model included differences in time interval detection, observer, and 3 covariates: distance from the observer, number of individuals aurally detected, and percent forested habitat within a 100-m radius of the point count. Detection probabilities were greatest during the first minute of detection, and then decreased. Detection probabilities (6 SD) decreased as distance from the observer (b 1⁄4 0.0020 6 0.0005, n 1⁄4 6,440) increased, but increased as the number of individuals detected at a point (b 1⁄4 0.15 6 0.04, n 1⁄4 6,440) increased. We used the most parsimonious model and mean covariate values to generate overall parameter estimates, which differed between observers and time intervals. We detected 637 individual northern bobwhite on 90 off-road transects across 4 sites from 2010 to 2011. We developed a suite of 10 a priori occupancy models in Program MARK to estimate off-road survey detection probabilities and site occupancy. Detection probabilities were greater (.26%) during the second point count visit (q 1⁄4 0.69 6 0.03) versus first (q 1⁄4 0.51 6 0.04) and third (q 1⁄4 0.47 6 0.04) visits (n 1⁄4 270). Detection probability increased as relative abundance increased (b 1⁄4 2.90 6 0.22, n 1⁄4 270). Occupancy was held constant and was not affected by any covariates evaluated. Peak northern bobwhite detection probabilities occurred from 1 to 25 June, an important consideration for population models that use breeding season survey data. Distance from road was not a significant grouping variable in any of the models, suggesting that roadside bias may not be an important consideration in designing bobwhite monitoring strategies. We located 295 radio-marked male bobwhites from 2010 to 2011. Marked males called on 115 of 295 points (39.0%). The furthest distance a radio-marked male moved during the survey period was 60 m, and movement distances were generally small (x ̄ 1⁄4 4.2 6 10.3 m, n 1⁄4 295). We compared 8 a priori time-of-detection models in Program MARK to estimate radiotelemetry survey detection probabilities. We grouped surveys based on year and included time-of-day, and day- of-year as additional temporal covariates. Detection probability was inversely related to time of day (b 1⁄4 0.04 6 0.10, n 1⁄4 105), but positively related to day of year (b 1⁄4 0.010 6 0.008, n 1⁄4 105); b estimates overlapped 0 suggested weak relationships. Our results documented the first attempt to explicitly model differences in northern bobwhite detection related to spatial (potential roadside biases, habitat parameters, northern bobwhite distances), temporal (seasonality, annual fluctuations), and behavioral (observer, northern bobwhite relative abundance) variables. We used a combination of 3 methodologies to estimate detection parameters and will adjust indices of relative abundance and density estimates across a broad spatial extent. Our spatially-balanced roadside survey can be effectively used to monitor northern bobwhite populations across broad spatial extents and incorporates the components of detection to improve estimates of northern bobwhite relative abundance

Evaluation of elicitation methods to quantify Bayes linear models

The Bayes linear methodology allows decision makers to express their subjective beliefs and adjust these beliefs as observations are made. It is similar in spirit to probabilistic Bayesian approaches, but differs as it uses expectation as its primitive. While substantial work has been carried out in Bayes linear analysis, both in terms of theory development and application, there is little published material on the elicitation of structured expert judgement to quantify models. This paper investigates different methods that could be used by analysts when creating an elicitation process. The theoretical underpinnings of the elicitation methods developed are explored and an evaluation of their use is presented. This work was motivated by, and is a precursor to, an industrial application of Bayes linear modelling of the reliability of defence systems. An illustrative example demonstrates how the methods can be used in practice

Observations of SN 2017ein Reveal Shock Breakout Emission and A Massive Progenitor Star for a Type Ic Supernova

We present optical and ultraviolet observations of nearby type Ic supernova SN 2017ein as well as detailed analysis of its progenitor properties from both the early-time observations and the prediscovery Hubble Space Telescope (HST) images. The optical light curves started from within one day to $\sim$275 days after explosion, and optical spectra range from $\sim$2 days to $\sim$90 days after explosion. Compared to other normal SNe Ic like SN 2007gr and SN 2013ge, \mbox{SN 2017ein} seems to have more prominent C{\footnotesize II} absorption and higher expansion velocities in early phases, suggestive of relatively lower ejecta mass. The earliest photometry obtained for \mbox{SN 2017ein} show indications of shock cooling. The best-fit obtained by including a shock cooling component gives an estimate of the envelope mass as $\sim$0.02 M$_{\odot}$ and stellar radius as 8$\pm$4 R$_{\odot}$. Examining the pre-explosion images taken with the HST WFPC2, we find that the SN position coincides with a luminous and blue point-like source, with an extinction-corrected absolute magnitude of M$_V$$\sim$$-$8.2 mag and M$_I$$\sim$$-$7.7 mag.Comparisons of the observations to the theoretical models indicate that the counterpart source was either a single WR star or a binary with whose members had high initial masses, or a young compact star cluster. To further distinguish between different scenarios requires revisiting the site of the progenitor with HST after the SN fades away.Comment: 28 pages, 19 figures; accepted for publication in The Astrophysical Journa

Compulsory admission at first presentation to services for psychosis: does ethnicity still matter? Findings from two population-based studies of first episode psychosis

Objectives Compared with the majority population, those from minority ethnic groups in the UK are more likely to be admitted compulsorily during a first episode of psychosis (FEP). We investigated whether these disparities in pathways in to care continue. Methods We analysed data from two first episode psychosis studies, conducted in the same geographical area in south London 15 years apart: the Aetiology and Ethnicity in Schizophrenia and Other Psychosis (AESOP) and the Clinical Record Interactive Search-First Episode Psychosis (CRIS-FEP) studies. The inclusion/exclusion criteria for case ascertainment for first episode psychosis were identical across the two studies. We performed multivariable logistic regression to estimate odds of compulsory admission by ethnic group, controlling for confounders. Participants Two hundred sixty-six patients with first episode psychosis, aged 18–64 years, who presented to mental health services in south London in 1997–1999 and 446 with FEP who presented in 2010–2012. Results When the two samples were compared, ethnic differences in compulsory admission appear to have remained the same for black African patients, i.e. three times higher than white British in both samples: AESOP (adj. OR = 3.96; 95% CI = 1.80–8.71) vs. CRIS-FEP (adj. OR = 3.12; 95% CI = 1.52–6.35). Black Caribbean patients were three times more likely to be compulsorily admitted in AESOP (adj. OR = 3.20; 95% CI = 1.56–6.54). This was lower in the CRIS-FEP sample (adj. OR = 1.68; 95% CI = 0.71–3.98) and did not meet conventional levels for statistical significance. Conclusion Ethnicity is strongly associated with compulsory admissions at first presentation for psychosis with evidence of heterogeneity across groups, which deserves further research