The L_X--M relation of Clusters of Galaxies

We present a new measurement of the scaling relation between X-ray luminosity and total mass for 17,000 galaxy clusters in the maxBCG cluster sample. Stacking sub-samples within fixed ranges of optical richness, N_200, we measure the mean 0.1-2.4 keV X-ray luminosity, , from the ROSAT All-Sky Survey. The mean mass, , is measured from weak gravitational lensing of SDSS background galaxies (Johnston et al. 2007). For 9 <= N_200 < 200, the data are well fit by a power-law, /10^42 h^-2 erg/s = (12.6+1.4-1.3 (stat) +/- 1.6 (sys)) (/10^14 h^-1 M_sun)^1.65+/-0.13. The slope agrees to within 10% with previous estimates based on X-ray selected catalogs, implying that the covariance in L_X and N_200 at fixed halo mass is not large. The luminosity intercent is 30%, or 2\sigma, lower than determined from the X-ray flux-limited sample of Reiprich & Bohringer (2002), assuming hydrostatic equilibrium. This difference could arise from a combination of Malmquist bias and/or systematic error in hydrostatic mass estimates, both of which are expected. The intercept agrees with that derived by Stanek et al. (2006) using a model for the statistical correspondence between clusters and halos in a WMAP3 cosmology with power spectrum normalization sigma_8 = 0.85. Similar exercises applied to future data sets will allow constraints on the covariance among optical and hot gas properties of clusters at fixed mass.Comment: 5 pages, 1 figure, MNRAS accepte

The equivalence of numbers: The social value of avoiding health decline: An experimental web-based study

BACKGROUND: Health economic analysis aimed at informing policy makers and supporting resource allocation decisions has to evaluate not only improvements in health but also avoided decline. Little is known however, whether the "direction" in which changes in health are experienced is important for the public in prioritizing among patients. This experimental study investigates the social value people place on avoiding (further) health decline when directly compared to curative treatments in resource allocation decisions. METHODS: 127 individuals completed an interactive survey that was published in the World Wide Web. They were confronted with a standard gamble (SG) and three person trade-off tasks, either comparing improvements in health (PTO-Up), avoided decline (PTO-Down), or both, contrasting health changes of equal magnitude differing in the direction in which they are experienced (PTO-WAD). Finally, a direct priority ranking of various interventions was obtained. RESULTS: Participants strongly prioritized improving patients' health rather than avoiding decline. The mean substitution rate between health improvements and avoided decline (WAD) ranged between 0.47 and 0.64 dependent on the intervention. Weighting PTO values according to the direction in which changes in health are experienced improved their accuracy in predicting a direct prioritization ranking. Health state utilities obtained by the standard gamble method seem not to reflect social values in resource allocation contexts. CONCLUSION: Results suggest that the utility of being cured of a given health state might not be a good approximation for the societal value of avoiding this health state, especially in cases of competition between preventive and curative interventions

The social value of a QALY : raising the bar or barring the raise?

Background: Since the inception of the National Institute for Health and Clinical Excellence (NICE) in England, there have been questions about the empirical basis for the cost-per-QALY threshold used by NICE and whether QALYs gained by different beneficiaries of health care should be weighted equally. The Social Value of a QALY (SVQ) project, reported in this paper, was commissioned to address these two questions. The results of SVQ were released during a time of considerable debate about the NICE threshold, and authors with differing perspectives have drawn on the SVQ results to support their cases. As these discussions continue, and given the selective use of results by those involved, it is important, therefore, not only to present a summary overview of SVQ, but also for those who conducted the research to contribute to the debate as to its implications for NICE. Discussion: The issue of the threshold was addressed in two ways: first, by combining, via a set of models, the current UK Value of a Prevented Fatality (used in transport policy) with data on fatality age, life expectancy and age-related quality of life; and, second, via a survey designed to test the feasibility of combining respondents’ answers to willingness to pay and health state utility questions to arrive at values of a QALY. Modelling resulted in values of £10,000-£70,000 per QALY. Via survey research, most methods of aggregating the data resulted in values of a QALY of £18,000-£40,000, although others resulted in implausibly high values. An additional survey, addressing the issue of weighting QALYs, used two methods, one indicating that QALYs should not be weighted and the other that greater weight could be given to QALYs gained by some groups. Summary: Although we conducted only a feasibility study and a modelling exercise, neither present compelling evidence for moving the NICE threshold up or down. Some preliminary evidence would indicate it could be moved up for some types of QALY and down for others. While many members of the public appear to be open to the possibility of using somewhat different QALY weights for different groups of beneficiaries, we do not yet have any secure evidence base for introducing such a system

Evidence for a Weak Galactic Center Magnetic Field from Diffuse Low Frequency Nonthermal Radio Emission

New low-frequency 74 and 330 MHz observations of the Galactic center (GC) region reveal the presence of a large-scale (6\arcdeg\times 2\arcdeg) diffuse source of nonthermal synchrotron emission. A minimum energy analysis of this emission yields a total energy of $\sim (\phi^{4/7}f^{3/7})\times 10^{52}$ ergs and a magnetic field strength of $\sim 6(\phi/f)^{2/7}$ \muG (where $\phi$ is the proton to electron energy ratio and $f$ is the filling factor of the synchrotron emitting gas). The equipartition particle energy density is $1.2(\phi/f)^{2/7}$ \evcm, a value consistent with cosmic-ray data. However, the derived magnetic field is several orders of magnitude below the 1 mG field commonly invoked for the GC. With this field the source can be maintained with the SN rate inferred from the GC star formation. Furthermore, a strong magnetic field implies an abnormally low GC cosmic-ray energy density. We conclude that the mean magnetic field in the GC region must be weak, of order 10 \muG (at least on size scales \ga 125\arcsec).Comment: 12 pages, 1 JPEG figure, uses aastex.sty; Accepted for publication, ApJL (2005, published

Trading people versus trading time: What is the difference?

BACKGROUND: Person trade-off (PTO) elicitations yield different values than standard utility measures, such as time trade-off (TTO) elicitations. Some people believe this difference arises because the PTO captures the importance of distributive principles other than maximizing treatment benefits. We conducted a qualitative study to determine whether people mention considerations related to distributive principles other than QALY-maximization more often in PTO elicitations than in TTO elicitations and whether this could account for the empirical differences. METHODS: 64 members of the general public were randomized to one of three different face-to-face interviews, thinking aloud as they responded to TTO and PTO elicitations. Participants responded to a TTO followed by a PTO elicitation within contexts that compared either: 1) two life-saving treatments; 2) two cure treatments; or 3) a life-saving treatment versus a cure treatment. RESULTS: When people were asked to choose between life-saving treatments, non-maximizing principles were more common with the PTO than the TTO task. Only 5% of participants considered non-maximizing principles as they responded to the TTO elicitation compared to 68% of participants who did so when responding to the PTO elicitation. Non-maximizing principles that emerged included importance of equality of life and a desire to avoid discrimination. However, these principles were less common in the other two contexts. Regardless of context, though, participants were significantly more likely to respond from a societal perspective with the PTO compared to the TTO elicitation. CONCLUSION: When lives are at stake, within the context of a PTO elicitation, people are more likely to consider non-maximizing principles, including the importance of equal access to a life-saving treatment, avoiding prejudice or discrimination, and in rare cases giving treatment priority based purely on the position of being worse-off

Measuring the mean and scatter of the X-ray luminosity -- optical richness relation for maxBCG galaxy clusters

Determining the scaling relations between galaxy cluster observables requires large samples of uniformly observed clusters. We measure the mean X-ray luminosity--optical richness (L_X--N_200) relation for an approximately volume-limited sample of more than 17,000 optically-selected clusters from the maxBCG catalog spanning the redshift range 0.1<z<0.3. By stacking the X-ray emission from many clusters using ROSAT All-Sky Survey data, we are able to measure mean X-ray luminosities to ~10% (including systematic errors) for clusters in nine independent optical richness bins. In addition, we are able to crudely measure individual X-ray emission from ~800 of the richest clusters. Assuming a log-normal form for the scatter in the L_X--N_200 relation, we measure \sigma_\ln{L}=0.86+/-0.03 at fixed N_200. This scatter is large enough to significantly bias the mean stacked relation. The corrected median relation can be parameterized by L_X = (e^\alpha)(N_200/40)^\beta 10^42 h^-2 ergs/s, where \alpha = 3.57+/-0.08 and \beta = 1.82+/-0.05. We find that X-ray selected clusters are significantly brighter than optically-selected clusters at a given optical richness. This selection bias explains the apparently X-ray underluminous nature of optically-selected cluster catalogs.Comment: 21 pages, 12 figures, revised after referee's comments. ApJ accepte

Cluster randomized adaptive implementation trial comparing a standard versus enhanced implementation intervention to improve uptake of an effective re-engagement program for patients with serious mental illness

Abstract Background Persons with serious mental illness (SMI) are disproportionately burdened by premature mortality. This disparity is exacerbated by poor continuity of care with the health system. The Veterans Health Administration (VA) developed Re-Engage, an effective population-based outreach program to identify veterans with SMI lost to care and to reconnect them with VA services. However, such programs often encounter barriers getting implemented into routine care. Adaptive designs are needed when the implementation intervention requires augmentation within sites that do not initially respond to an initial implementation intervention. This protocol describes the methods used in an adaptive implementation design study that aims to compare the effectiveness of a standard implementation strategy (Replicating Effective Programs, or REP) with REP enhanced with External Facilitation (enhanced REP) to promote the uptake of Re-Engage. Methods/Design This study employs a four-phase, two-arm, longitudinal, clustered randomized trial design. VA sites (n = 158) across the United States with a designated Re-Engage provider, at least one Veteran with SMI lost to care, and who received standard REP during a six-month run-in phase. Subsequently, 88 sites with inadequate uptake were stratified at the cluster level by geographic region (n = 4) and VA regional service network (n = 20) and randomized to REP (n = 49) vs. enhanced REP (n = 39) in phase two. The primary outcome was the percentage of veterans on each facility outreach list documented on an electronic web registry. The intervention was at the site and network level and consisted of standard REP versus REP enhanced by external phone facilitation consults. At 12 months, enhanced REP sites returned to standard REP and 36 sites with inadequate participation received enhanced REP for six months in phase three. Secondary implementation outcomes included the percentage of veterans contacted directly by site providers and the percentage re-engaged in VA health services. Discussion Adaptive implementation designs consisting of a sequence of decision rules that are tailored based on a site’s uptake of an effective program may produce more relevant, rapid, and generalizable results by more quickly validating or rejecting new implementation strategies, thus enhancing the efficiency and sustainability of implementation research and potentially leading to the rollout of more cost-efficient implementation strategies. Trial registration Current Controlled Trials ISRCTN21059161 .http://deepblue.lib.umich.edu/bitstream/2027.42/112609/1/13012_2013_Article_711.pd

Cluster randomized trial comparing standard versus enhanced implementation strategies for improving outreach to persons with SMI: 12-month results

http://deepblue.lib.umich.edu/bitstream/2027.42/134545/1/13012_2015_Article_940.pd

The Distribution Of Chlorine And Iodine In Soil In The Vicinity Of Lead Mining And Smelting Operations, Bixby Area, S.E. Missouri, U.S.A.

Iodine and Cl are enriched in soils in the vicinity of the Magmont and Buick lead mines near Bixby, southeastern Missouri. The enrichments, up to 5.6 ppm I and 305 ppm Cl, are against regional background of 1.26 ppm I and 41 ppm Cl. The area of highest I and Cl is thought to reflect a zone of base metal sulphide mineralization occurring about 400 m below the surface. Iodine and Cl are also enriched in soils immediately adjacent to a tailings pond, hence these elements would appear to be leached from this source. A zone of enhanced I values (up to 2.65 ppm I) to the north of a lead smelter is superimposed on a much larger zone of lead enrichment (up to 12,000 ppm Pb) and is thought to represent I released from sulphide ores on smelting. © 1988

Antibiotic resistance patterns of Escherichia coli isolates from different aquatic environmental sources in Leon, Nicaragua

AbstractAntibiotic-resistant bacteria have emerged due to the selective pressure of antimicrobial use in humans and animals. Water plays an important role in dissemination of these organisms among humans, animals and the environment. We studied the antibiotic resistance patterns among 493 Escherichia col/isolates from different aquatic environmental sources collected from October 2008 to May 2009 in Leon, Nicaragua. High levels of antibiotic resistance were found in E. coli isolates in hospital sewage water and in eight of 87 well-water samples. Among the resistant isolates from the hospital sewage, ampicillin, chloramphenicol, ciprofloxacin, nalidixic acid, trimethoprim-sulphamethoxazole was the most common multi-resistance profile. Among the resistant isolates from the wells, 19% were resistant to ampicillin, ceftazidime, ceftriaxone, cefotaxime, chloramphenicol, ciprofloxacin, gentamicin, nalidixic acid and trimethoprim-sulphameth-oxazole. E. coli producing ESBL and harbouring blaCTX-M genes were detected in one of the hospital sewage samples and in 26% of the resistant isolates from the well-water samples. The blaCTX-M-9 group was more prevalent in E. coli isolates from the hospital sewage samples and the blaCTX-M-1 group was more prevalent in the well-water samples