The cost-effectiveness of Cochlear implants in Swedish adults.

BackgroundResearch has shown unilateral cochlear implants (CIs) significantly improve clinical outcomes and quality of life in adults. However, only 13% of eligible Swedish adults currently use a unilateral CI. The objective was to estimate the cost-effectiveness of unilateral CIs compared to a hearing aid for Swedish adults with severe to profound hearing loss.MethodsA Markov model with a lifetime horizon and six-month cycle length was developed to estimate the benefits and costs of unilateral CIs from the Swedish health system perspective. A treatment pathway was developed through consultation with clinical experts to estimate resource use and costs. Unit costs were derived from the Swedish National Board of Health and Welfare and the Swedish Association of Local Authorities and Regions. Health outcomes were reported in terms of Quality Adjusted Life Years (QALYs).ResultsUnilateral CIs for Swedish adults with severe to profound hearing loss are likely to be deemed cost-effective when compared to a hearing aid (SEK 140,474 per QALY gained). The results were most sensitive to the age when patients are implanted with a CI and the proportion of patients eligible for CIs after triage.ConclusionsAn increase in the prevalence of Swedish adults with severe to profound hearing loss is expected as the population ages. Earlier implantation of unilateral CIs improves the cost-effectiveness among people eligible for CIs. Unilateral CIs are an efficacious and cost-effective option to improve hearing and quality of life in Swedish adults with severe to profound hearing loss

Early symptoms and sensations as predictors of lung cancer: a machine learning multivariate model.

The aim of this study was to identify a combination of early predictive symptoms/sensations attributable to primary lung cancer (LC). An interactive e-questionnaire comprised of pre-diagnostic descriptors of first symptoms/sensations was administered to patients referred for suspected LC. Respondents were included in the present analysis only if they later received a primary LC diagnosis or had no cancer; and inclusion of each descriptor required ≥4 observations. Fully-completed data from 506/670 individuals later diagnosed with primary LC (n = 311) or no cancer (n = 195) were modelled with orthogonal projections to latent structures (OPLS). After analysing 145/285 descriptors, meeting inclusion criteria, through randomised seven-fold cross-validation (six-fold training set: n = 433; test set: n = 73), 63 provided best LC prediction. The most-significant LC-positive descriptors included a cough that varied over the day, back pain/aches/discomfort, early satiety, appetite loss, and having less strength. Upon combining the descriptors with the background variables current smoking, a cold/flu or pneumonia within the past two years, female sex, older age, a history of COPD (positive LC-association); antibiotics within the past two years, and a history of pneumonia (negative LC-association); the resulting 70-variable model had accurate cross-validated test set performance: area under the ROC curve = 0.767 (descriptors only: 0.736/background predictors only: 0.652), sensitivity = 84.8% (73.9/76.1%, respectively), specificity = 55.6% (66.7/51.9%, respectively). In conclusion, accurate prediction of LC was found through 63 early symptoms/sensations and seven background factors. Further research and precision in this model may lead to a tool for referral and LC diagnostic decision-making

A prospective study of asthma incidence and its predictors: the RHINE study.

To access publisher full text version of this article. Please click on the hyperlink in Additional LinkThe objective of this longitudinal study was to estimate the incidence rate of asthma, and to compare the incidence between subjects with or without baseline reporting of certain respiratory symptoms. A follow-up of the random population samples in the European Respiratory Health Survey (ECRHS) in Sweden, Norway, Denmark, Iceland and Estonia was conducted in 1999-2001, in a population aged 30-54 yrs at follow-up (n=14,731). Asthma was defined as reporting either asthma or physician-diagnosed asthma, and a reported year when asthma symptoms were first noticed. Incidence rates, incidence rate ratios and hazard ratios were calculated with 95% confidence intervals. The incidence rate of asthma was 2.2 cases per 1,000 person-yrs. The incidence was higher among females (2.9 cases.1,000 person-yrs(-1)) than among males (1.5 cases.1,000 person-yrs(-1)). When subjects with baseline reporting of wheezing were excluded, the incidence rate decreased to 1.7 cases.1,000 person-yrs(-1), with a further decrease to 1.5 cases.1,000 person-yrs(-1) after exclusion of subjects with wheezing, nocturnal dyspnoea, chest tightness and cough. There was a strong association between onset of asthma and wheezing at baseline. In this prospective, population-based study, the incidence rate of asthma in the whole population sample ranged 1.5-2.2.1,000 person-yrs(-1), with a higher incidence range among females. The incidence was dependent on the extent to which subjects with respiratory symptoms were excluded from follow-up. Hence, for comparability between studies, the exclusion criteria in the follow-up population must be stated

A search for two body muon decay signals

Lepton family number violation is tested by searching for $\mu^+\to e^+X^0$ decays among the 5.8$\times 10^8$ positive muon decay events analyzed by the TWIST collaboration. Limits are set on the production of both massless and massive $X^0$ bosons. The large angular acceptance of this experiment allows limits to be placed on anisotropic $\mu^+\to e^+X^0$ decays, which can arise from interactions violating both lepton flavor and parity conservation. Branching ratio limits of order $10^{-5}$ are obtained for bosons with masses of 13 - 80 MeV/c$^2$ and with different decay asymmetries. For bosons with masses less than 13 MeV/c$^{2}$ the asymmetry dependence is much stronger and the 90% limit on the branching ratio varies up to $5.8 \times 10^{-5}$. This is the first study that explicitly evaluates the limits for anisotropic two body muon decays.Comment: 7 pages, 5 figures, 2 tables, accepted by PR

Measurement of the Muon Decay Parameter delta

The muon decay parameter delta has been measured by the TWIST collaboration. We find delta = 0.74964 +- 0.00066(stat.) +- 0.00112(syst.), consistent with the Standard Model value of 3/4. This result implies that the product Pmuxi of the muon polarization in pion decay, Pmu, and the muon decay parameter xi falls within the 90% confidence interval 0.9960 < Pmuxi < xi < 1.0040. It also has implications for left-right-symmetric and other extensions of the Standard Model.Comment: Extended to 5 pages. Referee's comments answere

Production of antihydrogen at reduced magnetic field for anti-atom trapping

We have demonstrated production of antihydrogen in a 1$,$T solenoidal magnetic field. This field strength is significantly smaller than that used in the first generation experiments ATHENA (3$,$T) and ATRAP (5$,$T). The motivation for using a smaller magnetic field is to facilitate trapping of antihydrogen atoms in a neutral atom trap surrounding the production region. We report the results of measurements with the ALPHA (Antihydrogen Laser PHysics Apparatus) device, which can capture and cool antiprotons at 3$,$T, and then mix the antiprotons with positrons at 1$,$T. We infer antihydrogen production from the time structure of antiproton annihilations during mixing, using mixing with heated positrons as the null experiment, as demonstrated in ATHENA. Implications for antihydrogen trapping are discussed

A novel antiproton radial diagnostic based on octupole induced ballistic loss

We report results from a novel diagnostic that probes the outer radial profile of trapped antiproton clouds. The diagnostic allows us to determine the profile by monitoring the time-history of antiproton losses that occur as an octupole field in the antiproton confinement region is increased. We show several examples of how this diagnostic helps us to understand the radial dynamics of antiprotons in normal and nested Penning-Malmberg traps. Better understanding of these dynamics may aid current attempts to trap antihydrogen atoms

Alpha Antihydrogen Experiment

ALPHA is an experiment at CERN, whose ultimate goal is to perform a precise test of CPT symmetry with trapped antihydrogen atoms. After reviewing the motivations, we discuss our recent progress toward the initial goal of stable trapping of antihydrogen, with some emphasis on particle detection techniques.Comment: Invited talk presented at the Fifth Meeting on CPT and Lorentz Symmetry, Bloomington, Indiana, June 28-July 2, 201