The death of cost-minimization analysis?

Four different types of evaluation methods, cost-benefit analysis (CBA), cost-utility analysis (CUA), cost-effectiveness analysis (CEA) and cost-minimization analysis (CMA), are usually distinguished. In this note, we pronounce the (near) death of CMA by showing the rare circumstances under which CMA is an appropriate method of analysis. We argue that it is inappropriate for separate and sequential hypothesis tests on differences in effects and costs to determine whether incremental cost-effectiveness (or cost-utility) should be estimated. We further argue that the analytic focus should be on the estimation of the joint density of cost and effect differences, the quantification of uncertainty surrounding the incremental cost-effectiveness ratio and the presentation of such data as cost-effectiveness acceptability curves. Two examples from recently published CEA are employed to illustrate the issues. The first shows a situation where analysts might be tempted (inappropriately) to employ CMA rather than CEA. The second illustrates one of the rare circumstances in which CMA may be justified as a legitimate form of analysis

Fasciola hepatica:The therapeutic potential of a worm secretome

The success of helminth parasites is partly related to their ability to modulate host immune responses towards an anti-inflammatory/regulatory phenotype. This ability resides with the molecules contained in the secretome of various helminths that have been shown to interact with host immune cells and influence their function. Consequently, there exists a unique opportunity to exploit these molecules for the prophylactic and therapeutic treatment of human pro- and auto-inflammatory disorders (for example septic shock, transplant rejection and autoimmune disease). In this review, we describe the mechanisms used by the trematode parasite, Fasciola hepatica, to modulate the immune responses of its host and discuss the potent immune-modulatory effects of three individual molecules within the secretome; namely cathepsin L1, peroxiredoxin and helminth defence molecule. With a focus on the requirements from industry, we discuss the strategies by which these molecules may be clinically developed to control human immune responses in a way that is conducive to the prevention of immune-mediated diseases

Cardiorespiratory responses in an Antarctic fish suggest limited capacity for thermal acclimation

Polar fishes are at high risk from increasing seawater temperatures. Characterising the 30 physiological responses to such changes may both clarify mechanisms that permit life 31 under extreme conditions, and identify limitations in the response to continued global 32 warming. We hypothesised that Notothenia coriiceps would show physiological 33 compensation after an acute exposure to 5oC, and following 6wk warm acclimation, 34 compared to ambient temperature (0oC). However, initial tachycardia (22.4±2.8 vs. 35 12.8±1.1min-1; P<0.01) was not reversed by acclimation (21.0±1.9min-1). 36 Hyperventilation (45.5±3.1 vs. 21.4±2.4min-1; P<0.001) showed a modest reduction 37 (38.0±2.9min-1; P<0.05), while resting oxygen consumption (0.52±0.08mmol.kg–1.h– 38 1) was acutely increased at 5oC (1.07±0.10mmol.kg–1.h–1; P<0.001) but unchanged 39 with acclimation. Autonomic blockade showed initial responses were mainly of vagal 40 origin, with little subsequent withdrawal or recovery in long-term heart rate variability 41 after 6wk. Given the limited cardiorespiratory capacity to withstand sustained 42 warming, effective physiological compensation likely requires a more prolonged 43 acclimation period

Rapid automated measurement of body fat distribution from whole-body MRI

The accurate determination of a person’s total body fat is an important issue in medical analysis because obesity is a significant contributing factor to a variety of serious health problems. The medical literature identifies a wide range of diseases that are closely linked to obesity. Current methods of fat assessment are largely inaccurate, and most current methods of fat determination cannot show regional fat distribution, which is important in defining disease risk. We introduce a method that combines computer-aided techniques with whole-body MRI techniques and enables accurate quantification and visualization of total body fat burden and regional fat distribution. This technique may be important in identifying and treating at-risk populations

NeXtQSM -- A complete deep learning pipeline for data-consistent quantitative susceptibility mapping trained with hybrid data

Deep learning based Quantitative Susceptibility Mapping (QSM) has shown great potential in recent years, obtaining similar results to established non-learning approaches. Many current deep learning approaches are not data consistent, require in vivo training data or solve the QSM problem in consecutive steps resulting in the propagation of errors. Here we aim to overcome these limitations and developed a framework to solve the QSM processing steps jointly. We developed a new hybrid training data generation method that enables the end-to-end training for solving background field correction and dipole inversion in a data-consistent fashion using a variational network that combines the QSM model term and a learned regularizer. We demonstrate that NeXtQSM overcomes the limitations of previous deep learning methods. NeXtQSM offers a new deep learning based pipeline for computing quantitative susceptibility maps that integrates each processing step into the training and provides results that are robust and fast

Socioeconomic status and infectious intestinal disease in the community: a longitudinal study (IID2 study).

Infectious intestinal diseases (IID) are common, affecting around 25% of people in UK each year at an estimated annual cost to the economy, individuals and the NHS of £1.5 billion. While there is evidence of higher IID hospital admissions in more disadvantaged groups, the association between socioeconomic status (SES) and risk of IID remains unclear. This study aims to investigate the relationship between SES and IID in a large community cohort.Longitudinal analysis of a prospective community cohort in the UK following 6836 participants of all ages was undertaken. Hazard ratios for IID by SES were estimated using Cox proportional hazard, adjusting for follow-up time and potential confounding factors.In the fully adjusted analysis, hazard ratio of IID was significantly lower among routine/manual occupations compared with managerial/professional occupations (HR 0.74, 95% CI 0.61-0.90).In this large community cohort, lower SES was associated with lower IID risk. This may be partially explained by the low response rate which varied by SES. However, it may be related to differences in exposure or recognition of IID symptoms by SES. Higher hospital admissions associated with lower SES observed in some studies could relate to more severe consequences, rather than increased infection risk

Shock fronts in the symbiotic system BI Crucis

We investigate the symbiotic star BI Crucis through a comprehensive and self-consistent analysis of the spectra emitted in three different epochs: 60's, 70's, and late 80's. In particular, we would like to find out the physical conditions in the shocked nebula and in the dust shells, as well as their location within the symbiotic system, by exploiting both photometric and spectroscopic data from radio to UV. We suggest a model which, on the basis of optical imaging, emission line ratios and spectral energy distribution profile, is able to account for collision of the winds, formation of lobes and jets by accretion onto the WD, as well as for the interaction of the blast wave from a past, unrecorded outburst with the ISM. We have found that the spectra observed throughout the years show the marks of the different processes at work within BI Cru, perhaps signatures of a post-outburst evolution. We then call for new infrared and millimeter observations, potentially able to resolve the inner structure of the symbiotic nebula.Comment: 13 pages, 9 figures, 2 tables; accepted for publication in MNRA

Chromosome painting among Proboscidea, Hyracoidea and Sirenia: support for Paenungulata (Afrotheria, Mammalia) but not Tethytheria

Despite marked improvements in the interpretation of systematic relationships within Eutheria, particular nodes, including Paenungulata (Hyracoidea, Sirenia and Proboscidea), remain ambiguous. The combination of a rapid radiation, a deep divergence and an extensive morphological diversification has resulted in a limited phylogenetic signal confounding resolution within this clade both at the morphological and nucleotide levels. Cross-species chromosome painting was used to delineate regions of homology between Loxodonta africana (2n=56), Procavia capensis (2n=54), Trichechus manatus latirostris (2n=48) and an outgroup taxon, the aardvark (Orycteropus afer, 2n=20). Changes specific to each lineage were identified and although the presence of a minimum of 11 synapomorphies confirmed the monophyly of Paenungulata, no change characterizing intrapaenungulate relationships was evident. The reconstruction of an ancestral paenungulate karyotype and the estimation of rates of chromosomal evolution indicate a reduced rate of genomic repatterning following the paenungulate radiation. In comparison to data available for other mammalian taxa, the paenungulate rate of chromosomal evolution is slow to moderate. As a consequence, the absence of a chromosomal character uniting two paenungulates (at the level of resolution characterized in this study) may be due to a reduced rate of chromosomal change relative to the length of time separating successive divergence events

Short-term emission line and continuum variations in Mrk110

We present results of a variability campaign of Mrk110 performed with the 9.2-m Hobby-Eberly Telescope (HET) at McDonald Observatory. The high S/N spectra cover most of the optical range. They were taken from 1999 November through 2000 May. The average interval between the observations was 7.3 days and the median interval was only 3.0 days. Mrk110 is a narrow-line Seyfert 1 galaxy. During our campaign the continuum flux was in a historically low stage. Considering the delays of the emission lines with respect to the continuum variations we could verify an ionization stratification of the BLR. We derived virial masses of the central black hole from the radial distances of the different emission lines and from their widths. The calculated central masses agree within 20%. Furthermore, we identified optical HeI singlet emission lines emitted in the broad-line region. The observed line fluxes agree with theoretical predictions. We show that a broad wing on the red side of the [OIII]5007 line is caused by the HeI singlet line at 5016A.Comment: 11 pages, 16 figures, A&A Latex. Accepted for publication in A&A Main Journa

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Kartoffelausgabe im Hof des städtischen Ernährungamte