Economic analysis of the implementation of autologous transfusion technologies throughout England

Objectives: This study aims to provide the first estimates of the costs and effects of the large scale introduction of autologous transfusion technologies into the United Kingdom National Health Service. Methods: A model was constructed to allow disparate data sources to be combined to produce estimates of the scale, costs, and effects of introducing four interventions. The interventions considered were preparing patients for surgery (PPS) clinics, preoperative autologous donation (PAD), intraoperative cell salvage (ICS), and postoperative cell salvage (PoCS). Results: The key determinants of cost per operation are the anticipated level of reductions in blood use, the mean level of blood use, mean length of stay, and the cost of the technology. The results show the potential for considerable reductions in blood use. The greatest reductions are anticipated to be through the use of PPS and ICS. Vascular surgery, transplant surgery, and cardiothoracic surgery appear to be the specialties that will benefit most from the technologies. Conclusions: Several simplifications were used in the production of these estimates; consequently, caution should be used in their interpretation and use. Despite the drawbacks in the methods used in the study, the model shows the scale of the issue, the importance of gathering better data, and the form that data must take. Such preliminary modeling exercises are essential for rational policy development and to direct future research and discussion among stakeholders

The Great Recession and Material Hardship

Little research looks at the relationship between macroeconomic indicators and material hardship. High unemployment rates as a result of economic downturns are likely to lead to lost income, increased poverty, and material hardship. We examine the effect of the unemployment rate on hardship – food insecurity, difficulty paying bills, housing insecurity, unmet medical needs, and having utilities cut off – and investigate the role that government safety nets play in mitigating the effects of unemployment on the experience of material hardship. We use data from the Fragile Families and Child Well-being Study. The latest wave of data was collected during the Great Recession, the worst recession since the Great Depression, providing a unique opportunity to look at how high unemployment rates affect the well-being of low income families.Material Hardship, Unemployment, Recession

Avoiding Patterns in the Abelian Sense

We classify all 3 letter patterns that are avoidable in the abelian sense. A short list of four letter patterns for which abelian avoidance is undecided is given. Using a generalization of Zimin words we deduce some properties of ω-words avoiding these patterns.Research of both authors supported by NSERC Operating Grants.https://www.cambridge.org/core/journals/canadian-journal-of-mathematics/article/avoiding-patterns-in-the-abelian-sense/42148B0781A38A6618A537AAD7D39B8

Socioeconomic inequalities in health among Swedish adolescents - adding the subjective perspective

Abstract Background Socioeconomic inequalities in adolescent health predict future inequalities in adult health. Subjective measures of socioeconomic status (SES) may contribute with an increased understanding of these inequalities. The aim of this study was to investigate socioeconomic health inequalities using both a subjective and an objective measure of SES among Swedish adolescents. Method Cross-sectional HBSC-data from 2002 to 2014 was used with a total sample of 23,088 adolescents aged 11–15 years. Three measures of self-rated health (dependent variables) were assessed: multiple health complaints, life satisfaction and health perception. SES was measured objectively by the Family Affluence Scale (FAS) and subjectively by “perceived family wealth” (independent variables). The trend for health inequalities was investigated descriptively with independent t-tests and the relationship between independent and dependent variables was investigated with multiple logistic regression analysis. Gender, age and survey year was considered as possible confounders. Results Subjective SES was more strongly related to health outcomes than the objective measure (FAS). Also, the relation between FAS and health was weakened and even reversed (for multiple health complaints) when subjective SES was tested simultaneously in regression models (FAS OR: 1.03, CI: 1.00;1.06 and subjective SES OR: 0.66, CI: 0.63;0.68). Conclusions The level of socioeconomic inequalities in adolescent health varied depending on which measure that was used to define SES. When focusing on adolescents, the subjective appraisals of SES is important to consider because they seem to provide a stronger tool for identifying inequalities in health for this group. This finding is important for policy makers to consider given the persistence of health inequalities in Sweden and other high-income countries

New evidence on Allyn Young's style and influence as a teacher

This paper publishes the hitherto unpublished correspondence between Allyn Abbott Young's biographer Charles Blitch and 17 of Young's former students or associates. Together with related biographical and archival material, the paper shows the way in which this adds to our knowledge of Young's considerable influence as a teacher upon some of the twentieth century's greatest economists. The correspondents are as follows: James W Angell, Colin Clark, Arthur H Cole, Lauchlin Currie, Melvin G de Chazeau, Eleanor Lansing Dulles, Howard S Ellis, Frank W Fetter, Earl J Hamilton, Seymour S Harris, Richard S Howey, Nicholas Kaldor, Melvin M Knight, Bertil Ohlin, Geoffrey Shepherd, Overton H Taylor, and Gilbert Walker

Suffix conjugates for a class of morphic subshifts

Let A be a finite alphabet and f: A^* --> A^* be a morphism with an iterative fixed point f^\omega(\alpha), where \alpha{} is in A. Consider the subshift (X, T), where X is the shift orbit closure of f^\omega(\alpha) and T: X --> X is the shift map. Let S be a finite alphabet that is in bijective correspondence via a mapping c with the set of nonempty suffixes of the images f(a) for a in A. Let calS be a subset S^N be the set of infinite words s = (s_n)_{n\geq 0} such that \pi(s):= c(s_0)f(c(s_1)) f^2(c(s_2))... is in X. We show that if f is primitive and f(A) is a suffix code, then there exists a mapping H: calS --> calS such that (calS, H) is a topological dynamical system and \pi: (calS, H) --> (X, T) is a conjugacy; we call (calS, H) the suffix conjugate of (X, T). In the special case when f is the Fibonacci or the Thue-Morse morphism, we show that the subshift (calS, T) is sofic, that is, the language of calS is regular

Efficient dynamical downscaling of general circulation models using continuous data assimilation

Continuous data assimilation (CDA) is successfully implemented for the first time for efficient dynamical downscaling of a global atmospheric reanalysis. A comparison of the performance of CDA with the standard grid and spectral nudging techniques for representing long- and short-scale features in the downscaled fields using the Weather Research and Forecast (WRF) model is further presented and analyzed. The WRF model is configured at 25km horizontal resolution and is driven by 250km initial and boundary conditions from NCEP/NCAR reanalysis fields. Downscaling experiments are performed over a one-month period in January, 2016. The similarity metric is used to evaluate the performance of the downscaling methods for large and small scales. Similarity results are compared for the outputs of the WRF model with different downscaling techniques, NCEP reanalysis, and Final Analysis. Both spectral nudging and CDA describe better the small-scale features compared to grid nudging. The choice of the wave number is critical in spectral nudging; increasing the number of retained frequencies generally produced better small-scale features, but only up to a certain threshold after which its solution gradually became closer to grid nudging. CDA maintains the balance of the large- and small-scale features similar to that of the best simulation achieved by the best spectral nudging configuration, without the need of a spectral decomposition. The different downscaled atmospheric variables, including rainfall distribution, with CDA is most consistent with the observations. The Brier skill score values further indicate that the added value of CDA is distributed over the entire model domain. The overall results clearly suggest that CDA provides an efficient new approach for dynamical downscaling by maintaining better balance between the global model and the downscaled fields

Remarks on separating words

The separating words problem asks for the size of the smallest DFA needed to distinguish between two words of length <= n (by accepting one and rejecting the other). In this paper we survey what is known and unknown about the problem, consider some variations, and prove several new results

A Hadrosaurid (Dinosauria: Ornithischia) from the Late Cretaceous (Campanian) Kanguk Formation of Axel Heiberg Island, Nunavut, Canada, and Its Ecological and Geographical Implications

A hadrosaurid vertebra was recovered during a palynological survey of the Upper Cretaceous Kanguk Formation in the eastern Canadian Arctic. This vertebra represents the farthest north record of any non-avian dinosaur to date. Although highly abraded, the fossil nonetheless represents an interesting biogeographic data point. During the Campanian, when this vertebra was deposited, the eastern Canadian Arctic was likely isolated both from western North America by the Western Interior Seaway and from more southern regions of eastern North America by the Hudson Seaway. This fossil suggests that large-bodied hadrosaurid dinosaurs may have inhabited a large polar insular landmass during the Late Cretaceous, where they would have lived year-round, unable to migrate to more southern regions during winters. It is possible that the resident herbivorous dinosaurs could have fed on non-deciduous conifers, as well as other woody twigs and stems, during the long, dark winter months when most deciduous plant species had lost their leaves.La vertèbre d’un hadrosauridé a été retrouvée pendant l’étude palynologique de la formation Kanguk remontant au Crétacé supérieur, dans l’est de l’Arctique canadien. Il s’agit de la vertèbre appartenant à un dinosaure non avien qui a été recueillie la plus au nord jusqu’à maintenant. Même si ce fossile est fortement abrasé, il n’en reste pas moins qu’il représente un point de donnée biogéographique intéressant. Pendant le Campanien, lorsque cette vertèbre a été déposée, l’est de l’Arctique canadien était vraisemblablement isolé de l’ouest de l’Amérique du Nord par la mer intérieure occidentale, et des régions plus au sud de l’est de l’Amérique du Nord par le bras de mer Hudson. Ce fossile suggère que de gros dinosaures hadrosauridés auraient pu habiter une grande masse terrestre insulaire polaire pendant le Crétacé tardif, où ils auraient évolué à l’année, étant incapables de migrer vers les régions plus au sud pendant l’hiver. Il est possible que les dinosaures herbivores résidents se soient nourris de conifères non décidus ainsi que d’autres tiges ou brindilles ligneuses pendant les longs mois sombres de l’hiver, lorsque la plupart des espèces végétales décidues avaient perdu leurs feuilles.