A review and meta analysis of health state utility values in breast cancer

Background and purpose: Health-related quality of life is an important issue in the treatment of breast cancer, and health-state utilities are essential for cost-utility analysis. This paper identifies and summarises published utilities for common health-related quality of life outcomes for breast cancer, considers the impact of variation in study designs used, and pools utilities for some breast cancer health states. Data sources and study selection: 13 databases were searched using key words relating to breast cancer and utility measurement. Articles were included if specified empirical methods for deriving utility values were used and details of the method, including number of respondents, were given. Articles were excluded if values were based on expert opinion or were not unique. Data extraction and synthesis: The authors identified 49 articles which met their inclusion criteria, providing 476 unique utilities for breast cancer health states. Where possible, mean utility estimates were pooled using ordinary least squares with utilities clustered within study group and weighted by both number of respondents and inverse of the variance of each utility. Regressions included controls for disease state, utility assessment method and other features of study design. Results: Utility values found in the review are summarised for six categories: 1) screening related states, 2) preventative states, 3) adverse events in breast cancer and its treatment, 4) non-specific breast cancer, 5) metastatic breast cancer states and 6) early breast cancer states. Pooled utility values for the latter two categories are estimated, showing base state utility values of between 0.668 and 0.782 for early breast cancer and 0.721 and 0.806 metastatic breast cancer depending upon which model is used. Utilities were found to vary significantly by valuation method, and who conducted the valuation. Conclusions: A large number of utility values for breast cancer are available in the literature; the states that these refer to are often complex, making pooling of values problematic

The application of the ventilation equations to cleanrooms - Part 2: Decay of contamination

This article is the second of a three-part series that investigates the application of the ventilation equations to designing and testing cleanrooms. This part is concerned with the decay equation. The recovery test, described in ISO 14644-3 (2005) is discussed, and improvements recommended. The application of the decay equation to the ‘clean up’ requirement given in the EU GGMP (2008) is also discussed. Finally, a method is considered that calculates the time needed for airborne contamination in cleanroom areas to decay to acceptable concentrations

Decay of airborne contamination and ventilation effectiveness of cleanrooms

This article reports an investigation into the ability of the air supply in non-unidirectional cleanrooms to aid recovery from episodes of airborne contamination, and minimise airborne contamination at important locations. The ISO 14644-3 (2005) recovery test, which measures the rate of decay of test particles, was assessed and a reinterpretation of the test results suggested. This allowed air change effectiveness indexes to be calculated and used to evaluate the ventilation effectiveness of the cleanroom’s air supply. Air change effectiveness indexes were measured in various designs of cleanrooms, and reasons for deviations in the value of the indexes investigated

Reduced dynamics of Ward solitons

The moduli space of static finite energy solutions to Ward's integrable chiral model is the space $M_N$ of based rational maps from \CP^1 to itself with degree $N$. The Lagrangian of Ward's model gives rise to a K\"ahler metric and a magnetic vector potential on this space. However, the magnetic field strength vanishes, and the approximate non--relativistic solutions to Ward's model correspond to a geodesic motion on $M_N$. These solutions can be compared with exact solutions which describe non--scattering or scattering solitons.Comment: Final version, to appear in Nonlinearit

Bond patterns and charge order amplitude in 1/4-filled charge-transfer solids

Metal-insulator transition accompanied by charge-ordering has been widely investigated in quasi-one-dimensional conductors, including in particular organic charge-transfer solids. Among such materials the 1/4-filled band charge-transfer solids are of strong interest, because of the commensurate nature of the charge-ordering in these systems. The period-four charge-order pattern ...1100... here is accompanied by two distinct bond distortion patterns, giving rise to bond-charge-density waves (BCDW) of types 1 and 2. Using quantum Monte Carlo methods, we determine the phase diagram within the extended Hubbard Hamiltonian that gives both types 1 and 2 BCDW in the thermodynamic limit. We further investigate the effect of electron-electron and electron-phonon interactions on the amount of charge disproportionation. Our results show that between these two bond patterns, one (BCDW2) in general coexists with a large magnitude charge order, which is highly sensitive to electron-phonon interactions, while the other (BCDW1) is characterized by weak charge order. We discuss the relevance of our work to experiments on several 1/4-filled conductors, focusing in particular on the materials (EDO-TTF)_2X and (DMEDO-TTF)_2X with large amplitude charge-order.Comment: 7 pages, 8 figure

Extended Gas in Seyfert Galaxies: Near Infrared Observations of NGC 2110 and Circinus

We present results of near--IR long-slit spectroscopy in the J and K bands of the Seyfert 2 galaxies NGC 2110 and Circinus, investigating the gaseous distribution, excitation, reddening and kinematics. In NGC 2110, the emission line ratio [FeII]/Pa beta increases towards the nucleus (to ~ 7). The nuclear [Fe II]1.257 (microns) and Pa beta lines are broader (FWHM ~ 500 km/s) than the H2 (2.121) line (FWHM ~ 300 km/s). Both these results suggest that shocks, driven by the radio jet, are an important source of excitation of [Fe II]. The H2 excitation appears to be dominated by X-rays from the nucleus. In Circinus, both [FeII]/Pa beta and H2/Br gamma decrease from ~ 2 at 4 arcsec from the nucleus to nuclear values of ~ 0.6 and ~ 1, respectively, suggesting that the starburst dominates the nuclear excitation, while the AGN dominates the excitation further out (r > 2 arcsec). For both galaxies, the gaseous kinematics are consistent with circular rotation in the plane of the disk. Our rotation curves suggest that the nucleus (identified with the peak of the IR continuum) is displaced from the kinematic centre of the galaxies. This effect has been observed previously in NGC 2110 based on the kinematics of optical emission lines, but the displacement is smaller in the infrared, suggesting the effect is related to obscuration. The continuum J-K colours of the nuclear region indicate a red stellar population in NGC 2110 and a reddened young stellar population in Circinus. Right at the nucleus of both galaxies, the colours are redder, apparently a result of hot dust emission from the inner edge of a circumnuclear torus.Comment: 11 pages, 14 figures, accepted for publication in MNRA

The effects of acceleration stress on human workload and manual control

The effects of +Gz stress on operator task performance and workload were assessed. Subjects were presented a two dimensional maze and were required to solve it as rapidly as possible (by moving a light dot through it via a trim switch on a control stick) while under G-stress at levels from +1 Gz to +6 Gz. The G-stress was provided by a human centrifuge. The effects of this stress were assessed by two techniques; (1) objective performance measures on the primary maze-solving task, and (2) subjective workload measures obtained using the subjective workload assessment technique (SWAT). It was found that while neither moderate (+3 Gz) nor high (+5 Gz and +6 Gz) levels of G-stress affected maze solving performance, the high G levels did increase significantly the subjective workload of the maze task

Global and regional importance of the direct dust-climate feedback.

Feedbacks between the global dust cycle and the climate system might have amplified past climate changes. Yet, it remains unclear what role the dust-climate feedback will play in future anthropogenic climate change. Here, we estimate the direct dust-climate feedback, arising from changes in the dust direct radiative effect (DRE), using a simple theoretical framework that combines constraints on the dust DRE with a series of climate model results. We find that the direct dust-climate feedback is likely in the range of -0.04 to +0.02 Wm -2 K-1, such that it could account for a substantial fraction of the total aerosol feedbacks in the climate system. On a regional scale, the direct dust-climate feedback is enhanced by approximately an order of magnitude close to major source regions. This suggests that it could play an important role in shaping the future climates of Northern Africa, the Sahel, the Mediterranean region, the Middle East, and Central Asia

Bounding inconsistency using a novel threshold metric for dead reckoning update packet generation

Human-to-human interaction across distributed applications requires that sufficient consistency be maintained among participants in the face of network characteristics such as latency and limited bandwidth. The level of inconsistency arising from the network is proportional to the network delay, and thus a function of bandwidth consumption. Distributed simulation has often used a bandwidth reduction technique known as dead reckoning that combines approximation and estimation in the communication of entity movement to reduce network traffic, and thus improve consistency. However, unless carefully tuned to application and network characteristics, such an approach can introduce more inconsistency than it avoids. The key tuning metric is the distance threshold. This paper questions the suitability of the standard distance threshold as a metric for use in the dead reckoning scheme. Using a model relating entity path curvature and inconsistency, a major performance related limitation of the distance threshold technique is highlighted. We then propose an alternative time—space threshold criterion. The time—space threshold is demonstrated, through simulation, to perform better for low curvature movement. However, it too has a limitation. Based on this, we further propose a novel hybrid scheme. Through simulation and live trials, this scheme is shown to perform well across a range of curvature values, and places bounds on both the spatial and absolute inconsistency arising from dead reckoning