The Importance of Economic Perspective and Quantitative Approaches in Oncology Value Frameworks of Drug Selection and Shared Decision Making

The debate around value in oncology drug selection has been prominent in recent years, and several professional bodies have furthered this debate by advocating for so-called value frameworks. Herein, we provide a viewpoint on these value frameworks, emphasizing the need to consider 4 key aspects: (1) the economic underpinnings of value; (2) the importance of the perspective adopted in the valuation; (3) the importance of the difference between absolute and relative measures of risk and measuring patient preferences; and (4) the recognition of multiple quality-of-life (QoL) domains, and the aggregation and valuation of those domains, through utilities within a multicriteria decision analysis, may allow prioritization of QoL above the tallying of safety events, particularly in a value framework focusing on the individual patient. While several frameworks exist, they incorporate different attributes and—importantly—assess value from alternative perspectives, including those of patients, regulators, payers, and society. The various perspectives necessarily lead to potentially different, if not sometimes divergent, conclusions about the valuation. We show that the perspective of the valuation affects the framing of the risk/benefit question and the methodology to measure the individual patient choice, or preference, as opposed to the collective, or population, choice. We focus specifically on the American Society of Clinical Oncology (ASCO) Value Framework. We argue that its laudable intent to assist in shared clinician-patient decision making can be augmented by more formally adopting methodology underpinned by micro- and health economic concepts, as well as application of formal quantitative approaches. Our recommendations for value frameworks focusing on the individual patient, such as the ASCO Value Framework, are 3-fold: (1) ensure that stakeholders understand the importance of the adopted (economic) perspective; (2) consider using exclusively absolute measures of risk and formal patientpreference methodology; and (3) consider foregoing safety parameters for higher-order utility considerations

Gain limits of a Thick GEM in high-purity Ne, Ar and Xe

The dependence of the avalanche charge gain in Thick Gas Electron Multipliers (THGEM) on the purity of Ne, Ar and Xe filling gases was investigated. The gain, measured with alpha-particles in standard conditions (atmospheric pressure, room temperature), was found to considerably drop in gases purified by non-evaporable getters. On the other hand, small N2 admixtures to noble gases resulted in high reachable gains. The results are of general relevance in the operation of gas-avalanche detectors in noble gases, particularly that of two-phase cryogenic detectors for rare events.Comment: 15 pages, 6 figures, submitted to JINS

Velocity-Based Gain-Scheduled Lateral Auto-Pilot For An Agile Missile

This paper investigates the application of velocity-based gain-scheduling techniques to a demanding, highly nonlinear, missile control design task. Scheduling on instantaneous incidence (a rapidly varying quantity) is well known to lead to considerable difficulties with conventional gain-scheduling methods. Moreover, the missile dynamics do not have well-defined relative degree at operating points where the lateral velocity is zero and thus conventional feedback linearisation methods cannot be applied to design a controller

Shading Reduces Yields of Edible Ginger Rhizomes Grown in Sub-Irrigated Pots

The purpose of this study was to determine the effects of four shading levels on the yield of edible ginger rhizomes that were grown in sub-irrigated pots under plastic-covered rainshelters

Bowhead whales, and not right whales, were the primary target of 16th- to 17th-century Basque Whalers in the Western North Atlantic

During the 16th and 17th centuries, Basque whalers travelled annually to the Strait of Belle Isle and Gulf of St. Lawrence to hunt whales. The hunting that occurred during this period is of primary significance for the North Atlantic right whale, Eubalaena glacialis (Müller, 1776), because it has been interpreted as the largest human-induced reduction of the western North Atlantic population, with ~12250–21 000 whales killed. It has been frequently reported that the Basques targeted two species in this region: the North Atlantic right whale and the bowhead whale, Balaena mysticetus L., 1758. To evaluate this hypothesis and the relative impact of this period of whaling on both species, we collected samples from 364 whale bones during a comprehensive search of Basque whaling ports from the 16th to the 17th century in the Strait of Belle Isle and Gulf of St. Lawrence. Bones were found and sampled at 10 of the 20 sites investigated. DNA was extracted from a subset (n = 218) of these samples. Analysis of the mitochondrial cytochrome b region identified five whale species. The identification of only a single right whale bone and 203 bowhead whale bones from at least 72 individuals indicates that the bowhead whale was likely the principal target of the hunt. These results imply that this whaling had a much greater impact (in terms of numbers of whales removed) on the bowhead whale population than on the western North Atlantic right whale population.Aux XVIe et XVIIe siècles, les baleiniers basques se rendaient tous les ans au détroit de Belle Isle et au golfe du Saint- Laurent pour faire la chasse aux baleines. La chasse qui s’est effectuée pendant cette période revêt une grande importance pour la baleine franche ou baleine noire de l’Atlantique Nord, Eubalaena glacialis (Müller, 1776), car cette activité serait interprétée comme la plus grande réduction de la population de baleines franches de l’Atlantique Nord causée par l’être humain, au rythme d’environ 12 250 à 21 000 baleines tuées. On a souvent signalé que les Basques visaient deux espèces dans cette région, soit la baleine franche de l’Atlantique Nord et la baleine boréale, Balaena mysticetus L., 1758. Pour évaluer cette hypothèse et l’incidence relative de cette période de pêche aux baleines sur ces deux espèces, nous avons recueilli des échantillons provenant de 364 ossements de baleines dans le cadre d’une recherche approfondie de ports basques de chasse à la baleine remontant aux XVIe et XVIIe siècles dans le détroit de Belle Isle et le golfe du Saint-Laurent. Des ossements ont été trouvés et échantillonnés à 10 des 20 sites ayant fait l’objet de notre recherche. De l’ADN a été extrait d’un sous-ensemble (n = 218) de ces échantillons. L’analyse mitochondriale cytochrome b de la région a permis d’identifier cinq espèces de baleines. L’identification d’un seul os de baleine franche et de 203 os de baleines boréales provenant d’au moins 72 individus laisse croire que la baleine boréale était probablement la cible principale des chasseurs. Ces résultats impliquent que la chasse à la baleine a eu des incidences beaucoup plus grandes (en termes de nombres de baleines éliminées) sur la population de baleines boréales que sur la population de baleines franches de l’ouest de l’Atlantique Nord

Factorization of shell-model ground-states

We present a new method that accurately approximates the shell-model ground-state by products of suitable states. The optimal factors are determined by a variational principle and result from the solution of rather low-dimensional eigenvalue problems. The power of this method is demonstrated by computations of ground-states and low-lying excitations in sd-shell and pf-shell nuclei.Comment: 5+epsilon pages, 5 eps-figures. Main additions: wave-function overlaps, angular momentum expectation values, application to Ni56. To be published as Rapid Communication in PR

Towards the architecture of an instructional multimedia database

The applicability of multimedia databases in education may be extended if they can serve multiple target groups, leading to affordable costs per unit for the user. In this contribution, an approach is described to build generic multimedia databases to serve that purpose. This approach is elaborated within the ODB Project ('Instructional Design of an Optical DataBase'); the term optical refers to the use of optical storage media to hold the audiovisual components. The project aims at developing a database in which a hypermedia encyclopedia is combined with instructional multimedia applications for different target groups at different educational levels. The architecture of the Optical Database will allow for switching between application types while working (for instance from tutorial instruction via the encyclopedia to a simulation and back). For instruction, the content of the database is thereby organized around so-called standard instruction routes: one route per target group. In the project, the teacher is regarded as the manager of instruction.\ud \ud From that perspective, the database is primarily organized as a teaching facility. Central to the research is the condition that the architecture of the Optical Database has to enable teachers to select and tailor instruction routes to their needs in a way that is perceived as logical and easy to use

General boundary conditions for the envelope function in multiband k.p model

We have derived general boundary conditions (BC) for the multiband envelope functions (which do not contain spurious solutions) in semiconductor heterostructures with abrupt heterointerfaces. These BC require the conservation of the probability flux density normal to the interface and guarantee that the multiband Hamiltonian be self--adjoint. The BC are energy independent and are characteristic properties of the interface. Calculations have been performed of the effect of the general BC on the electron energy levels in a potential well with infinite potential barriers using a coupled two band model. The connection with other approaches to determining BC for the envelope function and to the spurious solution problem in the multiband k.p model are discussed.Comment: 15 pages, 2 figures; to be published in Phys. Rev. B 65, March 15 issue 200

Increasing eigenstructure assignment design degree of freedom using lifting

This paper presents the exposition of an output-lifting eigenstructure assignment (EA) design framework, wherein the available EA design degrees of freedom (DoF) is significantly increased, and the desired eigenstructure of a single-rate full state feedback solution can be achieved within an output feedback system. A structural mapping is introduced to release the output-lifting causality constraint. Additionally, the available design DoF can be further enlarged via involving the input-lifting into the output-lifting EA framework. The newly induced design DoF can be utilised to calculate a structurally constrained, causal gain matrix which will maintain the same assignment capability. In this paper, the robustification of the output-lifting EA is also proposed, which allows a trade-off between performance and robustness in the presence of structured model uncertainties to be established. A lateral flight control benchmark in the EA literature and a numerical example are used to demonstrate the effectiveness of the design framework

Simultaneous solution of Kompaneets equation and Radiative Transfer equation in the photon energy range 1 - 125 KeV

Radiative transfer equation in plane parallel geometry and Kompaneets equation is solved simultaneously to obtain theoretical spectrum of 1-125 KeV photon energy range. Diffuse radiation field is calculated using time-independent radiative transfer equation in plane parallel geometry, which is developed using discrete space theory (DST) of radiative transfer in a homogeneous medium for different optical depths. We assumed free-free emission and absorption and emission due to electron gas to be operating in the medium. The three terms $n, n^2$ and $\displaystyle \bigg({\frac {\partial n}{\partial x_k}}\bigg)$ where $n$ is photon phase density and $\displaystyle x_k= \bigg({\frac {h \nu} {k T_e}} \bigg)$, in Kompaneets equation and those due to free-free emission are utilized to calculate the change in the photon phase density in a hot electron gas. Two types of incident radiation are considered: (1) isotropic radiation with the modified black body radiation $I^{MB}$ [1] and (2) anisotropic radiation which is angle dependent. The emergent radiation at $\tau=0$ and reflected radiation $\tau=\tau_{max}$ are calculated by using the diffuse radiation from the medium. The emergent and reflected radiation contain the free-free emission and emission from the hot electron gas. Kompaneets equation gives the changes in photon phase densities in different types of media. Although the initial spectrum is angle dependent, the Kompaneets equation gives a spectrum which is angle independent after several Compton scattering times.Comment: 31 pages, 8 figures, Accepte