Individual freedom versus collective responsibility: an economic epidemiology perspective

Individuals' free choices in vaccination do not guarantee social optimum since individuals' decision is based on imperfect information, and vaccination decision involves positive externality. Public policy of compulsory vaccination or subsidised vaccination aims to increase aggregate private demand closer to social optimum. However, there is controversy over the effectiveness of public intervention compared to the free choice outcome in vaccination, and this article provides a brief discussion on this issue. It can be summarised that individuals' incentives to vaccination and accordingly their behavioural responses can greatly influence public policy's pursuit to control disease transmission, and compulsory (or subsidised) vaccination policy without incorporating such behavioural responses will not be able to achieve the best social outcome

An Analysis of Air Traffic Controllers’ Job Satisfaction

The air traffic controllers\u27 job is one of the most hectic in today’s world, predominantly due to its safety-critical operations and altering expectations. The primary purpose of this paper is to provide a holistic directory of determinants and synthesized reinforcements for air traffic controllers\u27 job satisfaction. Researchers in the past have put the spotlight on individual air traffic controller’s technical job satisfaction factors, such as impacts from remote tower operation, airplane trajectory changes, and dynamic air traffic situations. However, none described the connection among those factors and how adjusting those factors can enhance the cognitive components related to their job satisfaction. This paper\u27s in-depth analysis identified factors contributing to air traffic controllers\u27 job satisfaction based on past literature. It is intended to increase understanding and improve knowledge for future researchers and practitioners. The five predominant factors identified for air traffic controllers’ job satisfaction are ambiguity of job functions, overwhelming workload, complex task performance and uncertain work demand, job fatigue, and work-family conflict. Some effective methods to increase air traffic controllers’ job satisfaction are regular break between shifts, technological advancement to facilitate jobs, and sound insulations

Radiomic Texture Feature Descriptor to Distinguish Recurrent Brain Tumor From Radiation Necrosis Using Multimodal MRI

Despite multimodal aggressive treatment with chemo-radiation-therapy, and surgical resection, Glioblastoma Multiforme (GBM) may recur which is known as recurrent brain tumor (rBT), There are several instances where benign and malignant pathologies might appear very similar on radiographic imaging. One such illustration is radiation necrosis (RN) (a moderately benign impact of radiation treatment) which are visually almost indistinguishable from rBT on structural magnetic resonance imaging (MRI). There is hence a need for identification of reliable non-invasive quantitative measurements on routinely acquired brain MRI scans: pre-contrast T1-weighted (T1), post-contrast T1-weighted (T1Gd), T2-weighted (T2), and T2 Fluid Attenuated Inversion Recovery (FLAIR) that can accurately distinguish rBT from RN. In this work, sophisticated radiomic texture features are used to distinguish rBT from RN on multimodal MRI for disease characterization. First, stochastic multiresolution radiomic descriptor that captures voxel-level textural and structural heterogeneity as well as intensity and histogram features are extracted. Subsequently, these features are used in a machine learning setting to characterize the rBT from RN from four sequences of the MRI with 155 imaging slices for 30 GBM cases (12 RN, 18 rBT). To reduce the bias in accuracy estimation our model is implemented using Leave-one-out crossvalidation (LOOCV) and stratified 5-fold cross-validation with a Random Forest classifier. Our model offers mean accuracy of 0.967 ± 0.180 for LOOCV and 0.933 ± 0.082 for stratified 5-fold cross-validation using multiresolution texture features for discrimination of rBT from RN in this study. Our findings suggest that sophisticated texture feature may offer better discrimination between rBT and RN in MRI compared to other works in the literature

Bamboo as reinforcing material in concrete structures: A literature study

Proizvodnja konvencionalnih građevnih materijala kao što su čelik, beton i opeka uzrokuje značajno iskorištavanje prirodnih resursa i emisiju stakleničkih plinova. Stoga je potrebna primjena alternativnih, ekološki prihvatljivih, održivih i jeftinih građevnih materijala. Bambus je prirodni materijal koji može zamijeniti čelik u raznim konstrukcijama. U nekim istraživanjima razmatran je potencijal bambusa kao zamjene za čelik u konstrukcijama. Ovaj rad pruža pregled literature o uporabi betona armiranog bambusom u različitim zemljama.The production of conventional building materials such as steel, concrete, and brick causes severe exploitation of natural resources and emission of greenhouse gases. Therefore, alternative eco-friendly, sustainable, and inexpensive building materials are required. Bamboo is a natural material which can replace steel in various structures. Several studies have evaluated the potential of bamboo as a steel replacement in structures. This paper provides a literature review on the use of bamboo-reinforced concretes (BRC) in various countries

Is Drotrecogin alfa (activated) for adults with severe sepsis, cost-effective in routine clinical practice?

INTRODUCTION: Previous cost-effectiveness analyses (CEA) reported that Drotrecogin alfa (DrotAA) is cost-effective based on a Phase III clinical trial (PROWESS). There is little evidence on whether DrotAA is cost-effective in routine clinical practice. We assessed whether DrotAA is cost-effective in routine practice for adult patients with severe sepsis and multiple organ systems failing. METHODS: This CEA used data from a prospective cohort study that compared DrotAA versus no DrotAA (control) for severe sepsis patients with multiple organ systems failing admitted to critical care units in England, Wales, and Northern Ireland. The cohort study used case-mix and mortality data from a national audit, linked with a separate audit of DrotAA infusions. Re-admissions to critical care and corresponding mortality were recorded for four years. Patients receiving DrotAA (n = 1,076) were matched to controls (n = 1,650) with a propensity score (Pscore), and Genetic Matching (GenMatch). The CEA projected long-term survival to report lifetime incremental costs per quality-adjusted life year (QALY) overall, and for subgroups with two or three to five organ systems failing at baseline. RESULTS: The incremental costs per QALY for DrotAA were £30,000 overall, and £16,000 for the subgroups with three to five organ systems failing. For patients with two organ systems failing, DrotAA resulted in an average loss of one QALY at an incremental cost of £15,000. When the subgroup with two organ systems was restricted to patients receiving DrotAA within 24 hours, DrotAA led to a gain of 1.2 QALYs at a cost per QALY of £11,000. The results were robust to other assumptions including the approach taken to projecting long-term outcomes. CONCLUSIONS: DrotAA is cost-effective in routine practice for severe sepsis patients with three to five organ systems failing. For patients with two organ systems failing, this study could not provide unequivocal evidence on the cost-effectiveness of DrotAA

Modelling the impact of local reactive school closures on critical care provision during an influenza pandemic

Despite the fact that the 2009 H1N1 pandemic influenza strain was less severe than had been feared, both seasonal epidemics of influenza-like-illness and future influenza pandemics have the potential to place a serious burden on health services. The closure of schools has been postulated as a means of reducing transmission between children and hence reducing the number of cases at the peak of an epidemic; this is supported by the marked reduction in cases during school holidays observed across the world during the 2009 pandemic. However, a national policy of long-duration school closures could have severe economic costs. Reactive short-duration closure of schools in regions where health services are close to capacity offers a potential compromise, but it is unclear over what spatial scale and time frame closures would need to be made to be effective. Here, using detailed geographical information for England, we assess how localized school closures could alleviate the burden on hospital intensive care units (ICUs) that are reaching capacity. We show that, for a range of epidemiologically plausible assumptions, considerable local coordination of school closures is needed to achieve a substantial reduction in the number of hospitals where capacity is exceeded at the peak of the epidemic. The heterogeneity in demand per hospital ICU bed means that even widespread school closures are unlikely to have an impact on whether demand will exceed capacity for many hospitals. These results support the UK decision not to use localized school closures as a control mechanism, but have far wider international public-health implications. The spatial heterogeneities in both population density and hospital capacity that give rise to our results exist in many developed countries, while our model assumptions are sufficiently general to cover a wide range of pathogens. This leads us to believe that when a pandemic has severe implications for ICU capacity, only widespread school closures (with their associated costs and organizational challenges) are sufficient to mitigate the burden on the worst-affected hospitals

Application of concrete encased ecobrick blocks in the UK’s construction industry

The construction industry within the UK is at the forefront of new and alternative materials, which aid in efficient, sustainable and environmental-friendly construction projects. The concept of filling a single use plastic bottle with plastic waste and encasing it within a concrete surround, producing a composite block meets all three objectives. Due to the lack of ecobrick research within the UK, it became the catalyst for researching the concrete encased ecobrick block. At 7 day compressive testing the composite blocks were all weaker than the control samples and at 28 days the results were mixed. In comparison to a global study (Oman) the composite blocks were all greater in compressive strength. In conclusion, the composite blocks were found to be adequate for non-load bearing structural elements within the UK’s construction industry