Developing a health state classification system from NEWQOL for epilepsy using classical psychometric techniques and Rasch analysis: a technical report

Aims: Resource allocation amongst competing health care interventions is informed by evidence of both clinical- and cost-effectiveness. Cost-utility analysis is increasingly used to assess cost effectiveness through the use of Quality Adjusted Life Years (QALYs). This requires health state values. Generic measures of health related quality of life (HRQL) are usually used to produce these values, but there are concerns about their relevance and sensitivity in epilepsy. This study develops a health state classification system for epilepsy from the NEWQOL battery, a validated questionnaire measuring QoL in epilepsy. The classification system will be amenable to valuation for calculating QALYs. Methods: Factor and other psychometric analyses were undertaken to investigate the factor structure of the battery, and assess the validity and responsiveness of the items. These analyses were used alongside Rasch analysis to select the dimensions included in the classification system, and the items used to represent each domain. Analysis was carried out on a trial dataset of patients with epilepsy (n=1611). Rasch and factor analysis were performed on one half of the sample and validated on the remaining half. Dimensions and items were selected that performed well across all analyses. Results: The battery was found to demonstrate reliability and validity but responsiveness across time periods for many of the items was low. A six dimension classification system was developed: worry about seizures, depression, memory, cognition, stigmatism and control, each with four response levels. Conclusions: It is feasible to develop a health state classification system from a battery of instruments using a combination of classical psychometric, factor and Rasch analysis. This is the first condition-specific health state classification developed for epilepsy and the next stage will produce preference weights to enable the measure to be used in cost-utility analysis.quality adjusted life years; health related quality of life; Rasch analysis; preference-based measures of health; health states; epilepsy

Towards Bidirectional Ratcheted Key Exchange

Ratcheted key exchange (RKE) is a cryptographic technique used in instant messaging systems like Signal and the WhatsApp messenger for attaining strong security in the face of state exposure attacks. RKE received academic attention in the recent works of Cohn-Gordon et al. (EuroS&P 2017) and Bellare et al. (CRYPTO 2017). While the former is analytical in the sense that it aims primarily at assessing the security that one particular protocol does achieve (which might be weaker than the notion that it should achieve), the authors of the latter develop and instantiate a notion of security from scratch, independently of existing implementations. Unfortunately, however, their model is quite restricted, e.g. for considering only unidirectional communication and the exposure of only one of the two parties.In this article we resolve the limitations of prior work by developing alternative security definitions, for unidirectional RKE as well as for RKE where both parties contribute. We follow a purist approach, aiming at finding strong yet convincing notions that cover a realistic communication model with fully concurrent operation of both participants. We further propose secure instantiations (as the protocols analyzed or proposed by Cohn-Gordon et al. and Bellare et al. turn out to be weak in our models). While our scheme for the unidirectional case builds on a generic KEM as the main building block (differently to prior work that requires explicitly Diffie–Hellman), our schemes for bidirectional RKE require a stronger, HIBE-like component

Developing a health state classification system from NEWQOL for epilepsy using classical psychometric techniques and Rasch analysis: A technical report

Aims: Resource allocation amongst competing health care interventions is informed by evidence of both clinical- and cost-effectiveness. Cost-utility analysis is increasingly used to assess cost effectiveness through the use of Quality Adjusted Life Years (QALYs). This requires health state values. Generic measures of health related quality of life (HRQL) are usually used to produce these values, but there are concerns about their relevance and sensitivity in epilepsy. This study develops a health state classification system for epilepsy from the NEWQOL battery, a validated questionnaire measuring QoL in epilepsy. The classification system will be amenable to valuation for calculating QALYs. Methods: Factor and other psychometric analyses were undertaken to investigate the factor structure of the battery, and assess the validity and responsiveness of the items. These analyses were used alongside Rasch analysis to select the dimensions included in the classification system, and the items used to represent each domain. Analysis was carried out on a trial dataset of patients with epilepsy (n=1611). Rasch and factor analysis were performed on one half of the sample and validated on the remaining half. Dimensions and items were selected that performed well across all analyses. Results: The battery was found to demonstrate reliability and validity but responsiveness across time periods for many of the items was low. A six dimension classification system was developed: worry about seizures, depression, memory, cognition, stigmatism and control, each with four response levels. Conclusions: It is feasible to develop a health state classification system from a battery of instruments using a combination of classical psychometric, factor and Rasch analysis. This is the first condition-specific health state classification developed for epilepsy and the next stage will produce preference weights to enable the measure to be used in cost-utility analysis

L^2 stability estimates for shock solutions of scalar conservation laws using the relative entropy method

We consider scalar nonviscous conservation laws with strictly convex flux in one spatial dimension, and we investigate the behavior of bounded L^2 perturbations of shock wave solutions to the Riemann problem using the relative entropy method. We show that up to a time-dependent translation of the shock, the L^2 norm of a perturbed solution relative to the shock wave is bounded above by the L^2 norm of the initial perturbation.Comment: 17 page

Electronic submission and the movement towards a paperless law office in a modern university

The Government’s target of 50% of all under 30 year olds studying at higher education institutions by 2010, coupled with the National Committee Inquiry into Higher Education’ (1997) concluding that further expansion of higher education could not be afforded under the existing funding arrangements, may have serious ramifications for higher education in the UK. Alongside this increase in numbers, students are increasingly seen as educational consumers with increased choice in a demand-led market which universities must recognise. To compete in this academic environment these institutions are having to be ever more consumer aware in the services they offer and are having to increase choice to attract customers from rival enterprises. Information technology is playing an increasing role in the learning experience as noted by institutional commentators such as the Higher Education Funding Council for England, the Joint Information Systems Committee, the Electronic Books ON-screen Interface group and Lord Dearing’s Report. Technology’s use is further evidenced through institutions’ employment of the internet, e-mail and web-based learning to harness the power of this medium. This paper focuses on the concept of commercialism in the university sector and how a movement to a paperless office may be one way in which a university could gain an early competitive advantage over its rivals. The paper takes a student perspective to demonstrate whether students would wish to move towards electronic methods of submission of assessed work and considers the current problems that are encountered in physical submission of documents. This is the first paper in an on-going research project investigating the benefits and viability of a paperless law office, and the results demonstrate both that the students desire more flexibility in submission of university work and that their acceptance may be the easy first step on the road to the paperless law school

The calculation of the wave drag of a family of low-drag axisymmetric nose shapes of fineness ratio 4.5 at zero incidence at supersonic speeds

The pressure drag coefficients of a particular family of convex logarithmic projectile nose shapes in which the nose angle is an important parameter have been calculated over a range of supersonic Mach numbers using a rapid approximate method due to Zienkiewicz.5 The optimum nose angle for minimum wave drag of these profiles for each Mach number has been obtained. It is shown that above N = 1.5„ approximately, the optimum shape is similar to the hypersonic optimum profile and has the sane or- less wave drag than this profile. However for values of M/F, where P is the fineness ratio, below 0.5, both the hypersonic and the logarithmic optimum profiles have a higher drag than the so-called cubic profile (Ref, 9)

Standardized Outcomes in Nephrology-Transplantation: A Global Initiative to Develop a Core Outcome Set for Trials in Kidney Transplantation.

BACKGROUND: Although advances in treatment have dramatically improved short-term graft survival and acute rejection in kidney transplant recipients, long-term graft outcomes have not substantially improved. Transplant recipients also have a considerably increased risk of cancer, cardiovascular disease, diabetes, and infection, which all contribute to appreciable morbidity and premature mortality. Many trials in kidney transplantation are short-term, frequently use unvalidated surrogate endpoints, outcomes of uncertain relevance to patients and clinicians, and do not consistently measure and report key outcomes like death, graft loss, graft function, and adverse effects of therapy. This diminishes the value of trials in supporting treatment decisions that require individual-level multiple tradeoffs between graft survival and the risk of side effects, adverse events, and mortality. The Standardized Outcomes in Nephrology-Transplantation initiative aims to develop a core outcome set for trials in kidney transplantation that is based on the shared priorities of all stakeholders. METHODS: This will include a systematic review to identify outcomes reported in randomized trials, a Delphi survey with an international multistakeholder panel (patients, caregivers, clinicians, researchers, policy makers, members from industry) to develop a consensus-based prioritized list of outcome domains and a consensus workshop to review and finalize the core outcome set for trials in kidney transplantation. CONCLUSIONS: Developing and implementing a core outcome set to be reported, at a minimum, in all kidney transplantation trials will improve the transparency, quality, and relevance of research; to enable kidney transplant recipients and their clinicians to make better-informed treatment decisions for improved patient outcomes

Observing the Sun with the Atacama Large Millimeter-submillimeter Array (ALMA): Fast-Scan Single-Dish Mapping

The Atacama Large Millimeter-submillimeter Array (ALMA) radio telescope has commenced science observations of the Sun starting in late 2016. Since the Sun is much larger than the field of view of individual ALMA dishes, the ALMA interferometer is unable to measure the background level of solar emission when observing the solar disk. The absolute temperature scale is a critical measurement for much of ALMA solar science, including the understanding of energy transfer through the solar atmosphere, the properties of prominences, and the study of shock heating in the chromosphere. In order to provide an absolute temperature scale, ALMA solar observing will take advantage of the remarkable fast-scanning capabilities of the ALMA 12m dishes to make single-dish maps of the full Sun. This article reports on the results of an extensive commissioning effort to optimize the mapping procedure, and it describes the nature of the resulting data. Amplitude calibration is discussed in detail: a path that utilizes the two loads in the ALMA calibration system as well as sky measurements is described and applied to commissioning data. Inspection of a large number of single-dish datasets shows significant variation in the resulting temperatures, and based on the temperature distributions we derive quiet-Sun values at disk center of 7300 K at lambda=3 mm and 5900 K at lambda=1.3 mm. These values have statistical uncertainties of order 100 K, but systematic uncertainties in the temperature scale that may be significantly larger. Example images are presented from two periods with very different levels of solar activity. At a resolution of order 25 arcsec, the 1.3 mm wavelength images show temperatures on the disk that vary over about a 2000 K range.Comment: Solar Physics, accepted: 24 pages, 13 figure