A Cost Comparison of Treatments of Moderate to Severe Psoriasis

This study of the efficacy and cost-effectiveness of moderate to severe psoriasis treatments compared phototherapy, oral systemic agents, and biologics from a managed health care systems perspective. A literature review was conducted to identify published studies reporting Psoriasis Area and Severity Index (PASI) percentage improvement from baseline (PASI%) for selected treatments. The researchers then calculated total annualized costs. For each treatment, annualized cost-effectiveness was calculated by dividing total annualized costs of treatment by PASI%. The costs necessary to achieve clinically meaningful outcomes (PASI50 and PASI75) were then calculated. Of 3886 articles examined, 16 studies met inclusion criteria. Oral systemic medications, UV therapy, and UV therapy combined with acitretin appear to be the most cost-effective therapies for moderate to severe psoriasis

Advancing understanding of executive function impairments and psychopathology: bridging the gap between clinical and cognitive approaches

Executive function (EF) is essential for successfully navigating nearly all of our daily activities. Of critical importance for clinical psychological science, EF impairments are associated with most forms of psychopathology. However, despite the proliferation of research on EF in clinical populations, with notable exceptions clinical and cognitive approaches to EF have remained largely independent, leading to failures to apply theoretical and methodological advances in one field to the other field and hindering progress. First, we review the current state of knowledge of EF impairments associated with psychopathology and limitations to the previous research in light of recent advances in understanding and measuring EF. Next, we offer concrete suggestions for improving EF assessment. Last, we suggest future directions, including integrating modern models of EF with state of the art, hierarchical models of dimensional psychopathology as well as translational implications of EF-informed research on clinical science

Central equatorial Pacific zonal currents. I: The Sverdrup balance, nonlinearity and tropical instability waves. Annual mean dynamics

Several recent observational studies of central Pacific equatorial current dynamics have suggested that, in the vertical integral between the surface and the thermocline, the linear equatorial Sverdrup balance holds. However, in a high vertical resolution ocean general circulation model, we find that nonlinearity is an order (1) element of the local and the vertically integrated balances on and near the equator at 140W. Although this OGCM has been used in many studies of the tropical Pacific, its equatorial zonal momentum equation balances have never been described in detail and compared with observations. We describe the annual mean balances here, identify the similarities and differences between the model balances and observational estimates of the balances, and discuss various reasons why the model and the observations may disagree in the respects that they are found to do so. The term balances vary strongly with latitude and depth; the system is nonlinear and three dimensional. There is little tendency for pairs of terms (e.g., the meridional and vertical advection terms) to balance locally or in the vertical integral. Every term in the zonal momentum equation plays a role somewhere in the analysis region discussed here. Thus the generality of point estimates of these balances is small. The Tropical Instability Wave zonal momentum flux divergence, although not an O (1) term in the balance, acts like a \u27negative viscosity\u27 over the upper 40 m on the equator; its tendency is to drive westward flow. If the ocean balances resemble those of the model dynamics, gaining detailed perspective on the zonal balances will require a major observational effort. Because there is strong subseasonal and interannual variability of the flows in the central equatorial Pacific, time-mean balances are not simple to estimate. Further, special attention will have to be given to resolving the shears in the upper 50 m, because it is over these depths that the model and observational results differ most strongly. We suggest that the widely used technique of extrapolating the near-surface currents based on their shears in the uppermost bins of the ADCP profiles deserves careful scrutiny; subsampling the model flow profiles in this fashion leads to important errors. Until the strong vertically sheared very near-surface current field is observed accurately it will not be possible to determine if the model results are correct, but we suggest that the existing observational results should not be regarded as definitive

Information Security as Strategic (In)effectivity

Security of information flow is commonly understood as preventing any information leakage, regardless of how grave or harmless consequences the leakage can have. In this work, we suggest that information security is not a goal in itself, but rather a means of preventing potential attackers from compromising the correct behavior of the system. To formalize this, we first show how two information flows can be compared by looking at the adversary's ability to harm the system. Then, we propose that the information flow in a system is effectively information-secure if it does not allow for more harm than its idealized variant based on the classical notion of noninterference

History-sensitive versus future-sensitive approaches to security in distributed systems

We consider the use of aspect-oriented techniques as a flexible way to deal with security policies in distributed systems. Recent work suggests to use aspects for analysing the future behaviour of programs and to make access control decisions based on this; this gives the flavour of dealing with information flow rather than mere access control. We show in this paper that it is beneficial to augment this approach with history-based components as is the traditional approach in reference monitor-based approaches to mandatory access control. Our developments are performed in an aspect-oriented coordination language aiming to describe the Bell-LaPadula policy as elegantly as possible. Furthermore, the resulting language has the capability of combining both history- and future-sensitive policies, providing even more flexibility and power.Comment: In Proceedings ICE 2010, arXiv:1010.530

The impact of educational interventions on clinicians' knowledge of radiation protection: An integrative review

The aim of this review is to explore the impact of educational interventions on clinicians' knowledge of radiation protection. Following a comprehensive search of MEDLINE and EMBASE from 2000 to 2018, 1795 studies were identified, eight of which met the criteria for this review. All eight studies utilised pretest-posttest designs and involved the education of medical students or doctors. All studies reported an increase in participants' knowledge of radiation protection, five of which were statistically significant. In two studies, over half of participants stated that education received would impact on their future imaging requesting practice. Whilst a range of educational interventions have been shown to improve knowledge of radiation protection, there was wide variation in the study settings and type of educational programmes delivered. No studies assessed long-term knowledge retention or the impact on clinical practice. Therefore, robust research is needed to accurately measure the impact of educational programmes on knowledge of radiation protection in the UK and the implications this may have on referral practices. This review revealed that educational interventions are effective in increasing participants' knowledge levels of radiation protection. It is necessary to assess and ensure that this improvement in knowledge actually translates into an impact on referral practice/behaviour. The ideal outcome being that fewer unnecessary examinations are requested and our patients are protected from a needless increased radiation burden. [Abstract copyright: Copyright © 2020 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

Serving GODAE Data and Products to the Ocean Community

The Global Ocean Data Assimilation Experiment (GODAE [http:// www.godae.org]) has spanned a decade of rapid technological development. The ever-increasing volume and diversity of oceanographic data produced by in situ instruments, remote-sensing platforms, and computer simulations have driven the development of a number of innovative technologies that are essential for connecting scientists with the data that they need. This paper gives an overview of the technologies that have been developed and applied in the course of GODAE, which now provide users of oceanographic data with the capability to discover, evaluate, visualize, download, and analyze data from all over the world. The key to this capability is the ability to reduce the inherent complexity of oceanographic data by providing a consistent, harmonized view of the various data products. The challenges of data serving have been addressed over the last 10 years through the cooperative skills and energies of many individuals