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Dynamic charging system will enable moving electrical vehicles (EVs) to charge their batteries through magnetic induction by charging pads (CPs) placed on a portion of the roadbed. To realize such a system, the EVs need to communicate with the various parts of the system that include a bank, a charging service provider (CSP), road side units (RSUs), and CPs. In this paper, we propose a secure and privacy-preserving physical-layer-assisted scheme for dynamic charging systems to secure payment and authentication and also preserve the drivers’ location privacy. We develop an efficient hierarchical authentication scheme that considers the scalability nature of the system. Efficient cryptosystems are used to authenticate the EVs to the bank, CSP, and RSUs, but our evaluations indicate that the contact time of fast moving EVs and the CPs is too short to exchange multiple messages and execute time consuming operations. Therefore, we develop an efficient physical-layer-based authorization scheme that utilizes autocorrelation demodulation and hypothesis testing to enable the CPs to identify and charge the authorized EVs. Through extensive analysis, simulation, and practical experiments, we demonstrate that the proposed scheme is secure against the considered attacks and can achieve fast authentication and high authorization rate. Moreover, the proposed scheme can achieve full anonymity where no entity or even colluding entities can know the drivers’ locations.

Periparturient dairy cows experience impaired immune function, exhibited as a transient decrease in neutrophil function. This decrease in immune competence is associated with an increase in susceptibility to bacterial infections, including mastitis and metritis. Bovine granulocyte colony stimulating factor (bG-CSF) is an endogenous protein that enhances neutrophil bactericidal functions and increases the production of neutrophils from bone marrow precursors. Administration of pegbovigrastim (recombinant bG-CSF covalently bound to polyethylene glycol) around the time of calving has been shown to reduce the incidence of new clinical mastitis cases in a natural disease model system. To further explore the application of pegbovigrastim under herd management systems typical of those found in the US dairy industry, we conducted a multicenter field study to evaluate the efficacy and clinical safety of pegbovigrastim administered to multiparous cows and heifers approximately 7 d before calving and within 24 h of calving. Responses of treated cows were compared with those of animals treated with sterile saline. Animals treated with pegbovigrastim exhibited 4- to 5-fold increases in circulating neutrophil numbers within 24 h of treatment initiation, and this increase persisted at least a week beyond the second dose. Pegbovigrastim-treated animals exhibited a 35% decrease in the incidence of clinical mastitis relative to the controls during the first 30 d of lactation. Animals treated with pegbovigrastim also exhibited a 52% reduction in failure to return to visual estrus within 80 d of calving. We observed no differences in somatic cell count or milk composition between treated and control animals. We also found no differences in the duration of pregnancy or proportion of viable calves in treated cows relative to control animals. These results indicate that administration of pegbovigrastim provides a well-tolerated, novel approach to overcoming periparturient immune suppression, resulting in reduced susceptibility to clinical mastitis during early lactation.

In contrast to the recent proliferation of studies incorporating ordinal methods to generate health state values from adults, to date relatively few studies have utilised ordinal methods to generate health state values from adolescents. This paper reports upon a study to apply profile case best worst scaling methods to derive a new adolescent specific scoring algorithm for the Child Health Utility 9D (CHU9D), a generic preference based instrument that has been specifically designed for the estimation of quality adjusted life years for the economic evaluation of health care treatment and preventive programs targeted at young people. A survey was developed for administration in an on-line format in which consenting community based Australian adolescents aged 11-17 years (N = 1982) indicated the best and worst features of a series of 10 health states derived from the CHU9D descriptive system. The data were analyzed using latent class conditional logit models to estimate values (part worth utilities) for each level of the nine attributes relating to the CHU9D. A marginal utility matrix was then estimated to generate an adolescent-specific scoring algorithm on the full health = 1 and dead = 0 scale required for the calculation of QALYs. It was evident that different decision processes were being used in the best and worst choices. Whilst respondents appeared readily able to choose 'best' attribute levels for the CHU9D health states, a large amount of random variability and indeed different decision rules were evident for the choice of 'worst' attribute levels, to the extent that the best and worst data should not be pooled from the statistical perspective. The optimal adolescent-specific scoring algorithm was therefore derived using data obtained from the best choices only. The study provides important insights into the use of profile case best worst scaling methods to generate health state values with adolescent populations. Refereed/Peer-reviewed

Objectives: To examine the performance of two recently developed preference-based instruments-the Child Health Utility 9D (CHU9D) and the EuroQol five-dimensional questionnaire Youth version (EQ-5D-Y)-in assessing the health-related quality of life (HRQOL) of Australian adolescents. Methods: An online survey including the CHU9D and the EQ-5D-Y, self-reported health status, and a series of sociodemographic questions was developed for administration to a community-based sample of adolescents (aged 11-17 years). Individual responses to both instruments were translated into utilities using scoring algorithms derived from the Australian adult general population. Results: A total of 2020 adolescents completed the online survey. The mean ± SD utilities of the CHU9D and the EQ-5D-Y were very similar (0.82 ± 0.13 and 0.83 ± 0.19, respectively), and the intraclass correlation coefficient (0.80) suggested good levels of agreement. Both instruments were able to discriminate according to varying levels of self-reported health status (P < 0.001). Although exhibiting good levels of agreement overall, some wide divergences were apparent at an individual level. Conclusions: The study results are encouraging and illustrate the potential for both the CHU9D and the EQ-5D-Y to be more widely used for measuring and valuing the HRQOL of adolescent populations in Australia and internationally. Generating adolescent-specific scoring algorithms pertaining to each instrument and an empirical comparison of the resulting utilities is a natural next step. More evidence is required from the application of the CHU9D and the EQ-5D-Y in specific patient groups in adolescent health settings to inform the choice of instrument for measuring and valuing the HRQOL for the economic evaluation of adolescent health care treatments and services Refereed/Peer-reviewed

This report provides a detailed set of historical stressor data for 60 watersheds comprising the Laurentian Great Lakes basin. Archival records were transcribed from public records to create quantitative data on human activities: population, mining, deforestation, and agriculture. Yearly records of stressors are provided from 1780 through 2010. These data may be used to track historical impacts on Great Lakes coastal and open water conditions. They may further be used to examine corresponding effects on response variables such as biological communities quantified during monitoring and palaeoecological programmes. Open Practices This article has earned an Open Data badge for making publicly available the digitally‐shareable data necessary to reproduce the reported results. The data is available at https://doi.org/10.1594/PANGAEA.885879. Learn more about the Open Practices badges from the Center for Open Science: https://osf.io/tvyxz/wiki.

The main objective of this study was to compare and contrast adolescent and adult values for the Child Health Utility-9D (CHU9D), a new generic preference-based measure of health-related quality of life designed for application in the economic evaluation of treatment and preventive programmes for children and adolescents. Previous studies have indicated that there may be systematic differences in adolescent and adult values for identical health states. An online survey including a series of best-worst scaling discrete choice experiment questions for health states defined by the CHU9D was administered to two general population samples comprising adults and adolescents, respectively. The results highlight potentially important age-related differences in the values attached to CHU9D dimensions. Adults, in general, placed less weight upon impairments in mental health (worried, sad, annoyed) and more weight upon moderate to severe levels of pain relative to adolescents. The source of values (adults or adolescents) has important implications for economic evaluation and may impact significantly upon healthcare policy.

This letter presents an experimental demonstration of software-defined-radio-based wireless tomography using computer-hosted radio devices called Universal Software Radio Peripheral (USRP). This experimental brief follows our vision and previous theoretical study of wireless tomography that combines wireless communication and RF tomography to provide a novel approach to remote sensing. Automatic data acquisition is performed inside an RF anechoic chamber. Semidefinite relaxation is used for phase retrieval, and the Born iterative method is utilized for imaging the target. Experimental results are presented, validating our vision of wireless tomography.

As noted in Chapter 1, the BWS object case (henceforth, Case 1) deals with a list of objects, or things, that one wants to measure. Generally speaking, Case 1 can be used to measure things typically measured with rating scales and/or with variants of the method of paired comparisons (Thurstone, 1928 David, 1988). The types of things that Case 1 can be used to measure include the following indicative, but by no means exhaustive, list: • batteries of "agree/disagree" statements • traits or characteristics that apply to brands, people, even animals, etc. • pictures or graphical images, such as landscapes • politically relevant issues • electoral candidates • food products, wines, drinks, etc., tasted blind/non-blind • potential job candidates • academic journals and • product features. One first develops a list for measurement purposes then the process of using Case 1 to measure the things on the list is straightforward, which is part of its appeal. We are agnostic about the various ways researchers using Case 1 can compile lists of things to be measured. Therefore, we assume for the purpose of this discussion that a list of things is generated exogenous to the Case 1 process. It is the researcher's job to validate and justify the list and the things contained in it. However, we note that Case 1 can be applied equally to poorly justified and well-justified lists. Hence, poorly constituted and ill-justified lists of things to be measured have nothing whatsoever to do with the validity of BWS theory and measurement methods. Instead, the onus of doing this properly falls fully on researchers.

Objectives This study aimed to determine quantitatively the attributes of such screening tests that couples placed most value on. Methods A stated preference discrete choice experiment was conducted among a sample of pregnant women and their male partners. One four-level attribute (cost) and three two-level attributes (detection rate, gestation and time to wait for results) were used to generate eight hypothetical pairs of tests. Results A total of 103 participants fully completed the questionnaire (63 women, 40 men). Overall, the sample was most concerned with test cost. However, latent class analysis showed three groups of participants whose concern for attributes differed, with cost, detection rate and delay in receiving results being the most important to each. Willingness to pay calculations showed that participants who were most concerned with detection rate were prepared to pay more than four times the amount than those most cost-sensitive would pay for the ‘best test’ option as compared with the ‘worst test’. Conclusions Overall, couples were sensitive to the price of the screening test, but explicit subgroups are also shown that would pay large amounts for improvements in other attributes, particularly detection rates. This could provide important information to policymakers and practitioners in antenatal care, specifically in relation to the trade-offs made when couples decide about antenatal screening tests. © 2013 John Wiley & Sons, Ltd.

Singapore is in the midst of several healthcare reforms in efforts to finance and deliver health services for a rapidly aging population. The primary focus of these reforms is to make healthcare services, including those at the end of life (EOL), affordable. Given the increasingly high health care costs at the EOL, policy makers need to consider how best to allocate resources. One strategy is to allocate resources based on the preferences of sub-populations most likely to be affected. This paper thus aims to quantify preferences for EOL care both among community dwelling older adults (CDOAs) and among patients with a life-limiting illness. A discrete choice experiment was administered to CDOAs and advanced cancer patients in Singapore and willingness to pay (WTP) for specific EOL improvements was estimated. We find that patients have a higher WTP for nearly all EOL attributes compared with CDOAs. We also show that, for both groups, moderate life extension is not the most important consideration; WTP for one additional life year is lower than common thresholds for cost-effectiveness. Irrespective of whose preference are considered, the results highlight the importance of pain management and supporting home deaths at the EOL, perhaps at the expense of public funding for costly but only marginally effective treatments. (C) 2015 Elsevier Ireland Ltd. All rights reserved. Refereed/Peer-reviewed

This article appeared in a journal published by Elsevier Ltd. Under Elsevier's copyright, mandated authors are not permitted to make work available in an institutional repository., The Child Health Utility-9D (CHU-9D) and the Assessment of Quality of Life-6D (AQOL-6D) presently represent the only two generic preference-based instruments developed for application with young people with both adult- and adolescent-specific scoring algorithms. The main objective of this study was to compare and contrast the application of adult and adolescent scoring algorithms for the CHU-9D and AQOL-6D in valuing the health of a community-based sample of adolescents., Australian National Health & Medical Research Council

Purpose The benefits of health and social care are not confined to patient health alone and therefore broader measures of wellbeing may be useful for economic evaluation. This paper reports the development of a simple measure of capability wellbeing for adults (ICECAP-A). Methods In-depth, informant-led, interviews to identify the attributes of capability wellbeing were conducted with 36 adults in the UK. Eighteen semi-structured, repeat interviews were carried out to develop a capability-based descriptive system for the measure. Informants were purposively selected to ensure variation in socio-economic status, age, sex, ethnicity and health. Data analysis was carried out inductively and iteratively alongside interviews, and findings were used to shape the questions in later interviews. Results Five over-arching attributes of capability wellbeing were identified for the measure: "stability", "attachment", "achievement", "autonomy" and "enjoyment". One item, with four response categories, was developed for each attribute for the ICECAP-A descriptive system. Conclusions The ICECAP-A capability measure represents a departure from traditional health economics outcome measures, by treating health status as an influence over broader attributes of capability wellbeing. Further work is required to value and validate the attributes and test the sensitivity of the ICECAP-A to healthcare interventions. © Springer Science+Business Media B.V. 2011.

QALYs are increasingly being utilized as a health outcome measure to calculate the benefits of new treatments and interventions within cost-utility analyses for economic evaluation. Cost-utility analyses of adolescent-specific treatment programmes are scant in comparison with those reported upon for adults and tend to incorporate the views of clinicians or adults as the main source of preferences. However, it is not clear that the views of adults are in accordance with those of adolescents on this issue. Hence, the treatments and interventions most highly valued by adults may not correspond with those most highly valued by adolescents. Ordinal methods for health state valuation may be more easily understood and interpreted by young adolescent samples than conventional approaches. The availability of young adolescent-specific health state values for the estimation of QALYs will provide new insights into the types of treatment programmes and health services that are most highly valued by young adolescents.The first objective of this study was to assess the feasibility of applying best-worst scaling (BWS) discrete-choice experiment (DCE) methods in a young adolescent sample to value health states defined by the Child Health Utility 9D (CHU9D) instrument, a new generic preference-based measure of health-related quality of life developed specifically for application in young people. The second objective was to compare BWS DCE questions (where respondents are asked to indicate the best and worst attribute for each of a number of health states, presented one at a time) with conventional time trade-off (TTO) and standard gamble (SG) questions in terms of ease of understanding and completeness.A feasibility study sample of consenting young adolescent school children (n16) aged 1113 years participated in a face-to-face interview in which they were asked to indicate the best and worst attribute levels from a series of health states defined by the CHU9D, presented one at a time. Participants were also randomly allocated to receive additional conventional TTO or SG questions and prompted to indicate how difficult they found them to complete.The results indicate that participants were able to readily choose 'best' and 'worst' dimension levels in each of the CHU9D health states presented to them and provide justification for their choices. Furthermore, when presented with TTO or SG questions and prompted to make comparisons, participants found the BWS DCE task easier to understand and complete.The results of this feasibility study suggest that BWS DCE methods are potentially more readily understood and interpretable by vulnerable populations (e.g. young adolescents). These findings lend support to the potential application of BWS DCE methods to undertake large-scale health state valuation studies directly with young adolescent population samples. © 2011 Adis Data Information BV. All rights reserved.

We characterize a class of probabilistic choice models where the choice probabilities depend on two scales, one with a value for each available option and the other with a value for the set of available options. Then, we develop similar results for a task in which a person is presented with a profile of attributes, each at a pre-specified level, and chooses the best or the best and the worst of those attribute-levels. The latter design is an important variant on previous designs using best–worst choice to elicit preference information, and there is various evidence that it yields reliable interpretable data. Nonetheless, the data from a single such task cannot yield separate measures of the “importance” of an attribute and the “utility” of an attribute-level. We discuss various empirical designs, involving more than one task of the above general type, that may allow such separation of importance and utility.

This paper reports the first application of the capabilities approach to the development and valuation of an instrument for use in the economic evaluation of health and social care interventions. The ICECAP index of capability for older people focuses on quality of life rather than health or other influences on quality of life, and is intended to be used in decision making across health and social care in the UK. The measure draws on previous qualitative work in which five conceptual attributes were developed: attachment, security, role, enjoyment and control. This paper details the innovative use within health economics of further iterative qualitative work in the UK among 19 informants to refine lay terminology for each of the attributes and levels of attributes used in the eventual index. For the first time within quality of life measurement for economic evaluation, a best-worst scaling exercise has been used to estimate general population values (albeit for the population of those aged 65+ years) for the levels of attributes, with values anchored at one for full capability and zero for no capability. Death was assumed to be a state in which there is no capability. The values obtained indicate that attachment is the attribute with greatest impact but all attributes contribute to the total estimation of capability. Values that were estimated are feasible for use in practical applications of the index to measure the impact of health and social care interventions. © 2008 Elsevier Ltd. All rights reserved.

Discrete choice experiments - selecting the best and/or worst from a set of options—are increasingly used to provide more efficient and valid measurement of attitudes or preferences than conventional methods such as Likert scales. Discrete choice data have traditionally been analyzed with random utility models that have good measurement properties but provide limited insight into cognitive processes. We extend a well-established cognitive model, which has successfully explained both choices and response times for simple decision tasks, to complex, multi-attribute discrete choice data. The fits, and parameters, of the extended model for two sets of choice data (involving patient preferences for dermatology appointments, and consumer attitudes toward mobile phones) agree with those of standard choice models. The extended model also accounts for choice and response time data in a perceptual judgment task designed in a manner analogous to best–worst discrete choice experiments. We conclude that several research fields might benefit from discrete choice experiments, and that the particular accumulator-based models of decision making used in response time research can also provide process-level instantiations for random utility models. Refereed/Peer-reviewed

Developing indicators of ecosystem condition is a priority in the Great Lakes, but little is known about appropriate spatial scales to characterize disturbance or response for most indicators. We surveyed birds, fish, amphibians, aquatic macroinvertebrates, wetland vegetation, and diatoms at 276 coastal wetland locations throughout the U.S. Great Lakes coastal region during 2002-2004. We assessed the responsiveness of 66 candidate indicators to human disturbance (agriculture, urban devel- opment, and point source contaminants) characterized at multiple spatial scales (100, 500, 1,000, and 5,000 m buffers and whole watersheds) using classification and regression tree analysis (CART). Non- stressor covariables (lake, ecosection, watershed, and wetland area) accounted for a greater proportion of variance than disturbance variables. Row-crop agriculture and urban development, especially at

Recent works on the universality of Empirical Spectral Density (E.S.D) of Random Matrices have provided a framework to study the asymptotic behavior of random network data. In this paper, the behavior of a wireless campus network with low received base-station transmit power is investigated. Mobile users are organized into 10 clusters of 25 mobile users each and wireless IMT-Advanced Macro channel standard is used for the channel model. The network is simulated using Optimized Network Engineering Tools (OPNET) Modeler 17.5 platform and packet drop data is collected to form the entries of a non-hermittian random matrix. Data is collected for a duration of 400s during downlink transmission and analyzed for three scenarios namely: static mobile users with shadowing vs no-shadowing, and network interference from a stealth jamming source. The result shows that for static nodes with shadowing and no-shadowing, the spectral density of packet drop covariance matrix follows Marcenko and Pastur (MP) distribution and the Ring law accurately, but deviates considerably from MP distribution when the network is jammed using a pulsed jamming source. Outliers are also observed in the Ring-Law together with a shrinkage of eigenvalue distribution towards the center of the inner-circle of the Ring-Law when jammers are introduced into the network.

BACKGROUND: General practitioners with special interests (GPSIs) are increasingly being used to provide dermatology services in the U.K. Little is known about U.K. dermatology patient attitudes to ...

A little more than three decades ago, there was little doubt that baroreceptors were crucial for both the short-term and long-term control of mean arterial blood pressure (MAP). Then, in 1970 it was reported that baroreceptors reset completely within 48 hours in hypertensive rats. Three years later, it was reported that MAP was near normal in dogs with both aortic and carotid baroreceptors denervated based on continuous measurements, thus discrediting numerous reports of denervation-induced hypertension. These two observations quickly led to a reevaluation of the importance of baroreceptor input in long-term control mechanisms. Finally, a consensus emerged that baroreceptor input could not be involved in long-term control of MAP, and this conclusion can be found in all modern textbooks of physiology used in the instruction of medical students. However, recent experimental observations have challenged the conclusion that baroreceptor input plays no role in the long-term control of MAP. In this article, the principal arguments against baroreceptor involvement in long-term control of MAP are summarized, and the new findings that suggest that a reappraisal of our current concept is required are reviewed.

Objectives:This work has investigated under what conditions cost-effectiveness data from a cluster randomized trial (CRT) are suitable for analysis using a cluster-adjusted nonparametric bootstrap. The bootstrap's main advantages are in dealing with skewed data and its ability to take correlations between costs and effects into account. However, there are known theoretical problems with a commonly used cluster bootstrap procedure, and the practical implications of these require investigation.Methods:Simulations were used to estimate the coverage of confidence intervals around incremental cost-effectiveness ratios from CRTs using two bootstrap methods.Results:The bootstrap gave excessively narrow confidence intervals, but there was evidence to suggest that, when the number of clusters per treatment arm exceeded 24, it might give acceptable results. The method that resampled individuals as well as clusters did not perform well when cost and effectiveness data were correlated.Conclusions:If economic data from such trials are to be analyzed adequately, then there is a need for further investigations of more complex bootstrap procedures. Similarly, further research is required on methods such as the net benefit approach.

Understanding the relationship between human disturbance and ecological response is essential to the process of indicator development. For large-scale observational studies, sites should be selected across gradients of anthropogenic stress, but such gradients are often unknown for a population of sites prior to site selection. Stress data available from public sources can be used in a geographic information system (GIS) to partially characterize environmental conditions for large geographic areas without visiting the sites. We divided the U.S. Great Lakes coastal region into 762 units consisting of a shoreline reach and drainage-shed and then summarized over 200 environmental variables in seven categories for the units using a GIS. Redundancy within the categories of environmental variables was reduced using principal components analysis. Environmental strata were generated from cluster analysis using principal component scores as input. To protect against site selection bias, sites were selected in random order from clusters. The site selection process allowed us to exclude sites that were inaccessible and was shown to successfully distribute sites across the range of environmental variation in our GIS data. This design has broad applicability when the goal is to develop ecological indicators using observational data from large-scale surveys.

Objective—To compare concentrations of danofloxacin, enrofloxacin, and ciprofloxacin in plasma and respiratory tissues of calves treated after challenge withMannheimia haemolytica.Animals—75 calves.Procedure—24 hours after challenge withM haemolytica, 72 calves with clinical signs of respiratory tract disease were randomly assigned to 1 of 12 equal treatment groups. Three nonchallenged, nontreated calves formed a control group. Challenged calves were treated with danofloxacin (6 and 8 mg/kg, SC) and enrofloxacin (8 mg/kg, SC) once. At 1, 2, 6, and 12 hours after treatment, 6 calves from each treatment group were euthanatized. Antimicrobial drug concentrations were assayed in various specimens. Peak plasma concentration (Cmax)-to-minimum inhibitory concentration (MIC; Cmax-to-MIC) ratios and the area under the concentration versus time curve over a 12-hour period-to-MIC ratios (AUC12h-to-MIC) were calculated.Results—Danofloxacin and enrofloxacin had MICs of 0.03 µg/mL for theM haemolyticachallenge isolate. Danofloxacin administered at doses of 6 and 8 mg/kg resulted in numerically higher geometric mean concentrations of danofloxacin in plasma and all respiratory tissues than geometric mean concentrations of enrofloxacin after treatment with enrofloxacin. Geometric mean concentrations of enrofloxacin were numerically higher than geometric mean concentrations of ciprofloxacin metabolite in plasma and almost all respiratory tissues. Danofloxacin and enrofloxacin achieved Cmax-to-MIC ratios > 10 and AUC12h-to-MIC ratios > 125 hours.Conclusions and Clinical Relevance— When used to treat pneumonic pasteurellosis in calves, danofloxacin and enrofloxacin can be expected to deliver concentration-dependent bactericidal activity againstM haemolytica, the bacteria most commonly associated with bovine respiratory tract disease. (Am J Vet Res2005;66:342–349)

The Los Alamos Neutron Science Center (LANSCE) operates two spallation neutron sources dedicated to research in materials science, condensed-matter physics, and fundamental and applied nuclear physics. Prior to 1995, all thermal neutron radiography at Los Alamos was done on a beam port attached to the Omega West reactor, a small 8MW research reactor used primarily for radioisotope production and prompt and delayed neutron activation analysis. After the closure of this facility, two largely independent radiography development efforts were begun at LANSCE using moderated cold and thermal neutrons from the Target-1 source and high-energy neutrons from the Target-4 source. Investigations with cold and thermal neutrons employed a neutron converter and film, a scintillation screen and CCD camera system, and a new high-resolution amorphous silicon (a-Si) flat-panel detector system. Recent work with high-energy neutrons (En > 1 MeV) has involved storage-phosphor image plates. Some comparison high-energy images were obtained with both image plates and the a-Si panel and showed equivalent image quality for approximately equal exposure times.

This article is focused on how venture-backed companies are using offshoring during early-stage growth phases and the impact this has on venture capital financing and start-up operations. The work represented in this study is unique in that virtually all existing research and cases describe practices for mature companies and a significant knowledge gap exists for how start-ups take advantage of offshore resources.

The current consensus is that arterial baroreceptors are vitally important in the short term (seconds to minutes) control of mean arterial pressure (MAP) but are unimportant in determining the long-term level of MAP. The latter statement is based primarily on two observations: first, that baroreceptors rapidly reset to the prevailing level of MAP and second, that total baroreceptor denervation has no lasting effect on the average daily MAP, although the variability of MAP is increased dramatically. However, recent studies in intact experimental animals have produced results that suggest baroreceptor resetting may not be as rapid or complete as previously thought. Furthermore, reconsideration of the responses to baroreceptor denervation suggest that the condition may accurately represent responses to short-term baroreceptor unloading but not long-term unloading. Results obtained using a new model of chronic baroreceptor unloading indicate that the condition results in a sustained increase in MAP. These results strongly suggest that the role of baroreceptors in the long term control of MAP needs to be revisited.

When going 'beyond the patient', to measure QALYs for unpaid carers, a number of additional methodological considerations and value judgements must be made. While there is no theoretical reason to restrict the measurement of QALYs to patients, decisions have to be made about which carers to consider, what instruments to use and how to aggregate and present QALYs for carers and patients. Current, albeit limited, practice in measuring QALY gains to carers in economic evaluation varies, suggesting that there may be inconsistency in judgements about whether interventions are deemed cost effective.While conventional health-related quality-of-life tools can, in theory, be used to estimate QALYs, there are both theoretical and empirical concerns over the suitability of their use with carers. Measures that take a broader view of health or well-being may be more appropriate. Incorporating QALYs of carers in economic evaluations may have important distributional consequences and, therefore, greater normative discussion over the appropriateness of incorporating these impacts is required. In the longer term, more flexible forms of cost-per-QALY analysis may be required to take account of the broader impacts on carers and the weight these impacts should receive in decision making. © 2011 Adis Data Information BV. All rights reserved.

OBJECTIVE To evaluate effects of various doses of polyethylene glycol (PEG)–conjugated bovine granulocyte colony-stimulating factor (bG-CSF) on the incidence of naturally occurring clinical mastitis in periparturient dairy cattle. ANIMALS 211 periparturient Holstein cows and heifers. PROCEDURES Approximately 7 days before the anticipated date of parturition (day of parturition = day 0), healthy cattle received SC injections of sterile saline (0.9% NaCl) solution (control treatment) or PEG–bG-CSF at 5, 10, or 20 μg/kg. Cattle were commingled and housed in a pen with dirt flooring, which was kept wet to maximize the incidence of naturally occurring clinical mastitis. Within 24 hours after parturition, each animal again received the assigned treatment. Mammary glands and milk were visually scored for abnormalities twice daily for 28 days after parturition. Milk samples were aseptically collected from mammary glands with an abnormal appearance or abnormal milk and submitted for microbial culture. Daily milk production was recorded, and milk composition was assessed on days 3, 5, 7, and 10. RESULTS Cattle treated with PEG–bG-CSF at 10 and 20 μg/kg had significantly fewer cases of clinical mastitis (9/54 and 5/53, respectively), compared with control cattle (18/53). Administration of PEG –bG-CSF did not significantly affect daily milk production or milk composition. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that PEG–bG-CSF was effective for reducing the incidence of naturally occurring clinical mastitis in periparturient dairy cattle. Further investigations of the use of PEG–bG–CSF as a potential preventative intervention should be conducted.

15.1 Introduction The purpose of this chapter is to show how to combine an alternative-specific DCE design with a BW choice task. Secondary aims are (1) to show how to add informative choice sets to DCE tasks to gain insights and information about individual differences and (2) to show how to analyze and report choice totals from this type of DCE task to gain additional insights. Most private sector organizations need to understand pricing and the likely impacts of differences in and/or changes to prices of their own product/service prices and/or the likely impacts of competitor price changes. Similarly, many public sector organizations need to understand and anticipate the consequences of various pricing policies, such as offering incentives to uptake solar appliances, tolls on bridges and highways, usage fees for parks, and so on. As a result, there are numerous potential choice model pricing applications in both sectors. This chapter illustrates one such application, namely modeling the choices of a relevant sample of individuals faced with different airlines and fares for a holiday trip. I study the flight choices of a sample of 214 individuals randomly sampled from the Pureprofile online panel in Australia who (1) reside in the Sydney metropolitan area, (2) have flown to northern New South Wales (NSW) for a weekend or longer holiday in the past three years or (3) anticipate doing so in the next three years. At the time of the study there were five potential airline choices for such flights within NSW: Jetstar, Qantas, Rex, Tiger and Virgin. Fares for such flights ranged approximately between A$89 and A$239 at various times during the three years prior to the study. Differences between flights within NSW are not large, as most flights are no more than an hour. Airlines flying within NSW try to claim significant differences in services, and, to the extent that such differences exist, I would expect to see them manifest in differential choices of particular airlines. Thus, one can model and quantify preferences for airlines and fares by designing an alternative-specific discrete choice experiment (ASDCE). Typically, an ASDCE is appropriate when individuals in the market of interest will choose specific offers, such as brands, transport modes, holiday destinations, etc.

OBJECTIVES: In contrast to the proliferation of studies incorporating health state values from adults of all ages, relatively few studies have reported upon the application of the time trade off (TTO) approach to generate health state values from populations of younger adults. This study sought to employ a conventional TTO approach to obtain values for a selection of Child Health Utility 9D (CHU9D) health states from a sample of young adults aged 18-29 years and to compare with the values generated from application of the original UK adult standard gamble scoring algorithm and the Australian adolescent scoring algorithm. \ud \ud METHODS: A convenience sample of Flinders University undergraduate students aged 18-29 years were invited to participate in an interviewer administered conventional TTO task to value a series of five CHU9D health impairment states using the widely used variant developed by the York EQ-5D team. \ud \ud RESULTS: A total of 152 students within the target age range were approached to participate in the study of whom n = 38 consented to participate, giving an overall participation rate of 25 %. With the exception of one health state, the mean TTO values were consistently lower than those generated from application of the original scoring algorithm for the CHU9D elicited with adults of all ages. A significant proportion of participants (n = 17, 45 %) considered the most severe CHU9D (PITS) state to be worse than death. \ud \ud CONCLUSIONS: This study adds to a growing body of evidence indicating that the values attached to identical health states are typically lower for younger people in comparison with adults of all ages and dependent upon the elicitation method utilised. The values obtained are applicable for re-scaling raw CHU9D health state values obtained from younger adolescent samples using profile case best-worst scaling.

We developed a new model to examine the role of arterial baroreceptors in the long-term control of mean arterial pressure (MAP) in dogs. Baroreceptors in the aortic arch and one carotid sinus were denervated, and catheters were implanted in the descending aorta and common carotid arteries. MAP and carotid sinus pressure (CSP) averaged 104 ± 2 and 102 ± 2 mmHg (means ± 1 SE), respectively, during a 5-day control period. Baroreceptor unloading was induced by ligation of the common carotid artery proximal to the innervated sinus ( n = 6 dogs). MAP and CSP averaged 127 ± 7 and 100 ± 3 mmHg, respectively, during the 7-day period of baroreceptor unloading. MAP was significantly elevated ( P < 0.01) compared to control, but CSP was unchanged. Heart rate and plasma renin activity increased significantly in response to baroreceptor unloading. Removal of the ligature to restore normal flow through the carotid resulted in normalization of all variables. Ligation of the carotid below a denervated sinus ( n = 4) caused a significant decrease in CSP but no systemic hypertension. These results indicate that chronic unloading of carotid baroreceptors can produce neurogenic hypertension and provide strong evidence that arterial baroreceptors are involved in the long-term control of blood pressure.

Funding: SPIRIT is funded as part of the Centre for Informing Policy in Health with Evidence from Research (CIPHER), an Australian National Health and Medical Research Council Centre for Research Excellence (APP1001436) and administered by the University of Western Sydney. The Sax Institute receives a grant from the NSW Ministry of Health. Introduction: Governments in different countries have committed to better use of evidence from research in policy. Although many programmes are directed at assisting agencies to better use research, there have been few tests of the effectiveness of such programmes. This paper describes the protocol for SPIRIT (Supporting Policy In health with Research: an Intervention Trial), a trial designed to test the effectiveness of a multifaceted programme to build organisational capacity for the use of research evidence in policy and programme development. The primary aim is to determine whether SPIRIT results in an increase in the extent to which research and research expertise is sought, appraised, generated and used in the development of specific policy products produced by health policy agencies. Methods and analysis: A stepped wedge cluster randomised trial involving six health policy agencies located in Sydney, Australia. Policy agencies are the unit of randomisation and intervention. Agencies were randomly allocated to one of three start dates (steps) to receive the 1-year intervention programme, underpinned by an action framework. The SPIRIT intervention is tailored to suit the interests and needs of each agency and includes audit, feedback and goal setting; a leadership programme; staff training; the opportunity to test systems to assist in the use of research in policies; and exchange with researchers. Outcome measures will be collected at each agency every 6 months for 30 months (starting at the beginning of step 1). Ethics and dissemination: Ethics approval was granted by the University of Western Sydney Human Research and Ethics Committee HREC Approval H8855. The findings of this study will be disseminated broadly through peer-reviewed publications and presentations at conferences and used to inform future strategies. Publisher PDF

Researchers have typically used a flexible model in an attempt to accurately simulate peripheral milling forces. The approach generally described in the literature divides the model into manageable pieces by modeling a cutter as several disk-like elements in its axial direction and by dividing the turning cutter into several angular increments. When the forces calculated at each differential element are integrated, it is important to consider the angle (δ λ ) measured back as the flute engagement wraps up the helix. Therefore, flute engagement is very influential in determining the milling force profile and magnitude, and thus the effects of engaged flute length in the milling operation is of interest. In this paper, the concept of flute engagement is presented, and the equations calculating the engaged flute length (FL e ) are derived. In addition, a method for determining the number of engaged flutes caused by the radial and axial depths of cut is presented. It is felt that the results of this research may provide the basis for a machining force model.

We studied the effect of chronically denervating aortic baroreceptors (ABR; n = 6) or carotid baroreceptors (CBR; n= 7) on mean arterial pressure (MAP) and heart rate (HR) responses to hemorrhage in the dog. Neither denervation had a significant effect on basal MAP, the variability (standard deviation) of MAP, or resting HR. However, the breakpoint of MAP (defined as the volume of blood removed when MAP fell more than 10% below control and declined monotonically thereafter) was significantly reduced in dogs with only ABR functional (12.4 ± 1.4 ml/kg) compared with the volume in the intact condition (18.9 ± 1.8 ml/kg). In contrast, there was no difference in the breakpoint or the MAP at any time during hemorrhage in dogs with both CBR functional compared with their intact responses. In a different group of dogs ( n = 6), responses were determined with both CBR operating and again after unilateral denervation, leaving only one CBR (1CBR) functional. Basal MAP and the variability of MAP were not altered in dogs with only 1CBR functional, but the breakpoint (11.7 ± 1.4 ml/kg) during hemorrhage was significantly different compared with responses with two CBR (21.2 ± 2.3 ml/kg), and MAP fell to much lower levels. These results indicate that the CBR can compensate fully for loss of ABR during hemorrhage but not vice versa; and bilateral CBR inputs are required for normal responses to hemorrhage.

OBJECTIVES:To evaluate the proportion of tuberculosis (TB) cases initially treated with the recommended four-drug regimen of isoniazid (INH), rifampin (RIF), pyrazinamide (PZA) and ethambutol (EMB) or streptomycin; and to identify factors associated with the choice of initial therapy.DESIGN:Descriptive analysis of surveillance data obtained by TB case notifications from physicians and microbiology laboratories.SETTING:The island of Montreal (with a population of 1,854,435 people).STUDY POPULATION:All TB cases reported between January 1, 1995 and December 31, 1998.OUTCOME MEASURE:The proportion of TB cases initially treated with a four-drug regimen by sex, age, country of birth, site of disease and year of reporting.MAIN RESULTS:Seven hundred forty-one cases were reported during the study period. Among the 687 analyzed cases, 406 (59.1%) received the recommended initial four-drug regimen (INH-RIF-PZA-EMB), 187 (27.2%) received an INH-RIF-PZA regimen, 61 (8.9%) received an INH-RIF-EMB regimen and 33 (4.8%) received an INH-RIF regimen only. In a logistical regression model, a four-drug regimen was significantly associated with respiratory disease (odds ratio [OR] 4.48; 95% CI 3.15 to 6.39), age younger than 65 years (OR 2.32; 95% CI 1.55 to 3.45), being foreign-born (OR 1.62; 95% CI 1.06 to 2.48) and later year of reporting (OR 1.27; 95% CI 1.09 to 1.47).CONCLUSIONS:The proportion of TB cases initially treated with a four-drug regimen has increased steadily since 1995, reaching 65% in 1998. However, given the rate of INH resistance in Montreal, efforts to promote the use of the initial four-drug regimen must continue.

We have proposed that the reflex increase in arginine vasopressin (AVP) secretion in response to hypovolemia is due to arterial baroreceptor unloading. If arterial pressure is the key to the mechanism, the slope relating plasma AVP to arterial pressure should be the same in response to hemorrhage, a model of true hypovolemia, and in response to thoracic inferior vena caval constriction (IVCC), a model of central hypovolemia. We tested this hypothesis in conscious, chronically instrumented dogs ( n = 8). The mean coefficient of determination ( r 2) values obtained from the individual regressions of log AVP onto systolic pressure (SP) and mean arterial pressure (MAP) in response to hemorrhage were 0.953 ± 0.009 and 0.845 ± 0.047, respectively. Paired comparisons indicated a significant difference between the means ( P < 0.05), hence, SP was used in subsequent analyses. The mean slopes relating the log of plasma AVP to SP in response to hemorrhage and IVCC were −0.034 ± 0.003 and −0.032 ± 0.002, respectively, and the means were not significantly different ( P = 0.7). The slopes were not altered when the experiments were repeated during acute blockade of cardiac receptors by intrapericardial procaine. Finally, sinoaortic denervation ( n = 4) markedly reduced the slope in both the hemorrhage and IVCC treatments. We conclude that baroreceptors monitoring arterial pressure provide the principal reflex control of AVP secretion in response to hypovolemia.

Some practical areas of computer science, such as computer graphics, computer-aided design, robotics, and pattern recognition, give rise to geometrical problems. Voronoi diagrams are useful in those cases. Another popular application is in machining toolpath planning, using a contour-parallel strategy. When the contour-parallel strategy is applied to machining toolpath planning, geometric degeneracies can occur and require the performance of complicated and significantly time-consuming computations of offset curves. The best way to deal with geometric degeneracies is with the bisector on each end-point of the contour segment of the Voronoi diagrams. Furthermore, if islands are considered in the toolpath planning, it is essential to calculate the minimum passage width between the islands, or between the islands and contour segments. The best way to deal with the minimum passage width is with the offset curves. This paper presents the incremental algorithms of the Voronoi diagram technique to calculate the offset distance and minimum passage width for toolpath planning.

We studied the role of cardiac and arterial baroreceptors in the reflex control of arginine vasopressin (AVP) and renin secretion during graded hypotension in conscious dogs. The dogs were prepared with Silastic cuffs on the thoracic inferior vena cava and catheters in the pericardial space. Each experiment consisted of a control period followed by four periods of inferior vena caval constriction, during which mean arterial pressure (MAP) was reduced in increments of ∼10 mmHg. The hormonal responses were measured in five dogs under four treatment conditions: 1) intact, 2) acute cardiac denervation (CD) by intrapericardial infusion of procaine, 3) after sinoaortic denervation (SAD), and 4) during combined SAD+CD. The individual slopes relating MAP to plasma AVP and plasma renin activity (PRA) were used to compare the treatment effects using a 2 × 2 factorial analysis. There was a significant ( P < 0.01) effect of SAD on the slope relating plasma AVP to MAP but no effect of CD and no SAD × CD interaction. In contrast, the slope relating PRA and MAP was increased ( P < 0.05) by SAD but was not affected by CD. These results support the hypothesis that stimulation of AVP secretion in response to graded hypotension is primarily driven by unloading arterial baroreceptors in the dog.

There have been significant improvements in the prognosis for patients suffering from hydrocephalus stemming from the introduction of the cerebrospinal fluid (CSF) shunt some 40 years ago. Currently, one of the major obstacles to effective shunt treatment is the mismatch between the physiology of the patient and the hydraulics of the shunt system. In order to maintain the proper relationship between CSF and cerebrovascular pressures, the implanted shunt needs to establish normal CSF outflow (absorption) and storage (compliance). Many of today's shunts establish a limited range of normal CSF outflow (absorption) and storage (compliance) once implanted, but a mismatch between CSF and cerebrovascular pressures may exist when the patient changes body position during daily activities. An uncoupling of these pressures creates mechanical strains within cerebral tissues, which are implicated in pathologies related to shunt malfunction. We suggest that re-establishment of normal CSF outflow resistance, which by definition is an indicator of both absorption and compliance, is a fundamental requirement for shunt treatment under most conditions.

A versatile ICP-vacuum interface was constructed to investigate the gas dynamics and gas flow profiles of the ICP-MS interface. This new interface combines a low interface pressure, ≥0.24 Torr, with the ability to accommodate a variety of skimmer designs at sampler to skimmer spacings up to 80 mm. Plasma beams were extracted by placing a 0.9 or 2.0 mm diameter skimming orifice at distances of 6.7-47 mm behind the sampling orifice. Gas flow profiles of each resulting plasma beam were measured using an impact pressure probe placed at distances of 35-105 mm behind the skimmer. The centreline flux and width of the gas beam were compared with those calculated for an ideally skimmed beam. The results for the 0.9 mm diameter skimmer orifice showed that placing the skimmer at 17.0 and 27.3 mm downstream of the sampler formed the highest intensity and narrowest beams. In contrast, by placing the skimmer closer to the sampler, as in common interface designs, the beam profile is less intense on the centreline and much wider. Using a larger 2.0 mm diameter skimming orifice at 16.5-26.8 mm downstream of the sampler produced a more intense beam than any arrangement using the 0.9 mm skimming orifice. However with the 2.0 mm diameter skimmer, centreline intensities were still about half those of an ideally skimmed beam.

Objective: To assess the economic impact of adding granulocyte colony-stimulating factor (G-CSF) to amphotericin B to treat a presumed deep-seated fungal infection in neutropenic patients. This study was conducted from the perspective of the National Health Service (NHS) hospital sector. Design: We used our previously reported trial as the clinical basis for the analysis (see Participants and interventions). These data were combined with resource utilisation data, enabling us to construct a decision tree model of the treatment paths attributable to managing patients in each arm of the trial. The model was used to calculate the cost effectiveness of using amphotericin B plus G-CSF compared to amphotericin B monotherapy in neutropenic patients with a presumed deep-seated fungal infection. Setting: An adult leukaemia/bone marrow transplant (BMT) unit in a large UK teaching hospital. Participants: Patients with a neutrophil count of

Discrete choice experiments (DCEs) are used to elicit preferences of current and future patients and healthcare professionals about how they value different aspects of healthcare. Risk is an integral part of most healthcare decisions. Despite the use of risk attributes in DCEs consistently being highlighted as an area for further research, current methods of incorporating risk attributes in DCEs have not been reviewed explicitly. This study aimed to systematically identify published healthcare DCEs that incorporated a risk attribute, summarise and appraise methods used to present and analyse risk attributes, and recommend best practice regarding including, analysing and transparently reporting the methodology supporting risk attributes in future DCEs. The Web of Science, MEDLINE, EMBASE, PsycINFO and Econlit databases were searched on 18 April 2013 for DCEs that included a risk attribute published since 1995, and on 23 April 2013 to identify studies assessing risk communication in the general (non-DCE) health literature. Healthcare-related DCEs with a risk attribute mentioned or suggested in the title/abstract were obtained and retained in the final review if a risk attribute meeting our definition was included. Extracted data were tabulated and critically appraised to summarise the quality of reporting, and the format, presentation and interpretation of the risk attribute were summarised. This review identified 117 healthcare DCEs that incorporated at least one risk attribute. Whilst there was some evidence of good practice incorporated into the presentation of risk attributes, little evidence was found that developing methods and recommendations from other disciplines about effective methods and validation of risk communication were systematically applied to DCEs. In general, the reviewed DCE studies did not thoroughly report the methodology supporting the explanation of risk in training materials, the impact of framing risk, or exploring the validity of risk communication. The primary limitation of this review was that the methods underlying presentation, format and analysis of risk attributes could only be appraised to the extent that they were reported. Improvements in reporting and transparency of risk presentation from conception to the analysis of DCEs are needed. To define best practice, further research is needed to test how the process of communicating risk affects the way in which people value risk attributes in DCEs.

Iliac compression syndrome is usually diagnosed during the third and fourth decades of life when the patient has iliofemoral deep vein thrombosis. Catheter-directed thrombolytic therapy is an accepted method of treatment for iliofemoral deep vein thrombosis, which has been reported to afford greater success with clot dissolution than with system therapy. Although this method is not new, this is the first case, to our knowledge, reporting successful treatment of computerized tomographically demonstrated iliac compression syndrome with stent placement after lysis and insufficient response to balloon angioplasty. (J VASC SURG 1995;21:510-4.)

Neutrons are unique particles to probe samples in many fields of research ranging from biology to material sciences to engineering and security applications. Access to bright, pulsed sources is currently limited to large accelerator facilities and there has been a growing need for compact sources over the recent years. Short pulse laser driven neutron sources could be a compact and relatively cheap way to produce neutrons with energies in excess of 10 MeV. For more than a decade experiments have tried to obtain neutron numbers sufficient for applications. Our recent experiments demonstrated an ion acceleration mechanism based on the concept of relativistic transparency. Using this new mechanism, we produced an intense beam of high energy (up to 170 MeV) deuterons directed into a Be converter to produce a forward peaked neutron flux with a record yield, on the order of ${10}^{10}\text{ }\text{ }\mathrm{n}/\mathrm{sr}$. We present results comparing the two acceleration mechanisms and the first short pulse laser generated neutron radiograph.