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Purpose: To create a preference-based value set scoring system for the MobQoL-7D outcome measure, and to examine differences in the health state preferences of the general population and individuals with impaired mobility. Methods and materials: A preference elicitation study was undertaken to ascribe utility weights to all health states (i.e., all unique combination of answers) described by the MobQoL-7D. The elicitation exercise was developed using the Online Elicitation of Personal Utility Functions (OPUF) tool. Two UK sample groups were recruited; firstly a representative general population sample (N = 504), secondly a balanced sample of individuals with impaired mobility (N = 368). Distinct preference-based value sets were developed for each sample. Differences in dimension ranking, weighting, and overall utility values were assessed. Results: The general population sample considered most health states, especially the more severe states, to be worse than the mobility impaired sample comparatively. Statistically significant differences between the samples were observed in four of the seven MobQoL-7D dimensions. Conclusions: This study is the first to provide preference-based value sets for the MobQoL-7D, ready for use in economic evaluations, QALY calculation, and other clinical or research applications. The study demonstrates how the general public and individuals with impaired mobility value health states differently. IMPLICATIONS FOR REHABILITATION: The MobQoL-7D offers a concise and valid tool for rehabilitation professionals to measure and monitor quality of life and quality-adjusted life years (QALYs) in the context of mobility impairment. The MobQoL-7D value set calculator allows summary utility scores and QALYs to be calculated using MobQoL-7D outcome data; the first of its kind. The general public and individuals with impaired mobility value health states differently, which could impact cost-per QALY calculations and subsequent service commissioning and funding decisions. [ABSTRACT FROM AUTHOR]

The development of several popular social networks and the publication of social networks' data have led to the risk of leakage of sensitive and confidential information of individuals. This requires the preservation of privacy before the publication of a user's data available from his Online Social Network (OSN) presence. Numerous algorithms have been proposed in the area of preserving the privacy of social network users' information such as K-anonymity and L-diversity. Previous work has shown good results based on the concept of adding edges and noise nodes for achieving K-anonymity and L-diversity. K-anonymization techniques are able to prevent identity disclosure of users but are not sufficient to prevent the disclosure of sensitive information of users. In this direction, a number of techniques for preserving the sensitive information of social network users have been proposed. Although these techniques have shown reasonably good results to achieve anonymity, but they also lead to a substantial change in the original structure of the OSNs. In this article, the problems of preventing sensitive attribute disclosure and reducing the noisy nodes have been addressed by perturbing the sensitive attributes. Existing research uses L-diversity for preventing sensitive attribute disclosure resulting in skewness and similarity attacks. We have addressed the skewness attacks by removing the duplicate noisy nodes from the final dataset to be published for stakeholders by the OSN service providers. All the information of duplicate nodes has been stored in a table named Reference Attribute Table (RAT). This table will be accessible only to the service providers for the purpose of de-anonymizing the data of users. The proposed technique has been extensively evaluated using five metrics viz. APL, ACSPL, RRTI, number of noisy nodes, and information loss using four real-time datasets collected for OSNs namely CORA, ARNET, DBLP, and Twitter. Results of evaluation parameters viz. APL and RRTI show that there is less change in the structure of datasets after anonymization. Results of ACSPL show that our proposed technique is able to preserve sensitive attributes in the datasets. The maximum number of noisy nodes amongst all four datasets is 5.4% and the maximum information loss is 2.2%. Evaluation results make it evident that our proposed technique ensures privacy preservation with less loss of information and thus preserving the utility of published data. [ABSTRACT FROM AUTHOR]

To orchestrate behaviors for survival, multiple psychological components have evolved. The current theories do not clearly distinguish the distinct components. In this article, we provide a unified theoretical framework. To optimize survival, there should be four components; (1) "need", an alarm based on a predicted deficiency. (2) "motivation", a direct behavior driver. (3) "pleasure", a teacher based on immediate outcomes. (4) "utility", a teacher based on final delayed outcomes. For behavior stability, need should be accumulated into motivation to drive behavior. Based on the immediate outcome of the behavior, the pleasure should teach whether to continue the current behavior. Based on the final delay outcome, the utility should teach whether to increase future behavior by reshaping the other three components. We provide several neural substrate candidates in the food context. The proposed theoretical framework, in combination with appropriate experiments, will unravel the neural components responsible for each theoretical component. [ABSTRACT FROM AUTHOR]

We study the fashion game, a classical network coordination/anti-coordination game employed to model social dynamics in decision-making processes, especially in fashion choices. In this game, individuals, represented as vertices in a graph, make decisions based on their neighbors’ choices. Some individuals are positively influenced by their neighbors while others are negatively affected. Analyzing the game’s outcome aids in understanding fashion trends and flux within the population. In an instance of the fashion game, an action profile is formed when all individuals have made their choices. The utility of an individual under an action profile is defined according to the choices he and his neighbors made. A pure Nash equilibria is an action profile under which each individual has a nonnegative utility. To further study the existence of pure Nash equilibria, we investigate an associated optimization problem aimed at maximizing the minimal individual utility, referred to as the utility of a fashion game instance. The fashion game with two different but symmetric actions (choices) has been studied extensively in the literature. This paper seeks to extend the fashion game analysis to scenarios with more than two available actions, thereby enhancing comprehension of social dynamics in decision-making processes. We determine the utilities of all instances on paths, cycles and complete graphs. For instances where each individual likes to anti-coordinate, graph is planar and three actions are available, we illustrate the time complexity of determining the utility of such instances. Additionally, for instances containing both coordinating and anti-coordinating individuals, we extend the results on the time complexity of determining the utility of instances with two available actions to cases with more than two actions. [ABSTRACT FROM AUTHOR]

Introduction: Acid sphingomyelinase deficiency (ASMD) type B is a rare genetic disorder leading to enlargement of the spleen and liver, pulmonary dysfunction, and other symptoms. Cost-utility analyses are often conducted to quantify the value of new treatments, and these analyses require health state utilities. Therefore, the purpose of this study was to estimate utilities associated with varying levels of severity of adult and pediatric ASMD type B. Methods: Seven adult and seven child health state vignettes describing ASMD were developed based on published literature, clinical trial results, and interviews with clinicians, patients with ASMD, and parents of children with ASMD. The health states were valued in time trade-off interviews with adult general population respondents in the UK. Results: Interviews were completed with 202 participants (50.0% female; mean age = 41.3 years). The health state representing ASMD without impairment had the highest mean utility for both the adult and child health states (0.92/0.94), and severe ASMD had the lowest mean utility (0.33/0.45). Every child health state had a significantly greater utility than the corresponding adult health state. Differences between adult/child paired states ranged from 0.02 to 0.13. Subgroup analyses explored the impact of parenting status on valuation of child health states. Discussion: Greater severity of ASMD was associated with lower mean utility. Results have implications for valuation of pediatric health states. The resulting utilities may be useful in cost-utility modeling estimating the value of treatment for ASMD. [ABSTRACT FROM AUTHOR]

Introduction: The Individualized Neuromuscular Quality of Life Questionnaire (INQoL) is used to measure quality of life in neuromuscular disorders such as non-dystrophic myotonia (NDM). Here we report methods to estimate utilities, with a focus on NDM, from this questionnaire based on two preference elicitation exercises. Methods: Eight items from the INQoL were selected with input from three neuromuscular disorder clinical experts with expertise in treating NDM. A discrete choice experiment (DCE) survey of UK general public respondents (n = 508) described outcomes defined by the INQoL items. The same 8 items were also valued using time trade-off (TTO) face-to-face interviews (n = 200). A hybrid regression modelling approach combined both datasets to inform the utility weights. Results: Hybrid modelling of DCE and TTO data in conjunction improved out-of-sample predictive accuracy. The selected INQoL utility model indicates substantial disutility associated with all eight dimensions of health, with the greatest losses associated with subjective items such as pain and depression. Discussion: The hybrid modelling approach allows us to combine data from the two methodologies and maximize the information from each to inform the utility weights for the INQoL. The TTO is the more conventional valuation method, but combined with the larger DCE study produced better descriptive coverage. This is a relatively novel method for estimating weights which we think is particularly well suited to economic evaluations of orphan drugs. [ABSTRACT FROM AUTHOR]

Introduction: At different times, China has pursued different carbon emission reduction targets, so it is crucial to develop a reasonable and flexible allocation scheme for Chinese carbon emissions quotas, referred to as Chinese Emission Allowance (CEA), in order to achieve carbon reduction goals. As important responsible entities for carbon reduction, each province needs to rely on a welldesigned CEA allocation scheme to help achieve their emission reduction goals. Methods: Therefore, based on the utility perspective, this paper constructs allocation principles and methods to formulate the inter-provincial CEA allocation scheme for China in 2030. Specifically, the entropy method, SBM model, improved variable weight function, and ARIMA time series model are sequentially adopted to simulate the re-allocation scheme, examine its rationality, and develop CEA allocation schemes under different principles. Results and Discussion: The following conclusions are drawn: 1) The allocation scheme formulated based on historical emission simulation methods, industry benchmark methods, and other current CEA allocation methods has certain irrationality, and future CEA allocation should not follow the original methods; 2) The improved variable weight function is better suited for allocation in CEA than the current original allocation method. The allocation scheme developed under this method, which balances fairness and efficiency principles, is more appropriate for the actual reduction of carbon emissions in China. [ABSTRACT FROM AUTHOR]

Background and purpose Methods Results Conclusions The rapidly evolving landscape of effective treatment options in multiple sclerosis has led to a shift of treatment objectives towards a treat‐to‐target approach aiming to suppress disease activity below the level of detectability early during the disease. To enable treat‐to‐target, a thorough reappraisal of available outcome measures with respect to their ability in this regard is required.To that end, we conducted a comprehensive systematic literature review of more than 1000 studies using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) 2020 methodology focusing on underlying evidence as well as utility and implementability in clinical practice.From there, we propose a set of measurable outcomes for everyday routine clinical practice as well as advanced/aspirational measurables requiring additional resources. We also outline remaining knowledge/technology gaps that need to be overcome to enable a treat‐to‐target approach.This work provides the basis for an evidence‐based definition of outcome targets for relevant stakeholders and regulatory authorities. [ABSTRACT FROM AUTHOR]

Objective. To evaluate factors associated with the long-term durability of cost-effectiveness (CE) in ASD patients. Background. A substantial increase in costs associated with the surgical treatment for adult spinal deformity (ASD) has given precedence to scrutinize the value and utility it provides. Methods. We included 327 operative ASD patients with five-year (5 yr) follow-up. Published methods were used to determine costs based on CMS.gov definitions and were based on the average DRG reimbursement rates. The utility was calculated using quality-adjusted life-years (QALY) utilizing the Oswestry Disability Index (ODI) converted to Short-Form Six-Dimension (SF-6D), with a 3% discount applied for its decline in life expectancy. The CE threshold of $150,000 was used for primary analysis. Results. Major and minor complication rates were 11% and 47%, respectively, with 26% undergoing reoperation by five years. The mean cost associated with surgery was $91,095 ± $47,003, with a utility gain of 0.091 ±0.086 at one years, QALY gained at 2 years of 0.171± 0.183, and at five years of 0.42 ±0.43. The cost per QALY at two years was $414,885, which decreased to $142,058 at five years. With the threshold of $150,000 for CE, 19% met CE at two years and 56% at five years. In those in which revision was avoided, 87% met cumulative CE till life expectancy. Controlling analysis depicted higher baseline CCI and pelvic tilt (PT) to be the strongest predictors for not maintaining durable CE to five years [CCI OR: 1.821 (1.159--2.862), P=0.009] [PT OR: 1.079 (1.007--1.155), P=0.030]. Conclusions. Most patients achieved cost-effectiveness after four years postoperatively, with 56% meeting at five years postoperatively. When revision was avoided, 87% of patients met cumulative cost-effectiveness till life expectancy. Mechanical complications were predictive of failure to achieve cost-effectiveness at two years, while comorbidity burden and medical complications were at five years. [ABSTRACT FROM AUTHOR]

Currently, the settlement of soft ground is measured using instruments operated by on-site workers. However, this method is expensive and inefficient in terms of data consistency, costeffectiveness, and utility. On the other hand, surveying using unmanned aerial vehicle (UAV) light detection and ranging (LiDAR) is used in various fields. However, studies on its utility in soft ground are insufficient. Therefore, in this study, we examined the optimal method for creating digital elevation models (DEMs) for estimating the settlement of soft ground using UAV LiDAR survey data. This method involved selecting a coastal construction site as the study area and acquiring data through UAV LiDAR surveying. The acquired data were used to create DEMs through preprocessing and postprocessing. Settlement measurements obtained from onsite instruments and settlement estimates derived from DEMs created using various interpolation methods and grid sizes were compared and analyzed. Additionally, the utility of the created time-series DEMs in the settlement estimation of soft ground was evaluated. We proposed the optimal method for creating DEMs for estimating the settlement of soft ground and suggested methods to utilize the proposed time-series DEMs. Our research results show that the use of UAV LiDAR survey data can lead to the economical and efficient settlement estimation of soft ground. [ABSTRACT FROM AUTHOR]

This study aimed to map the Lequesne index onto the EuroQol 5 Dimension (EQ-5D-5L) utility index for patients with knee osteoarthritis. Baseline data from a previous randomized controlled trial were used; 461 patients were involved in the mapping development, and 230 in the validation phase. Various modeling techniques, including generalized linear models, tobit, and beta regression, were used. Factors such as age, sex, and body mass index were considered as covariates. Model selection was based on criteria such as Akaike and Bayesian information criteria, adjusted R2, mean absolute error, and root mean squared error. Validation involved assessing the preselected models using mean absolute error, root mean squared error, and intraclass correlation coefficient. This study follows the Mapping Onto Preference-Based Measures Reporting Standards statement. Five models were developed, with 2 incorporating age, sex, with or without body mass index along with the Lequesne index showing the best fit across regressions. Validation results were similar for the 3 regressions, with beta regression models exhibiting wider ranges closer to the validation data set. Intraclass correlation coefficient values were better for beta regression models. Both models tended to overpredict for lower EQ-5D-5L values and underpredict for better health status. These mapping functions, the first of their kind, effectively translate the Lequesne index to EQ-5D-5L values in patients with knee osteoarthritis. They demonstrate satisfactory fit and precision, providing valuable tools for clinicians and researchers, particularly in situations where generic preference-based health-related quality of life instruments are inaccessible for utility derivation in cost-effectiveness studies. • Addressing the burden of knee osteoarthritis (OA), this study pioneers the development of mapping functions to translate Lequesne index scores to EQ-5D-5L values, providing a novel tool for future investigations in health outcomes assessment for patients with knee OA. • Using rigorous modeling techniques, including generalized linear model, tobit, and beta regressions, the research establishes 2 models with age, sex, body mass index, and Lequesne index as key factors, showing good goodness-of-fit indexes, widening the scope for accurate health predictions. • These mapping functions provide clinicians and researchers with valuable tools to accurately assess the health status of patients with knee OA, especially in situations where generic preference-based instruments are inaccessible, thereby facilitating progress in cost-effectiveness studies. [ABSTRACT FROM AUTHOR]

We have developed a new patient-centered, preference-based generic health-outcome measure, Château-Santé Base (CS-Base), which is based on a novel multiattribute preference response (MAPR) measurement framework. This study aimed to generate a first utility set for the CS-Base, making it suitable for use in health-economic evaluations. CS-Base comprises 12 health attributes: mobility, vision, hearing, cognition, mood, anxiety, pain, fatigue, social functioning, daily activities, self-esteem, and independence, each with 4 levels. Our methodology to generate utilities for the CS-Base was 2-fold. First, we derived coefficients from patient MAPR data to calculate CS-Base values. Subsequently, these were normalized to a 0.0 to 1.0 utility scale, in which 0.0 signifies dead. The dead position was estimated using general population data from a discrete choice experiment (discrete choice experiment + dead), using a division-value strategy, which localize the position of states better or worse than dead. We analyzed MAPR data from 3222 patients and discrete choice experiment + dead data from 1995 respondents. All MAPR coefficients were negative, logically ordered, and significantly different from the reference level. The dead position was denoted by a division value of −148.385. Utility values spanned from −0.071 to 1.0, and only 53 of 16 777 216 states were deemed worse than dead. This study introduced the first CS-Base utility set, underlining a 2-step utility derivation method. This method, blending societal and patient views, surpasses traditional preference-based approaches, yielding firmer results. However, improvement of the normalization procedure is expected. Estimating CS-Base utilities is an ongoing process that gains precision over time. • A generic patient-centered preference-based health-outcome measure Château-Santé Base has been developed. • This study introduces the first Château-Santé Base utility set using a 2-step approach. • The 2-step approach applied a novel preference-based method, which might overcome traditional health-economic preference challenges and merged societal and patient views. [ABSTRACT FROM AUTHOR]

In the contemporary era, online social networks have become the prevalent medium for interpersonal interactions, encompassing a multitude of virtual social relationships. To prevent attackers from inferring more sensitive information through social relationships, numerous researchers have devised privacy protection methodologies tailored to these social relationships. However, most of research achievements have tended to overlook considerations pertaining to algorithmic efficiency and the delicate balance between privacy and utility. To address this issue, we first identify vulnerable nodes within social networks using two indicators, namely, the Marchenko–Pastur law rate and the mean spectral radius. This approach aims to enhance algorithm efficiency. Furthermore, we propose a privacy-preserving algorithm based on vulnerable nodes, PPVN, which classifies the friendship links associated with vulnerable nodes into three distinct levels, thereby ensuring precise safeguarding of social relationship privacy while striking an optimal equilibrium between privacy and structural utility. To bolster privacy safeguards, we develop a replacement index θ, designed explicitly to preclude replaced friendship links from evolving into newly sensitive links. Empirical findings substantiate the remarkable efficacy of the PPVN algorithm in preserving user privacy while concurrently upholding data utility. Compared with other privacy-preserving methods, the PPVN algorithm demonstrates superior privacy protection within the shortest computational timeframe. [ABSTRACT FROM AUTHOR]

This paper presents a paradigm of leadership within the nursing profession. It argues that it is vitally important to (re)kindle debate about – and, through this process, ascertain the realization of – complementarity between values and competency bases for the leadership profiles of the nursing profession. The article proposes how this clinical leadership may be understood and realized in the organizational and societal context of 2024. Our ambition is to start a necessary debate, focussing on how to strengthen this requisite leadership, in order to ensure quality and development in nursing care, and the professional competence development of nurses. [ABSTRACT FROM AUTHOR]

Towards the end of his life, Bataille became increasingly fascinated by prehistoric culture. His analysis of the Lascaux cave frames it as the symbolic site of our birth, envisioning in its art the final step to anthropogenesis: we, as a species, became human once we began smearing pigment on cave walls. Bataille’s account of this dual birth of art and humanity is neither an ode to our rational mind nor to our capacity for aesthetic contemplation. Rather, the murals adorning the cave would be the result of primordial ecstatic experiences. For Bataille, art ties in with excess: an activity devoid of use-value rising above necessity or instinct. Lascaux becomes the scene of a primordial crime against utility. Bataille’s cave stands as a counterargument to the enlightenment’s fixation on progress and productivity. The decades since, have seen our obsession with productivity grow even more pervasive. This paper explores the constellation of excessive behaviours which Bataille presents as key to the birth of art and, through an autoethnographic study, asks whether, and how, this ‘spectrum of excess’ is still relevant to artists today. [ABSTRACT FROM AUTHOR]

Background: Duchenne muscular dystrophy (DMD) is a genetic disease resulting in progressive muscle weakness, loss of ambulation, and cardiorespiratory complications. Direct estimation of health-related quality of life for patients with DMD is challenging, highlighting the need for proxy measures. This study aims to catalog and compare existing published health state utility estimates for DMD and related conditions. Methods: Using two search strategies, relevant utilities were extracted from the Tufts Cost-Effectiveness Analysis Registry, including health states, utility estimates, and study and patient characteristics. Analysis One identified health states with comparable utility estimates to a set of published US patient population utility estimates for DMD. A minimal clinically important difference of ± 0.03 was applied to each DMD utility estimate to establish a range, and the registry was searched to identify other health states with associated utilities that fell within each range. Analysis Two used pre-defined search terms to identify health states clinically similar to DMD. Mapping was based on the degree of clinical similarity. Results: Analysis One identified 4,308 unique utilities across 2,322 cost-effectiveness publications. The health states captured a wide range of acute and chronic conditions; 34% of utility records were extrapolated for US populations (n = 1,451); 1% were related to pediatric populations (n = 61). Analysis Two identified 153 utilities with health states clinically similar to DMD. The median utility estimates varied among identified health states. Health states similar to the early non-ambulatory DMD phase exhibited the greatest difference between the median estimate of the sample (0.39) and the existing estimate from published literature (0.21). Conclusions: When available estimates are limited, using novel search strategies to identify utilities of clinically similar conditions could be an approach for overcoming the information gap. However, it requires careful evaluation of the utility instruments, tariffs, and raters (proxy or self). [ABSTRACT FROM AUTHOR]

With the rapid development of new energy and smart technology, the demand for inter-device communication in medium–low-voltage smart distribution grids has sharply increased, leading to a surge in the variety and quantity of communication services. To meet the needs of diverse and massive communication services, deploying service function chains to flexibly combine virtual resources has become crucial. This paper proposes an optimization method based on fit entropy and network utility to address the limited communication network resources in medium–low-voltage smart distribution grids. This was conducted by modeling the distribution grid as a three-domain model consisting of a service domain, a logical domain, and a physical domain and transforming it into a hierarchical bipartite hypergraph-matching problem, which is a complex combinatorial optimization problem. This paper introduces two matching optimization algorithms: "business domain–logic domain–physical domain integration" and "service domain–logic domain, logic domain–physical domain two-stage", which effectively address this problem based on fit entropy and utility. The simulation results demonstrate that these algorithms significantly improve service success rates and resource utilization, enhancing overall network utility. [ABSTRACT FROM AUTHOR]

As autonomous systems rapidly become ubiquitous, there is a growing need for a legal and regulatory framework that addresses when and how such a system harms someone. There have been several attempts within the philosophy literature to define harm, but none of them has proven capable of dealing with the many examples that have been presented, leading some to suggest that the notion of harm should be abandoned and “replaced by more well-behaved notions”. As harm is generally something that is caused, most of these definitions have involved causality at some level. Yet surprisingly, none of them makes use of causal models and the definitions of actual causality that they can express. In this paper, which is an expanded version of the conference paper Beckers et al. (Adv Neural Inform Process Syst 35:2365–2376, 2022), we formally define a qualitative notion of harm that uses causal models and is based on a well-known definition of actual causality. The key features of our definition are that it is based on contrastive causation and uses a default utility to which the utility of actual outcomes is compared. We show that our definition is able to handle the examples from the literature, and illustrate its importance for reasoning about situations involving autonomous systems. [ABSTRACT FROM AUTHOR]

The article explores the ethical implications of resuscitation for organ preservation in brain dead patients or those being tested for brain death. It acknowledges the lack of consensus on this issue, with proponents arguing that resuscitation can honor the wishes of donors and benefit organ recipients, while opponents express concerns about exploiting the donor and causing distress to families. The article examines various ethical arguments and principles, emphasizing the importance of respecting autonomy and maximizing utility. It concludes with recommendations based on these considerations. The document provided is a list of references for articles related to organ donation and ethical considerations in the surgical ICU, offering valuable insights for researchers and healthcare professionals interested in these topics. [Extracted from the article]

It is abundantly clear that Vilfredo Pareto held Adam Smith in high regard for his contributions to political economy, yet, in his Trattato di Sociologia Generale, there is no mention of Smith's The Theory of Moral Sentiments. This study presents a comparison of these two great studies of sentiment, utility and action. It is established that there is a basic compatibility between Pareto's conception of non-logical action in the Sociologia and Smith's distinction in the TMS between regular and irregular sentiments, yet the two thinkers investigated these conceptions and distinctions from very different, sometimes inconsistent, perspectives. We also offer some reasons why there has been considerable debate over an alleged inconsistency between Smith's political economy and his philosophical study of sentiments, but no such similar debate in relation to Pareto's political economy and his sociological study of sentiments. [ABSTRACT FROM AUTHOR]

Values that accompany generic health measures are typically anchored at 1 = full health and 0 = dead. Some health states may then be considered 'worse than dead' (WTD) and assigned negative values, which causes fundamental measurement problems. In this paper, we challenge the assumption that anchoring values at 'dead = 0' is necessary for quality‐adjusted life year (QALY) estimation. We summarise the role of 'dead' in health state valuation and consider three critical questions: (i) whether the measurement properties of health state values require 'dead'; (ii) whether 'dead' needs to be valued relative to health states; and (iii) whether values for states WTD are meaningful or useful. We conclude that anchoring 0 at dead is not a requirement of health status measurement or cost‐effectiveness analysis. This results from reframing QALYs as the relevant unit of measurement and reframing values as being derived from QALYs rather than the reverse. [ABSTRACT FROM AUTHOR]

This paper aims at assessing asymmetric dynamics among migration preferences and various security and economic factors, focusing on the movements from Syria to Turkey and then to the EU via the Greek sea borders (2010M1−2022M12). We perform an economic analysis by developing a utility model, according to which migration preferences depend on security and employment and empirically test asymmetric responses of migration to corresponding shocks. We contribute to the literature by finding that migration is downwards sticky. Despite that theories of international relations may not be monolithic, the magnitude of security impact on migration implies that the state remains the primary actor responsible for managing this phenomenon, which brings us closer to neo-realism theory of International Relations (IR). Our findings reveal the factors that lead to the downwards stickiness of migration thus contributing to a better understating of the incentives for migration and to the formulation of more efficient policies. [ABSTRACT FROM AUTHOR]

Abstract Background Duchenne muscular dystrophy (DMD) is a genetic disease resulting in progressive muscle weakness, loss of ambulation, and cardiorespiratory complications. Direct estimation of health-related quality of life for patients with DMD is challenging, highlighting the need for proxy measures. This study aims to catalog and compare existing published health state utility estimates for DMD and related conditions. Methods Using two search strategies, relevant utilities were extracted from the Tufts Cost-Effectiveness Analysis Registry, including health states, utility estimates, and study and patient characteristics. Analysis One identified health states with comparable utility estimates to a set of published US patient population utility estimates for DMD. A minimal clinically important difference of ± 0.03 was applied to each DMD utility estimate to establish a range, and the registry was searched to identify other health states with associated utilities that fell within each range. Analysis Two used pre-defined search terms to identify health states clinically similar to DMD. Mapping was based on the degree of clinical similarity. Results Analysis One identified 4,308 unique utilities across 2,322 cost-effectiveness publications. The health states captured a wide range of acute and chronic conditions; 34% of utility records were extrapolated for US populations (n = 1,451); 1% were related to pediatric populations (n = 61). Analysis Two identified 153 utilities with health states clinically similar to DMD. The median utility estimates varied among identified health states. Health states similar to the early non-ambulatory DMD phase exhibited the greatest difference between the median estimate of the sample (0.39) and the existing estimate from published literature (0.21). Conclusions When available estimates are limited, using novel search strategies to identify utilities of clinically similar conditions could be an approach for overcoming the information gap. However, it requires careful evaluation of the utility instruments, tariffs, and raters (proxy or self).

In March 2021, the National Renewable Energy Laboratory (NREL) released the Los Angeles 100% Renewable Energy Study (LA100), a milestone analysis laying out pathways for the Los Angeles Department of Water and Power (LADWP, or DWP) to transition to 100% renewable energy by 2045. Among the options presented by the study, the Board of Water and Power Commissioners (the Board) selected the most ambitious: a scenario in which the 100% clean energy goal is met ten years earlier, in 2035, without reliance on biofuels (the Early & No Biofuels scenario). Although a boon for the City of LA’s environmental goals, fulfilling this plan entails significant investments in infrastructure, renewable generating capacity, and cutting-edge technological solutions, all of which have cost and downstream affordability impacts.Affordability refers to customers’ ability to pay their bills. The costs of the transition to 100% renewable electricity by 2035 are considerable, but necessary to combat climate change. Because home heating and transportation expenditures will be folded into electric bills as these services become electrified, increasing electricity costs are a particular equity concern for LADWP, as well as for LA residents and small businesses. Changing costs will directly influence energy burden and indirectly affect broader affordability for LADWP customers.  Generally, public utilities, such as LADWP, must directly recover costs through revenue increases — including the cost of transitioning to renewable energy. This primarily means increasing rates and fees assessed on customers. Since many low- and moderate-income LA residents already struggle with the burden of their LADWP bills and general cost of living, cost and revenue increases at the utility scale have equity- and economic justice-related ramifications that must be directly addressed by policy. It is thus a delicate balancing act to complete the transition to 100% clean energy without creating untenable financial burdens on the Angelenos least able to absorb them, while also ensuring that the broader benefits of the transition are equitably distributed. This task is also made more challenging by the considerable uncertainty about the exact level and timing of costs associated with the utility’s 100% renewable investments. To that end, LADWP commissioned the UCLA Luskin Center for Innovation (LCI) and School of Law to conduct an Energy Affordability and Policy Solutions analysis as part of the broader LA100 Equity Strategies effort. This work builds on LCI’s past work and ongoing engagement on utility affordability and broader equity issues in both Los Angeles and California. Our work on affordability in LA100 Equity Strategies complements NREL’s affordability-focused rate structure and on-bill financing modeling. Consequently, our research goes beyond rate (re)design to focus on implementable, robust, and long-term structural solutions. Specifically, this entails data, analysis, and strategy architecture that will comprehensively address affordability, building on ongoing efforts.  This work also complements the UCLA Center for Neighborhood Knowledge’s analysis of ethnic small business energy equity issues, including affordability.

BackgroundFamilies whose child has unexplained intellectual or developmental differences often hope that a genetic diagnosis will lower barriers to community-based therapeutic and support services. However, there is little known about efforts to mobilize genetic information outside the clinic or how socioeconomic disadvantage shapes and constrains outcomes.MethodsWe conducted an ethnographic study with predominantly socioeconomically disadvantaged families enrolled in a multi-year genomics research study, including clinic observations and in-depth interviews in English and Spanish at multiple time points. Coding and thematic development were used to collaboratively interpret fieldnotes and transcripts.ResultsThirty-two families participated. Themes included familial expectations that a genetic diagnosis could be translated into information, understanding, and assistance to improve the quality of a child's day-to-day life. After sequencing, however, genetic information was not readily converted into improved access to services beyond the clinic, with families often struggling to use a genetic diagnosis to advocate for their child.ConclusionFamilies' ability to use a genetic diagnosis as an effective advocacy tool beyond the clinic was limited by the knowledge and resources available to them, and by the eligibility criteria used by therapeutic service providers' - which focused on clinical diagnosis and functional criteria more than etiologic information. All families undertaking genomic testing, particularly those who are disadvantaged, need additional support to understand the limits and potential benefits of genetic information beyond the clinic.

The assessment of how to regain pre-event functionality of buildings after an earthquake within an adequate time has gained attention in the last years, where a critical aspect is to identify the restoration time of the lifeline services that serve those buildings. Existing studies focused on developing frameworks for specific topologies and hazard levels. These methods are mostly out of reach for practicing engineers because of the necessity of identifying the network topology, performing complex network analysis, or conducting a regional seismic hazard analysis. This study develops a generic, network-based probabilistic method to estimate the restoration time of interdependent lifeline services to buildings after an earthquake. By avoiding the complexities above, this method links lifeline networks to utility service restoration to generate service restoration curves useful for building functional recovery assessments. An application to Shelby County and Napa is presented, showing reasonable agreement with more complex network-based analyses. Due to limitations in estimating component quantities and fragility information in regions without data, as well as other assumptions, differences are observed while comparing this method to more rigorous approaches. Still, those differences are acceptable considering the scope of this work for supporting building decision analyses. [ABSTRACT FROM AUTHOR]

Jeff Schein,1 Martin Cloutier,2 Marjolaine Gauthier-Loiselle,2 Maryaline Catillon,3 Yan Meng,4 Beatrice Libchaber,2 Fanny Jiang,2 Ann Childress5 1Otsuka Pharmaceutical Development & Commercialization, Inc, Princeton, NJ, USA; 2Analysis Group, Inc, Montréal, QC, Canada; 3Analysis Group, Inc, New York, NY, USA; 4Analysis Group, Inc, London, UK; 5Center for Psychiatry and Behavioral Medicine, Las Vegas, NV, USACorrespondence: Maryaline Catillon, Analysis Group, Inc, 151 West 42nd Street, 23rd Floor, New York, NY, 10036, USA, Tel +1 857 222 6863, Email maryaline.catillon@analysisgroup.comBackground: Understanding patient preferences for treatments may facilitate shared decision-making. This study assessed adult patient preferences for attention-deficit/hyperactivity disorder (ADHD) treatments in a sample of 600 patients in the United States (US).Methods: A web-based discrete choice experiment (DCE) survey was conducted among treated adults with ADHD. Participants were recruited from Dynata’s US panel (06/22/2023-07/06/2023). Attributes and levels, identified based on clinical inputs and published data, included efficacy and safety. Participants’ preferences were estimated using conditional logistic regression. Willingness to trade-off and attributes’ relative importance were calculated. Overall preferences for treatment profiles approximating centanafadine, lisdexamfetamine, atomoxetine, and viloxazine were estimated using adjusted total utilities. Results were stratified by current treatment status. Sensitivity analyses including participants who passed validity tests were conducted.Results: Among the 600 participants (mean age 37.9 years; 66.2% female; 50.8% treated), all attributes had a statistically significant impact on preferences for ADHD treatments (p < 0.001); the most important attribute was improvement in ADHD symptoms (36%), followed by risks of nausea (25%), insomnia (20%), anxiety (8%), dry mouth (6%), and feeling jittery (5%). Together, safety attributes accounted for > 60% of relative importance in decision-making. Participants were willing to forgo 0.59, 0.57, 0.49, 0.32, and 0.17 percentage points of symptom improvement to achieve one-percentage-point reduced risk of insomnia, nausea, anxiety, feeling jittery, and dry mouth, respectively. Centanafadine profile had consistently higher adjusted total utilities than its comparators. Similar results were obtained in the subgroup and sensitivity analyses.Conclusion: Efficacy was the most important attribute for patients when making treatment decision, but taken together, AEs had greater relative importance than efficacy alone. Accordingly, a profile resembling that of centanafadine would be preferred by an average patient compared to key competitors due to its favorable safety profile. These findings may help improve treatment decision-making, enhance treatment satisfaction, and foster adherence.Keywords: ADHD, decision-making, discrete choice experiment, patient-centered care, patient satisfaction, patient preference, utility

Background: Rapid diagnostic test (mRDT) is a useful tool in demonstrating parasitologically proven malaria. Its efficacy is however hampered when parasite density is low. Prophylactic use of cotrimoxazoleas in cases of HIV infected children can cause reduction in parasite count. It is doubtful if mRDT will retain its diagnostic usefulness among such individuals. Objectives: The study sought to evaluate the diagnostic value of mRDT in HIV infected children on cotrimoxazole prophylaxis in Benin City. Methods: In the prospective, cross-sectional and descriptive study, we assessed malaria parasitaemia using standard methods in microscopy and parasite density and malaria antigenaemia using Care Start Pf (monoclonal antibodies specific to histidine rich protein 2 antigen) in 221 each of HIV infected subjects on cotrimoxazole managed in a specialist clinic and HIV negative controls all seen at the University of Benin Teaching Hospital between April and June 2016. Results: Malaria antigenaemia rate MAr (20.8%) was lower than malaria parasitaemia rate MPr (24.4%) in subjects. MAr (20.8) and MPr (24.4%) in subjects were higher than Mar (18.10%) and MPr (17.7%) in controls. Mean (SEM) parasite count in subjects of was low (50.88 + 2.24 per μ l).Using microscopy as gold standard the sensitivity, specificity, PPV and NPV of mRDT in subjects were 77.8%, 97.6%, 91.3% and 93.1%. Corresponding values in controls were 100.0%, 99.5%, 97.5% and 100.0%.Youden indices for subjects and controls were 0.75 and 0.99. Conclusions/Recommendations: Sensitivity of mRDT in HIV infected children on cotrimoxazole prophylaxis for opportunistic infections (OI) is reduced. However the indices of specificity, PPV and NPV are high enough to retain its value in the evaluation of HIV infected children for asymptomatic malaria and perhaps the clinical disease.

Abstract Balancing is an essential challenge in healthcare systems that requires effective strategies. This study aims to address this crucial issue by suggesting a practical approach. We show the potential of balancing a regional healthcare system to improve its utility. We consider a regional healthcare system comprising multiple hospitals with different sizes, capacities, quality of service, and accessibility. We define a utility function for the system based on the sectorization concept, which endeavors to form a balance between hospitals in terms of essential outputs such as waiting times and demands. The dynamic nature of the system means that this balance degrades over time, necessitating periodic sectorization, which is called resectorization. Our methodology stands out for incorporating resectorization as a dynamic strategy, enabling more flexible and responsive adaptations to continuously changing healthcare needs. Unlike previous studies, based on a system-oriented approach, our resectorization scenarios include the periodic closure of some hospitals. This enables us to enhance both the capacity and quality of healthcare facilities. Furthermore, in contrast to other studies, we investigate the states of diminishing demand throughout the resectorization process. To provide empirical insights, we conduct a simulation using data from a real-world case study. Our analysis spans multiple time periods, enabling us to dynamically quantify the utility of the healthcare system. The numerical findings demonstrate that substantial utility improvements are attainable through the defined scenarios. The study suggests a practical solution to the critical challenge of balancing issues in regional healthcare systems.

Background: Even if robotic assisted total knee arthroplasty (RATKA) is a widely used technique, there is still a gap of knowledge about whether this technology is effective in improving the patient utility. This measure is of paramount importance for conducting cost effectiveness analysis. The aim of this study was to compare the utility measure derived from self-reported outcomes questionnaires in patients who underwent RATKA compared to patients who underwent the manual surgery. Methods: We compared 72 patients operated with a robotic technique with 70 operated with traditional technique. The utility data were collected with the WOMAC (Western Ontario and McMaster University Osteoarthritis index) self-administrated questionnaire that investigates pain, stiffness and functionality of the patients, an then mapped to a utility value through a validated transforming function. We performed three surveys: the first one before the intervention (t0), the second one 1 year after the surgery (t1) and the third one at the 2 year follow up (t2). Results: we observed higher utility values in both groups. In detail, the mean utility score in the RATKA group increased from 0.37 to 0.71 (t1) and 0.78 (t2), while in the conventional group it increased from 0.41 to 0.78 (t1) and 0.78 (t2). The fixed effect coefficients of t1 and t2 were found to be 0.37 and 0.363 (p < 0.001 for both). The coefficient of the robotic technique, along with its interaction with the t1 and t2 time effect was non-significant. Conclusions: Even if at t1 the utility of patient who underwent RATKA were lower, at longer follow up (t2) we found no significant difference compared to traditional technique, leaving the superiority of robotic assisted technique yet to be proved. Our results may be useful for calculating the gained or lost Quality Adjusted Life Years (QALYs), so that the health care system (or an insurance company) could make an appropriate decision whether to fund the robotic approach or not, after a careful assessment of the incremental costs incurred. [ABSTRACT FROM AUTHOR]

Today, the utilization of small‐scale solar systems for houses has increased significantly around the globe. The rise of electricity prices due to elevated prices of fossil fuels coupled with the global concerns about the increased emission of greenhouse gases has fueled the increased application of renewable energy systems. However, such policies have been ineffective in particular countries where the electricity prices are kept too low to control social atmosphere and enhance the people's well‐being for political purposes—in this case, solar systems have witnessed no growth as they have rendered not economically justifiable. In this respect, the present research considers Iran as a country with very low electricity prices coupled with very large potentials for utilizing solar energy in the presence of imbalanced electricity supply and demand, with the research objective being an investigation of the required incentive policies to promote the utilization of distributed solar photovoltaic (DSPV) systems in the country. According to the results, it was figured out that, under the current conditions, escalating the price of electricity for houses (even to as high as 10 times the current prices) cannot cover the costs of the equivalent DSPV systems, indicating a need for another cluster of policies. As an option, one may consider buying the generated electricity by the customer (from renewable sources) at a higher price than that at which the electricity is offered to households via the grid (by a margin of 15 folds), which is supposed to provide the required incentive to expand the utilization of DSPV systems. [ABSTRACT FROM AUTHOR]

E-commerce application usability refers to the design and functional aspects that facilitate user interaction and goal achievement. Well-designed usability of e-commerce applications will lead to usage continuance by users. Therefore, this study tries to identify usability factors and measure the effect of usability on usage continuance. Based on previous studies, the variables hypothesized to be the factors that define usability are learnability, efficiency, memorability, accuracy, emotion, and utility. Utility is a variable that represents the functional aspects of usability. It is described in more detail into information search, interface display, and transaction. Furthermore, this study also examined the relationship between usability, usage continuance, satisfaction, and usefulness. This study’s hypotheses were evaluated using 242 survey responses from e-commerce application users. Structural equation modeling, or SEM, was applied to process the empirical data. Memorability, accuracy, efficiency, and utility were found to be able to describe the usability of e-commerce applications well. This proved that functional quality is also an essential part of usability. Usability was found to influence usage continuance. [ABSTRACT FROM AUTHOR]

Introduction: The Kansas City Cardiomyopathy Questionnaire (KCCQ), Seattle Angina Questionnaire (SAQ), and Minnesota Living with Heart Failure Questionnaire (MLHFQ) are widely used non-preference-based instruments that measure health-related quality of life (QOL) in people with heart disease. However, currently it is not possible to estimate quality-adjusted life-years (QALYs) for economic evaluation using these instruments as the summary scores produced are not preference-based. The MacNew-7D is a heart disease-specific preference-based instrument. This study provides different mapping algorithms for allocating utility scores to KCCQ, MLHFQ, and SAQ from MacNew-7D to calculate QALYs for economic evaluations. Methods: The study included 493 participants with heart failure or angina who completed the KCCQ, MLHFQ, SAQ, and MacNew-7D questionnaires. Regression techniques, namely, Gamma Generalized Linear Model (GLM), Bayesian GLM, Linear regression with stepwise selection and Random Forest were used to develop direct mapping algorithms. Cross-validation was employed due to the absence of an external validation dataset. The study followed the Mapping onto Preference-based measures reporting Standards checklist. Results: The best models to predict MacNew-7D utility scores were determined using KCCQ, MLHFQ, and SAQ item and domain scores. Random Forest performed well for item scores for all questionnaires and domain score for KCCQ, while Bayesian GLM and Linear Regression were best for MLHFQ and SAQ domain scores. However, models tended to over-predict severe health states. Conclusion: The three cardiac-specific non-preference-based QOL instruments can be mapped onto MacNew-7D utilities with good predictive accuracy using both direct response mapping techniques. The reported mapping algorithms may facilitate estimation of health utility for economic evaluations that have used these QOL instruments. [ABSTRACT FROM AUTHOR]

This article proposes a new algorithm for a newly emerging domain wisdom mining that claims to extract wisdom from data. Association rule mining is one of the dominant data mining techniques based on which a new algorithm called WisRule is proposed that generates both positive and negative association rules. These rules can be used for decision-making with less influence from a specialist. The existing algorithms of association rule extraction are based on the frequency of an itemset, which was introduced into the Apriori algorithm for the first time. In these algorithms, those itemsets are converted to the rules of the form Antecedent ⇒ Consequent that qualify the threshold of support, confidence and similar other measures. WisRule is proposed as an extension to the CBPNARM algorithm. WisRule produces both positive and negative association rules based on their frequency evaluated in a certain context (C), utility (U), time (T) and location (L). Rules that are valid in a given context, have high utility and are valid across multiple time intervals and locations become part of the final ruleset. The evaluation of a rule in these four dimensions is claimed as mining wisdom from the given data that is currently used as a hypothetical basis for a domain expert's decision. WisRule is compared with the Apriori, PNARM and CBPNARM algorithms in terms of precision, recall, number of rules, average confidence, F -measure and execution time. [ABSTRACT FROM AUTHOR]

c. [ABSTRACT FROM AUTHOR]

Objectives: To assess the feasibility of estimating an EQ-5D-5L value set using a small study design in cancer patients and to compare the EQ-5D-5L values based on the preferences of cancer patients with those of the general public. Methods: Patients with clinically diagnosed cancers were recruited from two hospitals in Shanghai, China. In face-to-face interviews using the EQ-PVT survey, health states were valued by cancer patients using both cTTO and DCE methods. cTTO data was modelled alone or jointly with DCE data. Forty-eight models using different model specifications (cross-attribute level effect [CALE] and additive models), random/fixed effects model assumptions, data heteroscedasticity and censoring were estimated. The best performed model was identified in terms of monotonicity of estimated model coefficients and out-of-sample prediction accuracy. Results: Data collected from 221 cancer patients who participated in the study were included. The hybrid CALE model using both TTO and DCE data performed best in terms of prediction accuracy (Lin's concordance coefficient = 0.989; root mean squared error = 0.058) and suggested that pain/discomfort and anxiety/depression were the most undesirable health problems. Compared to values based on general Chinese public's health preferences, the values based on cancer patients' preferences were much higher and lower for health states characterized by extreme mobility problems and severe/extreme pain or discomfort, respectively. Conclusion: This study demonstrated the feasibility of using a small design to develop EQ-5D-5L value sets based on cancer patients' health preferences. Since there were signs of differences between preferences of patients and general population, it may be valuable to develop patient-specific value sets and use them in clinical decision making and economic evaluations. [ABSTRACT FROM AUTHOR]

Copyright of Environmental & Social Management Journal / Revista de Gestão Social e Ambiental is the property of Environmental & Social Management Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Balancing is an essential challenge in healthcare systems that requires effective strategies. This study aims to address this crucial issue by suggesting a practical approach. We show the potential of balancing a regional healthcare system to improve its utility. We consider a regional healthcare system comprising multiple hospitals with different sizes, capacities, quality of service, and accessibility. We define a utility function for the system based on the sectorization concept, which endeavors to form a balance between hospitals in terms of essential outputs such as waiting times and demands. The dynamic nature of the system means that this balance degrades over time, necessitating periodic sectorization, which is called resectorization. Our methodology stands out for incorporating resectorization as a dynamic strategy, enabling more flexible and responsive adaptations to continuously changing healthcare needs. Unlike previous studies, based on a system-oriented approach, our resectorization scenarios include the periodic closure of some hospitals. This enables us to enhance both the capacity and quality of healthcare facilities. Furthermore, in contrast to other studies, we investigate the states of diminishing demand throughout the resectorization process. To provide empirical insights, we conduct a simulation using data from a real-world case study. Our analysis spans multiple time periods, enabling us to dynamically quantify the utility of the healthcare system. The numerical findings demonstrate that substantial utility improvements are attainable through the defined scenarios. The study suggests a practical solution to the critical challenge of balancing issues in regional healthcare systems. [ABSTRACT FROM AUTHOR]

"The Loose Framework was Challenging": A Reconsideration of Change, Collaboration, and Movement in Intra-Active Action Research The purpose of this article is to contribute to the discussion on how action research can create change and establish equitable relationships between practice and research. In the article, we engage in a dialogue regarding what can be understood as intra-active action research and argue that in its endeavor to incorporate a perspective on materiality, action research tends to overlook the significance of discourses in shaping relationships. In line with this, we explore how the potentially contradictory demands of action research for change as both emancipation and utility can be understood as discourses that are linked to knowledge production and materialise in relationships. Consequently, there is a need to rethink the relationship between discourses, materiality, and subjects in intra-active action research. The article engages in a dialogue with Moa Frid's (2021) article "Collaboration, movement, and change: An intraactive action research approach" and seeks to reframe Frid's reconsideration with a heighten ed focus on the significance of discourses. Our reconsideration is exemplified through empirical material from a research project. [ABSTRACT FROM AUTHOR]

Prediction models are everywhere in clinical medicine. We use them to assign a diagnosis or a prognosis, and there have been continuous efforts to develop better prediction models. It is important to understand the fundamentals of prediction modelling, thus, we herein describe nine steps to develop and validate a clinical prediction model with the intention of implementing it in clinical practice: Determine if there is a need for a new prediction model; define the purpose and intended use of the model; assess the quality and quantity of the data you wish to develop the model on; develop the model using sound statistical methods; generate risk predictions on the probability scale (0-100%); evaluate the performance of the model in terms of discrimination, calibration, and clinical utility; validate the model using bootstrapping to correct for the apparent optimism in performance; validate the model on external datasets to assess the generalisability and transportability of the model; and finally publish the model so that it can be implemented or validated by others. [ABSTRACT FROM AUTHOR]

Background: Allergic rhinitis (AR) impacts patients' physical and emotional well‐being. Assessing patients' values and preferences (V&P) related to AR is an essential part of patient‐centered care and of the guideline development process. We aimed to systematically summarize the information about patients' V&P on AR and its symptoms and impact on daily life. Methods: We conducted systematic review in a MEDLINE, Embase, PsychInfo, and CINAHL databases. We included studies which quantitatively assessed patients' V&P for specific outcomes in AR by assessing utilities, applying discrete choice approaches, or rating and ranking outcomes. We grouped outcomes as AR symptoms, functional status, and care‐related patient experience. Study selection and data extraction were supported by the Laser AI tool. We rated the certainty of evidence (CoE) using the GRADE approach. Results: Thirty‐six studies (41 records) were included: nine utility studies, seven direct‐choice studies and 21 studies of rating or ranking outcomes. Utilities were lower with increased AR severity and with the concomitant presence of asthma, but not with whether AR was seasonal or perennial (CoE = low–high). Patients rated AR symptom‐related outcomes as more important than those related to care‐related patient experience and functional status (CoE = very low–moderate). Nasal symptoms (mainly nasal congestion) followed by breathing disorders, general and ocular symptoms were rated as the symptoms with the highest impact. Conclusions: This systematic review provides a comprehensive overview of V&P of patients with AR. Patients generally considered nasal symptoms as the most important. Future studies with standardized methods are needed to provide more information on V&P in AR. [ABSTRACT FROM AUTHOR]

Both 'collegiality' and 'distributed leadership' have, as terms, occasioned a good deal of debate. Conceptually elastic, they are often used interchangeably, or not appreciated as embodying a range of leadership styles and relationships. Spurred by an unanswered query from a research project, this theoretical article attempts to clarify what the two words mean – especially in relation to each other. Collegiality is defined as an approach, characterised by equality, whereas distributed leadership is seen to be much more closely aligned to the goals of a team or organisation, thus making it more to do with utility. While formal distributed leadership is indifferent to collegiality - although not hostile to it - informal distributed leadership, it is argued, requires collegiality to be in place before it can exist, much less thrive. [ABSTRACT FROM AUTHOR]

Background: Clinical practice guidelines (CPGs) improve patient care by standardising medical practice. However, little is known about their applicability in low‐resource settings. Since 2010, Fiji has introduced guidelines to increase the application of evidence‐based practice. Aims: We describe the dissemination, utility and monitoring of guideline implementation in Fiji, a low‐resource setting in the Pacific. Methods: A mixed‐methods design included a survey and focus groups. All 178 doctors in five departments at Fiji's largest tertiary hospital were invited to participate. Subsequently, two focus group interviews explored clinicians' perspectives in more detail. Analysis included data description, multi‐variable logistic, multinomial regression and manifest content analyses. Results: The response rate was 74%. Most doctors agreed that CPGs were good for patient management (100%), doctors continuing medical education (CME) (96%), patient education (73%), supported by systematic reviews (91%) and consistent with existing norms/values (83%). Ninety‐five per cent stated that CPGs increased the quality of care, and 80% stated that CPGs increased physician satisfaction. Approximately two‐thirds stated that CPGs decreased medical‐legal problems (63%) and malpractice suits (68%). Sixty to 90% of doctors disagreed that CPGs were oversimplified/cookbook medicine (60%), too rigid to apply individually (65%), challenged physician autonomy (60%) or were ambiguous/unclear (86%) or not practical (89%). The preferred method of dissemination was CME, and quick reference guides were best for implementation. No formal CPG monitoring existed in any department. Conclusion: Most physicians found CPGs to be valuable for improving the consistency of care. In low‐resource settings, dissemination of guidelines should be paired with CME to improve their uptake. Increased monitoring of guideline use appears necessary. [ABSTRACT FROM AUTHOR]

The demand for Nitinol alloy machined parts in the automotive and aerospace industries necessitates the optimization of machining parameters to enhance process performance in terms of product quality and cost. Specifically, the spindle speed (S), feed (f), and depth of cut (t) are crucial process variables in machining. Output performance indices, such as material removal rate (MRR), tool wear (TW), and surface roughness (Ra), are important measures of process effectiveness. This study focuses on evaluating process performance in machining Nitinol 56 alloy, utilizing the Taguchi method to assess the impact of the aforementioned process variables on the output performance indices. It has been noticed that the feed was the most influential variable for surface roughness and material removal rate whereas spindle speed for the tool wear. Subsequently, multiple multi-attribute decision-making optimization methods (MADM), including Grey, Utility, and TOPSIS, are employed to identify the optimal combination of process variables that satisfy the conflicting performance indices. The optimal process variable combination determined across all methods is S = 835, f = 0.111, and d = 0.6. A Moreover, a confirmatory test was conducted to validate the optimal conditions, revealing an increase of 5% in the overall value of utility, 5.98% in grey coefficient, and 1.23% in the closeness coefficient. [ABSTRACT FROM AUTHOR]

legal modernity as a value-oriented framework considered the concept of "right" as an abstract and metaphysical concept in the eighteenth century. At the same time, utilitarian theory welcomed the method of empirical observation in legal analysis, and considering the socio-economic functions of right emerged as an independent theory and have challenged how metaphysics interacts with reality. The present study seeks to investigate the relationship between metaphysics and reality and the nature of the concept of right from the perspective of utilitarianism theory. The principle of "achieving the greatest welfare for the greatest number" in utilitarian school of thought can challenge the concept of right drastically. It seems that utilitarianism authorizes sacrificing individuals and their interests (rights derived from the theory of modern natural law) as a necessity for greater happiness and welfare. Further investigation revealed that the theory rejects the subjectivism that exists in modern natural law; in other words, in examining the concept of right, it simply does not reflect the precedence of metaphysics over reality and, therefore, can be consistent with a typical impression of the concept of "right". [ABSTRACT FROM AUTHOR]

A growing proportion of forested landscapes are interspersed with human infrastructure, such as utility lines and roads, increasing the potential for tree-failure consequences due to storms and other causes. Utilities and other institutions have strong incentives to reduce such interactions and allocate substantial resources to risk reduction, but trees and forests in densely populated landscapes also provide significant amenities to society. We present a generalized framework for "Stormwise" forest management, focused on resistance of roadside forests to storms, based on elements of arboricultural and silvicultural practice and tree biomechanics and architecture. We detail results of a multidisciplinary research program focused on management outcomes, opportunities and barriers to implementation, and allocation of investment based on physical and social landscape characteristics. We discuss initial findings, the potential for widespread adoption of resilience-focused management in roadside and infrastructure-adjacent forests, and the importance of such work, considering a changing climate. Study Implications: The research and implementation program we detail here illustrates the potential for "Stormwise" forest management to reduce storm-damage recovery costs, result in fewer and shorter-duration power and transportation interruptions, and allow for low-investment ground-based management in future forest entries. We illustrate a multifaceted, interdisciplinary research program that links the geospatial, social, and biophysical components of understanding forest infrastructure systems. We illustrate how implementation of Stormwise management has the potential to benefit stakeholders such as residents and utilities, offset the substantial economic costs of tree-related power outages, and reduce societal disruptions associated with interactions between trees and infrastructure during storms. [ABSTRACT FROM AUTHOR]

Copyright of Arcos: Design, Cultura e Visualidade is the property of Editora da Universidade do Estado do Rio de Janeiro (EdUERJ) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)