Solving the median shortest path problem in the planning and design of urban transportation networks using a vector labeling algorithm

This paper proposes an alternative algorithm to solve the median shortest path problem (MSPP) in the planning and design of urban transportation networks. The proposed vector labeling algorithm is based on the labeling of each node in terms of a multiple and conflicting vector of objectives which deletes cyclic, infeasible and extreme-dominated paths in the criteria space imposing cyclic break (CB), path cost constraint (PCC) and access cost parameter (ACP) respectively. The output of the algorithm is a set of Pareto optimal paths (POP) with an objective vector from predetermined origin to destination nodes. Thus, this paper formulates an algorithm to identify a non-inferior solution set of POP based on a non-dominated set of objective vectors that leaves the ultimate decision to decision-makers. A numerical experiment is conducted using an artificial transportation network in order to validate and compare results. Sensitivity analysis has shown that the proposed algorithm is more efficient and advantageous over existing solutions in terms of computing execution time and memory space used.

A novel exhaust heat recovery system to reduce fuel consumption

Internal combustion engines release about 1/3 of the energy bound in the fuel as exhaust waste gas energy and another 1/3 energy is wasted through heat transfer into the ambient. On the other hand losses through friction are the third largest root cause for energy loss in internal combustion engines. During city driving frictional losses can be of the same size as the effective work, and during cold start these losses are even bigger. Therefore it is obvious to utilise wasted exhaust energy to warm up the engine oil directly. Frictional losses of any engine can be reduced during part load. Sensitivity analyses have been conducted for different concepts that utilise exhaust energy to reduce engine viscosity and friction. For a new system with an exhaust gas/oil heat exchanger the following benefits have been demonstrated:

• Fuel consumption reductions of over 7% measured as an average over 5 NEDC tests
compared to the standard system configuration.
• Significant reductions in exhaust emissions, mainly CO and NOx have been achieved
• Significantly higher oil temperatures during cold start indicate large potential to
reduce engine wear through reduced water condensation in the crankcase
• Fuel consumption reductions of further 3.3% to 4.6% compared to the 7% measured
over the NEDC test can be expected under real world customer usage conditions at
lower ambient temperatures.

Oil temperature measurements and analysis resulted in the idea of a novel system with further potential to reduce fuel consumption. This Oil Viscosity Energy Recovery System (OVER 7™) consists of 3 key features that add significant synergies if combined in a certain way: an oil warm up circuit/bypass, including oil pressure control and Exhaust Gas/Oil Heat Exchanger. The system separates the thermal inertias of the oil in the engine galleries and the oil pan, reduces hydraulic pumping losses, increases the heat transfer from the cylinder head to the oil, and utilises the exhaust heat to reduce oil friction.

The project demonstrated that sensitivity analysis is an important tool for the evaluation of different concepts. Especially for new concepts that include transient heat transfer such a qualitative approach in combination with accurate experiments and measurements can be faster and more efficient in leading to the desired improvements compared to time consuming detailed simulations.

An algorithm to median shortest path problem (MSPP) in the design of urban transportation networks

This paper proposes an efficient solution algorithm for realistic multi-objective median shortest path problems in the design of urban transportation networks. The proposed problem formulation and solution algorithm to median shortest path problem is based on three realistic objectives via route cost or investment cost, overall travel time of the entire network and total toll revenue. The proposed solution approach to the problem is based on the heuristic labeling and exhaustive search technique in criteria space and solution space of the algorithm respectively. The first labels each node in terms of route cost and deletes cyclic and infeasible paths in criteria space imposing cyclic break and route cost constraint respectively. The latter deletes dominated paths in terms of objectives vector in solution space in order to identify a set of Pareto optimal paths. The approach, thus, proposes a non-inferior solution set of Pareto optimal paths based on non-dominated objective vector and leaves the ultimate decision to decision-makers for purpose specific final decision during applications. A numerical experiment is conducted to test the proposed algorithm using artificial transportation network. Sensitivity analyses have shown that the proposed algorithm is advantageous and efficient over existing algorithms to find a set of Pareto optimal paths to median shortest paths problems.

Ustekinumab for the treatment of moderate to severe psoriasis

This paper presents a summary of the evidence review group (ERG) report into the clinical effectiveness and cost-effectiveness of ustekinumab for the treatment of moderate to severe psoriasis based upon a review of the manufacturer's submission to the National Institute for Health and Clinical Excellence (NICE) as part of the single technology appraisal (STA) process. The submission's main evidence came from three randomised controlled trials (RCTs), of reasonable methodological quality and measuring a range of clinically relevant outcomes. Higher proportions of participants treated with ustekinumab (45 mg and 90 mg) than with placebo or etanercept achieved an improvement on the Psoriasis Area and Severity Index (PASI) of at least 75% (PASI 75) after 12 weeks. There were also statistically significant differences in favour of ustekinumab over placebo for PASI 50 and PASI 90 results, and for ustekinumab over etanercept for PASI 90 results. A weight-based subgroup dosing analysis for each trial was presented, but the methodology was poorly described and no statistical analysis to support the chosen weight threshold was presented. The manufacturer carried out a mixed treatment comparison (MTC); however, the appropriateness of some of the methodological aspects of the MTC is uncertain. The incidence of adverse events was similar between groups at 12 weeks and withdrawals due to adverse events were low and less frequent in the ustekinumab than in the placebo or etanercept groups; however, statistical comparisons were not reported. The manufacturer's economic model of treatments for psoriasis compared ustekinumab with other biological therapies. The model used a reasonable approach; however, it is not clear whether the clinical effectiveness estimates from the subgroup analysis, used in the base-case analysis, were methodologically appropriate. The base-case incremental cost-effectiveness ratio for ustekinumab versus supportive care was 29,587 pounds per quality-adjusted life-year (QALY). In one-way sensitivity analysis the model was most sensitive to the number of hospital days associated with supportive care, the cost estimate for intermittent etanercept 25 mg and the utility scores used. In the ERG's scenario analysis the model was most sensitive to the price of ustekinumab 90 mg, the proportion of patients with baseline weight > 100 kg and the relative risk of intermittent versus continuous etanercept 25 mg. In the ERG's probabilistic sensitivity analysis ustekinumab had the highest probability of being cost-effective at conventional NICE thresholds, assuming the same price for the 45-mg and 90-mg doses; however, doubling the price of ustekinumab 90 mg resulted in ustekinumab no longer dominating the comparators. In conclusion, the clinical effectiveness and cost-effectiveness of ustekinumab in relation to other drugs in this class is uncertain. Provisional NICE guidance issued as a result of the STA states that ustekinumab is recommended as a treatment option for adults with plaque psoriasis when a number of criteria are met. Final guidance is anticipated in September 2009.

Entecavir for the treatment of chronic hepatitis B infection

This paper presents a summary of the evidence review group (ERG) report into the clinical and cost-effectiveness of entecavir for the treatment of chronic hepatitis B (CHB) in adults based upon a review of the manufacturer's submission to the National Institute for Health and Clinical Excellence (NICE) as part of the single technology appraisal (STA) process. The submission's evidence came from five randomised controlled trials (RCTs), of good methodological quality and measuring a range of clinically relevant outcomes, comparing entecavir with lamivudine. After 1 year of treatment entecavir was statistically superior to lamivudine in terms of the proportion of patients achieving hepatitis B virus (HBV) DNA suppression, alanine aminotransferase (ALT) normalisation and histological improvement, but not in terms of the proportion of patients achieving hepatitis B e antigen (HBeAg) seroconversion. The incidence of adverse or serious adverse events was similar for both treatments. The results of the manufacturer's mixed treatment comparison (MTC) model to compare entecavir with the comparator drugs in nucleoside-naive patients were considered to be uncertain because of concerns over its conduct and reporting. For the economic evaluation the manufacturer constructed two Markov state transition models, one in HBeAg-positive and one in HBeAg-negative patients. The modelling approach was considered reasonable subject to some uncertainties and concerns over some of the structural assumptions. In HBeAg-positive patients the base-case incremental cost-effectiveness ratios (ICER) for entecavir compared with lamivudine and pegylated interferon alpha-2a were 14,329 pounds and 8403 pounds per quality-adjusted life-year (QALY) respectively. Entecavir was dominated by telbivudine. In HBeAg-negative patients the base-case ICERs for entecavir compared with lamivudine, pegylated interferon alpha-2a and telbivudine were 13,208 pounds, 7511 pounds and 6907 pounds per QALY respectively. In HBeAg-positive lamivudine-refractory patients entecavir dominated adefovir added to lamivudine. In one-way deterministic sensitivity analysis on all key input parameters for entecavir compared with lamivudine in nucleoside-naive patients, ICERs generally remained under 30,000 pounds per QALY. In probabilistic sensitivity analysis in nucleoside-naive HBeAg-positive patients the probability of the ICER for entecavir being below 20,000 pounds per QALY was 57%, 82% and 45% compared with lamivudine, pegylated interferon alpha-2a and telbivudine respectively. In nucleoside-naive HBeAg-negative patients the probabilities were 90%, 100% and 96% respectively. The manufacturer's lifetime treatment scenario for HBeAg-negative patients and the ERG's 20-year treatment scenario for HBeAg-positive patients increased the ICERs, particularly in the latter case. Amending the HBeAg-negative model so that patients with compensated cirrhosis would also receive lifetime treatment gave probabilities of entecavir being cost-effective at a willingness to pay of 20,000 pounds and 30,000 pounds of 4% and 40% respectively. The NICE guidance issued in August 2008 as a result of the STA states that entecavir is recommended as an option for the treatment of people with chronic HBeAg-positive or HBeAg-negative hepatitis B in whom antiviral treatment is indicated.

Potentialities of renewable energy in Victoria, Australia

In utility power system, electricity demand is being covered largely by fossil fueled power generation, which contributes high level of GHG (greenhouse gas) emission and causes global warming worldwide. In order to reduce GHG emission level, most of the countries in the world targeting towards green energy that is power generation from RE (renewable energy) sources. In this paper, it is considered to study prospects of RE sources in particular, solar and wind in Victoria State which are abundant as compared to other sources of renewable. The wind and solar energy feasibility study and sensitivity analysis has been done for Victoria with the aid of HOMER (hybrid optimization model of electric renewable) simulation software. From the study, it has clearly evicted that wind energy combinational HPS (hybrid power system) has more contribution, and high potential than solar PV (photovoltaic) systems for a particular location. This study also investigates the influences of energy storage in the proposed HPS.

Long-term water supply planning in an Australian coastal city : Dams or desalination?

Water resource managers and planners are continually involved in defining and evaluating alternative policies to better meet changing water supply conditions and the expectations of society. To undertake such long-term water supply planning, this study developed a novel integrated system dynamics model to combine economic, social and scientific variables and considerations within the planning horizon. Extensive sensitivity analysis for these variables was considered in this long term water resource planning process. The analysis suggests that over a longer time horizon, desalination provides a more viable, cost effective and secure bulk water supply alternative when compared to building large rain-dependent dams.

The accuracy of Fastloc-GPS locations and implications for animal tracking

Over recent years, a major breakthrough in marine animal tracking has occurred with the advent of Fastloc-GPS that provides highly accurate location data even for animals that only surface briefly such as sea turtles, marine mammals and penguins. We assessed the accuracy of Fastloc-GPS locations using fixed trials of tags in which >45 000 locations were obtained. Procedures for determining the speed of travel and heading were developed by simulating tracks and then adding Fastloc-GPS location errors. The levels of detail achievable for speed and heading estimates were illustrated by using empirical Fastloc-GPS data for a green turtle (Chelonia mydas, Linnaeus, 1758) travelling over 3000 km across the Indian Ocean. The accuracy of Fastloc-GPS locations varied as a function of the number of GPS satellites used in the location calculation. For example, when Fastloc-GPS locations were calculated using 4 GPS satellites, 50% of locations were within 36 m and 95% within 724 m of the true position. These values improved to 18 and 70 m, respectively, when 6 satellites were used. Simulations indicated that for animals travelling around 2·5 km h-1 (e.g. turtles, penguins and seals) and depending on the number of satellites used in the location calculation, robust speed and heading estimates would usually be obtained for locations only 1-6 h apart. Fastloc-GPS accuracy is several orders of magnitude better that conventional Argos tracking or light-based geolocation and consequently will allow new insights into small-scale movement patterns of marine animals.

Systematic review and quality appraisal of economic evaluation publications in dentistry

Economic evaluation (EE) studies have been undertaken in dentistry since the late 20th century because economic data provide additional information to policy makers to develop guidelines and set future direction for oral health services. The objectives of this study were to assess the methodological quality of EEs in oral health. Electronic searching of Ovid MEDLINE, the Cochrane Library, and the NHS Economic Evaluation Database from 1975 to 2013 were undertaken to identify publications that include costs and outcomes in dentistry. Relevant reference lists were also searched for additional studies. Studies were retrieved and reviewed independently for inclusion by 3 authors. Furthermore, to appraise the EE methods, 1 author applied the Drummond 10-item (13-criteria) checklist tool to each study. Of the 114 publications identified, 79 studies were considered full EE and 35 partial. Twenty-eight studies (30%) were published between the years 2011 and 2013. Sixty-four (53%) studies focused on dental caries prevention or treatment. Median appraisal scores calculated for full and partial EE studies were 11 and 9 out of 13, respectively. Quality assessment scores showed that the quality of partial EE studies published after 2000 significantly improved (P = 0.02) compared to those published before 2000. Significant quality improvement was not found in full EE studies. Common methodological limitations were identified: absence of sensitivity analysis, discounting, and insufficient information on how costs and outcomes were measured and valued. EE studies in dentistry increased over the last 40 y in both quantity and quality, but a number of publications failed to satisfy some components of standard EE research methods, such as sensitivity analysis and discounting.

BMI and healthcare cost impact of eliminating tax subsidy for advertising unhealthy food to youth

INTRODUCTION: Food and beverage TV advertising contributes to childhood obesity. The current tax treatment of advertising as an ordinary business expense in the U.S. subsidizes marketing of nutritionally poor foods and beverages to children. This study models the effect of a national intervention that eliminates the tax subsidy of advertising nutritionally poor foods and beverages on TV to children aged 2-19 years. METHODS: We adapted and modified the Assessing Cost Effectiveness framework and methods to create the Childhood Obesity Intervention Cost Effectiveness Study model to simulate the impact of the intervention over the 2015-2025 period for the U.S. population, including short-term effects on BMI and 10-year healthcare expenditures. We simulated uncertainty intervals (UIs) using probabilistic sensitivity analysis and discounted outcomes at 3% annually. Data were analyzed in 2014. RESULTS: We estimated the intervention would reduce an aggregate 2.13 million (95% UI=0.83 million, 3.52 million) BMI units in the population and would cost $1.16 per BMI unit reduced (95% UI=$0.51, $2.63). From 2015 to 2025, the intervention would result in $352 million (95% UI=$138 million, $581 million) in healthcare cost savings and gain 4,538 (95% UI=1,752, 7,489) quality-adjusted life-years. CONCLUSIONS: Eliminating the tax subsidy of TV advertising costs for nutritionally poor foods and beverages advertised to children and adolescents would likely be a cost-saving strategy to reduce childhood obesity and related healthcare expenditures.

Web-based alcohol screening and brief intervention for university students: a randomized trial

IMPORTANCE: Unhealthy alcohol use is a leading contributor to the global burden of disease, particularly among young people. Systematic reviews suggest efficacy of web-based alcohol screening and brief intervention and call for effectiveness trials in settings where it could be sustainably delivered. OBJECTIVE: To evaluate a national web-based alcohol screening and brief intervention program. DESIGN, SETTING, AND PARTICIPANTS: A multisite, double-blind, parallel-group, individually randomized trial was conducted at 7 New Zealand universities. In April and May of 2010, invitations containing hyperlinks to the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) screening test were e-mailed to 14,991 students aged 17 to 24 years. INTERVENTIONS: Participants who screened positive (AUDIT-C score ≥4) were randomized to undergo screening alone or to 10 minutes of assessment and feedback (including comparisons with medical guidelines and peer norms) on alcohol expenditure, peak blood alcohol concentration, alcohol dependence, and access to help and information. MAIN OUTCOMES AND MEASURES: A fully automated 5-month follow-up assessment was conducted that measured 6 primary outcomes: consumption per typical occasion, drinking frequency, volume of alcohol consumed, an academic problems score, and whether participants exceeded medical guidelines for acute harm (binge drinking) and chronic harm (heavy drinking). A Bonferroni-corrected significance threshold of .0083 was used to account for the 6 comparisons and a sensitivity analysis was used to assess possible attrition bias. RESULTS: Of 5135 students screened, 3422 scored 4 or greater and were randomized, and 83% were followed up. There was a significant effect on 1 of the 6 prespecified outcomes. Relative to control participants, those who received intervention consumed less alcohol per typical drinking occasion (median 4 drinks [interquartile range {IQR}, 2-8] vs 5 drinks [IQR 2-8]; rate ratio [RR], 0.93 [99.17% CI, 0.86-1.00]; P = .005) but not less often (RR, 0.95 [99.17% CI, 0.88-1.03]; P = .08) or less overall (RR, 0.95 [99.17% CI, 0.81-1.10]; P = .33). Academic problem scores were not lower (RR, 0.91 [99.17% CI, 0.76-1.08]; P = .14) and effects on the risks of binge drinking (odds ratio [OR], 0.84 [99.17% CI, 0.67-1.05]; P = .04) and heavy drinking (OR, 0.77 [99.17% CI, 0.56-1.05]; P = .03) were not significantly significant. In a sensitivity analysis accounting for attrition, the effect on alcohol per typical drinking occasion was no longer statistically significant. CONCLUSIONS AND RELEVANCE: A national web-based alcohol screening and brief intervention program produced no significant reductions in the frequency or overall volume of drinking or academic problems. There remains a possibility of a small reduction in the amount of alcohol consumed per typical drinking occasion. TRIAL REGISTRATION: anzctr.org.au Identifier: ACTRN12610000279022.

The population cost-effectiveness of a parenting intervention designed to prevent anxiety disorders in children

BACKGROUND: Prevention and early intervention for anxiety disorders has lagged behind many other forms of mental disorder. Recent research has demonstrated the efficacy of a parent-focussed psycho-educational programme. The programme is directed at parents of inhibited preschool children and has been shown to reduce anxiety disorders at 1 and 3 years following intervention. The current study assesses the cost-effectiveness of this intervention to determine whether it could provide value-for-money across a population. METHOD: A cost-utility economic framework, using Disability-Adjusted-Life-Years (DALYs) as the outcome, was adopted. Economic modelling techniques were used to assess the incremental cost-effectiveness ratio (ICER) of the intervention within the Australian population context, which was modelled as add-on to current practice. The perspective was the health sector. Uncertainty was measured using multivariate probabilistic testing and key assumptions were tested using univariate sensitivity analysis. RESULTS: The median ICER for the intervention was AUD$8,000 per DALY averted with 99.8% of the uncertainty iterations falling below the threshold value-for-money criterion of AUD$50,000 per DALY averted. The results were robust to sensitivity testing. CONCLUSIONS: Screening young children in a preschool setting for an inhibited temperament and providing a brief intervention to the parents of children with high levels of inhibition appears to provide very good value-for-money and worth considering in any package of preventive care. Further evaluation of this intervention under routine health service conditions will strengthen conclusions. Acceptability issues associated with this intervention, particularly to preschool staff and parents, need to be considered before wide-scale adoption is undertaken.

Habitat switching by Bewick's swans: Maximization of average long-term energy gain?

1. In a system where depletion drives a habitat shift, the hypothesis was tested that animals switch habitat as soon as the average daily net energy intake (or gain) drops below that attainable in the alternative habitat.

2. The study was performed in the Lauwersmeer area. Upon arrival during the autumn migration, Bewick's swans first feed on below-ground tubers of fennel pondweed on the lake, but subsequently switched to feeding on harvest remains in sugar beet fields.

3. The daily energy intake was estimated by multiplying the average time spent foraging per day with the instantaneous energy intake rate while foraging. In the case of pondweed feeding, the latter was estimated from the functional response and the depletion of tuber biomass. In the case of beet feeding, it was estimated from dropping production rate. Gross energy intake was converted to metabolizable energy intake using the assimilation as determined in digestion trials. The daily energy expenditure was estimated by the time-energy budget method. Energetic costs were determined using heart rate.

4. The daily gain of pondweed feeding at the median date of the habitat switch (i.e. when 50% of the swans had switched) was compared with that of beet feeding. The daily gain of beet feeding was calculated for two strategies depending on the night activity on the lake: additional pondweed feeding (mixed feeding) or sleeping (pure beet feeding).

5. The majority of the swans switched when the daily gain they could achieve by staying on the pondweed bed fell just below the average daily gain of pure beet feeders. However, mixed feeders would attain an average daily gain considerably above that of pondweed feeders. A sensitivity analysis showed that this result was robust.

6. We therefore reject the hypothesis that the habitat switch by swans can be explained by simple long-term energy rate maximization. State-dependency, predation risk, and protein requirements are put forward as explanations for the delay in habitat switch.