Determining the minimum clinically important differences for outcomes in the DOMINO trial

Although less likely to be reported in clinical trials than expressions of the statistical significance of differences in outcomes, whether or not a treatment has delivered a specified minimum clinically important difference (MCID) is also relevant to patients and their caregivers and doctors. Many dementia treatment randomised controlled trials (RCTs) have not reported MCIDs and, where they have been done, observed differences have not reached these.

The geriatric minimum data set for clinical trials (GMDS)

To overcome the weak evidence base coming from often poor and insufficient clinical research in older people, a minimum data set to achieve harmonisation is highly advisable. This will lead to uniform nomenclature and to the standardisation of the assessment tools. Our primary objective was to develop a Geriatric Minimum Data Set (GMDS) for clinical research.

Asymmetric information without common priors: an indirect evolutionary analysis of quantity competition

The common prior assumption justifies private beliefs as posterior probabilities when updating a common prior based on individual information. We dispose of the common prior assumption for a homogeneous oligopoly market with uncertain costs and firms entertaining arbitrary priors about other firms' cost-type. We show that true prior beliefs can not be evolutionarily stable when truly expected profit measures (reproductive) success.

Double-detonation sub-Chandrasekhar supernovae: Synthetic observables for minimum helium shell mass models

In the double-detonation scenario for Type Ia supernovae, it is suggested that a detonation initiates in a shell of helium-rich material accreted from a companion star by a sub-Chandrasekhar-mass white dwarf. This shell detonation drives a shock front into the carbon-oxygen white dwarf that triggers a secondary detonation in the core. The core detonation results in a complete disruption of the white dwarf. Earlier studies concluded that this scenario has difficulties in accounting for the observed properties of Type Ia supernovae since the explosion ejecta are surrounded by the products of explosive helium burning in the shell. Recently, however, it was proposed that detonations might be possible for much less massive helium shells than previously assumed (Bildsten et al.). Moreover, it was shown that even detonations of these minimum helium shell masses robustly trigger detonations of the carbon-oxygen core (Fink et al.). Therefore, it is possible that the impact of the helium layer on observables is less than previously thought. Here, we present time-dependent multi-wavelength radiative transfer calculations for models with minimum helium shell mass and derive synthetic observables for both the optical and ? -ray spectral regions. These differ strongly from those found in earlier simulations of sub-Chandrasekhar-mass explosions in which more massive helium shells were considered. Our models predict light curves that cover both the range of brightnesses and the rise and decline times of observed Type Ia supernovae. However, their colors and spectra do not match the observations. In particular, their B - V colors are generally too red. We show that this discrepancy is mainly due to the composition of the burning products of the helium shell of the Fink et al. models which contain significant amounts of titanium and chromium. Using a toy model, we also show that the burning products of the helium shell depend crucially on its initial composition. This leads us to conclude that good agreement between sub-Chandrasekhar-mass explosions and observed Type Ia supernovae may still be feasible but further study of the shell properties is required.

Double-detonation sub-Chandrasekhar supernovae: Can minimum helium shell masses detonate the core?

The explosion of sub-Chandrasekhar mass white dwarfs via the double detonation scenario is a potential explanation for type Ia supernovae. In this scenario, a surface detonation in a helium layer initiates a detonation in the underlying carbon/oxygen core leading to an explosion. For a given core mass, a lower bound has been determined on the mass of the helium shell required for dynamical burning during a helium flash, which is a necessary prerequisite for detonation. For a range of core and corresponding minimum helium shell masses, we investigate whether an assumed surface helium detonation is capable of triggering a subsequent detonation in the core even for this limiting case. We carried out hydrodynamic simulations on a co-expanding Eulerian grid in two dimensions assuming rotational symmetry. The detonations are propagated using the level-set approach and a simplified scheme for nuclear reactions that has been calibrated with a large nuclear network. The same network is used to determine detailed nucleosynthetic abundances in a post-processing step. Based on approximate detonation initiation criteria in the literature, we find that secondary core detonations are triggered for all of the simulated models, ranging in core mass from 0.810 up to 1.385 M? with corresponding shell masses from 0.126 down to 0.0035 M?. This implies that, as soon as a detonation triggers in a helium shell covering a carbon/oxygen white dwarf, a subsequent core detonation is virtually inevitable.

Price Discrimination in Quantity Setting Oligopoly

We analyze a two-stage quantity setting oligopolistic price discrimination game. In the first stage firms choose capacities and in the second stage they simultaneously choose the share that they assign to each segment. At the equilibrium the firms focus more on the high-valuation customers. When the capacities in the first stage are endogenous, the deadweight loss does not vanish with the level of price discrimination, as it does in one-stage games and monopoly. Moreover, the quantity-weighted average price increases with the level of price discrimination as opposed to established results in the literature for one-stage games.

Ecological dynamics of extinct species in empty habitat networks. 1. The role of habitat pattern and quantity, stochasticity and dispersal

We examined a remnant host plant (Primula veris L.) habitat network that was last inhabited by the rare butterfly Hamearis lucina L. in north Wales in 1943, to assess the relative contribution of several spatial parameters to its regional extinction. We first examined relationships between P. veris characteristics and H. lucina eggs in surviving H. lucina populations, and used these to predict the suitability and potential carrying capacity of the habitat network in north Wales. This resulted in an estimate of roughly 4500 eggs (ca 227 adults). We developed a discrete space, discrete time metapopulation model to evaluate the relative contribution of dispersal distance, habitat and environmental stochasticity as possible causes of extinction. We simulated the potential persistence of the butterfly in the current network as well as in three artificial (historical and present) habitat networks that differed in the quantity (current and X3) and fragmentation of the habitat (current and aggregated). We identified that reduced habitat quantity and increased isolation would have increased the probability of regional extinction, in conjunction with environmental stochasticity and H. lucina's dispersal distance. This general trend did not change in a qualitative manner when we modified the ability of dispersing females to stay in, and find suitable habitats (by changing the size of the grid cells used in the model). Contrary to most metapopulation model predictions, system persistence declined with increasing migration rate, suggesting that the mortality of migrating individuals in fragmented landscapes may pose significant risks to system-wide persistence. Based on model predictions for the present landscape we argue that a major programme of habitat restoration would be required for a re-established metapopulation to persist for > 100 years.

51 Pegasi - a planet-bearing Maunder minimum candidate

We observed 51 Peg, the first detected planet-bearing star, in a 55 ks XMM-Newton pointing and in 5 ks pointings each with Chandra HRC-I and ACIS-S. The star has a very low count rate in the XMM observation, but is clearly visible in the Chandra images due to the detectors' different sensitivity at low X-ray energies. This allows a temperature estimate for 51 Peg's corona of T⪉ 1 MK; the detected ACIS-S photons can be plausibly explained by emission lines of a very cool plasma near 200 eV. The constantly low X-ray surface flux and the flat-activity profile seen in optical Ca II data suggest that 51 Peg is a Maunder minimum star; an activity enhancement due to a Hot Jupiter, as proposed by recent studies, seems to be absent. The star's X-ray fluxes in different instruments are consistent with the exception of the HRC Imager, which might have a larger effective area below 200 eV than given in the calibration.

Guidance for laboratories performing molecular pathology for cancer patients

Molecular testing is becoming an important part of the diagnosis of any patient with cancer. The challenge to laboratories is to meet this need, using reliable methods and processes to ensure that patients receive a timely and accurate report on which their treatment will be based. The aim of this paper is to provide minimum requirements for the management of molecular pathology laboratories. This general guidance should be augmented by the specific guidance available for different tumour types and tests. Preanalytical considerations are important, and careful consideration of the way in which specimens are obtained and reach the laboratory is necessary. Sample receipt and handling follow standard operating procedures, but some alterations may be necessary if molecular testing is to be performed, for instance to control tissue fixation. DNA and RNA extraction can be standardised and should be checked for quality and quantity of output on a regular basis. The choice of analytical method(s) depends on clinical requirements, desired turnaround time, and expertise available. Internal quality control, regular internal audit of the whole testing process, laboratory accreditation, and continual participation in external quality assessment schemes are prerequisites for delivery of a reliable service. A molecular pathology report should accurately convey the information the clinician needs to treat the patient with sufficient information to allow for correct interpretation of the result. Molecular pathology is developing rapidly, and further detailed evidence-based recommendations are required for many of the topics covered here.