Description and predictors of hospital costs of oesophageal cancer during the first year following diagnosis in Northern Ireland

The cost-effectiveness of novel interventions in the treatment of cancer is well researched; however, relatively little attention is paid to the cost of many aspects of routine care. Oesophageal cancer is the ninth most common cancer in the UK and sixth most common cause of cancer death. It usually presents late and has a poor prognosis. The hospital costs incurred by oesophageal cancer patients diagnosed in Northern Ireland in 2005 (n = 198) were determined by review of medical records. The average cost of hospital care per patient in the 12 months from presentation was £7847. Variations in total hospital costs by age at diagnosis, gender, cancer stage, histological type, mortality at 1 year, co-morbidity count and socio-economic status were analysed using multiple regression analyses. Higher costs were associated with earlier stages of cancer and cancer stage remained a significant predictor of costs after controlling for cancer type, patient age and mortality at 1 year. Thus, although early detection of cancer usually improves survival, this would mean increased costs in the first year. Deprivation achieved borderline significance with those from more deprived areas having lower resource consumption relative to the more affluent. © 2013 John Wiley & Sons Ltd.

Machine Learning for Predictive Maintenance: A Multiple Classifiers Approach

In this paper a multiple classifier machine learning methodology for Predictive Maintenance (PdM) is presented. PdM is a prominent strategy for dealing with maintenance issues given the increasing need to minimize downtime and associated costs. One of the challenges with PdM is generating so called ’health factors’ or quantitative indicators of the status of a system associated with a given maintenance issue, and determining their relationship to operating costs and failure risk. The proposed PdM methodology allows dynamical decision rules to be adopted for maintenance management and can be used with high-dimensional and censored data problems. This is achieved by training multiple classification modules with different prediction horizons to provide different performance trade-offs in terms of frequency of unexpected breaks and unexploited lifetime and then employing this information in an operating cost based maintenance decision system to minimise expected costs. The effectiveness of the methodology is demonstrated using a simulated example and a benchmark semiconductor manufacturing maintenance problem.

Tooth replacement for partially dentate elders: a willingness-to-pay analysis

Objectives: The primary aim of this study was to investigate partially dentate elders' willingness-to-pay (WTP) for two different tooth replacement strategies: Removable Partial Dentures (RPDs) and, functionally orientated treatment according to the principles of the Shortened Dental Arch (SDA). The secondary aim was to measure the same patient groups' WTP for dental implant treatment.Methods: 55 patients who had completed a previous RCT comparing two tooth replacement strategies (RPDs (n=27) and SDA (n=28)) were recruited (Trial Registration no. ISRCTN26302774). Patients were asked to indicate their WTP for treatment to replace missing teeth in a number of hypothetical scenarios using the payment card method of contingency evaluation coupled to different costs. Data were collected on patients' social class, income levels and other social circumstances. A Mann-Whitney U Test was used to compare differences in WTP between the two treatment groups. To investigate predictive factors for WTP, multiple linear regression analyses were conducted.Results: The median age for the patient sample was 72.0 years (IQR: 71-75 years). Patients who had been provided with RPDs indicated that their WTP for this treatment strategy was significantly higher (€550; IQR: 500-650) than those patients who had received SDA treatment (€500; IQR: 450-550) (p=0.003). However patients provided with RPDs indicated that their WTP for SDA treatment (€650; IQR: 600-650) was also significantly higher than those patients who had actually received functionally orientated treatment (€550; IQR: 500-600) (p<0.001). The results indicated that both current income levels and previous treatment allocation were significantly correlated to WTP for both the RPD and the SDA groups. Patients in both treatment groups exhibited little WTP for dental implant treatment with a median value recorded which was half the market value for this treatment (€1000; IQR: 500-1000).Conclusions: Amongst this patient cohort previous treatment experience had a strong influence on WTP as did current income levels. Both treatment groups indicated a very strong WTP for simpler, functionally orientated care using adhesive fixed prostheses (SDA) over conventional RPDs. Clinical significance: Partially dentate older patients expressed a strong preference for functionally orientated tooth replacement as an alternative to conventional RPDs.

Classical Romantic: Identity in the Latin Poetry of Vincent Bourne

This monograph examines a selection of Vincent Bourne's Latin verse in its classical, neo-Latin and vernacular contexts, with particular attention to the theme of identity (and differing forms of identity). Its aim is to initiate the resurrection from silence of an author whose self-fashioning is achieved by investigating the identity of the self in relation to the other and by foregrounding multiple attempts to fashion other selves.

From Back Cover of published book:

Through close and perceptive analysis of Bourne's negotiation of poetic identity, Haan argues in new ways for the blend of classicism and Romanticism informing his marginalized status. As such, the book promises to revive scholarship on Bourne, and to be of use to students and scholars of Latin as well as vernacular verse.
Carla Mazzio, Professor of English, University of Chicago.


Estelle Haan is the UK's most eminent neo-Latinist. Her books with the APS on Milton (From Academia to Amicitia, Transactions 88, part 6) and Addison (Vergilius Redivivus, Transactions 95, part 2) are both important contributions to our knowledge of those authors, and their scholarship is presented in a way that accommodates the growing number of specialists who do not read Latin. Much of the content of this study is entirely new, and it is written in a way that will make it accessible to non-Latinists. The connections with English-language poets that Professor Haan adduces page after page will be a very considerable resource for students of vernacular poetry.
Gordon Campbell, Professor of Renaissance Literature, University of Leicester.


I have long thought that a modern study of Vincent Bourne was very much needed, and am greatly pleased that one has now been written. Estelle Haan offers a thoughtful and sensitive study that has remarkable depth. She capitalizes on the familiarity with other eighteenth-century English poets about whom she has previously written (Cowper, Gray, and most recently Addison) and she makes use of contempoary literary theory without becoming dependent on any single approach or disfiguring her writing with critical jargon. This work will, one hopes, provoke further research into Bourne and his poetry.
Dana F. Sutton, Professor Emeritus of Classics, The University of California, Irvine.

'Dare the boist'rous main': the role of the Belfast Newsletter in the process of emigration from Ulster to North America 1760-1800

Before the mass migrations from Ireland in the nineteenth century, earlier waves of migration in the eighteenth century saw significant numbers of people leave Ireland, predominantly from Ulster, to settle in North America. This article, using as its principal data source the Belfast News Letter ( BNL), its letters, advertisements and reports, focuses firstly on reconstructing the late eighteenth-century migration process and voyage, highlighting the barriers represented by the Atlantic Ocean. In addition to the challenges of the sea, there were problems with the ships, the ever-present danger of disease and also threats from other vessels, from privateers to press gangs. The voyage was recognized as a ‘universal dread’, and the risks taken to ‘dare the boist’rous main’ were perhaps not minimized in the pages of the BNL, whose editorial stance was antipathetic to the migration for the potential harm it caused to Ulster by removing so many of its industrious young. The second part of this article goes on to consider the newspaper’s and others’ vested interests in the emigration process, demonstrates how these were manifested in the press and sets the coverage of this very significant early emigration flow within the context of contemporary religious and colonial discourses at a period of very lively transatlantic interactions.

Energy storage in electrochemical capacitors: designing functional materials to improve device performance

Electrochemical capacitors, also known as supercapacitors, are becoming increasingly important components in energy storage, although their widespread use has not been attained due to a high cost/ performance ratio. Fundamental research is contributing to lowered costs through the engineering of new materials. Currently the most viable materials used in electrochemical capacitors are biomassderived and polymer-derived activated carbons, although other carbon materials are useful research tools. Metal oxides could result in a step change for electrochemical capacitor technology and is an exciting area of research. The selection of an appropriate electrolyte and electrode structure is fundamental in determining device performance. Although there are still many uncertainties in understanding the underlying mechanisms involved in electrochemical capacitors, genuine progress continues to be made. It is argued that a large, collaborative international research programme is necessary to fully develop the potential of electrochemical capacitors.

Why multiples matter: Reconceptualising the population referred to child and family social workers

Building on a body of previous research by the author and colleagues in relation to multiple adverse childhood experiences (MACE), this paper addresses the question of ‘why multiples matter’ in relation to issues of cumulative adversity. Illustrative evidence is drawn from three research domains, epidemiology, multiple services use and child maltreatment to demonstrate the collective weight of evidence to suggest a targeting of those children and families experiencing multiple adversities to diminish the effects of such adversities realised across the life-course. Whilst the history of previous largely unsuccessful attempts to widen the range of children prioritised for intervention by child and family social workers might lead to pessimism in relation to their ability to respond to a MACE informed public health agenda, there are clear possibilities for developing agency structures, assessment tools and social work practices directed toward meeting the needs of those sub populations already prioritised by social workers: namely Children in Need, Children in need of Protection and Looked after Children.

Accounts of debates in the House of Commons, March– April 1731, supplementary to the diary of the first earl of Egmont

John Perceval (1685–1748), 1st Viscount Perceval and (from 1733) 1st Earl of Egmont, was an assiduous recorder of his own life and times. His diaries, published by the Historical Manuscripts Commission from manuscripts in the British Library, are the best source for parliamentary debates at Westminster in the 1730s. For the years 1730-1733, when Perceval sat in the Commons (as an Irish peer) they are remarkably full. His practice seems to have been to prepare two versions (presumably on the basis of notes taken in the House), the first attributing speeches to individuals, and the second, entered up in the diary, which listed speakers and summarized all arguments on each side. His letterbooks for 1731 contain accounts of five debates that embody his first editing process, with speeches attributed to individuals. They were sent to an Irish correspondent, Marmaduke Coghill, and largely omitted from the diary because Perceval had already transcribed them elsewhere. They are new to historians and cast light on two main issues: the unsuccessful attempts by Perceval and the ‘Irish lobby’ to persuade the British parliament to settle the Irish woollen trade, a question bedevilling Anglo-Irish relations in this period; and an attempt by the opposition to stir up anger against perceived Spanish aggression against Gibraltar. One of the most interesting features is the insight afforded into the Commons performances of Sir Robert Walpole: his management of debates, his own style of speaking, and his sharp exchanges with opponents like William Pulteney.

Late-stage, primary open-angle glaucoma in Europe:Social and health care maintenance costs and quality of life of patients from 4 countries

Objective: The purpose of this study was to estimate costs and quality of life (QoL) of late-stage glaucoma patients in 4 European countries. Methods: Retrospective review of medical charts of patients with POAG who were followed in a low-vision or vision rehabilitation center in one of 4 countries for at least 1 year was used to determine patient characteristics, health status, and health care resource use. Visual impairment was measured by best-corrected visual acuity (Snellen score). Patients were also interviewed over the telephone in order to assess their health-related QoL (using EuroQol EQ-5D) and use of resources including: the number of visits to rehabilitation centers, visits to hospital and non-hospital specialists, the use of low-vision devices, medication, tests, and the use of hired home help. The costs associated with resource use were calculated from the perspective of a third-party payer of health and social care based on resource usage and unit costs in each country. Results: Patients undergoing visual rehabilitation in France (n=21), Denmark (n=59), Germany (n=60), and the United Kingdom (n=22) were identified, interviewed and had their medical charts reviewed. Annual maintenance costs of late-stage glaucoma amounted to €830 (±445) on average. Average home help costs were more than 3 times higher. QoL, on average, was 0.65 (±0.28). QoL was positively correlated with the level of visual acuity in the patients' best eye. On the other hand, visual acuity was also positively correlated to health care costs, but negatively correlated to costs of home help. Conclusions: The study was limited by its observational, uncontrolled design. The finding that late-stage glaucoma is associated with higher home help costs than health care maintenance costs suggests that potential savings from a better preventive treatment are to be found for social care payers rather than health care payers. © 2008 Informa UK Ltd All rights reserved.

A comparative study of biopolymers and alum in the separation and recovery of pulp fibres from paper mill effluent by flocculation

Recovery of cellulose fibres from paper mill effluent has been studied using common polysaccharides or biopolymers such as Guar gum, Xanthan gum and Locust bean gum as flocculent. Guar gum is commonly used in sizing paper and routinely used in paper making. The results have been compared with the performance of alum, which is a common coagulant and a key ingredient of the paper industry. Guar gum recovered about 3.86 mg/L of fibre and was most effective among the biopolymers. Settling velocity distribution curves demonstrated that Guar gum was able to settle the fibres faster than the other biopolymers; however, alum displayed the highest particle removal rate than all the biopolymers at any of the settling velocities. Alum, Guar gum, Xanthan gum and Locust bean gum removed 97.46%, 94.68%, 92.39% and 92.46% turbidity of raw effluent at a settling velocity of 0.5 cm/min, respectively. The conditions for obtaining the lowest sludge volume index such as pH, dose and mixing speed were optimised for guar gum which was the most effective among the biopolymers. Response surface methodology was used to design all experiments, and an optimum operational setting was proposed. The test results indicate similar performance of alum and Guar gum in terms of floc settling velocities and sludge volume index. Since Guar gum is a plant derived natural substance, it is environmentally benign and offers a green treatment option to the paper mills for pulp recycling.

Secure Multiuser Communications in Multiple Amplify-and-Forward Relay Networks

This paper proposes relay selection in order to increase the physical layer security in multiuser cooperative relay networks with multiple amplify-and-forward (AF) relays, in the presence of multiple eavesdroppers. To strengthen the network security against eavesdropping attack, we present three criteria to select the best relay and user pair. Specifically, criterion I and II study the received signal-to-noise ratio (SNR) at the receivers, and perform the selection by maximizing the SNR ratio of the user to the eavesdroppers. To this end, criterion I relies on both the main and eavesdropper links, while criterion II relies on the main links only. Criterion III is the standard max-min selection criterion,
which maximizes the minimum of the dual-hop channel gains of main links. For the three selection criteria, we examine the system secrecy performance by deriving the analytical expressions for the secrecy outage probability. We also derive the asymptotic analysis for the secrecy outage probability with high main-to eavesdropper ratio (MER). From the asymptotic analysis, an interesting observation is reached: for each criterion, the system diversity order is equivalent to the number of relays regardless of the number of users and eavesdroppers.

A predictive maintenance system for integral type faults based on support vector machines:An application to ion implantation

In semiconductor fabrication processes, effective management of maintenance operations is fundamental to decrease costs associated with failures and downtime. Predictive Maintenance (PdM) approaches, based on statistical methods and historical data, are becoming popular for their predictive capabilities and low (potentially zero) added costs. We present here a PdM module based on Support Vector Machines for prediction of integral type faults, that is, the kind of failures that happen due to machine usage and stress of equipment parts. The proposed module may also be employed as a health factor indicator. The module has been applied to a frequent maintenance problem in semiconductor manufacturing industry, namely the breaking of the filament in the ion-source of ion-implantation tools. The PdM has been tested on a real production dataset. © 2013 IEEE.