Clinical utility of ocular residual astigmatism and topographic disparity vector indexes in subclinical and clinical keratoconus

Purpose. We aimed to characterize the distribution of the vector parameters ocular residual astigmatism (ORA) and topography disparity (TD) in a sample of clinical and subclinical keratoconus eyes, and to evaluate their diagnostic value to discriminate between these conditions and healthy corneas. Methods. This study comprised a total of 43 keratoconic eyes (27 patients, 17–73 years) (keratoconus group), 11 subclinical keratoconus eyes (eight patients, 11–54 years) (subclinical keratoconus group) and 101 healthy eyes (101 patients, 15–64 years) (control group). In all cases, a complete corneal analysis was performed using a Scheimpflug photography-based topography system. Anterior corneal topographic data was imported from it to the iASSORT software (ASSORT Pty. Ltd), which allowed the calculation of ORA and TD. Results. Mean magnitude of the ORA was 3.23 ± 2.38, 1.16 ± 0.50 and 0.79 ± 0.43 D in the keratoconus, subclinical keratoconus and control groups, respectively (p < 0.001). Mean magnitude of the TD was 9.04 ± 8.08, 2.69 ± 2.42 and 0.89 ± 0.50 D in the keratoconus, subclinical keratoconus and control groups, respectively (p < 0.001). Good diagnostic performance of ORA (cutoff point: 1.21 D, sensitivity 83.7 %, specificity 87.1 %) and TD (cutoff point: 1.64 D, sensitivity 93.3 %, specificity 92.1 %) was found for the detection of keratoconus. The diagnostic ability of these parameters for the detection of subclinical keratoconus was more limited (ORA: cutoff 1.17 D, sensitivity 60.0 %, specificity 84.2 %; TD: cutoff 1.29 D, sensitivity 80.0 %, specificity 80.2 %). Conclusion. The vector parameters ORA and TD are able to discriminate with good levels of precision between keratoconus and healthy corneas. For the detection of subclinical keratoconus, only TD seems to be valid.

Utility functions on locally connected spaces

We investigate the role of local connectedness in utility theory and prove that any continuous total preorder on a locally connected separable space is continuously representable. This is a new simple criterion for the representability of continuous preferences, and is not a consequence of the standard theorems in utility theory that use conditions such as connectedness and separability, second countability, or path-connectedness. Finally we give applications to problems involving the existence of value functions in population ethics and to the problem of proving the existence of continuous utility functions in general equilibrium models with land as one of the commodities. (C) 2003 Elsevier B.V. All rights reserved.

Utility of signs and symptoms of chronic cough in predicting specific cause in children

Background: Paediatricians rely on cough descriptors to direct them to the level of investigations needed for a child presenting with chronic cough, yet there is a lack of published data to support this approach. A study was undertaken to evaluate ( 1) whether historical cough pointers can predict which children have a specific cause for their cough and ( 2) the usefulness of chest radiography and spirometry as standard investigations in children with chronic cough. Methods: This was a prospective cohort study of children referred to a tertiary hospital with a cough lasting 3 weeks between June 2002 and July 2004. All included children completed a detailed history and examination using a standardised data collection sheet and followed a pathway of investigation until a diagnosis was made. Results: In 100 consecutively recruited children of median age 2.8 years, the best predictor of specific cough observed was a moist cough at the time of consultation with an odds ratio ( OR) of 9.34 (95% CI 3.49 to 25.03). Chest examination or chest radiographic abnormalities were also predictive with OR 3.60 ( 95% CI 1.31 to 9.90) and 3.16 (95% CI 1.32 to 7.62), respectively. The most significant historical pointer for predicting a specific cause of the cough was a parental history of moist cough ( sensitivity 96%, specificity 26%, positive predictive value 74%). Conclusions: The most useful clinical marker in predicting specific cough is the presence of a daily moist cough. Both chest examination and chest radiographic abnormalities are also useful in predicting whether children have a specific cause of their cough.

Simulating the value of collaboration in multi-actor conservation planning

The loss of habitat and biodiversity worldwide has led to considerable resources being spent for conservation purposes on actions such as the acquisition and management of land, the rehabilitation of degraded habitats, and the purchase of easements from private landowners. Prioritising these actions is challenging due to the complexity of the problem and because there can be multiple actors undertaking conservation actions, often with divergent or partially overlapping objectives. We use a modelling framework to explore this issue with a study involving two agents sequentially purchasing land for conservation. We apply our model to simulated data using distributions taken from real data to simulate the cost of patches and the rarity and co-occurence of species. In our model each agent attempted to implement a conservation network that met its target for the minimum cost using the conservation planning software Marxan. We examine three scenarios where the conservation targets of the agents differ. The first scenario (called NGO-NGO) models the situation where two NGOs are both are targeting different sets of threatened species. The second and third scenarios (called NGO-Gov and Gov-NGO, respectively) represent a case where a government agency attempts to implement a complementary conservation network representing all species, while an NGO is focused on achieving additional protection for the most endangered species. For each of these scenarios we examined three types of interactions between agents: i) acting in isolation where the agents are attempting to achieve their targets solely though their own actions ii) sharing information where each agent is aware of the species representation achieved within the other agent’s conservation network and, iii) pooling resources where agents combine their resources and undertake conservation actions as a single entity. The latter two interactions represent different types of collaborations and in each scenario we determine the cost savings from sharing information or pooling resources. In each case we examined the utility of these interactions from the viewpoint of the combined conservation network resulting from both agents' actions, as well as from each agent’s individual perspective. The costs for each agent to achieve their objectives varied depending on the order in which the agents acted, the type of interaction between agents, and the specific goals of each agent. There were significant cost savings from increased collaboration via sharing information in the NGO-NGO scenario were the agent’s representation goals were mutually exclusive (in terms of specie targeted). In the NGO-Gov and Gov-NGO scenarios, collaboration generated much smaller savings. If the two agents collaborate by pooling resources there are multiple ways the total cost could be shared between both agents. For each scenario we investigate the costs and benefits for all possible cost sharing proportions. We find that there are a range of cost sharing proportions where both agents can benefit in the NGO-NGO scenarios while the NGO-Gov and Gov-NGO scenarios again showed little benefit. Although the model presented here has a range of simplifying assumptions, it demonstrates that the value of collaboration can vary significantly in different situations. In most cases, collaborating would have associated costs and these costs need to be weighed against the potential benefits from collaboration. The model demonstrates a method for determining the range of collaboration costs that would result in collaboration providing an efficient use of scarce conservation resources.

Differential effects of value consciousness and coupon proneness on consumers’ persuasion knowledge of pricing tactics

Pricing tactics persuasion knowledge (PTPK) is a relatively new concept that seeks to extend the research on persuasion knowledge to the pricing domain. Pricing tactics persuasion knowledge refers to the persuasion knowledge of consumers about marketers’ pricing tactics. Employing an acquisition–transaction utility theoretic perspective, this study examines the differential effects of value consciousness and coupon proneness on the accuracy, confidence, and calibration of consumers’ pricing tactics persuasion knowledge. The study finds that coupon proneness is negatively related to accuracy, confidence, and calibration of PTPK, while value consciousness is positively related to accuracy, confidence, and calibration of PTPK. The implications of the study are outlined.

The Shapley value for airport and irrigation games

In this paper cost sharing problems are considered. We focus on problems given by rooted trees, we call these problems cost-tree problems, and on the induced transferable utility cooperative games, called irrigation games. A formal notion of irrigation games is introduced, and the characterization of the class of these games is provided. The well-known class of airport games Littlechild and Thompson (1977) is a subclass of irrigation games. The Shapley value Shapley (1953) is probably the most popular solution concept for transferable utility cooperative games. Dubey (1982) and Moulin and Shenker (1992) show respectively, that Shapley's Shapley (1953) and Young (1985)'s axiomatizations of the Shapley value are valid on the class of airport games. In this paper we show that Dubey (1982)'s and Moulin and Shenker (1992)'s results can be proved by applying Shapley (1953)'s and Young (1985)'s proofs, that is those results are direct consequences of Shapley (1953)'s and Young (1985)'s results. Furthermore, we extend Dubey (1982)'s and Moulin and Shenker (1992)'s results to the class of irrigation games, that is we provide two characterizations of the Shapley value for cost sharing problems given by rooted trees. We also note that for irrigation games the Shapley value is always stable, that is it is always in the core Gillies (1959).

Examination of the impact of personality, social, and cognitive factors on the co-occurrence of health risk behaviors among multi-problem youth: The utility of an integrative framework

Research has identified a number of putative risk factors that places adolescents at incrementally higher risk for involvement in alcohol and other drug (AOD) use and sexual risk behaviors (SRBs). Such factors include personality characteristics such as sensation-seeking, cognitive factors such as positive expectancies and inhibition conflict as well as peer norm processes. The current study was guided by a conceptual perspective that support the notion that an integrative framework that includes multi-level factors has significant explanatory value for understanding processes associated with the co-occurrence of AOD use and sexual risk behavior outcomes. This study evaluated simultaneously the mediating role of AOD-sex related expectancies and inhibition conflict on antecedents of AOD use and SRBs including sexual sensation-seeking and peer norms for condom use.^ The sample was drawn from the Enhancing My Personal Options While Evaluating Risk (EMPOWER: Jonathan Tubman, PI), data set (N = 396; aged 12-18 years). Measures used in the study included Sexual Sensation-Seeking Scale, Inhibition Conflict for Condom Use, Risky Sex Scale. All relevant measures had well-documented psychometric properties. A global assessment of alcohol, drug use and sexual risk behaviors was used.^ Results demonstrated that AOD-sex related expectancies mediated the influence of sexual sensation-seeking on the co-occurrence of alcohol and other drug use and sexual risk behaviors. The evaluation of the integrative model also revealed that sexual sensation-seeking was positively associated with peer norms for condom use. Also, peer norms predicted inhibition conflict among this sample of multi-problem youth. ^ This dissertation research identified mechanisms of risk and protection associated with the co-occurrence of AOD use and SRBs among a multi-problem sample of adolescents receiving treatment for alcohol or drug use and related problems. This study is informative for adolescent-serving programs that address those individual and contextual characteristics that enhance treatment efficacy and effectiveness among adolescents receiving substance use and related problems services.^

Examination of Personality, Social and Cognitive Factors on the Co-Occurrence of Health Risk Behaviors among Multi-Problem Youth: The Utility of An Integrative Framework

Research has identified a number of putative risk factors that places adolescents at incrementally higher risk for involvement in alcohol and other drug (AOD) use and sexual risk behaviors (SRBs). Such factors include personality characteristics such as sensation-seeking, cognitive factors such as positive expectancies and inhibition conflict as well as peer norm processes. The current study was guided by a conceptual perspective that support the notion that an integrative framework that includes multi-level factors has significant explanatory value for understanding processes associated with the co-occurrence of AOD use and sexual risk behavior outcomes. This study evaluated simultaneously the mediating role of AOD-sex related expectancies and inhibition conflict on antecedents of AOD use and SRBs including sexual sensation-seeking and peer norms for condom use. The sample was drawn from the Enhancing My Personal Options While Evaluating Risk (EMPOWER: Jonathan Tubman, PI), data set (N = 396; aged 12-18 years). Measures used in the study included Sexual Sensation-Seeking Scale, Inhibition Conflict for Condom Use, Risky Sex Scale. All relevant measures had well-documented psychometric properties. A global assessment of alcohol, drug use and sexual risk behaviors was used. Results demonstrated that AOD-sex related expectancies mediated the influence of sexual sensation-seeking on the co-occurrence of alcohol and other drug use and sexual risk behaviors. The evaluation of the integrative model also revealed that sexual sensation-seeking was positively associated with peer norms for condom use. Also, peer norms predicted inhibition conflict among this sample of multi-problem youth. This dissertation research identified mechanisms of risk and protection associated with the co-occurrence of AOD use and SRBs among a multi-problem sample of adolescents receiving treatment for alcohol or drug use and related problems. This study is informative for adolescent-serving programs that address those individual and contextual characteristics that enhance treatment efficacy and effectiveness among adolescents receiving substance use and related problems services.

Functional educational characterisation of the utility of embalming fluids for anatomical education and research

Human cadavers have long been used to teach human anatomy and are increasingly used in other disciplines. Different embalming techniques have been reported in the literature; however there is no clear consensus on the opinion of anatomists on the utility of embalmed cadavers for the teaching of anatomy. To this end, we aimed to survey British and Irish anatomy teachers to report their opinions on different preservation methods for the teaching of anatomy. In this project eight human cadavers were embalmed using formalin, Genelyn, Thiel and Imperial College London- Soft Preserving (ICL-SP) techniques to compare different characteristics of these four techniques. The results of this thesis show that anatomy teachers consider hard-fixed cadavers not to be the most accurate teaching model in comparison to the human body, although it still serves as a useful teaching method (Chapter 2). In addition, our findings confirm that joints of cadavers embalmed using ICL-SP solution faithfully mimics joints of an unembalmed cadaver compared to the other techniques (Chapter 3). Embalming a human body prevents the deterioration in the quality of images and our findings highlight that the influence of the embalming solutions varied with the radiological modality used (Chapter 4). The method developed as part of this thesis enables anatomists and forensic scientists to quantify the decomposition rate of an embalmed human cadaver (Chapter 5). Formalin embalming solution showed the strongest antimicrobial abilities followed by Thiel, Genelyn and finally by ICL-SP (Chapter 6). The overarching viewpoint of this set of studies show that it is inaccurate to state that one embalming technique is ultimately the best. The value of each technique differs based on the requirement of the particular education or research area. Hence we highlight how different embalming techniques may be better suited to certain fields of study.

Risk and benefits in lifestyle sports: parkour, law and social value

This paper examines the interrelationship between law and lifestyle sports, viewed through the lens of parkour. We argue that the literature relating to legal approaches to lifestyle sport is currently underdeveloped and so seek to partially fill this lacuna. Hitherto, we argue, the law has been viewed as a largely negative presence, seen particularly in terms of the ways in which counter-cultural activities are policed and regulated, and where such activities are viewed as transgressive or undesirable. We argue that this is a somewhat unsophisticated take on how the law can operate, with law constructed as an outcome of constraints to behaviour (where the law authorises or prohibits), distinct from the legal contexts, environments and spaces in which these relationships occur. We argue that the distinctive settings in which lifestyle sports are practiced needs a more fine-grained analysis as they are settings which bear, and bring to life, laws and regulations that shape how space is to be experienced. We examine specifically the interrelationship between risk and benefit and how the law recognises issues of social utility or value, particularly within the context of lifestyle sport. We seek to move from user-centred constructions of law as an imposition, to a more nuanced position that looks at parkour at the intersections of law, space and lifestyle sport, in order to reveal how law can be used to support and extend claims to space.

Utility Analysis for Multiple Selection Devices and Multiple Outcomes

Traditional utility analysis only calculates the value of a given selection procedure over random selection. This assumption is not only an inaccurate representation of staffing policy but also leads to overestimates of a device’s value. This paper presents a more accurate method for computing the validity of a selection battery for when there are multiple selection devices and multiple criteria. Application of the method is illustrated using previous utility analysis work and an actual case of administrative assistants with eight predictors and nine criteria. A final example also is provided that includes these advancements as well as other researchers’ advances in a combined utility model. Results reveal that accounting for multiple criteria and outcomes dramatically reduces the utility estimates of implementing new selection devices.

Creating value, not wasting resources: sustainable innovation strategies

It is well-accepted in academic and public debate that society has overused natural resources. Business managers in consequence face a normative framework where products need to become more ‘sustainable’. The paper characterises the mechanisms and logic that make ‘[environmentally] sustainable innovation strategies’. Those mechanisms highlight multiple value creation and sustaining value beyond the original new product lifecycle. They yield as much utility as possible from the embedded natural resources. And they avoid creating waste. ‘Multiple value creation’ asks managers to revaluate the attrite product or to make customers change their use patterns. The paper then demonstrates how to extend the ‘old’ logic of innovation with a phase of revaluation: a phase promoting further use of the product and/or material. Our concept is empirically illustrated by two industry case examples. Namely, the copier industry and the emerging automotive lithium-ion batteries industry. We provide a patent analysis in order to demonstrate the assessment of extended life cycles, for the case of ‘recovery of raw materials from disposed products’.

Sorghum Crop Modeling and Its Utility in Agronomy and Breeding

Crop models are simplified mathematical representations of the interacting biological and environmental components of the dynamic soil–plant–environment system. Sorghum crop modeling has evolved in parallel with crop modeling capability in general, since its origins in the 1960s and 1970s. Here we briefly review the trajectory in sorghum crop modeling leading to the development of advanced models. We then (i) overview the structure and function of the sorghum model in the Agricultural Production System sIMulator (APSIM) to exemplify advanced modeling concepts that suit both agronomic and breeding applications, (ii) review an example of use of sorghum modeling in supporting agronomic management decisions, (iii) review an example of the use of sorghum modeling in plant breeding, and (iv) consider implications for future roles of sorghum crop modeling. Modeling and simulation provide an avenue to explore consequences of crop management decision options in situations confronted with risks associated with seasonal climate uncertainties. Here we consider the possibility of manipulating planting configuration and density in sorghum as a means to manipulate the productivity–risk trade-off. A simulation analysis of decision options is presented and avenues for its use with decision-makers discussed. Modeling and simulation also provide opportunities to improve breeding efficiency by either dissecting complex traits to more amenable targets for genetics and breeding, or by trait evaluation via phenotypic prediction in target production regions to help prioritize effort and assess breeding strategies. Here we consider studies on the stay-green trait in sorghum, which confers yield advantage in water-limited situations, to exemplify both aspects. The possible future roles of sorghum modeling in agronomy and breeding are discussed as are opportunities related to their synergistic interaction. The potential to add significant value to the revolution in plant breeding associated with genomic technologies is identified as the new modeling frontier.

An investigation into the utility of the Mini Addenbrooke's Cognitive Examination (M-ACE) for the early detection of dementia and mild cognitive impairment in people aged 75 and over

Background/Aims: The Mini Addenbrooke’s Cognitive Examination (M-ACE) is the abbreviated version of the widely-used Addenbrooke’s Cognitive Examination (ACE-III), a cognitive screening tool that is used internationally in the assessment of mild cognitive impairment (MCI) and dementia. The objectives of this study were to investigate the diagnostic accuracy of the M-ACE with individuals aged 75 and over to distinguish between those who do and do not have a dementia or MCI, and also to establish whether the cut-off scores recommended by Hsieh et al. (2014) [9] in the original validation study for the M-ACE are optimal for this age group. Methods: The M-ACE was administered to 58 participants (24 with a diagnosis of dementia, 17 with a diagnosis of MCI and 17 healthy controls). The extent to which scores distinguished between groups (dementia, MCI or no diagnosis) was explored using receiver operating characteristic curve analysis. Results: The optimal cut-off for detecting dementia was ≤ 21/30 (score ≤ 21/30 indicating dementia with a sensitivity of 0.95, a specificity of 1 and a positive predictive value of 1) compared to the original higher published cut-off of ≤ 25/30 (sensitivity of 0.95, specificity of 0.70 and a positive predictive value of 0.82 in this sample). Conclusions: The M-ACE has excellent diagnostic accuracy for the detection of dementia in a UK clinical sample. It may be necessary to consider lower cut-offs than those given in the original validation study.

The Value Of The 2005 International Society Of Urological Pathology (isup) Modified Gleason Grading System As A Predictor Of Biochemical Recurrence After Radical Prostatectomy.

To compare time and risk to biochemical recurrence (BR) after radical prostatectomy of two chronologically different groups of patients using the standard and the modified Gleason system (MGS). Cohort 1 comprised biopsies of 197 patients graded according to the standard Gleason system (SGS) in the period 1997/2004, and cohort 2, 176 biopsies graded according to the modified system in the period 2005/2011. Time to BR was analyzed with the Kaplan-Meier product-limit analysis and prediction of shorter time to recurrence using univariate and multivariate Cox proportional hazards model. Patients in cohort 2 reflected time-related changes: striking increase in clinical stage T1c, systematic use of extended biopsies, and lower percentage of total length of cancer in millimeter in all cores. The MGS used in cohort 2 showed fewer biopsies with Gleason score ≤ 6 and more biopsies of the intermediate Gleason score 7. Time to BR using the Kaplan-Meier curves showed statistical significance using the MGS in cohort 2, but not the SGS in cohort 1. Only the MGS predicted shorter time to BR on univariate analysis and on multivariate analysis was an independent predictor. The results favor that the 2005 International Society of Urological Pathology modified system is a refinement of the Gleason grading and valuable for contemporary clinical practice.