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We investigate the role of endowment inequality in a local and global public goods setting with multiple group membership and examine the effect of temporal role reversal on cooperation decisions. Subjects can contribute to a global public good which benefits all subjects and two local public goods which benefit only subjects of either their own group or the group of the other endowment type. Endowment inequality per-se decreases contributions of subjects with a high endowment to the global public good, but increases cooperation of subjects with a low endowment on their local public good, thereby aggravating income disparities. Exogenously induced role reversal for several periods affects cooperation behavior of subjects with a high endowment positively and induces them to contribute more to the global good. Cooperation in unequal environments thus appears to be more stable when all parties have experienced the public goods game from the disadvantageous perspective.
The Personalized Advantage Index (PAI) shows promise as a method for identifying the most effective treatment for individual patients. Previous studies have demonstrated its utility in retrospective evaluations across various settings. In this study, we explored the effect of different methodological choices in predictive modelling underlying the PAI.
Methods
Our approach involved a two-step procedure. First, we conducted a review of prior studies utilizing the PAI, evaluating each study using the Prediction model study Risk Of Bias Assessment Tool (PROBAST). We specifically assessed whether the studies adhered to two standards of predictive modeling: refraining from using leave-one-out cross-validation (LOO CV) and preventing data leakage. Second, we examined the impact of deviating from these methodological standards in real data. We employed both a traditional approach violating these standards and an advanced approach implementing them in two large-scale datasets, PANIC-net (n = 261) and Protect-AD (n = 614).
Results
The PROBAST-rating revealed a substantial risk of bias across studies, primarily due to inappropriate methodological choices. Most studies did not adhere to the examined prediction modeling standards, employing LOO CV and allowing data leakage. The comparison between the traditional and advanced approach revealed that ignoring these standards could systematically overestimate the utility of the PAI.
Conclusion
Our study cautions that violating standards in predictive modeling may strongly influence the evaluation of the PAI's utility, possibly leading to false positive results. To support an unbiased evaluation, crucial for potential clinical application, we provide a low-bias, openly accessible, and meticulously annotated script implementing the PAI.
We develop a new method suitable for establishing lower bounds on the ball measure of noncompactness of operators acting between considerably general quasinormed function spaces. This new method removes some of the restrictions oft-presented in the previous work. Most notably, the target function space need not be disjointly superadditive nor equipped with a norm. Instead, a property that is far more often at our disposal is exploited—namely the absolute continuity of the target quasinorm.
We use this new method to prove that limiting Sobolev embeddings into spaces of Brezis–Wainger type are so-called maximally noncompact, i.e. their ball measure of noncompactness is the worst possible.
Using Otoplan software, it is possible to measure the cochlea before cochlear implant surgery. Until now, computed tomography (CT) of the cochlea has been necessary for this purpose. The aim of this study was to find out whether measuring the cochlea with magnetic resonance imaging (MRI) using Otoplan is possible with the same accuracy.
Methods
The cochlea of 44 patients of the local cochlear implant centre was measured by Otoplan using high-resolution CT-bone and MRI images, and the determined lengths were compared.
Results
No significant difference was found between the cochlear lengths measured, regardless of whether the length measurement was based on a CT or an MRI data set.
Conclusion
For the determination of cochlear length prior to cochlear implant surgery, MRI images are just as suitable as CT images, therefore CT is not mandatory for length measurement by Otoplan, which could reduce the patient's radiation exposure.
The western part of Europe has played a pivotal role in the early development of modern testing starting with the work of scholars like Alfred Binet, William Stern, and Hugo Münsterberg in the early 1900s. However, most of the experts were driven out of the country by the Nazis and the Wehrmacht psychologists who largely replaced them favored non-psychometric methods. In the more recent history after World War II, there were several successful psychometric testing programs. While the Netherlands have embraced psychometric testing since the 1950s and widely apply it in education, testing and especially psychometric methods have traditionally been less frequently used to make important decisions in Germany, France, and Belgium. A recent trend is the increasing use of testing and assessment for quality control in education especially in the Netherlands and Germany. Another more recent trend is a shift of higher education to a global level which creates a new need to assess foreign applicants for Western European institutions. This chapter focuses on the development of modern testing in the Dutch, German, and French-speaking parts of Europe (France, The Netherlands, Belgium, Luxembourg, Germany, most parts of Switzerland, Austria, and the South Tirol region of Italy).
The prevalence of malnutrition is high among oncology patients in Northern China. Malnutrition is related to the longer hospital stay, and it can be used to predict the prognostic outcome of patients. This work focused on investigating the relationship of nutritional condition with the length of hospital stay (LOS) in Northern Chinese patients with lung adenocarcinoma (LUAD). The Patient-Generated Subjective Global Assessment (PG-SGA), Nutritional Risk Screening 2002 (NRS 2002) score, recent weight loss and BMI were assessed in a probabilistic sample of 389 LUAD patients without epidermal growth factor receptor (EGFR) mutations. This study collected the demographic and clinical features of patients in a prospective manner. Then, we examined the association of nutritional status with LOS among the population developing LUAD. According to the PG-SGA, 63 (16·3 %), 174 (44·7 %) and 78 (20·1 %) patients were at risk for undernutrition, moderate undernutrition and severe undernutrition, respectively. Nutritional risk was found in 141 (36·2 %) patients based on the NRS 2002. The average LOS for tumour patients in Northern China was 12·5 d. At admission, a risk of undernutrition or undernutrition according to the PG-SGA (P < 0·001), NRS 2002 (P < 0·001) and latest weight loss (P < 0·001) predicted the longer LOS. LOS was related to nutritional status and hospitalisation expenses (P < 0·001). LUAD patients who stayed in the ICU had a poorer nutritional status and a longer LOS (P < 0·001). In Northern Chinese patients with LUAD, a risk for undernutrition evaluated by the PG-SGA, the NRS 2002 and recent weight loss, but not BMI, could predict a longer LOS.
Opioid use disorder is a major public health crisis, and evidence suggests ways of better serving patients who live with opioid use disorder in the emergency department (ED). A multi-disciplinary team developed a quality improvement project to implement this evidence.
Methods
The intervention was developed by an expert working group consisting of specialists and stakeholders. The group set goals of increasing prescribing of buprenorphine/naloxone and providing next day walk-in referrals to opioid use disorder treatment clinics. From May to September 2018, three Alberta ED sites and three opioid use disorder treatment clinics worked together to trial the intervention. We used administrative data to track the number of ED visits where patients were given buprenorphine/naloxone. Monthly ED prescribing rates before and after the intervention were considered and compared with eight nonintervention sites. We considered whether patients continued to fill opioid agonist treatment prescriptions at 30, 60, and 90 days after their index ED visit to measure continuity in treatment.
Results
The intervention sites increased their prescribing of buprenorphine/naloxone during the intervention period and prescribed more buprenorphine/naloxone than the controls. Thirty-five of 47 patients (74.4%) discharged from the ED with buprenorphine/naloxone continued to fill opioid agonist treatment prescriptions 30 days and 60 days after their index ED visit. Thirty-four patients (72.3%) filled prescriptions at 90 days.
Conclusions
Emergency clinicians can effectively initiate patients on buprenorphine/naloxone when supports for this standardized evidence-based care are in place within their practice setting and timely follow-up in community is available.
We provide a new framework for valuing multidimensional real options where opportunities to exercise the option are generated by an exogenous Poisson process, which can be viewed as a liquidity constraint on decision times. This approach, which we call the Poisson optional stopping times (POST) method, finds the value function as a monotone sequence of lower bounds. In a case study, we demonstrate that the frequently used quasi-analytic method yields a suboptimal policy and an inaccurate value function. The proposed method is demonstrably correct, straightforward to implement, reliable in computation, and broadly applicable in analyzing multidimensional option-valuation problems.
The shallow subsurface of Groningen, the Netherlands, is heterogeneous due to its formation in a Holocene tidal coastal setting on a periglacially and glacially inherited landscape with strong lateral variation in subsurface architecture. Soft sediments with low, small-strain shear wave velocities (VS30 around 200 m s−1) are known to amplify earthquake motions. Knowledge of the architecture and properties of the subsurface and the combined effect on the propagation of earthquake waves is imperative for the prediction of geohazards of ground shaking and liquefaction at the surface. In order to provide information for the seismic hazard and risk analysis, two geological models were constructed. The first is the ‘Geological model for Site response in Groningen’ (GSG model) and is based on the detailed 3D GeoTOP voxel model containing lithostratigraphy and lithoclass attributes. The GeoTOP model was combined with information from boreholes, cone penetration tests, regional digital geological and geohydrological models to cover the full range from the surface down to the base of the North Sea Supergroup (base Paleogene) at ~800 m depth. The GSG model consists of a microzonation based on geology and a stack of soil stratigraphy for each of the 140,000 grid cells (100 m × 100 m) to which properties (VS and parameters relevant for nonlinear soil behaviour) were assigned. The GSG model serves as input to the site response calculations that feed into the Ground Motion Model. The second model is the ‘Geological model for Liquefaction sensitivity in Groningen’ (GLG). Generally, loosely packed sands might be susceptible to liquefaction upon earthquake shaking. In order to delineate zones of loosely packed sand in the first 40 m below the surface, GeoTOP was combined with relative densities inferred from a large cone penetration test database. The marine Naaldwijk and Eem Formations have the highest proportion of loosely packed sand (31% and 38%, respectively) and thus are considered to be the most vulnerable to liquefaction; other units contain 5–17% loosely packed sand. The GLG model serves as one of the inputs for further research on the liquefaction potential in Groningen, such as the development of region-specific magnitude scaling factors (MSF) and depth–stress reduction relationships (rd).
Decision making is an important part of managing one's life with dementia. Shared decision making is the preferred way of involving people in decisions. Our study aimed to describe the challenges of shared decision making in dementia care networks.
Methods:
A multi-perspective qualitative study using face-to-face interviews with 113 respondents in 23 care networks in the Netherlands consisting of 23 people with dementia, 44 of their informal caregivers, and 46 of their professional caregivers. The interview guide addressed the decision topics, who were involved in the decision making and their contributions to the decision making. We used content analysis to delineate categories and themes.
Results:
The themes and categories that emerged are: (1) adapting to a situation of diminishing independence, which includes the continuous changes in the care network, resulting in shifting decision-making roles and the need for anticipating future decisions; and (2) tensions in network interactions which result from different perspectives and interests and which require reaching agreement about what constitutes a problem by exchanging information in the care network.
Conclusion:
The challenges in dementia care networks relate to all dimensions of social health. They have implications for a model of shared decision making in dementia care networks. Such a model requires flexibility regarding changing capabilities to preserve the autonomy of the person with dementia. It needs working towards a shared view about what constitutes a problem in the situation. It asks for professionals to advocate for the involvement of people with dementia by helping them participate in ways that strengthen their remaining capacities.