Lower Utility Values Research Articles

Math motivational belief development during high school by race/ethnicity: Teachers and parents as predictors of changes.

The changes in adolescents' math motivational beliefs (i.e., expectancies for success, interest, and utility value) across Grades 9-11 and the associations between these changes and adolescents' experiences with socializers (i.e., perceived teacher unfairness and parent-adolescent discussions) were examined within each of the four largest racial/ethnic groups in the United States using the High School Longitudinal Study, a nationally representative data set (n = 19,010; 50% female; 9% Asian; 11% Black; 18% Latine; 62% White; Mage = 14.53 in Grade 9). Cross-tabulation analyses suggested that similar developmental trends emerged within each racial/ethnic group (which were tested separately). Many adolescents maintained their high or low expectancies, interest, and utility values across Grades 9-11. Some patterns varied by belief; for example, several adolescents switched from high to low interest by Grade 11, whereas several adolescents switched from low to high utility value. Parent-adolescent discussions predicted positive changes among Asian and Latine adolescents, whereas perceived teacher unfairness predicted negative changes among Black adolescents. The findings from the present study highlight the diverse developmental trends in adolescents' motivational beliefs and the potential role of socializers as sources of strength or challenge in their motivational belief development. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Health utility attributable to oral conditions in Japanese adults.

Utility values enable relative comparisons across various health conditions, providing information for efficient allocation of healthcare resources. This study aimed to (1) quantify the utility values attributable to oral health-related quality of life (OHRQoL) in Japanese adults and (2) develop models for converting the 14-item Oral Health Impact Profile (OHIP-14) scores into EuroQoL 5-dimension 5-level (EQ-5D-5L)-based utility values. This was a cross-sectional study. Data from a large-scale Internet survey of Japanese adults conducted in 2022 (n = 28 405; mean age 48.2 years) were analysed. Multiple linear regression models were fitted to investigate the association between OHIP-14 scores and EQ-5D-5L-based utility values, adjusting for confounders. Conversion models were developed using a random half of the participants, and the observed and predicted utility values in the other half were compared to evaluate the model performance. Among the participants, 55.2% scored 0, 20.9% scored 1-5 and 23.9% scored 6-56 on the OHIP-14, corresponding mean utility values of 0.93, 0.90 and 0.84, respectively. A one-point increase in the OHIP-14 score was associated with a lower utility value (coefficient: -0.0053; 95% confidence interval:health-related quality of life -0.0056, -0.0051). The estimated utility value attributable to OHIP-14 was -23.3 per 1000 individuals, greater than that for other prevalent chronic conditions, including hypertension and diabetes (-2.9 and -7.1 per 1000 individuals, respectively). The conversion model incorporated the OHIP-14 total score, age, sex and self-rated health, predicted utility scores on average and captured differences according to the number of teeth lost. However, there was a discrepancy between predicted and observed utility values in the lower utility value groups. OHRQoL substantially impacted utility values at the population level. The OHIP-14 holds the potential as a valuable tool for predicting average utility values based on oral health conditions; however, the prediction performance was relatively low for individuals with a lower health-related quality of life.

Discriminatory Properties of Quality-Adjusted Life-Years-Based Cost-Effectiveness Analyses for Patients With Disabilities: A Duchenne Muscular Dystrophy Case Study

ObjectivesQuality-adjusted life-years (QALYs) have been challenged as a measure of benefit for people with disabilities, particularly for those in low-utility health states or with irreversible disability. This study examined the impact of a QALY-based assessment on the price for a hypothetical treatment for Duchenne muscular dystrophy (DMD), a progressive, genetic neuromuscular disease. MethodsA previously published, 5-state model, which analyzed treatments for early ambulatory (EA) DMD patients, was replicated, validated, and adapted to include early nonambulatory (ENA) DMD patients. The model was used to assess a QALY-based threshold price (maximum cost-effective price) for a hypothetical treatment for 13-year-old ENA and 5-year-old EA patients (initial health states with lower and higher utility, respectively). All inputs were replicated including willingness-to-pay thresholds of $50 000 to $200 000/QALY. ResultsIn contrast to EA patients, ENA patients had a 98% modeled decline in QALY-based threshold price at a willingness-to-pay off $150 000/QALY or higher, despite equal treatment benefit (delayed progression/death). At $100 000/QALY or lower, net nontreatment costs exceeded health benefits, implying any treatment for ENA patients would not be considered cost-effective, even at $0 price, including an indefinite pause in disease progression. ConclusionsFor certain severe, disabling conditions, traditional approaches are likely to conclude that treatments are not cost-effective at any price once a patient progresses to a disabled health state with low utility value. These findings elucidate theoretical/ethical concerns regarding potential discriminatory properties of traditional QALY assessments for people with disabilities, particularly those who have lost ambulation or have other physical limitations.

Ecological construction status of photovoltaic power plants in China’s deserts

Solar photovoltaic (PV) is one of the most environmental-friendly and promising resources for achieving carbon peak and neutrality targets. Despite their ecological fragility, China’s vast desert regions have become the most promising areas for PV plant development due to their extensive land area and relatively low utilization value. Artificial ecological measures in the PV plants can reduce the environmental damage caused by the construction activity and promote the ecological condition of fragile desert ecosystems, therefore yield both ecological and economic benefits. However, the understanding of the current status and ecological benefits of this approach in existing desert PV plants is limited. Here we surveyed 40 PV plants in northern China’s deserts to identify the ecological construction modes and their influencing factors. We quantified the ecosystem service value (ESV) provided by these PV plants using remote sensing data and estimated the potential for ESV enhancement. Our results show that PV plant construction in desert regions can significantly improve the ecosystem, even with natural restoration measures (M1) alone, resulting in a 74% increase in average fractional vegetation cover (FVC) during the growing season, although the maximum average FVC of only about 10%. The integrated mode M4, which combined artificial vegetation planting M2 and sand control measures M3, further enhance the average growing season FVC to 14.53%. Currently, 22.5% of plants lack ecological measures, 40% employ only a single measure, but 92% of new plants since 2017 have adopted at least one ecological construction mode. The main influencing factors include surface type, policy support, water resources, ecological construction costs, and scientific management guidance. If artificial ecological construction were incorporated, a significant ESV could be achieved in these PV plants, reaching $8.9 million (a 7.7-fold increase) if assuming a targeted 50% vegetation coverage. This study provides evidence for evaluating the ecological benefit and planning of large-scale PV farms in deserts.

Cancer-Specific Health Utilities: Evaluation of Core Measurement Properties of the EORTC QLU-C10D in Lung Cancer Patients-Data from Four Multicentre LUX-Lung Trials, Applying Six Country Tariffs.

Cost-utility analysis generally requires valid preference-based measures (PBMs) to assess the utility of patient health. While generic PBMs are widely used, disease-specific PBMs may capture additional aspects of health relevant for certain patient populations. This study investigates the construct and concurrent criterion validity of the cancer-specific European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Utility-Core 10 dimensions (QLU-C10D) in non-small-cell lung cancer patients. We retrospectively analysed data from four multicentre LUX-Lung trials, all of which had administered the EORTC Quality of Life Questionnaire (QLQ-C30) and the EQ-5D-3L. We applied six country-specific value sets (Australia, Canada, Italy, the Netherlands, Poland, and the United Kingdom) to both instruments. Criterion validity was assessed via correlations between the instruments' utility scores. Correlations of divergent and convergent domains and Bland-Altman plots investigated construct validity. Floor and ceiling effects were assessed. The comparison of the EORTC QLU-C10D and EQ-5D-3L produced homogenous results for five of the six country tariffs. High correlations of utilities (r > 0.7) were found for all country tariffs except for the Netherlands. Moderate to high correlations of converging domain pairs (r from 0.472 to 0.718) were found with few exceptions, such as the Social Functioning-Usual Activities domain pair (max. r = 0.376). For all but the Dutch tariff, the EORTC QLU-C10D produced consistently lower utility values compared to the EQ-5D-3L (x̄ difference from -0.082 to 0.033). Floor and ceiling effects were consistently lower for the EORTC QLU-C10D (max. 4.67% for utilities). The six country tariffs showed good psychometric properties for the EORTC QLU-C10D in lung cancer patients. Criterion and construct validity was established. The QLU-C10D showed superior measurement precision towards the upper and lower end of the scale compared to the EQ-5D-3L, which is important when cost-utility analysis seeks to measure health change across the severity spectrum.

Perceptions of the Teaching Profession and Motivation to Teach among Slovenian University Students

This study examined the perception of the teaching profession among students of social sciences and languages who were finishing their undergraduate studies and intended to continue their studies with a master’s degree. A subgroup of students planning to study for a master’s degree in teaching reported on their motivation to teach and their satisfaction with their career choice, while a subgroup of students who planned to pursue a master’s degree programme without a teaching degree responded to an open-ended question about why they did not want to become teachers. Participants answered the FIT-Choice Scale, which measures twelve motivational factors and six perceptions about the teaching profession. Students recognised teachers’ expertise; however, social status and salary were rated lower, indicating an imbalance between demands and rewards in the teaching profession. Altruistic and intrinsic motives were the main reasons for choosing the teaching profession. Students who will study teaching also rated their ability to become a teacher highly. Extrinsic factors (job transferability, teaching as a fallback career and time for family) were less important. Qualitative thematic analysis of the responses of students who will not study to become a teacher revealed that low intrinsic value (e.g., disinterest in teaching) and low personal utility value (e.g., better professional development elsewhere) were the most common themes. The high job demands due to demanding interactions with children and parents were also mentioned, while the teacher education programme was perceived as excessively extensive. The implications of the study highlight important considerations for policymakers and teacher education programmes.

The association between loneliness with health service use and quality of life among informal carers in Australia

ObjectiveThe demanding nature of caregiving and limited social support can lead to informal carers experiencing loneliness, which can impact their well-being and overall health service use (HSU). The study aims to examine the association between loneliness with HSU and Health state utility values among informal carers in Australia. MethodsData were derived from three waves (2009, 2013, and 2017) of the nationally representative longitudinal Household Income and Labour Dynamics of Australia (HILDA) survey, focusing on adult informal carers. Outcome measures included visits to the General Practitioner, the number of hospital admissions, and the SF-6D score. Generalized Estimating Equations (GEE) analysis was conducted to explore the associations between loneliness and HSU, as well as loneliness and utility values (based on SF-6D) while adjusting for age, sex, education, marital status, income, and physical/mental health conditions. ResultsAfter controlling for covariates, lonely carers reported lower utility values (IRR = 0.91, 95%CI [0.89, 0.93], p < 0.001) compared to non-lonely carers. Lonely carers reported a higher number of GP visits (IRR = 1.18, 95% CI [1.04, 1.36], p < 0.05) as well as a higher likelihood of visiting specialists (AOR = 1.31, p = 0.046) and hospital doctors (AOR = 1.42, p = 0.013) compared to the non-lonely carers. ConclusionsThe findings of this study highlight the relationship between loneliness on both healthcare utilization and carers’ overall well-being. Addressing loneliness through targeted interventions and social support systems can help improve health outcomes and potentially reduce the overall healthcare costs among informal carers in Australia.

Additive enhanced passivation and lead immobilization of waste expandable polystyrene for perovskite photovoltaics

Every year, millions of tons of expandable polystyrene (EPS) are released into the environment, posing significant environmental pressure due to its slow natural decomposition that takes hundreds of years. Current recycling methods for EPS include organic solvent dissolution and recycling, composite material preparation, and building decoration. However, these methods are costly and have low utilization value. In this study, we propose an innovative approach by incorporating waste EPS into the assembly process of printable mesoscopic perovskite solar cells (p-MPSCs). Our findings reveal that EPS can not only utilize its uncoordinated Pb2+ coordination through the large π bond of the benzene ring, but also the functional groups of C=O and C≡N in its additives, benzophenone peroxide and azobisisobutyronitrile, respectively, play an efficient role in passivating lead defects. Furthermore, EPS effectively acts as a moisture barrier, preventing moisture from entering the interior of the device. This significantly improves device stability and immobilizes lead ions, preventing lead leakage. Our approach not only provides an efficient and environmentally friendly method to recycle EPS, but also offers new solutions to address fundamental scientific challenges in perovskite solar cells, such as lead leakage and stability issues.

Equilibrium and experimental study on carbothermal reduction of sulfur dioxide to elemental sulfur

In order to solve the problem of low utilization value of flue gas desulfurization by-product, reduction of sulfur dioxide to elemental sulfur has emerged as a new process for resource utilization of SO2 with promising application prospects. Herein, the thermodynamic equilibrium calculation was carried out to study the influence of temperatures and C/SO2 molar ratios on the C-SO2 reaction. The effects of reaction temperature, carbon mass, and CO concentration on SO2 reduction by coke and activated carbon were studied on a fixed bed reaction system. The theoretical results demonstrated that the highest equilibrium S yield occurred when the C/SO2 molar ratio is 1, with higher ratios resulting in the formation of COS, CS2, and CO. Experimental data revealed that at temperatures below 700 °C, both SO2 conversion and S yield are notably low. As the temperature increases, both the conversion and yield gradually increase and approach the thermodynamic equilibrium value. The evolution of carbon surface chemical properties under the action of CO was analyzed by FTIR and XPS, which indicated that the presence of CO promotes the decarboxylation reaction, and then increases SO2 conversion and S yield. The conclusion of this study provides guidance for the development of high efficiency SO2 reduction technology.

The contributions of group work, utility value, and self-assessments of learning to student performance in a general education class

We triangulated self-assessments of learning, course grades, and course evaluations from 28 students in a general education class to examine the effects of group work and perceptions of utility on learning, investigating three hypotheses: 1) self-assessments of learning provide triangulating information that deepens interpretations of traditional assessments; 2) group experiences influence students’ views of the course’s utility value; 3) students who believe the course has high utility value will learn more than students who believe the course has low utility value. We found support for all hypotheses. Triangulating information about learning provided a more nuanced understanding of learning than any single source did in isolation. Group work was associated with beliefs that the class was professionally useful. Stronger academic performance was present for students who believed the class was professionally useful, or reported more different types of class utility value. We discuss the implications of these findings for teaching and assessment of student learning.

Rare earth element recovery and aluminum-rich residue production from high alumina fly ash by alkali pre-desilication enhance the mechanochemical extraction process

Recycling rare earth elements (REEs) from coal fly ash by conventional acid leaching may generate large amounts of harmful waste acid, and the obtained acid residues have low utilization value. Accordingly, a green non-acid leaching approach for REE recovery and Al-rich residue production from high alumina fly ash (HAFA) was developed based on the alkali pre-desilication enhanced mechanochemical extraction process. REEs mainly existed in the chemically stable amorphous aluminosilicate glass phase of HAFA, which hindered the leaching of REEs. Thus, NaOH solution (150 g/L) was used to dissolve the glass phase and release REEs from the glass phase under a mild condition (80 °C, 2 h). The released REEs could be easily extracted by green EDTA during the mechanochemical extraction process. The extraction rates of La, Ce, Pr and Nd were about 82.03–88.71%, and valuable Al-rich residue (68.23% Al2O3 content and 2.51 Al/Si ratio) can be obtained when the mass ratio of the pre-desilication residue to EDTA, milling time, rotary speed, and liquid-solid ratio were 2:3, 2 h, 500 rpm, and 0.8, respectively. The used EDTA and REEs in the extracted solutions can be recycled by pH adjusting and organic solvent extraction. Thus, this study provides a new idea for green and high-value utilization of HAFA.

DETERMINANTS OF RURAL SECONDARY SCHOOL DROP-OUT IN ZIMBABWE: A CASE OF RUSHINGA DISTRICT, MASHONALAND CENTRAL PROVINCE

The study explored determinants for school dropouts as a basis for management strategies to reduce it in rural schools. Study was motivated by the prevalence of pupils dropping out of rural secondary schools in Rushinga District, Mashonaland Central Province. School dropouts are a direct attack on the education for all policy in Zimbabwe. This study was guided by pragmatism research philosophy poised at understanding appropriate rural school human related variables which can be analyzed using mixed methods to facilitate triangulation of survey, document analysis and focus group discussions. School dropout problem required data collection from purposive samples of schools, parents and learners. The inclusion criterion was their being rich sources, being available and willing to participate in the study. Data was gathered through focus group discussions contributed by 193 parents who attended school development meetings in nine (9) secondary schools. Seventy-two (72) learners from these schools responded to a selfadministered questionnaire. The study found a (2%) learner dropout prevalence rate in Rushinga. There is an association between gender and inclination to drop out. Girls were more inclined to drop out of school than boys. Factors motivating learner drop out included; low ability to handle academic curriculum, perceived low economic utility value of Zimbabwe’s education, perceived happiness in marriages and readily available cash for gold panning. The study recommends a decentralized curriculum developing skills for the utilization of local economic resources. For example, in rushing, a curriculum focused on mining and environmental conservation would be appropriate. Learners need parental support discouraging them from early marriages. Awareness campaigns against early marriages can be done in schools, churches and any social gatherings to educate both children and adults. Teachers are called upon to apply a variety of teaching methods to motivate pupils and raise their performance. The Ministry of Primary and Secondary Education facilitate low cost boarding facilities.

Recovery of carbon fiber-reinforced polymer waste using dimethylacetamide base on the resin swelling principle.

The mechanical recycling method of the carbon fiber-reinforced polymer (CFRP) has the advantages of simple process, less pollution and low cost, but only low utilization value of carbon fibers in powder or short fibers form can be obtained. To reduce the length and strength loss of the recycled carbon fibers, a novel and cost-effective dimethylacetamide (DMAC) swelling technique was developed to achieve rapid delamination of the CFRP laminates under mild conditions (120°C-160°C, 1h). The corresponding swelling ratios and mass-loss rates of cured epoxy resin (CEP) were about 121.39%-157.39% and 0-0.69%, respectively. Excessive swelling of CEP in DMAC resulted in the cracking of the resin matrix between the adjacent carbon fiber layers. Thus the CFRP laminates were delaminated into soft single carbon fiber layers, which showed excellent cutting performance and reinforcing properties. The delamination products were cut into thin strips of different sizes and vacuum bag molded into new CFRP laminates. The flexural strength and tensile strength of the newly produced CFRP laminates were about 76.38%-90.98% and 94.61%-98.54% of the original CFRP laminates, respectively. More importantly, the chemical compositions of DMAC and CEP were unchanged during the physical swelling process. No organic pollutants (caused by resin degradation) were generated. And the used DMAC can be easily recycled by filtration. Therefore, this study provides a strategy for low-cost and high-valued recycling of CFRP waste.

Expectancy-value profiles in math: How are student-perceived teaching behaviors related to motivational transitions?

This longitudinal study aimed to investigate how motivational transitions of adolescents in the domain of mathematics from Grades 9 to 10 were related to student-perceived mathematics teacher support and student-oriented teaching. Data were drawn from the 2012 Programme for International Student Assessment (PISA) and its German national extension called PISA Plus 2012–2013. We used a subsample of 2605 students (51.0 % girls) from 198 classrooms. Using latent profile analyses, we identified three motivational patterns based on expectancy-value theory that were meaningfully associated with students' mathematics test scores and work ethics. Latent transition analyses showed that these patterns were mostly stable across time. Occurring changes were characterized by a decrease in mathematics motivation across time. Student-oriented teaching as reported by students in Grade 9 impeded maladaptive motivational transitions. Students with particularly low interest and utility value benefitted from teachers who direct their instruction at students' motivational characteristics.

Tandem utilization of CO2 photoreduction products for the carbonylation of aryl iodides

Photocatalytic CO2 reduction reaction has been developed as an effective strategy to convert CO2 into reusable chemicals. However, the reduction products of this reaction are often of low utilization value. Herein, we effectively connect photocatalytic CO2 reduction and amino carbonylation reactions in series to reconvert inexpensive photoreduction product CO into value-added and easily isolated fine chemicals. In this tandem transformation system, we synthesize an efficient photocatalyst, NNU-55-Ni, which is transformed into nanosheets (NNU-55-Ni-NS) in situ to improve the photocatalytic CO2-to-CO activity significantly. After that, CO serving as reactant is further reconverted into organic molecules through the coupled carbonylation reactions. Especially in the carbonylation reaction of diethyltoluamide synthesis, CO conversion reaches up to 85%. Meanwhile, this tandem transformation also provides a simple and low-cost method for the 13C isotopically labeled organic molecules. This work represents an important and feasible pathway for the subsequent separation and application of CO2 photoreduction product.

Population Norms for SF-6Dv2 and EQ-5D-5L in China.

To derive the population norms for EQ-5D-5L and SF-6Dv2 among the Chinese general population. Data collected alongside the Chinese SF-6Dv2 valuation study conducted between June and September 2019 were used. SF-6Dv2 and EQ-5D-5L, as well as social-demographic characteristics and self-reported chronic conditions, were collected through face-to-face interviews among a representative sample of the general population stratified by age, gender, education, and area of residence (urban/rural) in China. SF-6Dv2 and EQ-5D-5L responses were converted to utility values using the corresponding Chinese value sets. Utility values for both measures and EQ VAS scores were summarized by age and gender, and then described by different social-demographic characteristics and chronic conditions. A total of 3397 respondents (51.2% male, age range 18-90 years) were included. 420 (12.4%) and 1726 (50.8%) respondents reported no problems on all SF-6Dv2 and EQ-5D-5L dimensions, respectively. The mean [standard deviation (SD)] utility values were 0.827 (0.143) for SF-6Dv2 and 0.946 (0.096) for EQ-5D-5L. The mean (SD) EQ VAS score was 87.1 (11.5). Respondents who resided in rural areas, were married, and were employed had higher utility values. Respondents with memory-related diseases or stroke had lower utility values than those with other chronic conditions. Utility values decreased with the increase in the number of chronic conditions. This study reports the first Chinese population norms for the EQ-5D-5L and SF-6Dv2 derived using a representative sample of the Chinese general population. The norms can be used as references for economic evaluations and healthcare decision-making in China.

Optimization of Enzymatic Hydrolysis of Perilla Meal Protein for Hydrolysate with High Hydrolysis Degree and Antioxidant Activity.

Botanical oils are staple consumer goods globally, but as a by-product of oil crops, meal is of low utilization value and prone to causing environmental problems. The development of proteins in meal into bioactive peptides, such as Perilla peptide, through biotechnology can not only solve environmental problems, but also create more valuable nutritional additives. In the present work, the hydrolysis process of Perilla meal protein suitable for industrial application was optimized with the response surface methodology (RSM) on the basis of single-factor experiments. Alcalase was firstly selected as the best-performing among four proteases. Then, based on Alcalase, the optimal hydrolysis conditions were as follows: enzyme concentration of 7%, hydrolysis temperature of 61.4 °C, liquid-solid ratio of 22.33:1 (mL/g) and hydrolysis time of 4 h. Under these conditions, the degree of hydrolysis (DH) of Perilla meal protein was 26.23 ± 0.83% and the DPPH scavenging capacity of hydrolysate was 94.15 ± 1.12%. The soluble peptide or protein concentration of Perilla meal protein hydrolysate rose up to 5.24 ± 0.05 mg/mL, the ideal yield of which was estimated to be 17.9%. SDS-PAGE indicated that a large proportion of new bands in hydrolysate with small molecular weights appeared, which was different from the original Perilla meal protein. The present data contributed to further, more specific research on the separation, purification and identification of antioxidant peptide from the hydrolysate of Perilla meal protein. The results showed that the hydrolysis of Perilla meal protein could yield peptides with high antioxidant activity and potential applications as natural antioxidants in the food industry.

P48 Joint Modelling Measurable Target Lesions, EQ5D/Utility and Overall Survival: Do We Still Need Partitioned Survival Models?

The biologic effect of treatment is typically analyzed using tumor burden or PFS, the latter often leads to loss of information due to being based on the categorization of RECIST criteria. Whereas, tumor burden is complete and rational summarization of the process which captures data on the primary mechanism through which most treatments are expected to act. The objective of this study is to estimate overall survival using joint model which simultaneously models patient’s longitudinal tumor burden (TB) trajectory, EQ-5D/utility and survival by accounting for the association between the three outcomes. We simulated data based on a clinical trial (n=110), repeated measure (940 observations). Tumor burden is defined as sum of the longest diameters of measurable prespecified target lesions. Joint model using current value association structure and several distribution was fitted to predict survival. Time was included as a random effect. No covariates were included in the model. We compared joint model with independently fitted models for OS and PFS. The median follow-up visit was 25 months (range: 22-29 months). Joint model showed a positive statistical association to TB, indicating that a higher value of TB increases the risk of death and a negative statistical association to EQ-5D/utility, indicating that proximity to death is linked to lower utility values. While the restricted mean estimates did not show differences between independently fitted models and the joint model, the overall uncertainty around long-term outcomes is dramatically reduced. Multivariate Joint modelling is a powerful tool which can simultaneously model multiple longitudinal biomarkers and survival that are relevant in economic evaluation and leads to more efficient treatment effect. Given the limitations associated with partitioned survival model, i.e. the structural assumptions that survival functions modeled are independent, this approach provides a new way to conduct cost-effectiveness analysis for metastatic oncology treatments.

Patient-Reported Health-Related Quality of Life in Individuals with Inherited Retinal Diseases.

PurposeTo evaluate the impact of inherited retinal diseases (IRDs) on quality of life (QoL) using multiattributable health utilities derived from primary patient data.DesignCross-sectional observational study.ParticipantsSeventy adult patients (mean age, 42.7 years) with IRD recruited from state-wide services in Australia.MethodsHealth utility values were calculated from the Assessment of Quality of Life 8-Dimension (AQoL-8D). Linear regressions were used to analyze the relationship between the 25-item and 39-item National Eye Institute Visual Function Questionnaires (NEI-VFQ-25 and NEI-VFQ-39, respectively) and health utilities from the AQoL-8D.Main Outcome MeasuresThe AQoL-8D utility values were compared between the IRD cohort and population norms. Regressions were used to determine explanatory power of the NEI-VFQ-25 and NEI-VFQ-39 for health utilities from the AQoL-8D.ResultsAverage health-related utility for patients with IRD was 0.58, significantly lower than population norms of 0.80. The IRD patient scores were significantly lower than population norms for all 8 domains of the AQoL-8D. Regressions showed a statistically significant relationship between the NEI-VFQ-39 and AQoL-8D, with the NEI-VFQ-39 and other clinical data explaining up to 73% of the variation in AQoL-8D values and 69% of the variation in the NEI-VFQ-25 values.ConclusionsPatients with IRD have significantly lower utility values across all dimensions of QoL, with the largest differences in independent living, senses, and relationships. The NEI-VFQ-25 and NEI-VFQ-39 are highly correlated with overall AQoL-8D utilities and, combined with other data, can reasonably estimate QoL utilities required for cost-effectiveness studies.

Dairy cattle farmers' preferences for different breeding tools

Breeding technologies play a significant role in improving dairy cattle production. Scientifically proven tools for improved management and genetic gain in dairy herds, such as sexed semen, beef semen, genomic testing, dairy crossbreeding, and multiple ovulation embryo transfer (MOET), are readily available to dairy farmers. However, despite good accessibility, decreasing costs, and continuous development of these tools, their use in Sweden is limited. This study investigated Swedish dairy farmers' preferences for breeding tools through a survey including a discrete choice experiment. The survey was distributed online to 1 521 Swedish farmers and by an open link published through a farming magazine. In total, the study included 204 completed responses. The discrete choice experiment consisted of 10 questions with two alternative combinations, which gave 48 combinations in total. Utility values and part-worth values were computed using a conditional logit model based on the responses in the discrete choice experiment for nine groups of respondents: one group with all respondents, two groups based on respondents using dairy crossbreeding or not within the past 12 months, two based on herd size, two based on respondent age, and two based on whether respondents had used breeding advisory services or not. The strongest preferences in all groups were for using sexed semen and beef semen. Genomic testing was also significantly preferred by all groups of respondents. Except in large herds, MOET on own animals was significantly and relatively strongly disfavoured by all groups. Buying embryos had no significant utility value to any group. Dairy crossbreeding had low and insignificant utility values in the group of all respondents, but it was strongly favoured by the group that had used dairy crossbreeding within the past 12 months, and it was disfavoured by the group that had not. Part-worth values of combined breeding tools showed that combinations of sexed and beef semen, alone or with genomic testing without dairy crossbreeding, were the most preferred tools. Compared with the most common combinations of breeding tools used in the past 12 months, the part-worth values indicated that Swedish dairy farmers may prefer to use breeding tools more than they do today. Statements on the different breeding tools indicated that the respondents agreed with the benefits attributed to the breeding tools, but these benefits may not be worth the cost of genomic testing and the time consumption of MOET. These valuable insights can be used for further development of breeding tools.