Net Probability Research Articles

National and Subnational Projection of Living Arrangements Pattern of Indian Elderly: Application of Net Transition Probability Macrosimulation Models

National and Subnational Projection of Living Arrangements Pattern of Indian Elderly: Application of Net Transition Probability Macrosimulation Models

A Causal Net approach to Relativistic Quantum Mechanics and Gravitation

In this paper we discuss a causal network model to describe quantum mechanics and gravittation, where space–time is built solely from point events and connecting probabilities. A causal net provides a representation which combines the quantum complementary features of both partticles and waves as each vertex on the causal net represents a possible point event or particle observation. Simultaneity on the causal net is defined by hyperplanes of equivalent proper time. The causal net model when constructed in Minkowksi space–time is shown to lead to a formulation for relativistic quantum mechanics including the Dirac equation. In a curved Riemann space–time the causal paths of the causal net are geodesics and in the local Lorentz frame the net probabilities and the Dirac formalism are preserved. The variation of space–time density of events in the causal paths modifies the metric and provides a space–time curvature leading to the Hilbert action associated with general relativity. Consideration of the Schwarzchild metric shows that in classical limit the perturbation in the density of possible events is proportional to the Newtonian gravitational potential.

Net escape velocity, transfer probability, and travel time distributions within a cross-ventilated room model sheltered by urban-like block array

Natural ventilation offers significant advantages, especially in terms of energy conservation. However, most published articles have focused on the ventilation flow rate to determine the average contaminant concentration, while few have examined local ventilation distributions. Therefore, isothermal steady-state Reynolds-averaged Navier–Stokes simulations were conducted to analyze the airflow and scalar concentration fields of a cross-ventilation model sheltered by buildings. Based on these fields, we generated the spatial distributions of ventilation indices, namely, the net escape velocity (NEV), point-to-point indices transfer probability (TP), and travel time (TT), to discuss the dispersion of scalars emitted from local points in a room with natural ventilation. The NEV, which indicates the direction of the scalar discharge from each cell, exhibited a distribution distinct from the advection velocity because of concentration gradient effect. Higher TPs were observed when evaluated from a contaminant source to a target point following the NEV streamlines. Meanwhile, lower TTs were observed when evaluated in a point near the source and also from a contaminant source to a target point following the NEV streamlines. Although TP and TT are independent ventilation indices, a negative correlation between them was observed. Instead of the ventilation flow rate, the detailed structure of scalar dispersion can now be described by simultaneously analyzing the ventilation efficiency indices, which provide information on the general contaminant transport direction, and the probability and duration of transfer from a source to a target point. This potentially helps in the design of ventilation system especially in room lay-out to avoid cross-contamination.

Camera-Based Net Avoidance Controls of Underwater Robots.

Fishing nets are dangerous obstacles for an underwater robot whose aim is to reach a goal in unknown underwater environments. This paper proposes how to make the robot reach its goal, while avoiding fishing nets that are detected using the robot's camera sensors. For the detection of underwater nets based on camera measurements of the robot, we can use deep neural networks. Passive camera sensors do not provide the distance information between the robot and a net. Camera sensors only provide the bearing angle of a net, with respect to the robot's camera pose. There may be trailing wires that extend from a net, and the wires can entangle the robot before the robot detects the net. Moreover, light, viewpoint, and sea floor condition can decrease the net detection probability in practice. Therefore, whenever a net is detected by the robot's camera, we make the robot avoid the detected net by moving away from the net abruptly. For moving away from the net, the robot uses the bounding box for the detected net in the camera image. After the robot moves backward for a certain distance, the robot makes a large circular turn to approach the goal, while avoiding the net. A large circular turn is used, since moving close to a net is too dangerous for the robot. As far as we know, our paper is unique in addressing reactive control laws for approaching the goal, while avoiding fishing nets detected using camera sensors. The effectiveness of the proposed net avoidance controls is verified using simulations.

Analisis Teknikal Dan Analisis Fundamental Terhadap Kelayakan Pembelian Saham PT Bank Negara Indonesiaia Tbk (BBNI)

The decision on the feasibility of purchasing a share is an indicator or criterion that is considered before finally deciding to invest or invest in the issuer. Researchers conducted technical analysis and fundamental analysis of PT Bank Negara Indonesia, Tbk. (BBNI) shares to find out whether the issuer's shares are suitable as issuers for investing or just for trading. Technical analysis and fundamental analysis are performed to see opportunity whether the shares are worthy of stock investment or not. Technical analysis is carried out using the simple moving average (SMA) and RSI methods. In addition, fundamental analysis is also carried out with several indicators such as price book value (PBV), price earning ratio (PER), debt equity ratio (DER), net probability margin (NPM), and earnings per share (EPS). In this study, the approach taken is a qualitative descriptive approach where data is presented in the form of narratives or detailed elaboration from experts. PT Bank Negara Indonesia (BBNI) shares are the oldest bank stocks that have a large market capitalization. This stock can also be said to have a relatively stable level of price fluctuation with a high level of profit and price. In terms of technical analysis and fundamental analysis, PT Bank Negara Indonesia (BBNI) shares are stocks that deserve to be an investment choice.

A patient organization perspective: charting the course to a cure for SCN2A-related disorders.

The SCN2A gene encodes the Nav1.2 protein, a voltage-gated sodium channel crucial for initiating and transmitting action potentials in neurons. Dysfunction in Nav1.2, often stemming from genetic mutations in the SCN2A gene, leads to SCN2A-related disorders. Individuals harboring pathogenic SCN2A variants present with severe neurodevelopmental disorders such as epilepsy, autism spectrum disorders, movement disorders, cortical visual impairment, and intellectual disabilities. The FamilieSCN2A Foundation, a 501(c)(3) patient advocacy organization, is dedicated to enhancing the lives of those affected by SCN2A-related disorders. Fueled by a vision of a world with effective treatments and cures for all patients with SCN2A-related disorders, FamilieSCN2A Foundation has charted the course to a cure based on their core values of urgency, integrity, collaboration, and inclusion. Their strategic plan centers on building a comprehensive research-readiness infrastructure that maximizes the probability of bringing curative therapies to SCN2A patients. Appreciating that statistically most drug development initiatives will fail, creating an infrastructure that maximizes the number of drugs in development for SCN2A-related disorders in turn maximizes the net probability of success that FamilieSCN2A Foundation will achieving their vision. Through dynamic initiatives and notable achievements, including raising ~$6 million USD, funding 26 research grants totaling ~$4.7 million USD, and forging strategic partnerships across the SCN2A-related disorder ecosystem the foundation is actively executing its strategic plan. With SCN2A research advancing rapidly and a thriving ecosystem of diverse, engaged stakeholders, FamilieSCN2A Foundation believes the outlook for SCN2A-related disorders is bright.

A new method of estimating prevalence of childhood cancer survivors (POCCS): example of the 20-year prevalence in The Netherlands.

Estimating the number of childhood cancer survivors is crucial for cancer control, including clinical guidelines. To compare estimates across countries despite data sharing restrictions, we propose a new method of computing limited-duration prevalence of childhood cancer survivors (POCCS) using aggregated data. We developed a Markov model that simulates, for each calendar year and birth cohort in a population, the proportion of individuals in the following health states: healthy, newly diagnosed with cancer, surviving with cancer, and deceased. Transitions between health states were informed using annual sex- and age-specific incidence rates, conditional 1-year net survival probabilities from the Netherlands Cancer Registry (1989-2011), and annual mortality probability by sex and age group for The Netherlands from the Human Mortality Database. Applying a Markov model, we computed 20-year prevalence of childhood cancer survivors. The resulting POCCS estimates, stratified by sex, were compared with SEER*Stat estimates derived from individual cancer records from the same registry. In 2011, POCCS predicted 654 males [95% confidence interval (95% CI): 637-672] and 539 females (95% CI: 523-555) per million persons living in The Netherlands after childhood cancer diagnosed within the previous 20 years. Using SEER*Stat, the 20-year prevalence was 665 males (95% CI: 647-683) and 544 females (95% CI: 529-560) per million persons on 1 July 2011. Using the POCCS model and aggregated cancer data, our estimates of childhood cancer survivors limited-duration prevalence were consistent with those computed by a standard method requiring individual cancer records. The POCCS method provides relevant information for planning follow-up and care for childhood cancer survivors.

Prediction of Risk of Metastatic Recurrence for Female Breast Cancer Patients in the Presence of Competing Causes of Death.

To estimate risk of recurrence for women diagnosed with nonmetastatic breast cancer considering the risks of other causes mortality. We extend a method based on the diagnosis-metastasis-death pathway to include risks of other causes mortality. We estimate three probabilities as cumulative incidence of: (i) being alive and recurrence-free, (ii) death for other causes before a recurrence, and (iii) recurrence. We apply the method to female breast cancer relative survival from the Surveillance, Epidemiology, and End Results Program registries (2000-2018) data. The cumulative incidence of recurrence shows a higher increase with more advanced cancer stage and is less influenced by age at diagnosis. At 5 years from diagnosis, the cumulative incidence of recurrence is less than 3% for those diagnosed with stage I, 10% to 13% for those diagnosed with stage II, and 37% to 47% for those diagnosed with stage III breast cancer. The estimates of recurrence considering versus ignoring the risks of dying from other causes were generally consistent, except for older women with more advanced stage, and longer time since diagnosis. In these groups, the net probability of recurrence, excluding the risks of dying from other causes, were overestimated. For patients with cancer who are older or long-term survivors, it is important to include the risks of other cause mortality as the crude cumulative incidence of recurrence is a more appropriate measure. These estimates are important in clinical decision making, as higher competing mortality may preclude the benefits of aggressive treatments.

Evaluation of Naples Score for Long-Term Mortality in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention.

The Naples score (NS), which is a composite of cardiovascular adverse event predictors including neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, albumin, and total cholesterol, has emerged as a prognostic risk score in cancer patients. We aimed to investigate the predictive value of NS for long-term mortality in ST-segment elevation myocardial infarction patients (STEMI). A total of 1889 STEMI patients were enrolled in this study. The median duration of the study was 43months (IQR: 32-78). Patients were divided into 2 groups according to NS as group 1 and group 2. We created 3 models as a baseline model, model 1 (baseline + NS in continuous), and model 2 (baseline + NS as categorical). Group 2 patients had higher long-term mortality rates than group 1 patients. The NS was independently associated with long-term mortality and adding NS to a baseline model improved the model performance for prediction and discrimination of long-term mortality. Decision curve analysis demonstrated that model 1 had a better net benefit probability for detecting mortality compared with the baseline model. NS had the highest contributive significant effect in the prediction model. An easily accessible and calculable NS might be used for risk stratification of long-term mortality in STEMI patients undergoing primary percutaneous coronary intervention.

Survival after breast cancer according to participation in organised or opportunistic screening and deprivation

BackgroundMany studies have investigated the survival of women by comparing those who participated in organised screening with those who did not. However, among those who do not participate in organised screening, some women undergo opportunistic screening, but these women remain difficult to identify, particularly in France. Therefore, the aim of this study was to identify opportunistic screening, and then to study survival after breast cancer separately according to participation in organised, opportunistic or no screening, and taking into account sociodemographic inequalities. MethodsThe study population was identified from 3 French cancer registries, whose data was crossed with the screening coordination centers and the National Health Data System to identify the different type of screening. The European Deprivation Index was used to define the level of deprivation. We estimated net survival using the Pohar-Perme method. ResultsThe 5-year net survival probabilities were higher for women who attended organised screening (97.0 %) than for women with opportunistic screening (94.1 %) or non-attenders (78.1 %). According to the level of deprivation, a significant difference was observed between the groups of women screened by organised and opportunistic screening, compared to the non-attenders. ConclusionThe identification of opportunistic screening is an important element in identifying women who do not screening. It enables to us to see that women who do not attend any screening have a much higher loss-of-opportunity in terms of survival than those who participate in organised or opportunistic screening, and even more so in the most deprived areas.

Cardiovascular, bone, and metabolic health in men with castrate-resistant prostate cancer treated with androgen deprivation: a matched cohort study

Background Descriptive data on late effects associated with castrate-resistant prostate cancer (CRPC) are sparse. We aimed to define the timing and incidence of cardiovascular disease (CVD), fractures, and diabetes in a patient population with CRPC. Methods In the population-based STHLM0 cohort 1464 men with CRPC were identified and matched with three men free from prostate cancer (PC) in the Stockholm region of Sweden. Kaplan–Meier estimates of net survival were used to describe time to CVD, fracture, and diabetes. Cox regression was used to compare incidence rates (IRRs) for the respective late effects. Cumulative incidence analyses of late effects in the presence of the competing risk of death were performed to estimate absolute risks. Results The Kaplan Meier estimates demonstrated a higher net probability for CVD, fracture, and diabetes among men diagnosed with CRPC compared to the matched comparators. The IRRs were 1.94 (95% CI: 1.79–2.12) for CVD, 2.08 (95% CI: 1.70–2.53) for fracture, and 2.00 (95% CI: 1.31–3.05) for diabetes, respectively, comparing men diagnosed with CRPC to men free from PC. The cumulative incidence of CVD at 12 months of follow-up was higher in men diagnosed with CRPC compared to healthy controls regardless of age with a difference in cumulative incidence being 0.20 for men aged <65 and 0.11 for men aged >84. Conclusions In this cohort, the incidence of CVD was significantly higher among men with CRPC compared to healthy controls. Despite having this end-stage disease this finding proves that clinicians must recognize this late effect in men diagnosed with CRPC to improve preventive actions. These men did not have a higher absolute risk of fractures and diabetes after accounting for deaths due to any cause compared to healthy controls.

Rigorous mathematical formulation of net escape velocity and net escape probability determining a macroscopic concentration.

Net escape velocity (NEV) and net escape probability (NEP) are concepts that describe that scalar quantity discharged from a source in an indoor air environment is expressed by the unique velocity scales of the returning and escaping populations. Despite the conceptual description and applications of several numerical simulations, the definitions were not precisely explained using a mathematical formula. Here, we derive rigorous mathematical formulations of the NEV and NEP. These formulations provide us with the physical interpretation of NEV, clarify the sufficient condition of perfect escape, and lead to a further formulation of the transfer probability of the scalar. To justify and apply the derived relationships, two simple problems were numerically solved: One was a diffusion equation, and the other was an advection-diffusion equation. The results of the diffusion problem clearly demonstrate that only the outgoing scalar flux exists on the surface of the control volume, covering the source at any location. In contrast, the advection-diffusion problem reveals that there is a returning population of the scalar in most locations, despite both diffusion and turbulent parts working to remove the scalar. This rigorous formulation contributes to apply NEV as an appropriate air quality index with the clear physical interpretation to determine the local scalar concentration.

Cost-effectiveness of lung cancer screening combined with nurse-led smoking cessation intervention: A population-based microsimulation study

BackgroundThe appropriate screening inclusion criteria of low-dose computed tomography screening for lung cancer in Chinese population remains unclear and the effect of combining screening with nurse-led smoking cessation intervention is poorly understood as well. ObjectiveWe compared the benefits and costs of lung cancer screening with and without nurse-led smoking cessation intervention in different inclusion criteria to help select optimal screening strategies. MethodsDifferent screening strategies were set based on diverse starting ages, smoking pack-year and whether nurse-led smoking cessation intervention was applied. We use nationally representative data published by the China Health and Retirement Longitudinal Survey, based on a microsimulation model, to predict incremental cost-effectiveness ratio and net health benefits under different strategies. ResultsThe incremental cost-effectiveness ratios for all lung cancer screening strategies were less than three times GDP per capita, and screening combined with smoking cessation intervention had lower incremental cost-effectiveness ratios. The largest net health benefits and probability of cost-effectiveness were both obtained in the strategy which conducted screening and nurse-led smoking cessation intervention for people over 45 years with at least 20 pack-year smoking history. In strategies screening alone, it was obtained in screening for people over 50 years and with at 20 pack-year smoking history. ConclusionsNurse-led smoking cessation intervention is recommended provided in conjunction with lung cancer screening. The optimal strategy is conducted screening with cessation intervention for current smokers or smoking quitters in the past 15 years who are over 45 years with at least 20 pack-year smoking history. For strategies screening alone, the target population should be over 50 years old with at least 20 pack year smoking history, when willingness to pay less than three times GPD per capita.

Packaging Materials Dual-Sourcing as Business Contingency Plan to Mitigate Operational Production Disruption

PT XYZ is one of the leading fast-moving consumer goods companies producing packaged mineral water in Indonesia. Water is a daily necessity and one of life’s most basic needs. Therefore, providing healthy hydration through safe and ready-to-consume drinking water aligned with the company’s mission to deliver health through food to as many Indonesian consumers as possible through sustainable operational production. Operational production is one key enabler in delivering these objectives. Dual-sourcing of validated packaging materials could catalyse sustainable production operations through supply risk mitigation, whose root causes come from internal and external factors. This paper uses quantitative, PDCA, and decision tree methods to analyse the supply and demand of packaging materials in short to mid-length timeframes to ensure capacity availability and redundancy, trial, and validation processes. Prioritization through risk assessment of potential net sales loss and probability leads to several implementation phases, periodic monitoring to track initiatives and ensure they stay on course, the timely escalation of solutions, and visibility of acceptable calculated risk.

Cost-utility analysis of cast compared to removable brace in the management of adult patients with ankle fractures.

AimsTo compare the cost-utility of removable brace compared with cast in the management of adult patients with ankle fracture.MethodsA within-trial economic evaluation conducted from the UK NHS and personnel social services (PSS) perspective. Health resources and quality-of-life data were collected as part of the Ankle Injury Rehabilitation (AIR) multicentre, randomized controlled trial over a 12-month period using trial case report forms and patient-completed questionnaires. Cost-utility analysis was estimated in terms of the incremental cost per quality adjusted life year (QALY) gained. Estimate uncertainty was explored by bootstrapping, visualized on the incremental cost-effectiveness ratio plane. Net monetary benefit and probability of cost-effectiveness were evaluated at a range of willingness-to-pay thresholds and visualized graphically.ResultsThe incremental cost and QALYs of using brace over a 12-month period were £46.73 (95% confidence interval (CI) £-9 to £147) and 0.0141 (95% CI -0.005 to 0.033), respectively. The cost per QALY gained was £3,318. The probability of brace being cost-effective at a £30,000 per QALY willingness-to-pay threshold was 88%. The results remained robust to a range of sensitivity analyses.ConclusionThis within-trial economic evaluation found that it is probable that using a removable brace provides good value to the NHS when compared to cast, in the management of adults with ankle fracture.Cite this article: Bone Jt Open 2022;3(6):455–462.

Simulation of bubble–particle attachment process and estimation of attachment probability using a coupled smoothed particle hydrodynamics–discrete element method model

The bubble–particle attachment is an important step in determining the success of recovery in froth flotation. In this study, the bubble–particle attachment process was investigated using a coupled smoothed particle hydrodynamics (SPH)–discrete element method (DEM) model. The effects of particle inertia and the drag of fluid flow on the particle motion were examined. The sliding time was determined for different particle sizes, densities, and bubble sizes, and the simulated sliding time was compared with the analytical solution and our own experimental results using a high-speed camera. As the particle size and density increased, the sliding time decreased. However, this value was independent of the bubble size. The induction time was calculated as a function of the particle size and contact angle from an empirical model, and it was used to determine the attachment and net probabilities in a dynamic simulation. Based on the SPH–DEM simulation results, novel probability models were developed for bubble–particle interactions. Both attachment and net probabilities could be decoupled into hydrodynamic and thermodynamic effects, given that the collision probability was also derived as a single function of the particle Stokes number. The developed probability models embodying the mutual influence of bubbles and particles can be extended to macroscopically describe flotation cells and evaluate cell performance including particle recovery.

Spatially-heterogeneous embedded stochastic SEIR models for the 2014–2016 Ebola outbreak in West Africa

The dynamics of human infectious diseases are challenging to understand, particularly when a pathogen spreads spatially over a large region. We present a stochastic, spatially-heterogeneous model framework derived from the foundational SEIR compartmental model. These models utilize a graph structure of spatial locations, facilitating mobility via random walks while progressing through disease states, parameterized by the net probability flux between locations. The analysis is bolstered by Approximate Bayesian Computation, by which epidemiological and mobility parameter distributions are estimated, including an empirically adjusted reproductive number, while model structure proposals are compared using Bayes Factors. The utility of this novel class of models is demonstrated through application to the 2014–2016 Ebola outbreak in West Africa. The flexibility of such models, whose complexity may be adjusted as desired, and complementary methods of analysis enable the exploration of various spatial divisions and mobility schema, while maintaining the essential spatiotemporal disease dynamics.

Superior performances strategies of different hybrid renewable energy systems configurations with energy storage units

The essential function of a hybrid renewable energy system is to produce an adequate electrical supply to the load demand with low cost. This paper proposes the optimization and operation of the renewable energy power sources for electrification of isolated rural city in Algeria desert. For this purpose, a system composed by PV panel (PV), Wind Turbine (WT), Battery Bank (BB) for storage of the electrical energy and Fuel Cell (FC) with hydrogen tank (H2 Tank) and electrolyzer (Elect) system for storage of the chemical energy is used to fulfill the need of the load. In the present paper we are interested in evolutionary algorithms for solving optimization problem of hybrid configuration of power system. However, a new heuristic algorithm namely whale optimization algorithm (WOA) is used to obtained the best solution of multi-objective optimization system of cost of energy (COE), total net present cost (TNPC) and loss power supply probability (LPSP). Two recent algorithms, particle swarm optimization (PSO) and grey wolf optimizer (GWO) are also implemented in this work. Seven cases studies have been tested for examining the efficient of proposed optimization technique. The suggested whale optimization algorithm, as demonstrated by simulations and comparisons with existing methods, solves the problem of multi-objective optimization of hybrid power system configurations with high accuracy and validity.

Abstract PD15-04: Breast Cancer Index and assessment of the Net Treatment Benefit (NTB) of extended endocrine therapy in HR+ breast cancer

Abstract Background: Extended endocrine therapy (EET) has shown modest gains in absolute benefit to reduce the long-term risk of recurrence in hormone receptor-positive (HR+) breast cancer but is accompanied by serious adverse events (AEs), such as bone and cardiovascular toxicities, endometrial cancer and other side effects that impair quality of life (QOL). Novel approaches that quantify the benefit-risk balance integrating both survival benefit and harm to determine a net health outcome would advance EET decision making. BCI is a gene expression-based assay that predicts benefit from endocrine therapy. Here, the ability of BCI by HOXB13/IL17BR (H/I) to predict the net benefit from 2.5 vs 5y of extended letrozole in patients treated in the IDEAL trial was examined by integrating both efficacy and toxicity outcomes into a single analysis. Methods: All IDEAL patients with available tumor specimens were eligible for this analysis. The Net Treatment Benefit (NTB) and the Win Ratio (WR) were examined using generalized pairwise comparisons to analyze both efficacy and safety wherein all possible patient pairs, one from each treatment arm, were compared based on several prioritized outcome measures scored as favorable, unfavorable, neutral or uninformative. The first prioritized outcome was recurrence-free survival (RFI) with a clinical threshold of ≥3 months; the second prioritized outcome was toxicity based on the highest grade of treatment related AEs. NTB was estimated as the difference in the proportions of favorable vs unfavorable pairs, representing the net probability of an improved health outcome with EET. WR was calculated as the ratio of favorable vs unfavorable pairs, representing the relative risk of an improvement in health outcomes with EET. AEs were evaluated in annual follow-up visits during the active treatment period. Bone-related AEs of ≥ grade 3 included arthralgia, osteoporosis, decreased joint range of motion, back pain and fracture. The most prevalent QOL-related AEs of ≥ grade 3 included hot flashes, fatigue, depression, insomnia and vaginal dryness. Results: 908 HR+ patients (73% pN+, median age 59y, 45% pT1, 48% pT2) were included, with 88% and 68% receiving prior treatment with an aromatase inhibitor (AI) or chemotherapy, respectively. When toxicity was assessed with treatment related AEs ≥ grade 2, no significant improvement in the benefit-risk was observed for EET in either BCI (H/I)-High or BCI (H/I)-Low group. However, when severe toxicity was assessed with AEs ≥ grade 3, significant benefit-risk improvements were observed for EET in BCI (H/I)-High patients (NTB=7.2%, WR=1.76, p=0.044), but not in BCI (H/I)-Low patients (NTB=-0.7%, WR=0.96, p=0.869). BCI (H/I)-High patients demonstrated significant NTB=7.7%/7.4%, WR=2.24/1.92 when analyzing bone-related and QOL-related toxicities, respectively (p=0.024, 0.024), while no significant results were observed in the BCI (H/I)-Low patients (p=0.902, 0.780, respectively). Prioritizing toxicity over efficacy produced similar results. Conclusion: Novel findings demonstrate that BCI not only significantly predicts preferential survival benefit from longer durations of endocrine therapy, but also significantly predicts the overall benefit/risk and likelihood of an improved health outcome from EET in HR+ patients treated with primary adjuvant AI, when severe AEs are considered. It should be noted that the results of our analysis could be biased due to a shorter AE recording period in the 2.5y arm, hence the true benefit/risk of EET could be larger than reported here. Quantification of a net treatment benefit when considering the impact of both efficacy and toxicity may represent a new paradigm for evaluation of the overall EET benefit and aid in patient selection for EET. Citation Format: Marc Buyse, Jenna Wong, Samuel Salvaggio, Jean-Christophe Chiem, Yi Zhang, Kai Treuner, Elma Meershoek-Klein Kranenbarg, Mickaël De Backer, Gerrit-Jan Liefers, Catherine A Schnabel. Breast Cancer Index and assessment of the Net Treatment Benefit (NTB) of extended endocrine therapy in HR+ breast cancer [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr PD15-04.

Health and economic impact of seasonal influenza mass vaccination strategies in European settings: A mathematical modelling and cost-effectiveness analysis

IntroductionDespite seasonal influenza vaccination programmes in most countries targeting individuals aged ≥ 65 (or ≥ 55) years and high risk-groups, significant disease burden remains. We explored the impact and cost-effectiveness of 27 vaccination programmes targeting the elderly and/or children in eight European settings (n = 205.8 million). MethodsWe used an age-structured dynamic-transmission model to infer age- and (sub-)type-specific seasonal influenza virus infections calibrated to England, France, Ireland, Navarra, The Netherlands, Portugal, Scotland, and Spain between 2010/11 and 2017/18. The base-case vaccination scenario consisted of non-adjuvanted, non-high dose trivalent vaccines (TV) and no universal paediatric vaccination. We explored i) moving the elderly to “improved” (i.e., adjuvanted or high-dose) trivalent vaccines (iTV) or non-adjuvanted non-high-dose quadrivalent vaccines (QV); ii) adopting mass paediatric vaccination with TV or QV; and iii) combining the elderly and paediatric strategies. We estimated setting-specific costs and quality-adjusted life years (QALYs) gained from the healthcare perspective, and discounted QALYs at 3.0%. ResultsIn the elderly, the estimated numbers of infection per 100,000 population are reduced by a median of 261.5 (range across settings: 154.4, 475.7) when moving the elderly to iTV and by 150.8 (77.6, 262.3) when moving them to QV. Through indirect protection, adopting mass paediatric programmes with 25% uptake achieves similar reductions in the elderly of 233.6 using TV (range: 58.9, 425.6) or 266.5 using QV (65.7, 477.9), with substantial health gains from averted infections across ages. At €35,000/QALY gained, moving the elderly to iTV plus adopting mass paediatric QV programmes provides the highest mean net benefits and probabilities of being cost-effective in all settings and paediatric coverage levels. ConclusionGiven the direct and indirect protection, and depending on the vaccine prices, model results support a combination of having moved the elderly to an improved vaccine and adopting universal paediatric vaccination programmes across the European settings.