Parametric and semiparametric estimation of ordered response models with sample selection and individual-specific thresholds

This paper provides a set of new Stata commands for parametric and semiparametric estimation of an extended version of ordered response models that accounts for both sample selection problems and heterogeneity in the thresholds for the latent variable. The standard estimator of ordered response models is therefore generalized along three directions. First, we account for the presence of endogenous selectivity effects that may lead to inconsistent estimates of the model parameters. Second, we control for both observed and unobserved heterogeneity in response scales by allowing the thresholds to depend on a set of covariates and a random individual effect. Finally, we consider two alternative specifications of the model, one parametric and one semiparametric. In the former, the error terms are assumed to follow a multivariate Gaussian distribution and the model parameters are estimated via maximum likelihood. In the latter, the distribution function of the error terms is instead approximated by following Gallant and Nychka (1997), and the model parameters are estimated via pseudo–maximum likelihood. After discussing identification and estimation issues, we present an empirical application using the second wave of the Survey on Health, Ageing and Retirement in Europe (SHARE). Specifically, we estimate an ordered response model for self-reported health on different domains by accounting for both sample selection bias due to survey nonresponse and reporting bias in the self-assessments of health.

Isolated first branchial cleft anomalies of the external auditory canal

Objective: Rare diseaseBackground: Branchial cleft anomalies are congenital aberrations of the first to fourth pharyngeal pouches. First branchial cleft anomalies are classified into 2 subtypes according to anatomical and histological features. Their diagno-sis can be difficult and depends on radiological and histological findings. In contrast, the required treatment is surgical removal, owing to the high risk of infection or malignancy. This case report introduces a first branchi-al cleft anomaly in an older woman with exclusive involvement of the external auditory canal (EAC).Case Report: This case report introduces a first branchial cleft anomaly in an 82-year-old woman with exclusive involvement of the EAC. She reported a history of mixed moderate hypoacusis and recurrent otitis media in the last year, without facial nerve involvement. Computed tomography and magnetic resonance imaging were performed to plan surgical treatment, which consisted of canaloplasty and Thiersch grafting. The histopathological exam-ination on operative findings revealed a cystic lesion that was lined by cylindrical epithelium adjacent to the squamous cells, compatible with a diagnosis of first branchial arch malformative residues.Conclusions: This is the unique case of first branchial cleft anomalies reported in an adult patient that exclusively involved the EAC. The onset of the disease was atypical, and surgery with the total removal of the lesion was the only possible treatment. Histopathology results revealed cylindric epithelium not represented in the EAC, compat-ible with first branchial arch malformative residues. This rare condition is a potential diagnostic option that should be considered in the differential diagnosis of cysts of the EAC

Osvaldo Lamborghini visual: corporalidad y escritura

En aquest article s'analitza una selecció de dibuixos i esbossos recentment rescatats de l'arxiu visual de l'escriptor argentí Osvaldo Lamborghini. Allò visual en relació amb les marques d'escriptura que se superposen interpel·la la seva narrativa visual, per això es posa l'accent en l'estudi de les polítiques corporals que destaquen per l'excés, l'obscenitat i els ritus vinculats amb la violència. La totalitat del seu llegat s'aparta voluntària i constantment de l'exigència canònica per a situar-se fora de l'univers legítim de la producció artística i literària de l'època. En la seva obra tant literària com artística es manifesta la corporalitat i els mecanismes de poder que operen des de l’àmbit sexual, pornogràfic i polític. La hipòtesi d'aquesta proposta planteja que, en l'obra visual pòstuma de Osvaldo Lamborghini, el cos se situa com a objecte de dominació sexual, es destaca el vincle entre amo i esclau, així com l'ull i la mà conformen les parts sensibles que habiliten la seva lectura des de l'estètica visual. L'objectiu és presentar la mirada des de la corporalitat demarcada i travessada per polítiques que presenten una important contribució a les discussions actuals sobre la construcció de poètiques del cos en l'encreuament amb estètiques visuals.This article analyzes a selection of drawings and sketches recently rescued from the visual archive of the Argentine writer Osvaldo Lamborghini. The visual in relation to the written marks that are superimposed challenges its visual narrative, for this reason there is a focus on the study of body politics that stand out for their excess, obscenity and rites linked to violence. The entirety of his legacy voluntarily and constantly deviates from the canonical requirement to place itself outside the legitimate universe of artistic and literary production of the time. In his literary and artistic work, corporality and the mechanisms of power that operate from the sexual, the pornographic and the political are manifested. The hypothesis of this proposal states that, in the posthumous visual work of Osvaldo Lamborghini, the body is located as an object of sexual domination, the link between master and slave is highlighted and, in turn, the eye and the hand make up the sensitive parts that enable its reading from visual aesthetics. The objective is to present the look from the corporeality demarcated and traversed by politics that present an important contribution to the current discussions around the construction of poetics of the body at the crossroads with visual aesthetics.En este artículo se analiza una selección de dibujos y bocetos recientemente rescatados del archivo visual del escritor argentino Osvaldo Lamborghini. Lo visual en relación con las marcas de escritura que se superponen interpela su narrativa, por ello se hace hincapié en el estudio de las políticas corporales que se destacan por el exceso, la obscenidad y los ritos vinculados con la violencia. La totalidad de su legado se aparta voluntaria y constantemente de la exigencia canónica para situarse fuera del universo legítimo de la producción artística y literaria de la época. En su obra tanto literaria como artística se manifiesta la corporalidad y los mecanismos de poder que operan desde lo sexual, lo pornográfico y lo político.  La hipótesis de esta propuesta plantea que, en la obra visual póstuma de Osvaldo Lamborghini, el cuerpo se ubica como objeto de dominación sexual, se destaca el vínculo entre amo y esclavo y, a su vez, el ojo y la mano conforman las partes sensibles que habilitan su lectura desde la estética visual. El objetivo es presentar la mirada desde la corporalidad demarcada y atravesada por políticas que presentan una importante contribución a las discusiones actuales en torno a la construcción de poéticas del cuerpo en el cruce con estéticas visuales.

Switch to maraviroc with darunavir/r, both QD, in patients with suppressed HIV-1 was well tolerated but virologically inferior to standard antiretroviral therapy: 48-Week results of a randomized trial

Objectives Primary study outcome was absence of treatment failure (virological failure, VF, or treatment interruption) per protocol at week 48. Methods Patients on 3-drug ART with stable HIV-1 RNA <50 copies/mL and CCR5-tropic virus were randomized 1:1 to maraviroc with darunavir/ritonavir qd (study arm) or continue current ART (continuation arm).Results In June 2015, 115 patients were evaluable for the primary outcome (56 study, 59 continuation arm). The study was discontinued due to excess of VF in the study arm (7 cases, 12.5%, vs 0 in the continuation arm, p = 0.005). The proportion free of treatment failure was 73.2% in the study and 59.3% in the continuation arm. Two participants in the study and 10 in the continuation arm discontinued therapy due to adverse events (p = 0.030). At VF, no emergent drug resistance was detected. Co-receptor tropism switched to non-R5 in one patient. Patients with VF reported lower adherence and had lower plasma drug levels. Femoral bone mineral density was significantly improved in the study arm. Conclusion Switching to maraviroc with darunavir/ritonavir qd in virologically suppressed patients was associated with improved tolerability but was virologically inferior to 3-drug therap

Uvulopalatopharyngoplasty and barbed reposition pharyngoplasty with and without hyoid suspension for obstructive sleep apnea hypopnea syndrome: A comparison of long-term functional results

Obstructive sleep apnea hypopnea syndrome (OSAHS) is a common condition; when conservative approaches are not effective, surgical techniques aimed at reducing the airway obstruction effect are used. This retrospective study aimed at comparing the functional outcomes in patients with OSAHS undergoing uvulopalatopharyngoplasty (UPPP) according to Fairbanks and barbed reposition pharyngoplasty (BRP) according to Mantovani, with or without hyoid suspension (HS). One-hundred twenty-two consecutive OSAHS patients who underwent surgical treatment were included in the study. Patients were divided into 4 groups; all patients underwent preoperative and postoperative polysomnography (PSG) with apnea/hypopnea index (AHI) and oxygen desaturation index (ODI) evaluation, and Epworth Sleepiness Scale (ESS) evaluation. The results were analyzed according to the different surgical procedures, in relation to the preoperative PSG and anthropometric data. A significant reduction was observed at 18-month follow-up for patients in BRP group for BMI (p = 0.004), ESS (p < 0.0001), ODI (p < 0.0001), and AHI (p < 0.0001). Risk factors for poor postoperative AHI reduction were evaluated; preoperative AHI was the strongest independent protective factor, while preoperative ODI was the strongest risk factor. The association of HS with UPPP or BRP showed significant results in terms of higher postoperative AHI reduction only when associated to UPPP (p < 0.0001). This study showed that the BRP technique was more effective compared to UPPP for patients with OSAHS. The association of HS showed greater benefits in UPPP compared to BRP.  Randomized prospective trials with longer follow-up are necessary to confirm our results and formulate a more accurate indication of the optimal therapeutic strategy

Evaluation of vestibular function in patients affected by obstructive sleep apnea performing functional head impulse test (fHIT)

Purpose: Obstructive sleep apnoea (OSA) is a common disease with significantly related complications. Since a connection between the vestibular nucleus and sleep regulator pathways has been demonstrated, vestibular evaluation in OSA patients was partially studied and none used functional head impulse test (fHIT) for this purpose. This paper aimed at evaluating the vestibular function in patients affected by OSA using fHIT, selecting patients who did not present any other related to cardiovascular, neurological, or metabolic diseases. Patients and Methods: Patients enrolled had a diagnosis of OSA by polysomnography type III and were cataloged according to American Association of Sleep Medicine criteria. Each patient underwent fHIT. Statistical significance was set at 0.05. Results: A total of 85 patients were enrolled in the study of which 50 had a diagnosis of OSA and were included in the case group, while 35 belonged to the control group. In 88.6% of subjects of the case group was evidenced a vestibular impairment with a substantial difference between the two study groups (p<0.05). Conclusion: The results show that the incidence of vestibular lesions in patients with obstructive sleep apnoea is underestimated and that fHIT can identify these lesions early

Challenges in the Diagnosis and Management of Bacterial Lung Infections in Solid Organ Recipients: A Narrative Review

Respiratory infections pose a significant threat to the success of solid organ transplantation, and the diagnosis and management of these infections are challenging. The current narrative review addressed some of these challenges, based on evidence from the literature published in the last 20 years. Specifically, we focused our attention on (i) the obstacles to an etiologic diagnosis of respiratory infections among solid organ transplant recipients, (ii) the management of bacterial respiratory infections in an era characterized by increased antimicrobial resistance, and (iii) the development of antimicrobial stewardship programs dedicated to solid organ transplant recipient

Thiersch graft follow-up with narrow band imaging for acquired atresia of the external auditory canal: Canaloplasty with Thiersch graft versus vascularization evaluated with narrow band imaging

Acquired atresia of the external ear canal is a narrowing of the external ear canal (EAC) that appears obstructed by fibrous tissue or bone tissue. Acquired atresia has two different phases: wet and dry stage. Computed tomography (CT) scan may show a scan where soft tissue fills EAC. Treatment may be medical and/or surgical. The surgical treatment of choice is represented by canaloplasty with a skin-free flap. To our knowledge, no article has reported data on the analysis of vascularization of acquired atresia of the external ear canal and vascularization of skin flap during follow-up with narrow-band imaging. This study evaluated patients suffering from acquired atresia of the external auditory duct, treated surgically in our Department of Organi di Senso of Sapienza University, from 2017 to 2020. All patients underwent: anamnestic collection, physical examination, CT. Preoperative and postoperative otoendoscopic evaluation (1,3,6 and12 months) was performed with both cold white light endoscopic vision (CWL) and narrowband imaging (NBI). 17 patients were enrolled in the study. Preoperative otoendoscopic examination of WL showed stenosis with a diameter <75% and a tympanic membrane not viewable in all patients. At 12 months of follow-up, 94% of patients had no recurrence of external ear canal stenosis. 88% of patients had normal NBI light vascularization. Our study evaluated how NBI can be a superior method, compared to CWL, to assess the state of the flap and can be relevant in the decision-making process of a re-intervention

Origin of optical nonlinearity in plasmonic semiconductor nanostructures

The development of nanoscale nonlinear elements in photonic integrated circuits is hindered by the physical limits to the nonlinear optical response of dielectrics, which requires that the interacting waves propagate in transparent volumes for distances much longer than their wavelength. Here we present experimental evidence that optical nonlinearities in doped semiconductors are due to free-electron and their efficiency could exceed by several orders of magnitude that of conventional dielectric nonlinearities. Our experimental findings are supported by comprehensive computational results based on the hydrodynamic modeling, which naturally includes nonlocal effects, of the free-electron dynamics in heavily doped semiconductors. By studying third-harmonic generation from plasmonic nanoantenna arrays made out of heavily n-doped InGaAs with increasing levels of free-carrier density, we discriminate between hydrodynamic and dielectric nonlinearities. As a result, the value of maximum nonlinear efficiency as well as its spectral location can now be controlled by tuning the doping level. Having employed the common material platform InGaAs/InP that supports integrated waveguides, our findings pave the way for future exploitation of plasmonic nonlinearities in all-semiconductor photonic integrated circuits

Acquired atresia of the external auditory canal and canaloplasty with Thiersch graft reconstruction: Outcomes and complications

Acquired atresia of the external auditory canal (EAC) is a rare disease characterized by otorrhea and progressive hearing loss. Clinically, it is differentiated into two stages: the wet stage and the dry stage. The dry stage does not respond to pharmacological treatment and has to be treated surgically. One surgical option is canaloplasty of the EAC with Thiersch graft reconstruction. This study aimed to report the follow-up outcomes (otomicroscopic signs and pure tone audiometry [PTA]) in patients with acquired atresia treated with this technique. Eighteen adult patients surgically treated for acquired atresia of the EAC between 2010 and 2020 were enrolled. All underwent canaloplasty with Thiersch graft reconstruction by one senior surgeon. Otomicroscopy and PTA results were evaluated before and after surgery. Postsurgical follow-up was performed at 1-3-6-12 months and then annually. Presurgical otomicroscopic examination revealed stenosis that occluded more than 75% of the EAC in all patients, and preoperative PTA showed conductive hearing loss in 89% of patients. However, postsurgical otomicroscopic examination showed that 94% of patients had a normal EAC diameter after one year, and only one patient had anterior blunting and recurrent atresia. In addition, postsurgical PTA evidenced a normal range in 89% of patients after one year. In conclusion, acquired atresia of the EAC is a troublesome disease usually associated with hearing loss. Therefore, treatment is chosen to resolve its symptoms. The results demonstrate evidence that canaloplasty with Thirsch graft may be a suitable surgical method considering the lower incidence of recurrence and the excellent hearing outcomes