Examining patient preferences in the treatment of rheumatoid arthritis using a discrete-choice approach

Background: Biological disease-modifying antirheumatic drugs (bDMARDs) used in second-line treatment of rheumatoid arthritis (RA) are administered parenterally. However, so-called targeted synthetic DMARDs (tsDMARDs) – developed more recently – offer alternative (ie, oral) administration forms in second-line treatment. Since bDMARDs and tsDMARDs can be regarded as equal in terms of efficacy, the present study examines whether such characteristics as route of administration drive RA patients’ treatment choice. This may ultimately suggest superiority of some second-line DMARDs over equally effective options, at least according to RA-patient preferences. Objective: The current study assessed the importance of oral administration among other treatment characteristics differing between available second-line DMARDs for RA patients’ preferences using a discrete-choice experiment (DCE). Materials and methods: The DCE involved scenarios of three hypothetical treatment options in a d-efficient design with varying levels of key attributes (route and frequency of administration, time till onset of drug effect, combination therapy, possible side effects), as defined by focus groups. Further patient characteristics were recorded by an accompanying questionnaire. In the DCE, patients were asked to choose best and worst options (best–worst scaling). Results were analyzed by count analysis and adjusted regression analysis. Results: A total of 1,588 subjects completed the DCE and were eligible for final analyses. Across all characteristics included in the DCE, “oral administration” was most desired and “intravenous infusion” was most strongly rejected. This was followed by “no combination with methotrexate” being strongly preferred and “intake every 1–2 weeks” being strongly rejected. On average, levels of route of administration showed strongest influences on patients’ decisions in post hoc bootstrapping analysis. Conclusion: According to the results, an oral DMARD that does not have to be combined with methotrexate and is not administered (only) every 1–2 weeks appears a highly favorable treatment option for patients with RA. DMARDs meeting these preferences may increase compliance and adherence in RA treatment

Environmental adaptation, phenotypic plasticity, and associative learning in insects: the desert locust as a case study

The ability to learn and store information should be adapted to the environment in which animals operate to confer a selective advantage. Yet the relationship between learning, memory, and the environment is poorly understood, and further complicated by phenotypic plasticity caused by the very environment in which learning and memory need to operate. Many insect species show polyphenism, an extreme form of phenotypic plasticity, allowing them to occupy distinct environments by producing two or more alternative phenotypes. Yet how the learning and memories capabilities of these alternative phenotypes are adapted to their specific environments remains unknown for most polyphenic insect species. The desert locust can exist as one of two extreme phenotypes or phases, solitarious and gregarious. Recent studies of associative food–odor learning in this locust have shown that aversive but not appetitive learning differs between phases. Furthermore, switching from the solitarious to the gregarious phase (gregarization) prevents locusts acquiring new learned aversions, enabling them to convert an aversive memory formed in the solitarious phase to an appetitive one in the gregarious phase. This conversion provides a neuroecological mechanism that matches key changes in the behavioral environments of the two phases. These findings emphasize the importance of understanding the neural mechanisms that generate ecologically relevant behaviors and the interactions between different forms of behavioral plasticity

Herbivore effect traits and their impact on plant community biomass: an experimental test using grasshoppers

1. Using trait-based approaches to study trophic interactions may represent one of the most promising approaches to evaluate the impact of trophic interactions on ecosystem functioning. To achieve this goal, it is necessary to clearly identify which traits determine the impact of one trophic level on another.2. Using functionally contrasting grasshopper species, we tested the ability of multiple traits (morphological, chemical and biomechanical) to predict herbivore impact on the biomass of a diverse plant community. We set up a cage experiment in an old species rich grassland field and evaluated how multiple candidate grasshopper effect traits mediated herbivore impact on plant biomass.3. Grasshoppers had different impact on plant community biomass (consuming up to 60 % of plant community biomass). Grasshopper impact was positively correlated with their incisive strength while body size or grasshopper C:N ratio exhibited low predictive ability. Importantly, the strong relationship between the incisive strength and the impact was mediated by the grasshopper feeding niche, which was well predicted in our study by two simple plant traits (leaf dry matter content, leaf C:N ratio). Feeding niche differences between grasshoppers were explained by differences in incisive strength, highlighting the fundamental linkage between grasshopper effect traits and their niche.4. Our study contributes to the development of the trait-based approach in the study of trophic interactions by providing a first experimental test of the relationship between herbivore effect traits, their impact on plant community biomass, and in a larger extent on ecosystem functioning. By comparing the relative importance of multiple interacting grasshopper traits, our study showed that incisive strength was a key effect trait which determined grasshopper feeding niche and its relative impact on plant community biomass

Essays on Economic Policy Design in the Presence of Political Constraints

This dissertation contains two essays on optimal policy design in the presence of political constraints. The first essay relates to an active debate among economists regarding clean energy subsidies. The models used to inform this debate have a common simplifying assumption: the preferences of the government are kept constant over time. In reality, control of the government often rotates between parties with very different policy preferences. This paper finds that adding turnover in party control of the government can have significant implications. Specifically, the party more concerned about the environment (``the green party") finds it optimal to subsidize irreversible investments in clean energy, even when carbon taxes are available and can be placed at any level. Quantitative evidence suggests that this mechanism can justify the use of relatively large clean energy investment subsidies. The next essay relates to the design of international climate agreements in a context where countries must be incentivized to voluntarily join the agreement. Existing literature has focused on two possible ways to incentivize participation in a climate agreement: 1. participants can threaten to increase carbon emissions if other countries don't join or 2. participants can threaten to place trade sanctions on countries who don't join. This paper offers a novel justification for using trade sanctions to incentivize participation: if there's a chance that punishments will have to actually be carried out, using trade sanctions is welfare improving because trade sanctions are far more efficient punishments than carbon emissions increases. This argument is formalized using a game with incomplete information. A calibration exercise suggests that using trade sanctions to enforce a climate agreement could significantly increase global welfare

Disciples of Vu

This project is in the design of high-fantasy sword and sorcery, wherein the concepts of mana and magic are employed as expressions of virtue to highlight contemporary issues of cultural identity and belonging. This project is also an experiment to attract a readership of non-traditional fantasy readers into the genre by creating, rather than assuming, a fantastic world context using immersive rhetorical techniques. This project in of itself is not so much a re-invention of the traditional adventure quest as it is an exploration of its post-Tolkien form (the attraction of mythology and folklore, the narrative use of prophecy), and also includes elements of satire, which respond to the stereotypical battle between good versus evil and the haphazard treasure hording conventions encouraged by fantasy gaming culture

High Fat Diet Increased Serum Glutamate Dehydrogenase more than Chronic Acetaminophen Dosing in Female Mice

This laboratory study examined the effects of acetaminophen overdose in normal fed and high-fat fed female mice. Forty female mice were placed on normal and high-fat diets at 4 weeks old. When the mice were significantly different in weight (between 6 and 9 months old), half the mice were dosed with acetaminophen. These mice were daily given an overdose of acetaminophen for 14 days. The dose used was 300 mg/kg mouse (LD50 = 338 mg/kg). The control group was given 10 µl water/g mouse. Levels of serum glutamate dehydrogenase (GDH) were measured to indicate liver damage. GDH is released from liver mitochondria indicating mitochondrial damage and toxicity. Based on a two-way ANOVA, the mean GDH levels were significantly higher in the high-fat diet mice groups (p \u3c 0.001). This suggests damage to liver mitochondria due to high-fat diet alone. Liver weights of all female mice groups were documented and statistically analyzed and showed significant difference between diet groups (p \u3c 0.001) and diet*treatment groups (p = 0.026). Visible fat content in all livers was also analyzed and showed significant difference between diet groups (p \u3c 0.001) and treatment (acetaminophen or control) groups (p = 0.001)

Movement and Angler Harvest of Fishes in the Des Moines River, Boone County, lowa

Fish tagging returns of the Iowa Cooperative Fisheries Research Unit from 1955 to the end of 1963 are summarized. Tag returns give minimum estimates of angler harvest as 4.6%, for channel catfish, Ictalurus punctatus, and 12.0% for walleyes, Stizostedion vitreum. Very few flathead catfish, Pylodictis olivaris, and smallmouth bass, Micropterus dolomieui, were reported caught by anglers. Channel catfish showed greatest movement of the species studied with downstream movement predominating. Walleyes moved as far as 18 miles. Smallmouth bass showed very little movement, except for one individual that moved about 40 miles. Data on both angler harvest and movement must be interpreted in the light of biases inherent in the study

The Roles of Bloggers in Web 2.0

This study examine the roles of bloggers in Web 2.0. Blogging is considered to be a fairly new phenomenon and blog authors are increasingly seen as producers of user-­generated content wielding influence on both their readers and respective industries. Thus, it is argued that recognizing the different roles assumed by bloggers will shed light on the importance of bloggers and how this may affect marketingpractices