Cost-effectiveness analysis of 3-D computerized tomography colonography versus optical colonoscopy for imaging symptomatic gastroenterology patients.

BACKGROUND: When symptomatic gastroenterology patients have an indication for colonic imaging, clinicians have a choice between optical colonoscopy (OC) and computerized tomography colonography with three-dimensional reconstruction (3-D CTC). 3-D CTC provides a minimally invasive and rapid evaluation of the entire colon, and it can be an efficient modality for diagnosing symptoms. It allows for a more targeted use of OC, which is associated with a higher risk of major adverse events and higher procedural costs. A case can be made for 3-D CTC as a primary test for colonic imaging followed if necessary by targeted therapeutic OC; however, the relative long-term costs and benefits of introducing 3-D CTC as a first-line investigation are unknown. AIM: The aim of this study was to assess the cost effectiveness of 3-D CTC versus OC for colonic imaging of symptomatic gastroenterology patients in the UK NHS. METHODS: We used a Markov model to follow a cohort of 100,000 symptomatic gastroenterology patients, aged 50 years or older, and estimate the expected lifetime outcomes, life years (LYs) and quality-adjusted life years (QALYs), and costs (£, 2010-2011) associated with 3-D CTC and OC. Sensitivity analyses were performed to assess the robustness of the base-case cost-effectiveness results to variation in input parameters and methodological assumptions. RESULTS: 3D-CTC provided a similar number of LYs (7.737 vs 7.739) and QALYs (7.013 vs 7.018) per individual compared with OC, and it was associated with substantially lower mean costs per patient (£467 vs £583), leading to a positive incremental net benefit. After accounting for the overall uncertainty, the probability of 3-D CTC being cost effective was around 60 %, at typical willingness-to-pay values of £20,000-£30,000 per QALY gained. CONCLUSION: 3-D CTC is a cost-saving and cost-effective option for colonic imaging of symptomatic gastroenterology patients compared with OC

Stigmatized campaign practices and the gendered dynamics of electoral viability

What happens when a traditional source of political capital becomes a health hazard? Stigmatized electoral practices, such as vote buying, are a double-edged sword: While these strategies may signal candidates’ electoral strength, they may also entail reputational costs. In normal times, street campaigns are a non-stigmatized electoral practice. During the Covid-19 pandemic, however, they imposed health risks. Employing data from a national survey experiment conducted in Brazil prior to the 2020 municipal elections (N = 2025), we extend research on the employment of stigmatized campaigns and the gendered dynamics of electoral viability. We find that voters evaluate candidates who engage in face-to-face activities as less electorally viable and report lower intent to support them. These dynamics do not impact all candidates equally: Voters more harshly punish women candidates who conduct street campaigns than men, leading women to lose the advantage they have over men when both employ non-stigmatized campaign practices

Ten Simple Rules for Taking Advantage of Git and GitHub.

Bioinformatics is a broad discipline in which one common denominator is the need to produce and/or use software that can be applied to biological data in different contexts. To enable and ensure the replicability and traceability of scientific claims, it is essential that the scientific publication, the corresponding datasets, and the data analysis are made publicly available [1,2]. All software used for the analysis should be either carefully documented (e.g., for commercial software) or, better yet, openly shared and directly accessible to others [3,4]. The rise of openly available software and source code alongside concomitant collaborative development is facilitated by the existence of several code repository services such as SourceForge, Bitbucket, GitLab, and GitHub, among others. These resources are also essential for collaborative software projects because they enable the organization and sharing of programming tasks between different remote contributors. Here, we introduce the main features of GitHub, a popular web-based platform that offers a free and integrated environment for hosting the source code, documentation, and project-related web content for open-source projects. GitHub also offers paid plans for private repositories (see Box 1) for individuals and businesses as well as free plans including private repositories for research and educational use.Biotechnology and Biological Sciences Research CouncilThis is the final version of the article. It first appeared from Public Library of Science via https://doi.org/10.1371/journal.pcbi.1004947

Poor youths and ‘pacification’:dilemmas between discourse and practice from the perspective of young people about policing in Rio de Janeiro’s favelas

This article explores the social representations of youngsters from favelas in Rio de Janeiro on police practices in the context of the implementation of ‘Pacifying Police Units’. Drawing from fieldwork, participant observation and interviews, the authors analyse the narratives and practices which influence relations between young people and the police in the Complexo do Alemão area of the city. The interviewees expressed a demand for further public security and social services. Young people noted some progress in police practices, although these changes appear to be unstable. The permanence of violent practices and prejudice by the police was verified in youngsters’ narratives. Any change in this scenario should be based on the replacement of the war logic of ‘pacification’ for another logic, that of participation.2030-01-0

Pseudodystonic Posture Secondary to Klippel–Feil Syndrome and Diastematomyelia

Background: Dystonic postures possess a great number of differential diagnoses. Phenomenology Shown: We describe a pseudodystonic posture in a 61‐year‐old woman with skeletal and extra‐skeletal abnormalities. Educational Value: Klippel–Feil syndrome represents an unusual cause of pseudodystonic posture to be considered in the differential diagnosis of dystonia

Uso de crack durante a gestação e prematuridade: análise de peso ao nascer e tamanho para a idade gestacional

O crack é uma droga produzida pelo aquecimento de uma solução aquosa de cocaína adicionada a um solvente que, após ser resfriada, se transforma em cristais. No Brasil, em 2013, existiam cerca de 370 mil usuários regulares de crack, sendo que a maior parcela se encontrava na região Sul. Os efeitos do consumo da droga são variados e incluem distúrbios do Sistema Nervoso Autônomo e cardiovasculares, além do risco de danos reprodutivos, em especial a prematuridade. O objetivo do estudo foi analisar, a partir dos nascidos vivos no Hospital São Vicente de Paulo, localizado em Passo Fundo/RS, o peso ao nascer e o tamanho adequado para a idade gestacional dos neonatos de mães referidas como usuárias crônicas de crack. Além disso, foi desejado verificar se havia prevalência de nascimentos prematuros no grupo estudado. Dez prontuários de neonatos nascidos de mães usuárias de crack entre 2009 e 2018, foram analisados. Do total, 90% nasceram prematuros. Seis nasceram com baixo peso, três tinham peso adequado e, apenas um, nasceu com o peso adequado. Em relação ao tamanho adequado para a idade gestacional, na maioria estavam adequados. Sugere-se, a partir dos resultados obtidos no local de pesquisa, que o desfecho de prematuridade estava presente nas gestações expostas ao uso de crack, assim como o baixo peso ao nascer. Ao contrário do esperado, não se encontrou relação entre uso da droga durante a gestação e desfecho de tamanho inadequado para idade gestacional

A declaração dos direitos do Homem e do cidadão de 1789 e sua influência nos direitos individuais das constituições liberais portuguesas (1822-1911)

Na Assembleia Nacional Francesa em 1789 foi aprovada a Declaração dos Direitos do Homem e do Cidadão. Esta Declaração pode ser considerada simbolicamente como um ato decisivo que assinalou o fim do Antigo Regime aniquilado pela Revolução Francesa, traçando os princípios e mudanças que se queriam imprimir segundo um novo modelo liberal e, principalmente, a reivindicação de se impor limites ao Poder e garantir o que hoje chamamos de direitos civis e políticos. Como um marco fundamental, espalhou sementes transformadoras da sociedade, servindo como fonte de inspiração ideal para os povos que lutaram por sua liberdade, tornando anseios, antes circunscritos nas teorias políticas e filosóficas, em direitos juridicamente reconhecidos e protegidos contra eventuais violações por parte do Estado. Nesse influxo, Portugal não se viu alheio a essas transformações, cujas influências podem ser sentidas na implantação de sua Monarquia Constitucional e posteriormente no seu Estado Republicano. Da análise dos debates parlamentares que precederam a elaboração dos textos constitucionais e do eco ocorrido na principal imprensa do período é possível identificar a memória, os valores e os ideais da Revolução Francesa e a evidente influência da Declaração dos Direitos do Homem e do Cidadão de 1789 no movimento constitucional português, nomeadamente nas garantias individuais insertas nas suas Constituições insculpidas sob o modelo liberal: as Monárquicas de 1822, 1826, 1838 e a Republicana de 1911.At the French National Assembly in 1789 the Declaration of the Rights of Man and Citizen was approved. This Declaration can be considered symbolically as a decisive act that established the end of the Old Regime annihilated by the French Revolution, outlining the principles and changes that were intended to be imprinted according to a new liberal model and, above all, the claim to impose limits on power and guarantee what we call nowadays civil and political rights. As a key milestone, it has spread transformative seeds of society, serving as an ideal source of inspiration for the people who fought for their freedom, making longings, once just circumscribed in political and philosophical theories, in legally recognized rights and protected against possible violations by the State. In this influx, Portugal was not unaware of these transformations, which influences can be felt in the establishment of its Constitutional Monarchy and later in its Republican State. From the analysis of the parliamentary debates that preceded the elaboration of the constitutional texts and the echo that occurred in the main press of this period, it is possible to identify the memory, values and ideals of the French Revolution and the evident influence of The Declaration of Rights of Man and Citizen of 1789 in the Portuguese constitutional movement, mainly in the individual guarantees inserted in its Constitutions inscribed under the liberal model: the Monarchies of 1822 , 1826, 1838 and the 1911 Republican

Estruturação da vigilância epidemiológica e manejo populacional de suídeos asselvajados (Sus scrofa) para área livre de peste suína clássica do Brasil.

Suplemento 2, ref. 30. Edição dos Resumos do 3 Encontro Nacional de Defesa Sanitária Animal, Foz de Iguaçu, dez. 2013