55 research outputs found
Essays in Econometrics with Applications to Social Networks
This thesis is comprised of three self-contained essays on econometrics. The frst paper illustrates how stochastic dominance criteria can be used to rank social networks in terms of effciency, and develops statistical in- ference procedures for assessing these criteria. The tests proposed can be viewed as extensions of a Pearson goodness-of-fit test and a studentized maximum modulus test often used to partially rank income distributions and inequality measures. We establish uniform convergence of the empirical size of the tests to the nominal level, and show their consistency under the usual conditions that guarantee the validity of the approximation of a multi- nomial distribution to a Gaussian distribution. Furthermore, we propose a bootstrap method that enhances the finite-sample properties of the tests. The performance of the tests is illustrated via Monte Carlo experiments and an empirical application to risk sharing networks in rural India. The second paper considers the problem of testing a hypothesis H0 : Beta = Beta0 where Beta is a vector representing the degree distribution of a graph and the sample acquired is an induced subgraph. We propose a novel bootstrap procedure to control the size of a test under the null hypothesis by con- structing a graph whose degree distribution conforms to the null hypothesis from which we may draw pseudo-samples in the form of induced subgraphs. We investigate the properties of the bootstrap with a simulation study in which a Wald-type statistic based on a truncated singular value estimator, whose null distribution is approximately chi-square, serves as a benchmark. We then discuss whether this test may be inverted to construct confidence intervals. The third paper presents a selective review of the Lasso estimator as it applies to econometric inference. We survey key papers addressing proper- ties of the Lasso of interest to the econometrician including conditions for consistency, the asymptotic distribution of the estimator, its ability to be bootstrapped, sample splitting for high dimensional inference, and how it may be used to solve the many instruments problem in instrumental variables regression.Thesis (Ph.D.) -- University of Adelaide, School of Economics, 201
A comparison of handwritten and computer-assisted prescriptions in an intensive care unit
BACKGROUND: We conducted a prospective comparative study to evaluate the potential benefit of computer-assisted prescribing (CAP). We compared the accuracy, completeness and time use of CAP with that of conventional handwritten prescribing at the intensive care unit (ICU) of the John Radcliffe Hospital, Oxford, UK. RESULTS: Twenty-five clinicians and 2409 drug entries were evaluated for accuracy, completeness, legibility and time spent prescribing. One hundred and twenty-eight handwritten and 110 CAP charts were monitored. One hundred percent of CAP charts were complete compared to 47% of handwritten charts.Drug prescriptions were divided into three categories: intravenous fluids, intravenous infusions and intermittent drugs. Percentage of correct entries in each category were 64%, 47.5% and 90% for handwritten, compared to 48%, 32% and 90% for CAP charts, respectively.The mean time taken to prescribe was 20 s for hand written prescribing and 55 s for CAP. CONCLUSIONS: Computer-assisted prescriptions were more complete, signed and dated than handwritten prescriptions. Errors in prescribing, including failure to discontinue a drug were not reduced by CAP. Handwritten prescribing was quicker than CAP. Simple enhancements of the computer software could be introduced which might overcome these deficiencies. CAP was successfully integrated into clinical practice in the ICU
The Profumo affair in popular culture: The Keeler Affair (1963) and âthe commercial exploitation of a public scandalâ
This article demonstrates that the Profumo affair, which obsessed Britain for large parts of 1963, was not simply a political scandal, but was also an important cultural event. Focussing on the production of The Keeler Affair, a feature film that figured prominently in contemporary coverage of the scandal but which has been largely overlooked since, the article shows that this film emerged from a situation in which cultural entrepreneurs, many of them associated with the satire boom, sought to exploit the scandal for financial gain. Many Profumo-related cultural products found an audience, and thus formed an integral part of, and helped to shape public attitudes towards, the Profumo affair. However, these products did not go uncontested, and resistance to them, and especially to the idea that Keeler might benefit materially from her role in the scandal, speak to concerns about cultural mediations of sex, politics and humour in early-1960s Britain
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The heterogeneity of wooded-agricultural landscape mosaics influences woodland bird community assemblages
Context
Landscape heterogeneity (the composition and configuration of different landcover types) plays a key role in shaping woodland bird assemblages in wooded-agricultural mosaics. Understanding how species respond to landscape factors could contribute to preventing further decline of woodland bird populations.
Objective
To investigate how woodland birds with different species traits respond to landscape heterogeneity, and to identify whether specific landcover types are important for maintaining diverse populations in wooded-agricultural environments.
Methods
Birds were sampled from woodlands in 58 2 x 2 km tetrads across southern Britain. Landscape heterogeneity was quantified for each tetrad. Bird assemblage response was determined using redundancy analysis combined with variation partitioning and response trait analyses.
Results
For woodland bird assemblages, the independent explanatory importance of landscape composition and landscape configuration variables were closely interrelated. When considered simultaneously during variation partitioning, the community response was better represented by compositional variables. Different species responded to different landscape features and this could be explained by traits relating to woodland association, foraging strata and nest location. Ubiquitous, generalist species, many of which were hole-nesters or ground foragers, correlated positively with urban landcover while specialists of broadleaved woodland avoided landscapes containing urban areas. Species typical of coniferous woodland correlated with large conifer plantations.
Conclusions
At the 2 x 2 km scale, there was evidence that the availability of resources provided by proximate landcover types was highly important for shaping woodland bird assemblages. Further research to disentangle the effects of composition and configuration at different spatial scales is advocated
An upper limit to the photon fraction in cosmic rays above 10^19 eV from the Pierre Auger Observatory
An upper limit of 16% (at 95% c.l.) is derived for the photon fraction in cosmic rays with energies above 10^19 eV, based on observations of the depth of shower maximum performed with the hybrid detector of the Pierre Auger Observatory. This is the first such limit on photons obtained by observing the fluorescence light profile of air showers. This upper limit confirms and improves on previous results from the Haverah Park and AGASA surface arrays. Additional data recorded with the Auger surface detectors for a subset of the event sample, support the conclusion that a photon origin of the observed events is not favoured
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Effect of Hydrocortisone on Mortality and Organ Support in Patients With Severe COVID-19: The REMAP-CAP COVID-19 Corticosteroid Domain Randomized Clinical Trial.
Importance: Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective: To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants: An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions: The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (nâ=â143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (nâ=â152), or no hydrocortisone (nâ=â108). Main Outcomes and Measures: The primary end point was organ support-free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned -1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results: After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (nâ=â137), shock-dependent (nâ=â146), and no (nâ=â101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support-free days were 0 (IQR, -1 to 15), 0 (IQR, -1 to 13), and 0 (-1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support-free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance: Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support-free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions. Trial Registration: ClinicalTrials.gov Identifier: NCT02735707
Association between trends in clinical variables and outcome in intensive care patients with faecal peritonitis: analysis of the GenOSept cohort
This is an Open Access article distributed under the terms of the Creative
Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain
Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article,
unless otherwise stated
An immune dysfunction score for stratification of patients with acute infection based on whole-blood gene expression
Dysregulated host responses to infection can lead to organ dysfunction and sepsis, causing millions of global deaths each year. To alleviate this burden, improved prognostication and biomarkers of response are urgently needed. We investigated the use of whole-blood transcriptomics for stratification of patients with severe infection by integrating data from 3149 samples from patients with sepsis due to community-acquired pneumonia or fecal peritonitis admitted to intensive care and healthy individuals into a gene expression reference map. We used this map to derive a quantitative sepsis response signature (SRSq) score reflective of immune dysfunction and predictive of clinical outcomes, which can be estimated using a 7- or 12-gene signature. Last, we built a machine learning framework, SepstratifieR, to deploy SRSq in adult and pediatric bacterial and viral sepsis, H1N1 influenza, and COVID-19, demonstrating clinically relevant stratification across diseases and revealing some of the physiological alterations linking immune dysregulation to mortality. Our method enables early identification of individuals with dysfunctional immune profiles, bringing us closer to precision medicine in infection.peer-reviewe
Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19
IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19.
Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19.
DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 nonâcritically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022).
INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (nâ=â257), ARB (nâ=â248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; nâ=â10), or no RAS inhibitor (control; nâ=â264) for up to 10 days.
MAIN OUTCOMES AND MEASURES The primary outcome was organ supportâfree days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes.
RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ supportâfree days among critically ill patients was 10 (â1 to 16) in the ACE inhibitor group (nâ=â231), 8 (â1 to 17) in the ARB group (nâ=â217), and 12 (0 to 17) in the control group (nâ=â231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ supportâfree days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively).
CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes.
TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570
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