227 research outputs found
A Score-Driven Conditional Correlation Model for Noisy and Asynchronous Data: An Application to High-Frequency Covariance Dynamics
The analysis of the intraday dynamics of covariances among high-frequency returns is challenging due to asynchronous trading and market microstructure noise. Both effects lead to significant data reduction and may severely affect the estimation of the covariances if traditional methods for low-frequency data are employed. We propose to model intraday log-prices through a multivariate local-level model with score-driven covariance matrices and to treat asynchronicity as a missing value problem. The main advantages of this approach are: (i) all available data are used when filtering the covariances, (ii) market microstructure noise is taken into account, (iii) estimation is performed by standard maximum likelihood. Our empirical analysis, performed on 1-sec NYSE data, shows that opening hours are dominated by idiosyncratic risk and that a market factor progressively emerges in the second part of the day. The method can be used as a nowcasting tool for high-frequency data, allowing to study the real-time response of covariances to macro-news announcements and to build intraday portfolios with very short optimization horizons
Prevalence of Iron-deficiency Anaemia among University Students in Noakhali Region, Bangladesh
Iron-deficiency anaemia (IDA) is a common health problem in rural women
and young children of Bangladesh. The university students usually take
food from residential halls, and the food value of their diets is not
always balanced. This cross-sectional study was conducted to estimate
the prevalence of irondeficiency anaemia among the university students
of Noakhali region, Bangladesh. Haemoglobin level of 300
randomly-selected students was measured calorimetrically, using
Sahli\u2019s haemoglobinometer during October to December 2011.
Statistical analysis was done by using SPSS software for Windows
(version 16) (SPSS Inc., Chicago, IL, USA). In the study, 55.3%
students were found anaemic, of whom 36.7% were male, and 63.3% were
female. Students aged 20-22 years were more anaemic (43.4%) than other
age-groups. Majority (51.3%) of male students showed their haemoglobin
level in the range of 13-15 g/dL, followed by 26.0% and 21.3% with
10-12 g/dL and 16-18 g/dL respectively. Although 50.5% anaemic and
51.1% non-anaemic female students showed normal BMI\u2014lower
percentage than anaemic (60.7%) and nonanaemic (71.9%) male students,
the underweight students were found more anaemic than the overweight
and obese subjects. Regular breakfast-taking habit showed significant
(p=0.035, 95% CI 0.5-1.0) influence on IDA compared to non-regular
breakfast takers. Consumption of meat, fish, poultry, eggs, or peanut
butter regularly; junk food; multivitamins; and iron/iron-rich food
showed insignificant (p=0.097, 95% CI 0.5-1.1; p=0.053, 95% CI 1.1-2.3;
p=0.148, 95% CI 0.6-1.2; and p=0.487, 95% CI 0.7-1.4 respectively) role
in provoking IDA. In the case of non-anaemic subjects, all of the above
parameters were significant, except the junk food consumption (p=0.342,
95% CI 0.5-1.2). Our study revealed that majority of university
students, especially female, were anaemic that might be aggravated by
food habit and lack of awareness. The results suggest that anaemia can
be prevented by providing proper knowledge on the healthful diet,
improved lifestyle, and harmful effect of anaemia to the students
Primaquine radical cure in patients with Plasmodium falciparum malaria in areas co-endemic for P falciparum and Plasmodium vivax (PRIMA): a multicentre, open-label, superiority randomised controlled trial
Background
In areas co-endemic for Plasmodium vivax and Plasmodium falciparum there is an increased risk of P vivax parasitaemia following P falciparum malaria. Radical cure is currently only recommended for patients presenting with P vivax malaria. Expanding the indication for radical cure to patients presenting with P falciparum malaria could reduce their risk of subsequent P vivax parasitaemia.
Methods
We did a multicentre, open-label, superiority randomised controlled trial in five health clinics in Bangladesh, Indonesia, and Ethiopia. In Bangladesh and Indonesia, patients were excluded if they were younger than 1 year, whereas in Ethiopia patients were excluded if they were younger than 18 years. Patients with uncomplicated P falciparum monoinfection who had fever or a history of fever in the 48 h preceding clinic visit were eligible for enrolment and were required to have a glucose-6-dehydrogenase (G6PD) activity of 70% or greater. Patients received blood schizontocidal treatment (artemether–lumefantrine in Ethiopia and Bangladesh and dihydroartemisinin–piperaquine in Indonesia) and were randomly assigned (1:1) to receive either high-dose short-course oral primaquine (intervention arm; total dose 7 mg/kg over 7 days) or standard care (standard care arm; single dose oral primaquine of 0·25 mg/kg). Random assignment was done by an independent statistician in blocks of eight by use of sealed envelopes. All randomly assigned and eligible patients were included in the primary and safety analyses. The per-protocol analysis excluded those who did not complete treatment or had substantial protocol violations. The primary endpoint was the incidence risk of P vivax parasitaemia on day 63. This trial is registered at ClinicalTrials.gov, NCT03916003.
Findings
Between Aug 18, 2019, and March 14, 2022, a total of 500 patients were enrolled and randomly assigned, and 495 eligible patients were included in the intention-to-treat analysis (246 intervention and 249 control). The incidence risk of P vivax parasitaemia at day 63 was 11·0% (95% CI 7·5–15·9) in the standard care arm compared with 2·5% (1·0–5·9) in the intervention arm (hazard ratio 0·20, 95% CI 0·08–0·51; p=0·0009). The effect size differed with blood schizontocidal treatment and site. Routine symptom reporting on day 2 and day 7 were similar between groups. In the first 42 days, there were a total of four primaquine-related adverse events reported in the standard care arm and 26 in the intervention arm; 132 (92%) of all 143 adverse events were mild. There were two serious adverse events in the intervention arm, which were considered unrelated to the study drug. None of the patients developed severe anaemia (defined as haemoglobin <5 g/dL).
Interpretation
In patients with a G6PD activity of 70% or greater, high-dose short-course primaquine was safe and relatively well tolerated and reduced the risk of subsequent P vivax parasitaemia within 63 days by five fold. Universal radical cure therefore potentially offers substantial clinical, public health, and operational benefits, but these benefits will vary with endemic setting.
Funding
Australian Academy of Science Regional Collaborations Program, Bill & Melinda Gates Foundation, and National Health and Medical Research Council
Potential impact of invasive alien species on ecosystem services provided by a tropical forested ecosystem: a case study from Montserrat
Local stakeholders at the important but
vulnerable Centre Hills on Montserrat consider that
the continued presence of feral livestock (particularly
goats and pigs) may lead to widespread replacement of
the reserve’s native vegetation by invasive alien trees
(Java plum and guava), and consequent negative
impacts on native animal species. Since 2009, a
hunting programme to control the feral livestock has
been in operation. However long-term funding is not
assured. Here, we estimate the effect of feral livestock
control on ecosystem services provided by the forest to
evaluate whether the biodiversity conservation rationale
for continuation of the control programme is
supported by an economic case. A new practical tool
(Toolkit for Ecosystem Service Site-based Assessment)
was employed to measure and compare ecosystem
service provision between two states of the
reserve (i.e. presence and absence of feral livestock
control) to estimate the net consequences of the
hunting programme on ecosystem services provided
by the forest. Based on this we estimate that cessation
of feral livestock management would substantially
reduce the net benefits provided by the site, including a
46 % reduction in nature-based tourism (from
228,000) and 36 % reduction in harvested
wild meat (from 132,000). The
overall net benefit generated from annual ecosystem
service flows associated with livestock control in thereserve, minus the management cost, was $214,000
per year. We conclude that continued feral livestock
control is important for maintaining the current level
of ecosystem services provided by the reserve
Illegal Immigration, Deportation Policy, and the Optimal Timing of Return
Countries with strict immigration policies often resort to deportation measures to reduce their stocks of illegal immigrants. Many of their undocumented foreign workers, however, are not deported but rather choose to return home voluntarily. This paper studies the optimizing behavior of undocumented immigrants who continuously face the risk of deportation, modeled by a stochastic process, and must decide how long to remain in the host country. It is found that the presence of uncertainty with respect to the length of stay abroad unambiguously reduces the desired migration duration and may trigger a voluntary return when a permanent stay would otherwise be optimal. Voluntary return is motivated by both economic and psychological factors. Calibration of the model to match the evidence on undocumented Thai migrants in Japan suggests that the psychological impact of being abroad as an illegal alien may be equivalent to as large as a 68% cut in the consumption rate at the point of return
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Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019: Update From the GBD 2019 Study
Cardiovascular diseases (CVDs), principally ischemic heart disease (IHD) and stroke, are the leading cause of global mortality and a major contributor to disability. This paper reviews the magnitude of total CVD burden, including 13 underlying causes of cardiovascular death and 9 related risk factors, using estimates from the Global Burden of Disease (GBD) Study 2019. GBD, an ongoing multinational collaboration to provide comparable and consistent estimates of population health over time, used all available population-level data sources on incidence, prevalence, case fatality, mortality, and health risks to produce estimates for 204 countries and territories from 1990 to 2019.
Prevalent cases of total CVD nearly doubled from 271 million (95% uncertainty interval [UI]: 257 to 285 million) in 1990 to 523 million (95% UI: 497 to 550 million) in 2019, and the number of CVD deaths steadily increased from 12.1 million (95% UI:11.4 to 12.6 million) in 1990, reaching 18.6 million (95% UI: 17.1 to 19.7 million) in 2019. The global trends for disability-adjusted life years (DALYs) and years of life lost also increased significantly, and years lived with disability doubled from 17.7 million (95% UI: 12.9 to 22.5 million) to 34.4 million (95% UI:24.9 to 43.6 million) over that period. The total number of DALYs due to IHD has risen steadily since 1990, reaching 182 million (95% UI: 170 to 194 million) DALYs, 9.14 million (95% UI: 8.40 to 9.74 million) deaths in the year 2019, and 197 million (95% UI: 178 to 220 million) prevalent cases of IHD in 2019. The total number of DALYs due to stroke has risen steadily since 1990, reaching 143 million (95% UI: 133 to 153 million) DALYs, 6.55 million (95% UI: 6.00 to 7.02 million) deaths in the year 2019, and 101 million (95% UI: 93.2 to 111 million) prevalent cases of stroke in 2019.
Cardiovascular diseases remain the leading cause of disease burden in the world. CVD burden continues its decades-long rise for almost all countries outside high-income countries, and alarmingly, the age-standardized rate of CVD has begun to rise in some locations where it was previously declining in high-income countries. There is an urgent need to focus on implementing existing cost-effective policies and interventions if the world is to meet the targets for Sustainable Development Goal 3 and achieve a 30% reduction in premature mortality due to noncommunicable diseases
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