A Good Sign for Multivariate Risk Taking

Decisions under risk are often multidimensional, where the preferences of the decision maker depend on several attributes. For example, an individual might be concerned about both her level of wealth and the condition of her health. Many times the signs of successive cross derivatives of a utility function play an important role in these models. However, there has not been a simple and intuitive interpretation for the meaning of such derivatives. The purpose of this paper is to give such an interpretation. In particular, we provide an equivalence between the signs of these cross derivatives and individual preference within a particular class of simple lotteries.correlation aversion, multivariate risk, prudence, risk aversion, temperance

Priority Setting in Health Care and Higher Order Degree Change in Risk

This paper examines how priority setting in health care expenditures is influenced by the presence of uncertainty surrounding first, the severity of the illness and second, the effectiveness of medical treatment. We provide necessary and sufficient conditions on social preferences for which a social planner will allocate more health care resources to the higher risk population. Change in risk is defined through the concept of stochastic dominance up to order n. The shape of the social utility function and an equity weighting function are considered to model the inequality aversion of the social planner. We show that for higher order risk changes, usual conditions on preferences such as prudence or relative risk aversion are not necessarily required to prioritise health care under more uncertainty

Crystallisation of a highly metastable hydrated calcium pyrophosphate phase

A simple and fast synthesis method was set up to obtain pure hydrated calcium pyrophosphate (CPP)phases of biological interest. This work focused on a specific phase synthesised at 25 uC and pH 4.5 in a stirred tank reactor. Powder X-ray diffraction, FTIR spectroscopy, scanning electron microscopy and thermogravimetric analyses revealed that the phase is unknown but presents similarities with a monoclinic tetrahydrated CPP phase (Ca2P2O7?4H2O, m-CPPT b phase) synthesised under the same conditions of pH and temperature. Characterisation of the unreferenced phase (u-CPP) has been performed, especially to better identify its composition, structure and stability, as well as its possible relation to the m-CPPT b phase or to other hydrated CPP phases

Structure of the calcium pyrophosphate monohydrate phase (Ca2P2O7·H2O): towards understanding the dehydration process in calcium pyrophosphate hydrates

Calcium pyrophosphate hydrate (CPP, Ca2P2O7·nH2O) and calcium orthophosphate compounds (including apatite, octa­calcium phosphate etc.) are among the most prevalent pathological calcifications in joints. Even though only two dihydrated forms of CPP (CPPD) have been detected in vivo (monoclinic and triclinic CPPD), investigations of other hydrated forms such as tetra­hydrated or amorphous CPP are relevant to a further understanding of the physicochemistry of those phases of biological inter­est. The synthesis of single crystals of calcium pyrophosphate monohydrate (CPPM; Ca2P2O7·H2O) by diffusion in silica gel at ambient temperature and the structural analysis of this phase are reported in this paper. Complementarily, data from synchrotron X-ray diffraction on a CPPM powder sample have been fitted to the crystal parameters. Finally, the relationship between the resolved structure for the CPPM phase and the structure of the tetra­hydrated calcium pyrophosphate [beta] phase (CPPT-[beta]) is discussed

Influence of ionic additives on triclinic calcium pyrophosphate dihydrate precipitation

Triclinic calcium pyrophosphate dihydrate (t- CPPD) crystals are one of the two polymorphs of microcrystals that have been found in the joints of patients suffering from pseudogout. However, there is currently no treatment for inhibiting the formation of these crystals, which present a high inflammatory potential. In this context we studied in vitro the precipitation of t-CPPD in a stirred reactor under pH- and temperature-controlled conditions and determined the effect of selected biologically relevant ionic additives (Mg2+, Cu2+, Fe3+, Zn2+, S2O3 2−) on its formation. The results showed that 1 mM Fe3+, Zn2+, or Cu2+ induced the most significant changes by partly inhibiting the crystallization of t-CPPD and favoring the formation of an amorphous-CPP phase (98 wt %) in the presence of Fe3+ or a monoclinic-CPPD phase (78 or 71 wt %, respectively) in the presence of Zn2+ or Cu2+. Correlations between 31P solid-state NMR, XRD, and elemental analyses showed that the additive cations are inserted into the monoclinic-CPPD and/or amorphous-CPP phases. This study, which combines structural, morphological, and elemental analyses, paves the way toward a deeper comprehension of the role of ionic additives in preventing the formation of CPPD crystalline phases, and is a key step in long-term development of an effective therapeutic treatmen

Physiological responses during acute stress recovery depend on stress coping style in European sea bass, Dicentrarchus labrax

Individual stress coping style (reactive, intermediate and proactive) was determined in 3 groups of 120 pit tagged European seabass using the hypoxia avoidance test. The same three groups (no change in social composition) were then reared according to the standards recommended for this species. Then, 127 days later, individuals initially characterized as reactive, intermediate or proactive were submitted to an acute confinement stress for 30 min. Blood samples were taken to measure plasma cortisol levels 30 min (Stress30) or 150 min (Stress150) after the end of the confinement stress. Individuals were then sacrificed to sample the telencephalon in order to measure the main monoamines and their catabolites (at Stress30 only). Individuals from Stress150 were sampled for whole brain for a transcriptomic analysis. The main results showed that reactive individuals had a lower body mass than intermediate individuals which did not differ from proactive individuals. The physiological cortisol response did not differ between coping style at Stress30 but at Stress150 when intermediate and proactive individuals had recovered pre stress levels, reactive individuals showed a significant higher level illustrating a modulation of stress recovery by coping style. Serotonin turnover ratio was higher in proactive and reactive individuals compared to intermediate individuals and a significant positive correlation was observed with cortisol levels whatever the coping style. Further, the confinement stress led to a general increase in the serotonin turnover comparable between coping styles. Stress150 had a significant effect on target mRNA copy number (Gapdh mRNA copy number decreased while ifrd1 mRNA copy number increased) and such changes tended to depend upon coping style

Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.

RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Modelling and psychosis : from raw material to its setting : sensoriality, archaic view and symbolization

La pratique de la médiation thérapeutique en groupe par le modelage de la terre avec des personnes autistes et psychotiques met en évidence les modalités de constitution et du travail du médium malléable.Ce dernier permet, à travers l’acte de modeler au sein du cadre dispositif, une mise en forme des traces sensori-motrices (ou traces sensorielles), préalables à la constitution de l’image du corps.Le travail du médium malléable rend aussi compte des modalités de constitution de l’enveloppe psychique, tant sur un plan individuel que groupal.Les formes constituées mettent en avant le recours à des actes symboliques, que nous répertorions, témoins de l’état de constitution de l’enveloppe psychique. De la bidimensionnalité (identification adhésive) à l’espace tridimensionnel (identification projective), le sujet émiette la matière, la morcelle, coupe, sépare, rassemble, assemble et construit.Le travail du médium malléable et le mode d’utilisation du médium réactualisent le lien à l’objet primaire. Ils permettent aussi de focaliser les effets transféro-contre-transférentiels. La spécificité de l’intervention des thérapeutes (en cothérapie dans ce dispositif) concerne la mise en acte de leur propre sensorialité, à travers l’adresse d’une « interprétation modelante ».Practising the therapeutics mediation in group by the modeling of the earth with autistics and psychotics persons underlines the modalities/mode of constitution of the “medium malleable” and the work that it allows.The latest makes possible, through the action of modeling within framework plan, a setting of sensori motor (or sensorial traces), prior to the composition of the body image.The work of the “medium malleable” keeps the forms of the psychological envelope, as an individual plan or as a group.The constituted shapes emphasize the resort to symbolic acts that can be listed, witnesses of the state of composition of the psychological envelope. From the bi-dimension (adhesive identification)/2 dimension measurement to the 3 dimension measurement (projective identification), the subject crumbles the material, divides it, breaks, separates, gathers, puts together and builds. The work of the “medium malleable” and its mode of use update the link to the primary object. They also allow focusing on the “transfero-contre-transférentiels” effects. The specificity of the therapists (in co therapy in this case) concerns the acting of their own sensoriality, through the faculty of a “modeling interpretation”

Optimal saving with a state-dependent interest rate

International audienc

A Note on Optimal Insurance in the presence of a Nonpecuniary Background Risk

Cross derivatives, Correlated risks, Insurance, Multivariate utility,