Incorporating patients' characteristics in cost-effectiveness studies with clinical trial data: a flexible Bayesian approach

Most published research on the comparison between medical treatment options merely compares the results (effectiveness and cost) obtained for each treatment group. The present work proposes the incorporation of other patient characteristics into the analysis. Most of the studies carried out in this context assume normality of both costs and effectiveness. In practice, however, the data are not always distributed according to this assumption. Altervative models have to be developed.In this paper, we present a general model of cost-effectiveness, incorporating both binary effectiveness and skewed cost. In a practical application, we compare two highly active antiretroviral treatments applied to asymptomatic HIV patients. We propose a logit model when the effectiveness is measured depending on whether an initial purpose is achieved. For this model, the measure to compare treatments is the difference in the probability of success. Besides, the cost data usually present a right skewing. We propose the use of the logtransformation to carry out the regression model. The three models are fitted demonstrating the advantages of this modelling. The cost-effectiveness acceptability curve is used as a measure for decision-making.Peer Reviewe

Bayesian Inference in Auditing with Partial Prior Information Using Maximum Entropy Priors

Problems in statistical auditing are usually one–sided. In fact, the main interest for auditors is to determine the quantiles of the total amount of error, and then to compare these quantiles with a given materiality fixed by the auditor, so that the accounting statement can be accepted or rejected. Dollar unit sampling (DUS) is a useful procedure to collect sample information, whereby items are chosen with a probability proportional to book amounts and in which the relevant error amount distribution is the distribution of the taints weighted by the book value. The likelihood induced by DUS refers to a 201–variate parameter p but the prior information is in a subparameter q linear function of p, representing the total amount of error. This means that partial prior information must be processed. In this paper, two main proposals are made: (1) to modify the likelihood, to make it compatible with prior information and thus obtain a Bayesian analysis for hypotheses to be tested; (2) to use a maximum entropy prior to incorporate limited auditor information. To achieve these goals, we obtain a modified likelihood function inspired by the induced likelihood described by Zehna (1966) and then adapt the Bayes’ theorem to this likelihood in order to derive a posterior distribution for q. This approach shows that the DUS methodology can be justified as a natural method of processing partial prior information in auditing and that a Bayesian analysis can be performed even when prior information is only available for a subparameter of the model. Finally, some numerical examples are presented.This research was partially funded by MINECO, Spain (grant number EC02017–85577–P)

Documentando o México Originario: Xantolo

Photographs.Fotografías

El legado de Samuelson. La preferencia revelada

The prolific work of the recently deceased Paul A. Samuelson makes a significant contribution to several areas of economic theory. He was awarded the 1970 Nobel Prize in Economics for doing more than any other contemporary economist to raise the level of scientific analysis in economic theory. He is also well-known as the author of several influential textbooks which are among all-time best-sellers. Although it is not easy to highlight only one of his contributions, over seventy years ago his revealed preference analysis opened a fertile field of research that went beyond the scope of consumer theory, thus creating a bridge that leads to reconciling economic theory with other social sciences.La fecunda obra del recientemente fallecido Paul A. Samuelson contiene aportaciones significativas en muy diversas áreas de la teoría económica. Premio Nobel de Economía en 1970 por contribuir activamente a elevar el nivel de análisis de la ciencia económica, es también conocida su labor divulgativa como autor de varios manuales que figuran entre los libros de texto universitarios más vendidos de la historia. Aunque no es fácil destacar una de sus contribuciones por encima de las demás, su teoría de la preferencia revelada abrió hace más de setenta años un fértil campo de investigación que ha sobrepasado el ámbito de la teoría del consumidor, estableciendo un puente que conduce a la reconciliación de la teoría económica con otras ciencias sociales

Should All Fractions of the Boar Ejaculate Be Prepared for Insemination Rather Than Using the Sperm Rich Only?

Boar ejaculate is released in several well-characterized fractions, differing in terms of sperm concentration, seminal plasma volume, and composition. However, the inclusion of the last part of the ejaculate for artificial insemination (AI) purposes is still under debate due to its controversial effects. Thus, there is a need to study the potential synergistic impact of the different ejaculate fractions. We aimed to evaluate the effect of accumulative ejaculate fractions on sperm conservation, AI performance, and offspring health. Ejaculates (n = 51) were collected and distributed as follows: F1: sperm-rich fraction; F2: sperm-rich + intermediate fractions; F3: sperm-rich + intermediate + poor fractions. Each group was diluted in a commercial extender, packaged in seminal doses (2000 × 106 sperm/60 mL), and stored at ~16 °C. On day 3 of conservation, sperm were analyzed and used for AI (n = 174). High sperm quality was observed after storage without a significant difference between the groups (p > 0.05). Moreover, no differences were obtained for AI performance (pregnancy and farrowing rates, and litter size; p > 0.05) and offspring health (growth and blood analysis; p > 0.05). Conclusively, the presence of all ejaculate fractions within the seminal doses does not impair the reproductive performance, reporting important economic savings according to the economic model included here.This research was supported by the Ministry of Science and Innovation (PID2019-106380RB-I00/AEI/10.13039/501100011033)

The Role of Popular Culture for Queer Teen Identities’ Formation in Netflix’s Sex Education

Queer teenagers are avid readers of popular culture; as numerous audience studies prove, television plays a significant role in identity-formation for LGBTIQ+ youth, providing them with the information about sexuality, gender roles or non-normative relationships usually unavailable in their educational and home environments. In this article we analyze how some of the protagonists of Netflix’s TV show Sex Education (2019-present) utilize popular culture as a tool to explore their desires, forbidden fantasies, and gender expressions, becoming instrumental in the formation of their queer identities in a way that metatextually reflects the role LGBTIQ+ shows play for their audiences. Such is the case of Adam, a bisexual teenager that masturbates to the image of a fictional actor featured in a 1980s action film poster; Lily, whose sexual fantasies of role playing with alien creatures are strongly influenced by spatial sci-fi; and Ola, whose onyric universe is influenced by David Bowie’s genderbending aesthetics. However, the most representative example of how popular culture influences the formation of queer identities is Eric, whose non-conforming gender expression follows the example set by the trans characters in Hedwig and the Angry Inch

Incorporating patients' characteristics in cost-effectiveness studies with clinical trial data : a flexible Bayesian approach

Most published research on the comparison between medical treatment options merely compares the results (effectiveness and cost) obtained for each treatment group. The present work proposes the incorporation of other patient characteristics into the analysis. Most of the studies carried out in this context assume normality of both costs and effectiveness. In practice, however, the data are not always distributed according to this assumption. Altervative models have to be developed. In this paper, we present a general model of cost-effectiveness, incorporating both binary effectiveness and skewed cost. In a practical application, we compare two highly active antiretroviral treatments applied to asymptomatic HIV patients. We propose a logit model when the effectiveness is measured depending on whether an initial purpose is achieved. For this model, the measure to compare treatments is the difference in the probability of success. Besides, the cost data usually present a right skewing. We propose the use of the logtransformation to carry out the regression model. The three models are fitted demonstrating the advantages of this modelling. The cost-effectiveness acceptability curve is used as a measure for decision-making

Clinical characteristics of malignant tumours originating in the external ear

AbstractBackgroundSkin tumours that originate in the external ear are common in individuals with type 1 skin and phenotype 1 and 2. The skin cancer is associated with chronic or intermittent, but intense sunlight. The most common malignant tumour is basal cell carcinoma, followed by squamous cell carcinoma and melanoma. The diagnosis of squamous cell skin cancer in head and neck area is usually made in the advanced stages and has a poor prognosis.Material and methodsA cross-sectional, retrospective analysis was performed on the database of patients with skin cancer of the external ear treated between 2011 and 2014. Histology type, stage, rate of clinical and occult metastases, and rate of loco-regional recurrence were evaluated.ResultsOf the 42 patients included there were, 25 squamous cell carcinomas, 11 basal cell carcinomas, and 6 invasive melanomas. The rate of lymph node metastases in patients with squamous cell carcinoma was 32%, mostly in the parotid and peri-parotid region, 7% of them with capsular rupture, 2/17 were staged as cN0, and 11.7% had occult metastases. All patients with nodal metastasis were classified as T2 with ulceration.None of the patients with basal cell carcinoma had lymph node metastases.All melanomas were superficial extension type with mean level of Breslow of 3mm. All underwent lymphatic mapping and sentinel node biopsy, with only one having metastases in the sentinel node.ConclusionThe most frequent tumour in the external ear in this series was squamous cell carcinoma. The possibility of lymph node metastases is associated with tumour size (T). Node dissection should be systematic in patients with T2 or greater

Automated low-cost device to produce sub-micrometric polymer fibers based on blow spun method

Attending the latest advances in polymeric fibers, the design of low-cost, and high-quality scientific equipment for obtaining fibers seemed essential. To overcome this challenge, a 3D printable prototype was designed, assembled, and validated to obtain fibers using the SBS method. The particular configuration of the prototype consisted of controlling the process conditions such as working distance and injection flow, as well as other parameters such as RPM and the axial movement of the cylindrical collector. Thus, these parameters were automated using a microcontroller (Arduino) that receives information from an Android device with bluetooth connectivity to control each of the elements of the equipment. Subsequently, the repeatability and reproducibility of the fibers was verified using polymers such as polystyrene (PS), polysulfone (PSF) and polyethylene oxide (PEO); furthermore, PSF fibers were manufactured to analyze the influence of working distance and the axial movement of the collector on their production.Fondos de Investigación de Fco. Javier González Benito, política de reinversión de costes generales, Universidad Carlos III de Madrid [2012/00130/004] and Acción Estratégica en Materiales Compuestos Poliméricos e Interfases, Universidad Carlos III de Madrid [2011/00287/002]. Besides, authors greatly appreciate the Consejo Nacional de Ciencia y Tecnología (CONACyT- México) for financial support associated to the scholarship number 625396

Aspectos sociales sobre la problemática sanitaria observada en gallinas domésticas dentro del área natural protegida “La Pera”, Chiapas

Se estudiaron problemas de los habitantes del área protegida denominada "La Pera" en la salud de sus gallinas domésticas. Se registraron explicaciones locales sobre padecimientos importantes y se hizo un estudio clínico preliminar que mostró la presencia de bacterias de las familias Microccocaceae, Enterobacteraceae y Sthaphylococcaceae. Se encontraron protozoarios de la familia Eimeridae y nemátodos de Trichuridae, Heterakidae, Eimeridae, Strongylidae, Trichostrongylidae y Ascaridae. Varios géneros de estos organismos pueden afectar la salud humana. Los habitantes reconocen que tales problemas sanitarios son severos pero no saben cómo emprender un enfoque preventivo, lo cual contrasta con la escasa intervención gubernamental. Así, debe fortalecerse el conocimiento local y modificarse las políticas públicas sobre las áreas naturales protegidas de Chiapas para fortalecer integradamente la salud animal y humana