Reframing the debate around state responses to infertility: considering the harms of subfertility and involuntary childlessness

Many countries are experiencing increasing levels of demand for access to assisted reproductive technologies (ART). Policies regarding who can access ART and with what (if any) support from a collective purse are highly contested, raising questions about what state responses are justified. Whilst much of this debate has focused on the status of infertility as a disease, we argue that this is something of a distraction, since disease framing does not provide the far-reaching, robust justification for state support that proponents of ART seem to suppose. Instead, we propose that debates about appropriate state responses should consider the various implications for health and broader well-being that may be associated with difficulties starting a family. We argue that the harms and disruption to valued life projects of subfertility-related suffering may provide a stronger basis for justifying state support in this context. Further, we suggest that, whilst ART may alleviate some of the harm resulting from subfertility, population-level considerations can indicate a broader range of interventions aimed at tackling different sources of subfertility-related harm, consistent with broader public health aims

Predictors of Response to Hydroxyurea and Switch to Ruxolitinib in HU-Resistant Polycythaemia VERA Patients: A Real-World PV-NET Study

: In polycythemia vera (PV), the prognostic relevance of an ELN-defined complete response (CR) to hydroxyurea (HU), the predictors of response, and patients' triggers for switching to ruxolitinib are uncertain. In a real-world analysis, we evaluated the predictors of response, their impact on the clinical outcomes of CR to HU, and the correlations between partial or no response (PR/NR) and a patient switching to ruxolitinib. Among 563 PV patients receiving HU for ≥12 months, 166 (29.5%) achieved CR, 264 achieved PR, and 133 achieved NR. In a multivariate analysis, the absence of splenomegaly (p = 0.03), pruritus (p = 0.002), and a median HU dose of ≥1 g/day (p < 0.001) remained associated with CR. Adverse events were more frequent with a median HU dose of ≥1 g/day. Overall, 283 PR/NR patients (71.3%) continued HU, and 114 switched to ruxolitinib. In the 449 patients receiving only HU, rates of thrombosis, hemorrhages, progression, and overall survival were comparable among the CR, PR, and NR groups. Many PV patients received underdosed HU, leading to lower CR and toxicity rates. In addition, many patients continued HU despite a PR/NR; however, splenomegaly and other symptoms were the main drivers of an early switch. Better HU management, standardization of the criteria for and timing of responses to HU, and adequate intervention in poor responders should be advised

Happiness economics

There is enough evidence to be confident that individuals are able and willing to provide a meaningful answer when asked to value on a finite scale their satisfaction with their own lives, a question that psychologists have long and often posed to respondents of large questionnaires. Without taking its limitations and criticisms too lightly, some economists have been using thismeasure of self-reported satisfaction as a proxy for utility so as to contribute to a better understanding of individuals' tastes and hopefully behavior. By means of satisfaction questions we can elicit information on individual likes and dislikes over a large set of relevant issues, such as income, working status and job amenities, the risk of becoming unemployed, inflation, and health status. This information can be used to evaluate existing ideas from a new perspective, understand individual behavior, evaluate and design public policies, study poverty and inequality, and develop a preference based valuation method. In this article I first critically assess the pros and cons of using satisfaction variables, and then discuss its main applications

Compiling the actuarial balance for pay-as-you-go pension systems. Is it better to use the hidden asset or the contribution asset?

The aim of this article is twofold: to establish the connection between the 'Contribution Asset' (CA) and the 'Hidden Asset' (HA) and to determine whether using either of them to compile the Actuarial Balance (AB) sheet in the Pay-As-You-Go (PAYG) pension system will provide a reliable solvency indicator. With these aims in mind, we develop a model based on those first put forward by Settergren and Mikula (2005) and Boado-Penas et al. (2008) to obtain the analytical properties of the CA and to confirm its soundness as a measure of the assets of a PAYG scheme. Our model also enables us to explore whether, and to what extent, the HA can be considered a second alternative measure of the assets for PAYG schemes. The main theoretical finding is that, despite their very different natures, the HA and the CA may nearly coincide at the limit when the interest rate of the financial market approaches the growth of the covered wage bill from above, but the HA supplies a solvency indicator which is not always consistent with the system's financial health.</p

COMBUSTION OFF-GAS CLEANING BY WET ELECTROSTATIC SCRUBBING: PRELIMINARY EXPERIMENTAL RESULTS

This paper reports preliminary experimental results on wet electrostatic scrubbing of model submicron particles in controlled hydrodynamic conditions based on the use of an electrospray exerted in dripping mode. The experimental results were successfully compared with the predictions of classical particle scavenging

Submicronic Particle Abatement using Electrified Water Droplets - an Experimental Investigation

During the recent past the direct and indirect impacts of particulate emissions on human health, ecosystems and climate has been unequivocally demonstrated. In spite of this situation, large scientific and technological efforts are still needed to reduce the emissions of submicronic particles from industrial processes or diesel engines below safety levels. The wet electrostatic scrubbing (WES) uses electrostatic interactions between particles and charged droplets to significantly enhance the particle capture efficiency of wet (uncharged) scrubbers. The WES was studied in the past for micron sized particles. The models developed and the few experimental investigations have shown how such a system is far more effective in the capture of submicronic particles. In this work a new experimental approach to the study of WES process is proposed. Experimental set up consists of a cylindrical chamber where a model particle laden gas (obtained from the dilution of an ethylene-air flame) comes into contact with a train of identically charged droplets that are produced by a specifically designed electrospray nozzle operating in dripping mode. The system is instrumented to measure and control reactor temperature and humidity, droplet size charge, and water and gas flow rates. The chamber is operated batchwise with reference to the gas phase and the concentration and size distribution of particles in the chamber is measured over time by means of a laser spectrometer. The design of the laboratory scale equipment and preliminary experimental results are presented in this paper. The main advantage of this new experimental approach is that the use of a train of droplets should overcome some complexities inherent in the use of spray (i.e. the knowledge of the actual value of droplet size and charge distribution and the jet dynamics) that are currently limiting the definition of specific design and scale up rules for WES unit