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Every five years, the World Congress of the Econometric Society brings together scholars from around the world. Leading scholars present state-of-the-art overviews of their areas of research, offering newcomers access to key research in economics. Advances in Economics and Econometrics: Twelfth World Congress consist of papers and commentaries presented at the Twelfth World Congress of the Econometric Society. This two-volume set includes surveys and interpretations of key developments in economics and econometrics, and discussion of future directions for a variety of topics, covering both theory and application. The first volume addresses such topics as contract theory, industrial organization, health and human capital, as well as racial justice, while the second volume includes theoretical and applied papers on climate change, time series econometrics, and causal inference. These papers are invaluable for experienced economists seeking to broaden their knowledge or young economists new to the field.
Every five years, the World Congress of the Econometric Society brings together scholars from around the world. Leading scholars present state-of-the-art overviews of their areas of research, offering newcomers access to key research in economics. Advances in Economics and Econometrics: Twelfth World Congress consist of papers and commentaries presented at the Twelfth World Congress of the Econometric Society. This two-volume set includes surveys and interpretations of key developments in economics and econometrics, and discussion of future directions for a variety of topics, covering both theory and application. The first volume addresses such topics as contract theory, industrial organization, health and human capital, as well as racial justice, while the second volume includes theoretical and applied papers on climate change, time series econometrics, and causal inference. These papers are invaluable for experienced economists seeking to broaden their knowledge or young economists new to the field.
In the first book-length study of the interwoven history of extradition in Hong Kong, Ivan Lee shows how British judges, lawyers, and officials navigated the nature of extradition, debated its legalities, and distinguished it over time from other modalities of criminal jurisdiction – including deportation, rendition, and trial and punishment under territorial and extraterritorial laws. These complex debates were rooted in the contested legal status of Chinese subjects under the Opium War treaties of 1842–43. They also intersected wider shifts and tensions in British ideas of territorial sovereignty, criminal justice and procedure, and the legal rights and liabilities of British subjects and alien persons in British territory. In the end, a new area of imperial law emerged as Britain incorporated a frontier colony into an increasingly territorial and legally homogenous empire. This important perspective revises our understanding of the legal origins of colonial Hong Kong and British imperialism in China.
Coastal wetland sediments are vital to the global carbon cycle as they represent large sinks of blue carbon – carbon from atmospheric and oceanic sources – which are threatened by ecosystem loss. The forms of sequestered carbon and the sequestration capability are affected by many bio- and geochemical factors that change unpredictably along coastal locales. In the present study, we investigated three unique coastal sites – a coastal mangrove and two sabkhas with contrasting geology and tidal influence in the Qatar peninsula – for their carbon capture ability to determine how biogeochemical indices affect their blue carbon sequestration potential. We applied a suite of biological and geochemical tools, collecting the sediment cores of approximately 40 cm depth; analysed sediment porewater; performed depth-profiling of the organic matter, sedimentary minerals, microbial community and analysis of sediment surface for pH, oxygen (O2); redox potential and hydrogen sulfide (H2S) by microsensors. High-resolution transmission electron microscopy with energy-dispersive X-ray spectroscopy (TEM-EDXS) and scanning transmission X-ray microscopy (STXM) revealed templating effects that promoted Mg-carbonate nucleation in coastal hypersaline environments. Microsensing reveals the intricacy of the oxic/anoxic transition at the sediment surface. Microbial DNA sequencing at various sediment depths shows the occurrence of microbial genera, whose functions explain the geochemical trends and carbon sequestration pathways observed at each site. Notably, we found that carbon sequestration in the mangrove and carbonate-sand sabkha was correlated with organic matter degradation and inorganic carbon content, while in the siliciclastic sabkha it was solely influenced by sediment density and depth.
Community pharmacists should provide qualified drug information services for the rational use of medicine in community. However, there is no standard professional incentive for the service in Indonesia. This study aimed to assess drug information services with incentives and its associated factors among community pharmacists in Indonesia.
Method:
A multi-centre cross-sectional study was conducted among community pharmacists in Medan City, Bandung City, Bandung Regency, and Makassar City. A validated online self-administered questionnaire was used to collect data on pharmacists’ demographics, pharmacy characteristics, and drug information provision practices. Multivariate logistic regression was applied to identify factors associated with incentivized drug information services.
Results:
A total of 639 community pharmacists participated, with representation from Medan (21.9%), Bandung City (20.8%), Bandung Regency (26%), and Makassar (31.3%). Most respondents were female (79%) with a median age of 31 years (IQR: 9). Only 12% of pharmacists reported receiving incentives for providing drug information services. Factors significantly associated with receiving incentives included being male (OR: 2.04, 95% CI: 1.16–3.58), aged 20–30 years (OR: 3.25, 95% CI: 1.10–9.58), working over 40 hours per week (OR: 2.30, 95% CI: 1.16–4.58), working in a chain pharmacy (OR: 2.08, 95% CI: 1.18–3.67), and having an onsite physician practice (OR: 1.72, 95% CI: 1.04–2.85).
Conclusion:
Limited number of community pharmacists received an incentive for drug information services. The development of a remuneration system for drug information services can be considered to enhance the quality of pharmaceutical care services in the community setting.
We study linearizability of actions of finite groups on singular cubic threefolds, using cohomological tools, intermediate Jacobians, Burnside invariants, and the equivariant Minimal Model Program.
A phenomenological description is presented to explain the intermediate and low-frequency/large-scale contributions to the wall-shear-stress (${\tau }_w$) and wall-pressure ($\,{p}_w$) spectra of canonical turbulent boundary layers, both of which are well known to increase with Reynolds number, albeit in a distinct manner. The explanation is based on the concept of active and inactive motions (Townsend, J. Fluid Mech., vol. 11, issue 1, 1961, pp. 97–120) associated with the attached-eddy hypothesis. Unique data sets of simultaneously acquired ${\tau }_w$, ${p}_w$ and velocity-fluctuation time series in the log region are considered, across a friction-Reynolds-number ($Re_{\tau }$) range of $ {O}(10^3) \lesssim Re_{\tau } \lesssim {O}(10^6)$. A recently proposed energy-decomposition methodology (Deshpande et al., J. Fluid Mech., vol. 914, 2021, A5) is implemented to reveal the active and inactive contributions to the ${\tau }_w$- and $p_w$-spectra. Empirical evidence is provided in support of Bradshaw's (J. Fluid Mech., vol. 30, issue 2, 1967, pp. 241–258) hypothesis that the inactive motions are responsible for the non-local wall-ward transport of the large-scale inertia-dominated energy, which is produced in the log region by active motions. This explains the large-scale signatures in the ${\tau }_w$-spectrum, which grow with $Re_{\tau }$ despite the statistically weak signature of large-scale turbulence production, in the near-wall region. For wall pressure, active and inactive motions respectively contribute to the intermediate and large scales of the $p_w$-spectrum. Both these contributions are found to increase with increasing $Re_{\tau }$ owing to the broadening and energization of the wall-scaled (attached) eddy hierarchy. This potentially explains the rapid $Re_{\tau }$-growth of the $p_w$-spectra relative to ${\tau }_w$, given the dependence of the latter only on the inactive contributions.
Vladimir Putin justifies his imperialist policy by use of the past. For him, Russia has always been an Empire and must remain so. The story of Russian imperialism has deep historical roots, and this book shows how Byzantium, the most powerful medieval and Christian empire, is repeatedly presented in Russian history as the source of the empire's imperial legitimacy.
The author reflects on the role of art and the humanities (especially history and art history) within the power ambitions of regimes and political parties over the last two centuries as tools for the repeated reinvention of an empire's identity; an identity built on a multitude of invented pasts. Within this self-referential narrative, Byzantium becomes the ultimate authority justifying the aggression of the Russian state, and Orthodox belief becomes the bridge linking the medieval past with the present. One of the paradoxes of this narrative is the use of the same past by regimes as different as those of the last Romanovs, Stalin, and Putin, leading to a fundamental question: does this propaganda image really underlie the core identity of Russia?
First-generation somatostatin analogues (SSA) are indicated as a first-line medical treatment for acromegaly in patients with persistent disease after surgery or who are not eligible for surgery. These drugs are the largest contributor to the direct medical cost of acromegaly management worldwide. We analyze the patterns of prescription and costs of SSA for the treatment of acromegaly in Brazil.
Methods
The first-generation SSA, octreotide LAR (OCT-LAR) and lanreotide autogel (LAN-ATG), are available in Brazil to treat acromegaly through the Specialized Component of Pharmaceutical Assistance policy. The public records of the nationwide database (DATASUS) were accessed to identify the drug use patterns during the year 2022. The current values of the drug acquisition costs of each medication in 2022 were consulted at the national prices database (BPS). Results were converted in purchase power parity (PPP) dollars according to the World Bank rates.
Results
The acquisition cost of each octreotide (OCT-LAR) ampoule was USD492.33 (10 mg), USD537.04 (20 mg), and USD703.79 (30 mg); for lanreotide (LAN-ATG), each ampoule was USD394.74 for the 60 mg dosage, and USD418.48 for the 90 mg and 120 mg dosages. The average annual cost of a monthly 30 mg dosage of OCT-LAR would be estimated as USD8,445,48 against an average annual cost of USD5,021.76 for a monthly 120 mg dosage of LAN-ATG. Thus, we estimate that USD15,520,747.59 was spent on first-generation SSA to treat acromegaly in Brazil’s Unified Health System (SUS) in the year 2022; of this, 79 percent was attributed to OCT-LAR.
Conclusions
Life-long treatment with SSA is related with a high economic burden in Brazil. There is a predominance of OCT-LAR prescription, where expanding the use of LAN-ATG may help reduce costs to the SUS. Nevertheless, studies and investments in other treatments, such as pituitary surgery and radiotherapy access, at a national level are also essential to improve acromegaly treatment costs.
Asthma affects individuals of all ages and is the most common chronic disease among children. The Brazilian Unified Health System (SUS) reimburses the use of mepolizumab as an additional maintenance treatment for severe eosinophilic asthma in adults. This study aimed to evaluate the cost-effectiveness of expanding the reimbursement of mepolizumab to patients aged six years and older.
Methods
The model included patients aged six years and older refractory to inhaled corticosteroid (ICS) plus long-acting beta-agonist (LABA) treatment. Baseline characteristics and outcomes were based on clinical trials and national hospitalization data. A Markov model with monthly cycles considered the health states without exacerbation, with exacerbation (including the need for oral steroids, emergency room admission, or hospitalization), and death. Direct medical costs (rate: USD1=BRL4.93) associated with all treatments were estimated from public health reimbursement sources. Quality-adjusted life years (QALY) was the primary outcome. Deterministic (Tornado) and probabilistic (Monte Carlo simulations) sensitivity analyses were conducted using Microsoft Excel.
Results
Considering the current mepolizumab price (USD964.49) reimbursed by the Ministry of Health (MOH), the incremental cost-effectiveness ratio (ICER) was USD137,384.92/QALY (95% confidence interval: USD92,625.64, USD208,542.44), exceeding the USD24,333.86 threshold proposed by the National Committee for Health Technology Incorporation (Conitec). Using the average price from local public purchases (USD417.74), the ICER was USD96,673.51/QALY. Considering the past proposed discount from the manufacturer (USD390,93) and dose fractionation in children up to 12 years, the ICER was estimated in USD50,574.06/QALY. The most impactful parameters were the utility without exacerbation, mepolizumab cost, and relative reduction in exacerbation rate.
Conclusions
Considering current reimbursement prices, mepolizumab use in children and adolescents with refractory severe eosinophilic asthma is not cost effective in Brazil. Alternative scenarios with price discounts and dose fractionation may alter these conclusions.
Dengue virus is a significant public health threat in Brazil. It is transmitted by Aedes aegypti mosquitoes and causes severe symptoms such as hemorrhagic fever and dengue shock syndrome. This study explored the economic evaluation of Wolbachia mosquito replacement as a promising dengue virus control strategy.
Methods
The model considered Wolbachia mosquito replacement in seven Brazilian cities: Belo Horizonte, Campo Grande, Fortaleza, Goiânia, Manaus, Niterói, and São Paulo. A mathematical microsimulation model tracked 23 million residents over 20 years and considered transitions between five health states (susceptible, asymptomatic, ambulatory, hospitalized, and death). The current dengue control strategy and the incorporation of Wolbachia mosquito replacement were analyzed from both the health sector (public and private) and the Unified Health System perspectives. Direct costs included local dengue control program resources, Wolbachia replacement implementation, and care of patients with dengue virus. The primary outcome was disability-adjusted life-years (DALYs) averted. Sensitivity analyses were also performed.
Results
The model projected 1,762,688 dengue cases over 20 years without Wolbachia replacement. Implementing Wolbachia replacement would prevent at least 1,295,566 cases, demonstrating a high benefit in all simulated cities. Except for Manaus and São Paulo, Wolbachia replacement was dominant (lower costs and higher effectiveness) over current control strategies. Nevertheless, estimated incremental cost-effectiveness ratios for Manaus and São Paulo, which ranged from BRL1,747.11 to BRL5,072.21 (USD309.51 to USD898.56), were well below the Brazilian cost-effectiveness threshold of BRL120,000 (USD21,258.50) for neglected diseases. Furthermore, all incremental net monetary benefit values remained positive for both scenarios in all cities—from BRL41.37 to BRL1,852.42 (USD7.33 to USD328.16).
Conclusions
Wolbachia replacement is a highly cost-effective option in the Brazilian context, aligning with previous international and diverse perspective studies. Sensitivity analysis and alternative scenarios confirmed the robustness of the findings.
Health technology assessment (HTA), by investigating clinical, economic, and social consequences of technologies in a country, enhances health system equity and sustainability. In low- and middle-income countries (LMICs), economic constraints and inadequate access to specialized human resources present challenges. Therefore, strategies to optimize resource allocation in the health sector are necessary.
Methods
A literature review was carried out, with studies that directly identified barriers or facilitators for the use of artificial intelligence (AI) in HTA being considered eligible. The texts were analyzed from the perspective of LMIC. The searches were carried out on 8 August 2023 using the following databases: MEDLINE via PubMed, Web of Science, and Google Scholar. The selection was performed in two stages: (i) screening by title and abstract and (ii) evaluation of the eligibility criteria in full text.
Results
After conducting the search, five studies were selected for narrative synthesis. Evidence of the potential benefits of using AI in HTA in low- and middle-income countries includes rationalization of resources; reduction of the burden on health systems and minimization of human workload; efficiency in data analysis, including clinical data; prediction of economic impact; and support for managerial decision-making. However, important challenges were also raised, such as the deficiency of local infrastructure; the training and education of professionals; the lack of ethical regulation; and the organizational and political considerations of these countries.
Conclusions
There are few studies in the literature that provide scientific support on the use of AI in HTA decision-making in LMIC. The evidence points to increasing the efficiency and rationality of resources, enhancing the results arising from HTA. With this, it is expected to expand access to health technologies and enable more sustainable health systems.
Recently, there has been considerable emphasis on survival curves for data extrapolation, especially in the field of economic evaluation in oncology. Common methods for adjusting survival curves are complex and heavily reliant on individual patient data (IPD), which may not be feasible for health technology assessment (HTA). We propose an alternative method for survival curve extrapolation with direct adjustment to aggregated data.
Methods
Common parametric survival analysis models were tested: exponential, Weibull, log-normal, log-logistic, generalized gamma, and Gompertz. We had access to the IPD from a published randomized clinical trial (n=694) testing therapies (anastrozole and fulvestrant) for metastatic breast cancer with 10 years of follow-up on progression-free survival (PFS) and overall survival (OS) outcomes. After adjusting the original IPD, we sought to fit models to published aggregated data (Kaplan–Meier curves) using nonlinear regressions and optimization algorithms. Both methods were compared in terms of visual inspection and statistical fit quality (Akaike information criterion [AIC] and Bayesian information criterion [BIC]).
Results
Survival curves directly adjusted to aggregated data showed a visually similar profile compared to IPD adjustments. According to AIC/BIC values, Weibull and generalized gamma distributions best fit OS data, both in individualized and aggregated approaches. For PFS, log-logistic and log-normal curves were the best choices for the anastrozole arm, and for fulvestrant, the best choices were log-normal and generalized gamma for individualized data, and Gompertz and generalized gamma for the aggregated method. The proposed R language code proved to be reproducible and amenable to automation in future HTA applications.
Conclusions
Directly adjusting survival curves to aggregated data is a simple and useful alternative in situations where access to IPD is not feasible.
In this paper, we apply sequential one-sided confidence interval estimation procedures with β-protection to adaptive mastery testing. The procedures of fixed-width and fixed proportional accuracy confidence interval estimation can be viewed as extensions of one-sided confidence interval procedures. It can be shown that the adaptive mastery testing procedure based on a one-sided confidence interval with β-protection is more efficient in terms of test length than a testing procedure based on a two-sided/fixed-width confidence interval. Some simulation studies applying the one-sided confidence interval procedure and its extensions mentioned above to adaptive mastery testing are conducted. For the purpose of comparison, we also have a numerical study of adaptive mastery testing based on Wald's sequential probability ratio test. The comparison of their performances is based on the correct classification probability, averages of test length, as well as the width of the “indifference regions.” From these empirical results, we found that applying the one-sided confidence interval procedure to adaptive mastery testing is very promising.
Item calibration is an essential issue in modern item response theory based psychological or educational testing. Due to the popularity of computerized adaptive testing, methods to efficiently calibrate new items have become more important than that in the time when paper and pencil test administration is the norm. There are many calibration processes being proposed and discussed from both theoretical and practical perspectives. Among them, the online calibration may be one of the most cost effective processes. In this paper, under a variable length computerized adaptive testing scenario, we integrate the methods of adaptive design, sequential estimation, and measurement error models to solve online item calibration problems. The proposed sequential estimate of item parameters is shown to be strongly consistent and asymptotically normally distributed with a prechosen accuracy. Numerical results show that the proposed method is very promising in terms of both estimation accuracy and efficiency. The results of using calibrated items to estimate the latent trait levels are also reported.
The hikikomori phenomenon has recently gained growing global interest, and evidences of its association with other psychopathological dimensions are slowly but steadily emerging. We aimed to evaluate the presence and correlates of hikikomori tendencies in an Italian University population, focusing on its relationships with autism spectrum, pathological computer gaming, and eating disorders. In particular, to our knowledge, no study has yet systematically evaluated the latter association, using psychometric instruments tailored to assess eating disorder symptoms.
Methods
2574 students were recruited via an online survey. All participants were assessed with the Hikikomori Questionnaire-25 (HQ-25), the Adult Autism Subthreshold Spectrum Questionnaire (AdAS Spectrum), the Eating Attitude test-26 (EAT-26), and the Assessment of Internet and Computer Game Addiction (AICA-S).
Results
The results outlined how hikikomori risk was significantly correlated to autistic dimensions, altered eating behaviors, and videogame addiction. The closest relationship was detected with the autism spectrum. Interestingly, pathological computer gaming, most autistic dimensions, and EAT-26 oral control emerged as significant predictors of a greater risk for hikikomori, while the proneness to inflexibility and adherence to routine emerged as negative predictors.
Conclusions
Our findings support the association among hikikomori, autism spectrum, pathological computer game use, and eating disorder symptoms.
The course of COVID-19 is highly variable, with genetics playing a significant role. Through large-scale genetic association studies, a link between single nucleotide polymorphisms and disease susceptibility and severity was established. However, individual single nucleotide polymorphisms identified thus far have shown modest effects, indicating a polygenic nature of this trait, and individually have limited predictive performance. To address this limitation, we investigated the performance of a polygenic risk score model in the context of COVID-19 severity in a Russian population. A genome-wide polygenic risk score model including information from over a million common single nucleotide polymorphisms was developed using summary statistics from the COVID-19 Host Genetics Initiative consortium. Low-coverage sequencing (5x) was performed for ~1000 participants, and polygenic risk score values were calculated for each individual. A multivariate logistic regression model was used to analyse the association between polygenic risk score and COVID-19 outcomes. We found that individuals in the top 10% of the polygenic risk score distribution had a markedly elevated risk of severe COVID-19, with adjusted odds ratio of 2.9 (95% confidence interval: 1.8–4.6, p-value = 4e-06), and more than four times higher risk of mortality from COVID-19 (adjusted odds ratio = 4.3, p-value = 2e-05). This study highlights the potential of polygenic risk score as a valuable tool for identifying individuals at increased risk of severe COVID-19 based on their genetic profile.