The association of internet searches and actual suicide in Spain

High suicide rates are a major issue in Spain, to the extent that they are the main non-natural cause of death in this country. The present study analyses the relationship between Internet searches and actual suicide rates in Spain. For this purpose, we employ data from actual suicide rates and Google® searches for Spain, differencing by the means used to commit suicide. Our results show that suicide ("suicidio") search term seems to be positively associated with higher total suicide rates, in addition to suicides using poison, suffocation and jumping. The suicide ("suicidio") topic presents similar results to the suicide search term, and suicide by car crash also seems to be associated with Internet searches of this topic.

Gender Differences in the Impact of the Informal Economy on the Labor Market: Evidence From Middle Eastern Countries

Although considerable discussion has been devoted to the macro determinants of labor market variables across genders, comparatively little attention has been given to the contribution of the informal economy to this market. This study was aimed at empirically investigating the impact of the size of the shadow or informal economy (IE) on labor market variables across genders in 12 Middle Eastern countries. The study used quarterly time series data on each country under investigation, covering 1991 to 2015. Phillips-Perron unit root tests were carried out to verify the stationarity of the examined economic series. An autoregressive distributed lag approach was adopted to conduct cointegration tests and estimate long-run regression coefficients and error correction terms. The results indicated that the IE served men and women differently across countries. Whereas this economy had a long-run positive relationship with men's employment rates in Bahrain, Iran, Qatar, and Turkey, this relationship existed among women only in Israel. IE activities matter in the employment of men and women in Middle Eastern countries. The sizes of IEs in the labor market are a significant factor that favors men's employment rather than that of women.

elegans lifespan

Caenorhabditis elegans is an instrumental model in aging research due to its large brood size, short lifespan, and malleable genetics. However, maintaining a synchronous nematode population for longevity studies is challenging and time consuming due to their quick rate of development and reproduction. Multiple methods are employed in the field, ranging from worm strains with temperature dependent sterility to DNA replication inhibitors such as 5'-fluorodeoxyuridine (FUdR). In this study, we characterize a small molecule (C22) that impairs eggshell integrity and disrupts early embryogenesis to determine its applicability as a potential FUdR alternative. We find that C22 prevents egg hatching in a concentration dependent manner. However, it extends the lifespan of wild type worms and can induce FMO-2, a longevity regulating enzyme downstream of dietary restriction. Our results suggest that C22 is unlikely to be widely useful as an alternative to FUdR but its mechanism for lifespan extension may be worth further investigation.

Temporally Local Maximum Likelihood with Application to SIS Model

The parametric estimators applied by rolling are commonly used for the analysis of time series with nonlinear patterns, including time varying parameters and local trends. This paper examines the properties of rolling estimators in the class of temporally local maximum likelihood (TLML) estimators. We consider the TLML estimators of (a) constant parameters, (b) stochastic, stationary parameters and (c) parameters with the ultra-long run (ULR) dynamics bridging the gap between the constant and stochastic parameters. We show that the weights used in the TLML estimators have a strong impact on the inference. For illustration, we provide a simulation study of the epidemiological susceptible-infected-susceptible (SIS) model, which explores the finite sample performance of TLML estimators of a time varying contagion parameter.

Time-specific average estimation of dynamic panel regressions

This paper introduces an unbiased estimator based on least squares involving time-specific cross-sectional averages for a first-order panel autoregression with a strictly exogenous covariate. The proposed estimator is straightforward to implement as long as the variables of interest have sufficient time variation. The number of cross-sections (N) and the number of time periods (T) can be large, and there is no restriction on the growth rate of N relative to T. It is demonstrated via both theory and a simulation study that the estimator is asymptotically unbiased, and it can provide correct empirical coverage probabilities for the 'true' coefficients of the model for various combinations of N and T. An empirical application is also provided to confirm the feasibility of the proposed approach.

Identifying the cycles in COVID-19 infection: the case of Turkey

The new coronavirus disease, called COVID-19, has spread extremely quickly to more than 200 countries since its detection in December 2019 in China. COVID-19 marks the return of a very old and familiar enemy. Throughout human history, disasters such as earthquakes, volcanic eruptions and even wars have not caused more human losses than lethal diseases, which are caused by viruses, bacteria and parasites. The first COVID-19 case was detected in Turkey on 12 March 2020 and researchers have since then attempted to examine periodicity in the number of daily new cases. One of the most curious questions in the pandemic process that affects the whole world is whether there will be a second wave. Such questions can be answered by examining any periodicities in the series of daily cases. Periodic series are frequently seen in many disciplines. An important method based on harmonic regression is the focus of the study. The main aim of this study is to identify the hidden periodic structure of the daily infected cases. Infected case of Turkey is analyzed by using periodogram-based methodology. Our results revealed that there are 4, 5 and 62 days cycles in the daily new cases of Turkey.

Cost-effectiveness and potential value of pharmaceutical treatment of nonalcoholic fatty liver disease

BACKGROUND

Nonalcoholic fatty liver disease (NAFLD) is associated with substantial morbidity, mortality, and economic burden. With currently no approved treatment, an effective pharmaceutical intervention for this disease must be both clinically- and cost-effective.

METHODS

A Markov model was constructed to estimate the clinical outcomes, costs, and quality of life impact of a hypothetical pharmaceutical intervention. Lifetime clinical outcomes, life-years, quality-adjusted life-years (QALYs), costs (2020 $US), incremental cost-effectiveness ratios (ICERs), and economically justifiable prices (EJPs) were quantified. Only patients with fibrosis stage F2-F4 were assumed eligible to initiate pharmaceutical treatment.

RESULTS

Over a mean life expectancy of approximately 21 years in the simulated cohort, drug treatment reduced liver-related mortality by 6.0% (2.7% absolute reduction). Assuming an annual drug cost of $36,000, total discounted medical costs were $574,238 and $120,312 for drug and usual care, respectively, with discounted QALYs estimated to be 9.452 and 9.272 for the two comparators. This yielded an ICER of $2,517,676/QALY gained. The EJP of the drug at an ICER threshold of $150,000/QALY gained was $2,633, a 93% reduction from a base case. Sensitivity analyses suggest that, without a substantial decrease in the drug price, ICERs would exceed $500,000/QALY gained even with the most favorable efficacy assumptions.

CONCLUSIONS

For a pharmaceutical intervention to be considered cost-effective in the NAFLD fibrosis population, the substantial clinical benefit will need to be coupled with a modest annual price. Annual drug costs exceeding $12,000 likely will not provide reasonable value, even with favorable efficacy. More work is needed to estimate the cost-effectiveness of lifestyle modifications.

Modeling operational quality metrics and costs of long-acting antibiotics for acute bacterial skin and skin structure infection treatment in the emergency department

Aims: To model implementation of a new treatment pathway leveraging long-acting antibiotics (LAs) for treatment of acute bacterial skin and skin structure infections (ABSSSIs) in a hospital emergency department (ED) with an observation unit, and to quantify health resource utilization and economic outcomes versus standard care (intravenous vancomycin). Materials and methods: Discrete-event simulation was used to model implementation of the LA treatment pathway in the ED versus standard care from the US Medicare perspective. Model inputs were derived from published sources to simulate a real-world hospital ED with an observation unit. Outcomes included key ED metrics such as patient throughput rate and length of stay (LOS) and cost (estimated through reimbursed amounts in 2017 USD). Results: Implementation of an LA pathway in the ED improved ABSSSI patient throughput rate by 350% (+5.8 dispositions/ED and observation unit day) and reduced LOS by 68% (-7.2 h/patient). These improvements in patient outcomes are driven by the reduced infusion time required for LA antibiotics and are greater for dalbavancin than oritavancin owing to the shorter infusion duration (30 min vs. 3 h). Limitations: External validity of the model was not assessed. The model was limited to care received in EDs; therefore, certain clinical variables outside the ED were not captured for this analysis. Conclusions: LA pathway implementation for ABSSSI treatment in the ED supported improved efficiency, which may translate to economic value. As EDs continue to focus on improving key metrics such as throughput rate and LOS, LA pathway implementation should be considered as a potential approach for abbreviated ABSSSI treatment in the ED.

Cost-effectiveness analysis of sequential biologic therapy with ixekizumab versus secukinumab as first-line treatment of moderate-to-severe psoriasis in the UK

AIMS

Patients with psoriasis often undergo treatment with a sequence of biologic agents because of poor/loss of response to initial therapy. With the availability of newer agents like ixekizumab and secukinumab, there is a need for cost-effectiveness analyses to better reflect current clinical practice. This study aimed to assess the cost-effectiveness of a sequence of biologic therapies containing first-line ixekizumab vs first-line secukinumab in patients with moderate-to-severe plaque psoriasis in the UK.

MATERIALS AND METHODS

A Markov model with a lifetime horizon was developed to compare the cost-effectiveness of ixekizumab and secukinumab treatment sequences: ixekizumab → ustekinumab → infliximab → best supportive care (BSC) vs secukinumab → ustekinumab → infliximab → BSC. The model used monthly cycles, and included four health states: trial period, treatment maintenance, BSC, and death. At the end of the trial period, responders transitioned to maintenance therapy; non-responders transitioned to the next biologic in the sequence. An annual discontinuation rate of 20% was assumed for maintenance therapy.

RESULTS

The ixekizumab sequence provided cost savings of £898 (£176,203 vs 177,101) [year 2015 values] and gained 0.03 more quality-adjusted life-years (QALYs: 1.45 vs 1.42) vs the secukinumab sequence over the lifetime horizon. Probabilistic sensitivity analysis showed an 89.8% likelihood that the ixekizumab sequence would be cost-effective at a threshold of £20,000 per QALY gained.

LIMITATIONS

The analysis used list prices for drugs rather than confidential, preferentially priced Patient Access Scheme costs. In addition, efficacy input data were based on a network meta-analysis, as there were no head-to-head trials comparing ixekizumab and secukinumab.

CONCLUSION

First-line treatment with ixekizumab as part of a specific sequential biologic therapy for moderate-to-severe plaque psoriasis in the UK provided slight advantages in cost savings and QALYs gained over a similar treatment sequence initiated with secukinumab. In view of the small magnitude of these differences, factors such as patient preferences (e.g. for number of injections) and long-term safety (e.g. related to time on the market) may also be important for clinical decision-making.

Volatility transmissions between renminbi and Asia-Pacific on-shore and off-shore U.S. dollar futures

This paper uses multivariate GARCH techniques to study volatility spillovers between the Chinese non-deliverable forward market and seven of its Asia-Pacific counterparts over the period January 1998 to March 2005. To account for the time-variability of conditional correlation, a dynamic correlation structure is included in the volatility model specification. The empirical results demonstrate that the renminbi non-deliverable forward (NDF) has been a driver of various Asian currency markets but that such co-movements exhibit a substantial degree of heterogeneity. As to the determinants of the magnitude of these co-movements, we test the relevance of potential factors and find that it is the degree of real and financial integration, in particular, that exerts the largest influence on volatility transmission.