Treatment of lower urinary tract symptoms/benign prostatic hyperplasia and erectile dysfunction

Abstract

This article summarizes years of challenging research on erectile dysfunction (ED), a condition that has an important social and cultural relevance. Preclinical and clinical research progress has led to new therapeutic approaches to ED in patients with different comorbidities and particularly in those with low urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH). These goals were possible only by combined work of specialists and researchers of different and intertwined medical disciplines. Currently, tadalafil (5?mg/d) is the best choice; other phosphodiesterase-5 inhibitors (PDE5i) are not included among options, despite the growing evidence of therapeutic effects. Different regimens of tadalafil may be prescribed based on patient needs, severity of LUTS/BPH – ED profile, and clinical experience. An integrated approach is necessary to choose for a combined therapy with PDE5i and α-blockers following urological and cardiac counseling in terms of outcomes and adverse effects.     

LEGAL STANDARDS,ENFORCEMENT, AND CORRUPTION

Stricter laws require more incisive and costlier enforcement. Because enforcement activity depends both on available tax revenue and the honesty of officials, the optimal legal standard of a benevolent government is increasing in per capita income and decreasing in officials' corruption. In contrast to the “tollbooth view” of regulation, the standard chosen by a self‐interested government is a non‐monotonic function of officials' corruption, and can be either lower or higher than that chosen by a benevolent regulator. International evidence on environmental regulation shows that standards correlate positively with per‐capita income, and negatively with corruption, consistent with the model's predictions for benevolent governments. (JEL: D73, K42, L51)     

Comparing and generating Latin Hypercube designs in Kriging models

In Computer Experiments (CE), a careful selection of the design points is essential for predicting the system response at untried points, based on the values observed at tried points. In physical experiments, the protocol is based on Design of Experiments, a methodology whose basic principles are questioned in CE. When the responses of a CE are modeled as jointly Gaussian random variables with their covariance depending on the distance between points, the use of the so called space-filling designs (random designs, stratified designs and Latin Hypercube designs) is a common choice, because it is expected that the nearer the untried point is to the design points, the better is the prediction. In this paper we focus on the class of Latin Hypercube (LH) designs. The behavior of various LH designs is examined according to the Gaussian assumption with exponential correlation, in order to minimize the total prediction error at the points of a regular lattice. In such a special case, the problem is reduced to an algebraic statistical model, which is solved using both symbolic algebraic software and statistical software. We provide closed-form computation of the variance of the Gaussian linear predictor as a function of the design, in order to make a comparison between LH designs. In principle, the method applies to any number of factors and any number of levels, and also to classes of designs other than LHs. In our current implementation, the applicability is limited by the high computational complexity of the algorithms involved.     

Estimating percentile-specific treatment effects in counterfactual models: a case-study of micronutrient supplementation, birth weight and infant mortality

Summary.  Clinical trials of micronutrient supplementation are aimed at reducing the risk of infant mortality by increasing birth weight. Because infant mortality is greatest among the low birth weight (LBW) infants (2500 g or under), an effective intervention increases the birth weight among the smallest babies. The paper defines population and counterfactual parameters for estimating the treatment effects on birth weight and on survival as functions of the percentiles of the birth weight distribution. We use a Bayesian approach with data augmentation to approximate the posterior distributions of the parameters, taking into account uncertainty that is associated with the imputation of the counterfactuals. This approach is particularly suitable for exploring the sensitivity of the results to unverifiable modelling assumptions and other prior beliefs. We estimate that the average causal effect of the treatment on birth weight is 72 g (95% posterior regions 33–110 g) and that this causal effect is largest among the LBW infants. Posterior inferences about average causal effects of the treatment on birth weight are robust to modelling assumptions. However, inferences about causal effects for babies at the tails of the birth weight distribution can be highly sensitive to the unverifiable assumption about the correl-ation between the observed and the counterfactuals birth weights. Among the LBW infants who have a large causal effect of the treatment on birth weight, we estimate that a baby receiving the treatment has 5% less chance of death than if the same baby had received the control. Among the LBW infants, we found weak evidence supporting an additional beneficial effect of the treatment on mortality independent of birth weight.     

Regional foods and rural development: The role of product qualification

Qualification schemes have become popular tools for supporting regional foods, yet little is understood about the impacts they have on the rural development contribution of such foods. Qualification processes may stimulate new networks and community actions, but they may also be incompatible with strategies of extended territorial development because of their foundation in theories of competitive advantage. To explore these issues, the evolution is traced of three cases of regional food production, where local actors pursue the opportunity to qualify products under EEC Regulation 2081/92. The results reveal, in practice, the different experiences that can evolve under the same qualification mechanism, and also how the consequences for rural development can vary. The paper concludes with analysis of factors influencing the involvement and behaviour of actors in regional food qualification, and what these infer for the rural development approach pursued.     

CONGESTION MODELS AND WEIGHTED BAYESIAN POTENTIAL GAMES

Games associated with congestion situations à la Rosenthal (1973) have pure Nash equilibria. This result implicitly relies on the existence of a potential function. In this paper we provide a characterization of potential games in terms of coordination games and dummy games. Second, we extend Rosenthal's congestion model to an incomplete information setting, and show that the related Bayesian games are potential games and therefore have pure Bayesian equilibria.     

A test of concordance based on Gini’s mean difference

A new rank correlation index, which can be used to measure the extent of concordance or discordance between two rankings, is proposed. This index is based on Gini’s mean difference computed on the totals ranks corresponding to each unit and it turns out to be a special case of a more general measure of the agreement of m rankings. The proposed index can be used in a test for the independence of two criteria used to rank the units of a sample, against their concordance/discordance. It can then be regarded as a competitor of other classical methods, such as Kendall’s tau. The exact distribution of the proposed test-statistic under the null hypothesis of independence is studied and its expectation and variance are determined; moreover, the asymptotic distribution of the test-statistic is derived. Finally, the implementation of the proposed test and its performance are discussed. Both the authors contributed equally to this work; however, the actual writing of the paper was as follows: Sects. 2 and 3 are due to C. G. Borroni, Sects. 1 and 4 are due to M. Zenga.     

Statistical methods for noisy images with discontinuities

In this paper, we describe a new statistical method for images which contain discontinuities. The method tries to improve the quality of a 'measured' image, which is degraded by the presence of random distortions. This is achieved by using knowledge about the degradation process and a priori information about the main characteristics of the underlying ideal image. Specifically, the method uses information about the discontinuity patterns in small areas of the 'true' image. Some auxiliary labels 'explicitly' describe the location of discontinuities in the true image. A Bayesian model for the image grey levels and the discontinuity labels is built. The maximum a posteriori estimator is considered. The iterated conditional modes algorithm is used to find a (local) maximum of the posterior distribution. The proposed method has been successfully applied to both artificial and real magnetic resonance images. A comparison of the results with those obtained from three other known methods also has been performed. Finally, the connection between Bayesian 'explicity and 'implicit' models is studied. In implicit modelling, there is no use of any set of labels explicitly describing the location of discontinuities. For these models, we derive some constraints of the function by which the presence of the discontinuities is taken into account.     

And yet it moves! (Climate) migration as a symptom in the Anthropocene

ABSTRACT

While the climate-migration nexus raises crucial questions of mobility and climate justice, it is commonly understood through simplistic narratives that reify a complex set of relations. The spectre of environmentally-induced exodus is recurrent in media, policy and activist circles, in spite of numerous studies that reveal the empirical flaws and noxious normative implications of such narratives. This article explores this insistence and the desire(s) for there to be a reified relation between climate and migration such insistence reveals. The article proceeds in three movements. First, it situates discourses on climate migration in relation to the crisis of humanism the Anthropocene signifies. Second, it operates a symptomatic reading of climate migration discourses, drawing on two understandings of symptom elaborated by Lacan – as ‘return of the repressed’ and as ‘Sinthome’. Read as a symptom, the figure of the climate migrant/refugee appears as the return of fundamental contradictions that carve contemporary regimes of socioecological (re)production. Through the concept of ‘Sinthome’, discourses on climate migration can be read as (illusory) attempts to shore up for the waning consistence of modern forms of ‘being human’. Finally, the article proposes a symptomatic reading of the Anthropocene itself, and elaborates on what the dissolution of this symptom/ Sinthome would entail.