Impact of coverage-dependent marginal costs on optimal HPV vaccination strategies.

The effectiveness of vaccinating males against the human papillomavirus (HPV) remains a controversial subject. Many existing studies conclude that increasing female coverage is more effective than diverting resources into male vaccination. Recently, several empirical studies on HPV immunization have been published, providing evidence of the fact that marginal vaccination costs increase with coverage. In this study, we use a stochastic agent-based modeling framework to revisit the male vaccination debate in light of these new findings. Within this framework, we assess the impact of coverage-dependent marginal costs of vaccine distribution on optimal immunization strategies against HPV. Focusing on the two scenarios of ongoing and new vaccination programs, we analyze different resource allocation policies and their effects on overall disease burden. Our results suggest that if the costs associated with vaccinating males are relatively close to those associated with vaccinating females, then coverage-dependent, increasing marginal costs may favor vaccination strategies that entail immunization of both genders. In particular, this study emphasizes the necessity for further empirical research on the nature of coverage-dependent vaccination costs.

Propuesta didáctica para la enseñanza de la probabilidad marginal y conjunta en grado undécimo

El informe que se presenta es el resultado de nuestro trabajo de investigación para optar el título de Licenciadas en educación básica con énfasis en matemáticas. Se diseñó e implementó una secuencia de actividades sobre la enseñanza de la noción de Probabilidad marginal y conjunta a 72 estudiantes de Grado Undécimo del Instituto Técnico Industrial Francisco José de Caldas, teniendo como referente la resolución de problemas y la teoría de las situaciones didácticas propuestas por Brousseau.

'Marginal gothic': mediating the monstrous in British romanticism

In this paper I look at texts from the Romantic Period which strategically employ elements of the Gothic genre in what I describe as a `marginal` relationship with the Gothic canon. My intention is both to explore the way the boundaries of the genre might be extended, and to cast fresh light on some of the texts discussed, specifically in relation to the ways in which the `monstrous` is perceived and portrayed as villainy. In the first half of the paper, using Burke’s Philosophical Enquiry on the Sublime and the Beautiful as a starting point, I consider Burke’s Reflections on the Revolution in France, Godwin’s Caleb Williams, Radcliffe’s The Italian, and Blake’s The Marriage of Heaven and Hell as all in various ways examples of `marginal Gothic` that present evil doing as monstrous aberrations, also noting the contemporary reception of Beckford’s Vathek, praised in 1786 for its `accuracy and credibility`. In addition, I suggest that Wordsworth’s `Tintern Abbey` and Book VI of The Prelude provide evidence of marginal, but significant, Gothic influence that references Radcliffe’s and Burke’s explorations of a terror of the unknown. In the second half of the paper I focus on Scott’s Guy Mannering, or The Astrologer (1815) as an important example of a `marginal` Gothic novel. Scott’s reference to Vathek at a key point in his plot suggests that he had read Beckford’s novel as entirely `Gothic`. This discussion incorporates a comparison between Mannering’s youthful enthusiasm for astrological divination, and themes to be found in Shelley’s Frankenstein, notably with respect to the nature of Victor Frankenstein’s response to `old` and `new` science and medicine, and to the creation and control of Gothic monstrosity. In these and in other instances, it will be argued that the `marginal Gothic` of Scott’s novel may be read as a precursor to Shelley’s work. [From the Author]

Marginal adaptation and performance of bioactive dental restorative materials in deciduous and young permanent teeth

Objective: The aim of this study was to investigate the adaptation of different types of restorations towards deciduous and young permanent teeth. Materials and Methods: Class V cavities were prepared in deciduous and young permanent teeth and filled with different materials (a conventional glass-ionomer, a resin-modified glass-ionomer, a poly-acid-modified composite resin and a conventional composite resin). Specimens were aged in artificial saliva for 1, 6, 12 and 18 months, then examined by SEM. Results: The composite resin and the polyacid-modified composite had better marginal adaptation than the glass-ionomers,though microcracks developed in the enamel of the tooth. The glass-ionomers showed inferior marginal quality and durability, but no microcracking of the enamel. The margins of the resin-modified glass-ionomer were slightly superior to the conventional glass-ionomer. Conditioning improved the adaptation of the composite resin, but the type of tooth made little or no difference to the performance of the restorative material. All materials were associated with the formation of crystals in the gaps between the filling and the tooth; the quantity and shape of these crystals varied with the material. Conclusions: Resin-based materials are generally better at forming sound, durable margins in deciduous and young permanent teeth than cements, but are associated with microcracks in the enamel. All fluoride-releasing materials give rise to crystalline deposits.

Tropical Marginal Seas: Priority Regions for Managing Marine Biodiversity and Ecosystem Function

Tropical marginal seas (TMSs) are natural subregions of tropical oceans containing biodiverse ecosystems with conspicuous, valued, and vulnerable biodiversity assets. They are focal points for global marine conservation because they occur in regions where human populations are rapidly expanding. Our review of 11 TMSs focuses on three key ecosystems—coral reefs and emergent atolls, deep benthic systems, and pelagic biomes—and synthesizes, illustrates, and contrasts knowledge of biodiversity, ecosystem function, interaction between adjacent habitats, and anthropogenic pressures. TMSs vary in the extent that they have been subject to human influence—from the nearly pristine Coral Sea to the heavily exploited South China and Caribbean Seas—but we predict that they will all be similarly complex to manage because most span multiple national jurisdictions. We conclude that developing a structured process to identify ecologically and biologically significant areas that uses a set of globally agreed criteria is a tractable first step toward effective multinational and transboundary ecosystem management of TMSs.

The marginal willingness-to-pay for attributes of a hypothetical HIV vaccine

This paper estimates the marginal willingness-to-pay for attributes of a hypothetical HIV vaccine using discrete choice modeling. We use primary data from 326 respondents from Bangkok and Chiang Mai, Thailand, in 2008–2009, selected using purposive, venue-based sampling across two strata. Participants completed a structured questionnaire and full rank discrete choice modeling task administered using computer-assisted personal interviewing. The choice experiment was used to rank eight hypothetical HIV vaccine scenarios, with each scenario comprising seven attributes (including cost) each of which had two levels. The data were analyzed in two alternative specifications: (1) best-worst; and (2) full-rank, using logit likelihood functions estimated with custom routines in Gauss matrix programming language. In the full-rank specification, all vaccine attributes are significant predictors of probability of vaccine choice. The biomedical attributes of the hypothetical HIV vaccine (efficacy, absence of VISP, absence of side effects, and duration of effect) are the most important attributes for HIV vaccine choice. On average respondents are more than twice as likely to accept a vaccine with 99% efficacy, than a vaccine with 50% efficacy. This translates to a willingness to pay US$383 more for a high efficacy vaccine compared with the low efficacy vaccine. Knowledge of the relative importance of determinants of HIV vaccine acceptability is important to ensure the success of future vaccination programs. Future acceptability studies of hypothetical HIV vaccines should use more finely grained biomedical attributes, and could also improve the external validity of results by including more levels of the cost attribute.

mfx: Marginal Effects, Odds Ratios and Incidence Rate Ratios for GLMs

Estimates probit, logit, Poisson, negative binomial, and beta regression models, returning their marginal effects, odds ratios, or incidence rate ratios as an output.