Dose Banding -- weighing up benefits, therapeutic failure and risks

Aim Dose banding is a commonly used method of dose individualisation in which all patients with similar characteristics are allocated to the same dosing group. Dose banding results in some patients receiving less intensive treatment with the potential for a reduction in therapeutic benefit (iatrogenic therapeutic failure). This study aims to explore the effects of dose banding on therapeutic success and failure. Methods This was a simulation study conducted using MATLAB. Virtual patients were simulated under a simple pharmacokinetic model with a predefined target steady-state average concentration (c_(ss,ave)). Clearance was correlated with a covariate used for dosing. Dose individualisation was based on: one-dose-fits-all, covariate based dosing, empirical dose banding, dose banding optimised for benefit:risk only and dose banding optimised for both benefit:risk and minimising iatrogenic therapeutic failure. Results The lowest and highest probabilities of target attainment (PrTA) were 46% for one-dose-fits-all and 72% for fully individualised covariate-based dosing. Neither dosing approach would result in iatrogenic therapeutic failure as lower dose intensities do not occur. Empirical dose banding performed better than once-dose-fits-all with 59% PTA but not as good as either optimised method (64-69% PrTA) while carrying a risk of iatrogenic therapeutic failure in 25% of patients. Optimising for benefit:risk (only) improved PrTA but carried a risk of iatrogenic therapeutic failure of up to 10%. Optimising for benefit:risk and minimising iatrogenic therapeutic failure provided the best balance. Conclusion Future application of dose banding needs to consider both the probability of benefit:risk as well the risk of causing iatrogenic therapeutic failure.

Productivity and quality of watermelon fruits as a function of doses potassium in the Western Amazon

Potassium is the nutrient most demanded by watermelon, performing various physiological and biochemical functions, and its availability in the soil influences the production and quality of fruits. However, there is no recommendation for specific fertilization for the state of Rondônia, which has limited the production and quality of the harvested fruits. The objective of this work was to evaluate the effects of potassium doses on the productivity and quality of watermelon fruits, cultivar Crimson Sweet, in southern Western Amazonia. The experiment was carried out at the Federal University of Rondônia, in the municipality of Rolim de Moura, in an experimental design in randomized blocks, with five treatments and four replications. The treatments were doses 0 (control), 50, 100, 150 and 200 kg ha-1 of K2O. The variables analyzed were fruit mass, longitudinal and transverse diameter of fruits, number of fruits per plant, soluble solids content, exocarp thickness and productivity. Potassium doses did not influence the mean mass and longitudinal and transverse diameter of the fruits. The number of fruits per plant increased linearly as a function of the potassium doses applied, and with 157 kg ha‑1 of K2O the highest values of °Brix were obtained. The dose of 147.2 kg ha-1 of K2O promotes yields 61.6% above the national average and 82% above the state average.

A Comparative Analysis of COVID-19 Physical Distancing Policies in Botswana, India, Jamaica, Mozambique, Namibia, Ukraine, and the United States

BackgroundUnderstanding the differences in timing and composition of physical distancing policies is important to evaluate the early global response to COVID-19. A physical distancing intensity framework comprising 16 domains was recently published to compare physical distancing approaches between U.S. States. We applied this framework to a diverse set of low and middle-income countries (LMICs) (Botswana, India, Jamaica, Mozambique, Namibia, and Ukraine) to test the appropriateness of this framework in the global context and to compare the policy responses in this set of LMICs and with a sample of U.S. States during the first 100-days of the epidemic.ResultsAll six of the LMICs in our sample adopted wide ranging physical distancing policies. The highest peak daily physical distancing intensity in each country was: Botswana (4.60); India (4.40); Ukraine (4.40); Namibia (4.20); and Jamaica (3.80). The number of days each country stayed at peak intensity ranged from 12-days (Jamaica) to more than 67-days (Mozambique). We found some key similarities and differences, including substantial differences in whether and how countries expressly required certain groups to stay at home. We also found that the LMICs generally implemented physical distancing policies when there were few confirmed cases and the easing of physical distancing policies did not discernably correlate with change in COVID-19 incidence. The physical distancing responses in the LMIC sample were generally more intense than in a sample of U.S. States, but results vary depending on the U.S. State. For example, California had a peak intensity of 4.29, which would place California below the peak intensity for Botswana, India, and Ukraine but above Mozambique, Namibia and Jamaica. The U.S. State of Georgia had a peak intensity of 3.07, which would place it lower than all of the LMICs in this sample. The peak intensity for the U.S. 12-state average was 3.84, which would place it lower than every LMIC in this sample except Jamaica.ConclusionThis analysis helps to highlight the differing paths taken by the countries in this sample and may provide lessons to other countries regarding options for structuring physical distancing policies in response to COVID-19 and future outbreaks.

Factors Influencing the Fish Consumption Preferences: Understandings from the tribes of Wayanad, Kerala

Fish consumption preferences vary with communities. The study aims to study the socio personal and fish consumption profile of the seven major tribes of Wayanad, Kerala. Species preferences, factors affecting the fish purchase and consumption, health profile and symptoms of tribes in relation with iron deficiency anaemia, association between fish consumption and health of tribes were investigated. Data were gathered through a questionnaire completed by 200 tribal households from different socioeconomic backgrounds. Results indicate that Sardine was the most consumed and preferred fish and percapita fish consumption of tribes was far below the state average. In conclusion, the price of fish ranked as the first and foremost important factor affecting the fish purchase and consumption of the tribes surveyed, and the fish consumption variables were highly associated with health values. Increasing awareness about the health benefits of fish consumption and building capacity of tribes to prepare fish-based products based on their taste and preferences can aid improved fish consumption among Wayanad tribes. Therefore, to establish and adopt fish consumption guidelines for the tribes of Wayanad, the factors mentioned in the study need to be integrated into the projects and policies.

A Combined Upper-Sided Synthetic S2 Chart for Monitoring the Process Variance

In order to monitor the process variance, this paper proposes a combined upper-sided synthetic S2 chart for monitoring the process standard deviation of a normally distributed process. This combined upper-sided synthetic S2 chart comprises a synthetic chart and an upper-sided S2 chart. The design and performance of the proposed chart are presented, and the steady-state average run length comparisons show that the combined upper-sided synthetic S2 chart outperforms the standard synthetic S2 chart as well as several run rules S2 charts, especially for larger shifts in the process variance.

Analysis of Socio-economic Status of People in aspirational districts of Odisha for Inclusive growth

Aspirational district programme was launched by the government of India to uplift the 117 backward districts in the country through rapid development. Ten districts of Odisha were included in this programme which included Dhenkanal, Gajapati, Kandhamal, Balangir, Kalahandi, Rayagada, Koraput, Malkangiri, Nuapada and Nabarangpur. Socio-economic variables formed important dimension for identifying the backwardness of districts. Hence, the socio-economic status of people in the 101 blocks in the ten backward districts were analyzed to address the weak points. The socio-economic indicators analyzed were: population density, sex ratio, SC and ST population, total literacy percent, male and female literacy percent, and gender gap in literacy percent and they were compared with the state average. Most of the aspirational districts are located in the southern part of Odisha except Dhenkanal. In the aspirational districts 89.3 percent of the population live in rural areas compared to 83.3 percent for state average. These aspirational districts have high tribal population (39.4 percent) with lower human density (153 per sq km), higher sex ratio (1010), low total literacy (58.1 percent), low female literacy (47.1 percent) and high gender gap in literacy (22.2 percent). The 101 blocks in the aspirational districts of Odisha were also ranked based on these indictors. The study revealed that the socio-economic indicators in the aspirational districts were weak which need focused attention for their improvement.

Economic performance and electoral volatility: Testing the economic voting hypothesis on Indian states, 1957–2013

The consequences of variations in economic growth for vote volatility are analyzed on a panel of 14 Indian states between 1957 and 2013. Two measures of volatility are used: changes in party vote shares at the assembly level and changes in the state average of vote volatilities constructed at the constituency level. While the results find that both vary inversely with income growth rates, volatility at the constituency level is found to be more sensitive to growth rates. Examination of the periodicity of income growth’s impact finds that growth in the final year of governance has a stronger effect on volatility than does the average growth rate arising over the incumbent’s tenure. We confirm for Indian states that vote volatility responds more to negative changes than positive changes in the growth rate and, by decomposing volatility and find, contrary to most studies, that growth rates affect internal vote shifting more than between exiting parties and newcomers. The responsiveness of volatility to economic and political characteristics of the state reinforces the hypothesis that theories of economic voting have an important role to play in understanding electoral volatility and may provide a more insightful way of approaching the political business cycle.

Geographical Patterns of Multidimensional Poverty and Deprivation in Uttar Pradesh

Based on Census data (2011) by districts this study attempts to analyze the inter-district variations in the levels of poverty as well as levels of deprivation in Uttar Pradesh. To find out the magnitude of variations among indicators of poverty and deprivation; causal relationship between level of poverty (dependent) and explanatory indicators of deprivation (independent) have been taken into account. To fulfil the objectives, Z- score, coefficient of variation, and correlation coefficient techniques have been used in this study. The study reveals that 51 per cent districts of the state recorded high level (above state average) of poverty, while 40 per cent districts witnessed high level of deprivation. Similarly, 49 per cent and 60 per cent districts registered low level (below state average) of poverty and deprivation respectively. The level of poverty is high in southeastern part of the state, and it is low in the west northern part. The level of deprivation is high in the northeastern part and low in the western and central south parts of the study area. It has been found that infant mortality rate and illiteracy rate are the major determinants of high level of multidimensional poverty among the districts of Uttar Pradesh.