A Statistical Analysis of the Lake Levels at Lake Neusiedl

A long record of daily data is used to study the lake levels of Lake Neusiedl, a large steppe lake at the eastern border of Austria. Daily lake level changes are modeled as functions of precipitation, temperature, and wind conditions. The occurrence and the amount of daily precipitation are modeled with logistic regressions and generalized linear models

Efficacy and cost-effectiveness of the 13C-urea breath test as the primary diagnostic investigation for the detection of Helicobacter pylori infection compared to invasive and non-invasive diagnostic tests

Background: Helicobacter pylori (H. pylori) is one of the most common bacterial infections in humans. There is a risk factor for gastric or duodenal ulcers, gastric cancer and MALT (Mucosa Associated Lymphoid Tissue)-Lymphomas. There are several invasive and non-invasive methods available for the diagnosis of H. pylori. The 13C-urea breath test is a non-invasive method recommended for monitoring H. pylori eradication therapy. However, this test is not yet used for primary assessment of H. pylori in Germany. Objectives: What are the clinical and health economic benefits of the 13C-urea breath test in the primary assessment of H. pylori compared to other invasive and non-invasive methods? Methods: A systematic literature search including a hand search was performed for studies investigating test criteria and cost-effectiveness of the 13C-urea breath test in comparison to other methods used in the primary assessment of H. pylori. Only studies that directly compared the 13C-urea breath test to other H. pylori-tests were included. For the medical part, biopsy-based tests were used as the gold standard. Results: 30 medical studies are included. Compared to the immunoglobulin G (IgG) test, the sensitivity of the 13C-urea breath test is higher in twelve studies, lower in six studies and one study reports no differences. The specificity is higher in 13 studies, lower in three studies and two studies report no differences. Compared to the stool antigen test, the sensitivity of the 13C-urea breath test is higher in nine studies, lower in three studies and one study reports no difference. The specificity is higher in nine studies, lower in two studies and two studies report no differences. Compared to the urease test, the sensitivity of the 13C-urea breath test is higher in four studies, lower in three studies and four studies report no differences. The specificity is higher in five studies, lower in five studies and one study reports no difference. Compared to histology, the sensitivity of the 13C-urea breath test is higher in one study and lower in two studies. The specificity is higher in two studies and lower in one study. One study each compares the 13C-urea breath test to the 14C-urea breath test and the polymerase chain reaction (PCR) test, respectively, and reports no difference in sensitivity and specificity with the 14C-urea breath test, and lower sensitivity and higher specificity compared to PCR. The statistical significance of these differences is described for six of the 30 studies. Nine health economic evaluations are included in the Health Technology Assessment (HTA) report. Among these studies, the test-and-treat strategy using the 13C-urea breath test is compared to test-and-treat using serology in six analyses and to test and treat using the stool antigen test in three analyses. Thereby, test-and-treat using the breath test is shown to be cost-effective over the serology based strategy in three models and is dominated by a test-and-treat strategy using the stool antigen test in one model. A cost-effectiveness comparison between the urea breath test approach and the empirical antisecretory therapy is carried out in four studies. Of these, two studies report that the strategy using the urea breath test is cost-effective over the empirical antisecretory therapy. In two studies, test-and-treat using the 13C-urea breath test is compared to the empirical eradication therapy and in five studies to endoscopy-based strategies. The breath test approach dominates endoscopy in two studies and is dominated by this strategy in one study. Discussion: All included medical and economic studies are limited to a greater or lesser extent. Additionally, the results of the studies are heterogeneous regarding medical and economic outcomes respectively. Thus, the majority of the medical studies do not report the statistical significance of the differences in sensitivity and specificity. In direct comparisons the 13C- urea breath test shows higher sensitivity and specificity than the IgG and stool antigen tests. In comparison to the urease test, results for sensitivity are inconsistent, and the specificity is slightly higher for the 13C-urea breath test. There are not enough results for comparisons between the 13C-urea breath test and the 14C-urea breath test, histology and PCR to describe tendencies. The included economic studies suggest that the test-and-treat strategy using the 13C-urea breath test is cost-effective compared to test-and-treat using serology as well as empirical antisecretory therapies. Due to a lack of valid studies, it is not possible to assess the breath test approach in comparison to test-and-treat using the stool antigen test and the empirical eradication therapy respectively, regarding the cost-effectiveness. The results of economic analyses comparing test-and-treat using the breath test to endoscopy strategies are too heterogeneous to draw any conclusions. Overall, none of the included economic models is able to completely capture the complexity of managing patients with dyspeptic complaints. Conclusions/Recommendations: Based on available medical and economic studies, there is no sufficient evidence to recommend test and-treat using 13C-urea breath testing for the detection of H. pylori infection as the standard procedure for the management of uninvestigated dyspepsia in the German health care system. In addition, it must be considered that the DVGS guidelines of the Deutsche Gesellschaft für Verdauungs- und Stoffwechselkrankheiten (DVGS) recommend endoscopy based methods for the management of patients with dyspeptic complaints

Philosophy’s response to skepticism Stanley Cavell and the inheritance of Ludwig Wittgenstein

This dissertation presents an original interpretation of the critical philosophy of Ludwig Wittgenstein and Stanley Cavell. It is well known that Wittgenstein interprets philosophical puzzles posed by the metaphysical tradition dramatically and psychologically as a kind of illness, rendering the philosophical response to metaphysics a matter of acquiring intellectually sanity. Cavell’s interpretation of Wittgenstein goes beyond the traditional understanding by viewing the return from metaphysics not just as a path to personal sanity and intellectual clarity. Instead of focusing only on individuals or specific fields like philosophy, Cavell sees it as a necessary response to the cultural and historical tendency to repudiate the ordinary. Insofar as Cavell interprets this drive not only as pertaining to the individual but as permeating public history of the modern period (since Descartes and Shakespeare), the response to skepticism (the repudiation of the ordinary), hence philosophy, epitomized by the “Wittgensteinian voice”, presents itself as a critique of modernity. While such a reading of Cavell’s work is readily available, mostly notably in his mid-period book Disowning Knowledge, in his magnum opus The Claim of Reason and his late text This New Yet Unapproachable America, going back to Wittgenstein with Cavell, and reading Wittgenstein’s Philosophical Investigations as exemplifying a critique of modernity presents the real challenge of this dissertation. Cavell, I argue, permits us to interpret Wittgenstein’s psychological dramatization of metaphysics as depicting a catastrophic eventuality for a culture, of public history and presence. Besides attempting to place Wittgenstein and Cavell in a broader thematic context of modernity and culture, this dissertation’s second thread concerns their mode of response to skepticism, which, as I suggest, is best conceived in terms of interpretations and critical responses to text, as opposed to solutions of what has been traditionally associated with Wittgenstein, namely canonical problems of philosophy. For Cavell and Wittgenstein a text can be read and interpreted as exemplifying and instantiating the repudiation of the human

Determinants of school attendance in rural Ethiopia

Die vorliegende Studie verwendet den Ethiopian Rural Household Survey aus dem Jahr 2009, um die Faktoren, die den Schulbesuch von Kindern im Grundschulalter (7-15 Jahre) im ländlichen Äthiopien beeinflussen, zu untersuchen. Die Analyse wird dabei aufgeteilt in einen Bereich, der relevante Faktoren auf individueller Ebene wie zum Beispiel Alter und Geschlecht der Kinder sowie die Verwendung ihrer Zeit für verschiedene Aktivitäten untersucht, sowie einen Bereich, der Faktoren auf Haushaltsebene wie zum Beispiel Vermögen, Besitz von verschiedenen Gegenständen, Zusammensetzung des Haushalts sowie bestimmte Eigenschaften der Eltern sowie des Haushaltsvorstands behandelt. Für beide Analysebereiche werden Probit Modelle verwendet, für die individuelle Ebene kommt zusätzlich ein Linear Probability Model sowohl mit als auch ohne Fixed Effects für denselben Haushalt zum Einsatz. Auf der individuellen Ebene wird ein starker negativer Effekt des Alters sowie der Zeit, die für Arbeitstätigkeiten verwendet wird, auf den Schulbesuch gefunden. Auf der Haushaltsebene hat das Vermögen des Haushalts einen positiven Einfluss auf den Schulbesuch, während sich Landbesitz negativ auswirkt, was höchstwahrscheinlich darin begründet ist, dass es keinen funktionierenden Arbeitsmarkt gibt und gleichzeitig die Arbeitskraft der im Haushalt lebenden Kinder produktiver verwendet werden kann, wenn der Haushalt Land besitzt. Andere Faktoren, wie das Haltern von kleinen Tieren und die Zusammensetzung des Haushalts, von denen ebenfalls angenommen werden konnte, dass sie die Produktivität der im Haushalt lebenden Kinder erhöhen und dadurch auf den Schulbesuch negativ einwirken, zeigen keinen Effekt. Die Zeit- und Risikopräferenzen der Haushaltsvorstände scheinen ebenfalls keine Rolle zu spielen.Using the 2009 Ethiopian Rural Household Survey this study investigates the determinants of school attendance among children of primary school age (7-15 years) in rural Ethiopia. The investigation is separated into an analysis of factors operating on the individual level such as the age and gender of children or the allocation of their time to various activities and factors operating on the household level such as wealth, assets, household composition and characteristics of the parents of the children or the head of the household. Probit Models are used both on the individual and on the household level, yet on the individual level a Linear Probability Model with and without household fixed effects is also employed. On the individual level, above all a strong negative effect of age and time allocated to work on school attendance activities is found. On the household level, the wealth of the household has a positive effect while ownership of land affects school attendance negatively. The latter effect is most likely due to the fact that labor markets are largely absent and the work of children becomes more productive at the same time when the household owns land. Other factors that would have been expected to raise children’s productivity and thereby decrease school attendance rates, such as the keeping of small animals or the household composition show no effect however. The risk and time preferences of the heads of households also do not seem to play a role

Shifting the Tax Burden away from Labour towards Inheritances and Gifts: Simulation results for Germany

Germany’s tax system places a relatively strong emphasis on direct taxes, particularly on labour. At the same time, revenues from the inheritance and gift tax are relatively low. This points towards a large-scale transfer of wealth from one generation to the next that is largely untaxed and thereby maintaining the high degree of wealth inequality observed in Germany. This is due mainly to the wide-ranging tax exemptions for business assets, which make the system complex, inefficient and regressive. This paper presents three hypothetical budget-neutral scenarios of broadening the inheritance and gift tax base while reducing the tax burden on labour income. Keeping the current progressive rates but abolishing tax exemptions would lead to about EUR 9-12 billion additional annual inheritance and gift tax revenue. Replacing the current tax regime by a flat rate of 10% or 15% could yield about EUR 0.5-2.3 billion or EUR 4-6.5 billion. Using EUROMOD, the microsimulation model of the EU, we show that these additional revenues could be used to reduce the tax burden on labour, which would improve income equality. Furthermore, estimations of labour supply responses to these reforms, based on the EUROLAB labour supply model, indicate that lowering the tax burden on labour may also lead to a slight increase in labour supply in particular for low-income earners.JRC.B.2 - Fiscal Policy Analysi

Concentration of vascular endothelial growth factor (VEGF) in the serum of patients with suspected ovarian cancer.

As a promoter of angiogenesis, vascular endothelial growth factor (VEGF) is believed to play a pivotal role in tumour growth and metastasis. The aim of this study was to determine the value of preoperative serum VEGF levels in the early diagnosis of ovarian cancer and in the differential diagnosis of adnexal masses. We examined preoperative serum VEGF levels in healthy women (n = 131), patients with benign ovarian cysts (n = 81) and in ovarian cancer patients (n = 44) by using an ELISA (R&D Systems, Minneapolis, MN, USA). A logistic regression model was carried out to determine the influence of VEGF and CA 125 on the probability of malignancy. VEGF revealed a significant influence on the odds of presenting with malignancy vs healthy women (P = 0.001). At 363.7 pg ml(-1), VEGF achieved a sensitivity of 54% and a specificity of 77%. With respect to the differentiation between benign cysts and ovarian cancer, CA 125 (P < 0.0001) but not VEGF (P = 0.229) predicts the presence of malignancy in a multivariate model. In conclusion, VEGF does not appear to be a useful tool in the early diagnosis of ovarian cancer or for indicating the absence or presence of malignancy in patients with an adnexal mass

Transferring urban traveling speed model fits across cities

Purpose Link traveling time models form the basis for route planning methods used in navigation devices as well as for logistic applications. These models are provided based on extensive real world data sets which are available to a differing degree in different cities as well as for different links within a given city. For smaller cities, where typically fewer data is available or less frequently measured links, it might be beneficial to transfer models from close-by cities or links from the same city with sufficient data basis. In this paper, the potential for transferring link traveling time model fits, that is, the estimated models, between cities and within a city is investigated. Methods that combine information typically contained in street maps with empirically derived features that are easily transferred are developed and tested with substantial real world data sets. This provides the basis for developing route planning methods in cities with insufficient real world data coverage to base accurate route traveling time predictions on. Methods Link traveling time models are derived on the basis of an extensive floating taxi data set in Vienna, Austria. The models incorporate typical map information such as speed limits and functional road classification (frc). Estimation is performed using penalized least squares methods to control for overfitting. The expected accuracy for the model transfer is investigated both in terms of intracity transfer (from modelled links to other links in the same city) and in terms of intercity transfer (from one city to another city). Data sets of different extent are used from the two Austrian cities of Vienna and Linz as well as for the French city of Lyon. Results The models presented in this paper are demonstrated to lead to superior performance compared to the benchmark model of Leodolter et al. (2015). It is shown that transfer between cities in the same country (here using the Vienna model for Linz) may be beneficial in terms of prediction accuracy while the transfer between countries (here from Vienna to Lyon) decreases accuracy but not dramatically. Conclusion These results demonstrate that the transfer of link traveling time models within a city or from one city to another city can provide acceptable prediction accuracy and thus can be used as the basis for navigation algorithms in case no good data basis is accessible for a city. Document type: Articl