Seasonal occurrence and individual variability of bull sharks, Carcharhinus leucas, in a marine reserve of the southwestern Gulf of California.

Background: Studying how the bull sharks aggregate and how they can be driven by life history traits such as reproduction, prey availability, predator avoidance and social interaction in a National Park such as Cabo Pulmo, is key to understand and protect the species. Methods: The occurrence variability of 32 bull sharks tracked with passive acoustic telemetry were investigated via a hierarchical logistic regression model, with inference conducted in a Bayesian framework, comparing sex, and their response to temperature and chlorophyll. Results: Based on the fitted model, occurrence probability varied by sex and length. Juvenile females had the highest values, whereas adult males the lowest. A strong seasonality or day of the year was recorded, where sharks were generally absent during September-November. However, some sharks did not show the common pattern, being detected just for a short period. This is one of the first studies where the Bayesian framework is used to study passive acoustic telemetry proving the potential to be used in further studies.

Exploring the mechanisms behind the country-specific time of Zika virusimportation.

The international spread of Zika virus (ZIKV) began in Brazil in 2015. To estimate the riskof observing imported ZIKV cases, we calculated effective distance, typically an excellent predictorof arrival time, from airline network data. However, we eventually concluded that, for ZIKV, effectivedistance alone is not an adequate predictor of arrival time, which we partly attributed to the difficultyof diagnosing and ascertaining ZIKV infections. Herein, we explored the mechanisms behind theobserved time delay of ZIKV importation by country, statistically decomposing the delay into twoparts: the actual time to importation from Brazil and the reporting delay. The latter was modeled as afunction of the gross domestic product (GDP) and other variables that influence underlying diagnosticcapacity in a given country. We showed that a high GDP per capita is a good predictor of shortreporting delay. ZIKV infection is generally mild and, without substantial laboratory capacity, casescan be underestimated. This study successfully demonstrates this phenomenon and emphasizes theimportance of accounting for reporting delays as part of the data generating process for estimatingtime to importation.

Aplicación de modelos paramétricos alternativos para el análisis de supervivencia de pacientes con cáncer / Application of alternative parametric models for the survival analysis of cancer patients

RESUMEN En el presente artículo se describe una metodología que permite tener un acercamiento a modelos probabilísticos alternativos para el análisis de supervivencia, con censura por la derecha, distintos a los que usualmente se estudian (distribución: exponencial, gamma, Weibull y log-normal), ya que es posible que los datos no se ajusten siempre con suficiente precisión por las distribuciones existentes. La metodología utilizada permite mayor flexibilidad de modelar observaciones extremas, ubicadas generalmente en la cola derecha de la distribución de los datos, lo cual admite que algunos eventos aún tengan la probabilidad de ocurrir, lo que no sucede con los modelos tradicionales y el estimador de Kaplan-Meier, el cual estima para los tiempos más prolongados, probabilidades de supervivencia aproximadamente iguales a cero. Para mostrar la utilidad de la propuesta metodológica, se consideró una aplicación con datos reales que relaciona tiempos de supervivencia de pacientes con cáncer de colon.

ABSTRACT This article describes a methodology that allows an approach to alternative right-censored probabilistic models for the analysis of survival, different to those usually studied (exponential, gamma, Weibull, and log-normal distribution) since it is possible that the data do not always fit with sufficient precision due to existing distributions. The methodology used allows for greater flexibility when modeling extreme observations, generally located in the right tail of data distribution, which admits that some events still have the probability of occurring, which is not the case with traditional models and the Kaplan-Meier estimator, which estimates for the longest times, survival probabilities approximately equal to zero. To show the usefulness of the methodological proposal, we considered an application with real data that relates survival times of patients with colon cancer (CC).

Cost Effectiveness of Intracranial Pressure Monitoring in Pediatric Patients with Severe Traumatic Brain Injury: A Simulation Modeling Approach.

OBJECTIVES: To conduct an economic evaluation of intracranial pressure (ICP) monitoring on the basis of current evidence from pediatric patients with severe traumatic brain injury, through a statistical model. METHODS: The statistical model is a decision tree, whose branches take into account the severity of the lesion, the hospitalization costs, and the quality-adjusted life-year for the first 6 months post-trauma. The inputs consist of probability distributions calculated from a sample of 33 surviving children with severe traumatic brain injury, divided into two groups: with ICP monitoring (monitoring group) and without ICP monitoring (control group). The uncertainty of the parameters from the sample was quantified through a probabilistic sensitivity analysis using the Monte-Carlo simulation method. The model overcomes the drawbacks of small sample sizes, unequal groups, and the ethical difficulty in randomly assigning patients to a control group (without monitoring). RESULTS: The incremental cost in the monitoring group was Mex$3,934 (Mexican pesos), with an increase in quality-adjusted life-year of 0.05. The incremental cost-effectiveness ratio was Mex$81,062. The cost-effectiveness acceptability curve had a maximum at 54% of the cost effective iterations. The incremental net health benefit for a willingness to pay equal to 1 time the per capita gross domestic product for Mexico was 0.03, and the incremental net monetary benefit was Mex$5,358. CONCLUSIONS: The results of the model suggest that ICP monitoring is cost effective because there was a monetary gain in terms of the incremental net monetary benefit.

Gasto catastrófico en salud en México y sus factores determinantes, 2002-2014.

OBJECTIVE: To assess the financial protection of public health insurance by analyzing the percentage of households with catastrophic health expenditure (HCHE) in Mexico and its relationship with poverty status, size of locality, federal entity, insurance status and items of health spending. METHOD: Mexican National Survey of Income and Expenditures 2002-2014 was used to estimate the percentage of HCHE. Through a probit model, factors associated with the occurrence of catastrophic spending are identified. Analysis was performed using Stata-SE 12. RESULTS: In 2014 there were 2.08% of HCHE (1.82-2.34%; N = 657,474). The estimated probit model correctly classified 98.2% of HCHE (Pr (D) ≥ 0.5). Factors affecting the catastrophic expenditures were affiliation, presence of chronic disease, hospitalization expenditure, rural condition and that the household is below the food poverty line. CONCLUSIONS: The percentage of HCHE decreased in recent years, improving financial protection in health. This decline seems to have stalled, keeping inequities in access to health services, especially in rural population without affiliation to any health institution, below the food poverty line and suffering from chronic diseases.

Thresholds of species loss in Amazonian deforestation frontier landscapes.

In the Brazilian Amazon, private land accounts for the majority of remaining native vegetation. Understanding how land-use change affects the composition and distribution of biodiversity in farmlands is critical for improving conservation strategies in the face of rapid agricultural expansion. Working across an area exceeding 3 million ha in the southwestern state of Rondônia, we assessed how the extent and configuration of remnant forest in replicate 10,000-ha landscapes has affected the occurrence of a suite of Amazonian mammals and birds. In each of 31 landscapes, we used field sampling and semistructured interviews with landowners to determine the presence of 28 large and medium sized mammals and birds, as well as a further 7 understory birds. We then combined results of field surveys and interviews with a probabilistic model of deforestation. We found strong evidence for a threshold response of sampled biodiversity to landscape level forest cover; landscapes with <30-40% forest cover hosted markedly fewer species. Results from field surveys and interviews yielded similar thresholds. These results imply that in partially deforested landscapes many species are susceptible to extirpation following relatively small additional reductions in forest area. In the model of deforestation by 2030 the number of 10,000-ha landscapes under a conservative threshold of 43% forest cover almost doubled, such that only 22% of landscapes would likely to be able to sustain at least 75% of the 35 focal species we sampled. Brazilian law requires rural property owners in the Amazon to retain 80% forest cover, although this is rarely achieved. Prioritizing efforts to ensure that entire landscapes, rather than individual farms, retain at least 50% forest cover may help safeguard native biodiversity in private forest reserves in the Amazon.