Explore the vast range of titles available.

\"A picture book biography of Georgia O'Keeffe, with an emphasis on her sustainable homestead in Abiquiu, New Mexico\"-- Provided by publisher.

Researchers and policymakers have long been interested in developing simple decision rules to aid in determining whether an intervention is, or is not, cost-effective. In global health, interventions that impose costs per disability-adjusted life year averted less than three and one times gross domestic product per capita are often considered cost-effective and very cost-effective, respectively. This article explores the conceptual foundation and derivation of these thresholds. Its goal is to promote understanding of how these thresholds were derived and their implications, as well as to suggest options for improvement. These thresholds are intended to reflect the monetary value of the benefits to affected individuals, based on their preferences for spending on health vs spending on other goods and services. However, the current values were not rigorously derived, which means that their application may lead to inappropriate conclusions regarding which interventions should be adopted as well as misallocation of resources across health and other investments. Improving the basis for these cost-effectiveness thresholds is of particular importance in low-and middle-income countries, given the limited resources available and the significant needs of their populations. Depuis longtemps, les chercheurs et les décideurs politiques se sont intéressés à l’élaboration de règles de prise de décisions simples dans le but d’aider à déterminer si une intervention est rentable ou non. Dans le domaine de la santé mondiale, les interventions qui imposent des coûts par année de vie corrigée de l’incapacité et permettent d’éviter de dépenser entre moins de trois à une fois le produit intérieur brut par habitant sont souvent considérées comme rentables et très rentables, respectivement. Le présent article explore la base conceptuelle et la dérivation de ces seuils. Son but est de mieux comprendre la façon dont ces seuils ont été dérivés et leurs implications, mais aussi de suggérer des options de perfectionnement. Ces seuils visent à refléter la valeur monétaire des prestations versées aux personnes touchées, en fonction de leurs préférences en matière de dépenses sanitaires par rapport aux dépenses engagées pour d’autres biens et services. Toutefois, les valeurs actuelles n’ont pas été calculées de manière rigoureuse, ce qui signifie que leur application peut conduire à des conclusions inappropriées quant aux interventions à adopter ainsi qu’à une mauvaise répartition des ressources entre les investissements du secteur de la santé et ceux des autres secteurs. L’amélioration de la base de ces seuils de rentabilité revêt une importance particuliè re dans les pays à revenu faible ou intermédiaire, compte tenu des ressources limitées disponibles et des besoins importants de leurs populations. Los investigadores y los responsables de la formulación de políticas han estado interesados durante mucho tiempo en desarrollar reglas simples de decisión para ayudar a determinar si una intervención es o no costo-efectiva. En la salud mundial, las intervenciones que imponen costos por año de vida ajustado por discapacidad evitado de menos de tres o una vez el producto interno bruto per cápita se consideran a menudo costo-efectivas y muy costo-efectivas, respectivamente. Este artículo explora la base conceptual y la derivación de estos umbrales. Su objetivo es promover la comprensión de cómo se derivaron estos umbrales y sus implicaciones, así como sugerir opciones para mejorarlos. Estos umbrales pretenden reflejar el valor monetario de los beneficios para las personas afectadas, con base en sus preferencias por el gasto en salud versus el gasto en otros bienes y servicios. Sin embargo, los valores actuales no fueron rigurosamente derivados, lo que significa que su aplicación puede conducir a conclusiones inapropiadas con respecto a cuales intervenciones deben adoptarse, así como a la mala asignación de recursos entre la salud y otras inversiones. Mejorar la base de estos umbrales de costo-efectividad es particularmente importante en los países de ingresos bajos y medios, dados los limitados recursos disponibles y las necesidades significativas de sus poblaciones. 长期以来, 研究者和决策者都希望建立一套简单的规则, 来帮 助判断一项干预的成本效果。在全球卫生中, 若每减少一个伤 残调整的生命年, 干预的成本小于人均GDP的三倍, 则成本效 果较好, 若小于人均GDP, 则成本效果非常好。本文探讨上述 阈值的概念基础和产生, 旨在促进对这些阈值的发展过程及影 响的了解, 并提出改进的建议。这些阈值的目的是根据受益个 体对医疗支出和其他产品和服务支出的偏向, 以货币价值反映 这些个体在经济上的获益。但是目前的价值并非严格产生, 因 此可能会误导干预的选择, 以及医疗和其他产业的资源配置。 考虑到中低收入国家资源有限, 卫生需求大, 改进成本效果阈 值对于这些国家尤其重要。

\"In revolutionary France, a girl named Marguerite Lalanne longed to perform above large crowds on a tightrope, just like her acrobatic parents. Sneaking off to the fairgrounds for secret tightrope walking lessons, Marguerite finessed her performance skills, ultimately performing for crowds as a young rope dancer. And eventually, Marguerite would perform as Madame Saqui, waltzing and pirouetting across- and never falling off- countless ropes above adoring crowds. A nouvelle chřie de Paris, Madame Saqui cemented her place in circus history, winning the adoration of the French people and royalty alike, including Emperor Napoleon Bonaparte\"-- Provided by publisher.

The estimates used to value mortality risk reductions are a major determinant of the benefits of many public health and environmental policies. These estimates (typically expressed as the value per statistical life, VSL) describe the willingness of those affected by a policy to exchange their own income for the risk reductions they experience. While these values are relatively well studied in high-income countries, less is known about the values held by lower-income populations. We identify 26 studies conducted in the 172 countries considered low- or middle-income in any of the past 20 years; several have significant limitations. Thus there are few or no direct estimates of VSL for most such countries. Instead, analysts typically extrapolate values from wealthier countries, adjusting only for income differences. This extrapolation requires selecting a base value and an income elasticity that summarizes the rate at which VSL changes with income. Because any such approach depends on assumptions of uncertain validity, we recommend that analysts conduct a standardized sensitivity analysis to assess the extent to which their conclusions change depending on these estimates. In the longer term, more research on the value of mortality risk reductions in low- and middle-income countries is essential.

This is an introduction to genetics, including cells. From cloning the first pet cat to the advent of the Human Genome Project, a spotlight is on the ethics of genetic science, and this text explains this ever-changing information in an easy-to-understand way.

Physiological blood flow induces the secretion of vasoactive compounds, notably nitric oxide, and promotes endothelial cell elongation and reorientation parallel to the direction of applied shear. How shear is sensed and relayed to intracellular effectors is incompletely understood. Here, we demonstrate that an apical spectrin network is essential to convey the force imposed by shear to endothelial mechanosensors. By anchoring CD44, spectrins modulate the cell surface density of hyaluronan and sense and translate shear into changes in plasma membrane tension. Spectrins also regulate the stability of apical caveolae, where the mechanosensitive PIEZO1 channels are thought to reside. Accordingly, shear-induced PIEZO1 activation and the associated calcium influx were absent in spectrin-deficient cells. As a result, cell realignment and flow-induced endothelial nitric oxide synthase stimulation were similarly dependent on spectrin. We conclude that the apical spectrin network is not only required for shear sensing but also transmits and distributes the resulting tensile forces to mechanosensors that elicit protective and vasoactive responses. Mylvaganam et al. report that an apical spectrin network in endothelial cells can transmit mechanical forces in response to shear flow-induced stress, requiring hyaluronic acid and involving PIEZO1.

This poetic and visual picture book celebrates persistent women throughout history.

We review the characteristics of osteoblast differentiation and bone matrix synthesis. Bone in air breathing vertebrates is a specialized tissue that developmentally replaces simpler solid tissues, usually cartilage. Bone is a living organ bounded by a layer of osteoblasts that, because of transport and compartmentalization requirements, produce bone matrix exclusively as an organized tight epithelium. With matrix growth, osteoblasts are reorganized and incorporated into the matrix as living cells, osteocytes, which communicate with each other and surface epithelium by cell processes within canaliculi in the matrix. The osteoblasts secrete the organic matrix, which are dense collagen layers that alternate parallel and orthogonal to the axis of stress loading. Into this matrix is deposited extremely dense hydroxyapatite-based mineral driven by both active and passive transport and pH control. As the matrix matures, hydroxyapatite microcrystals are organized into a sophisticated composite in the collagen layer by nucleation in the protein lattice. Recent studies on differentiating osteoblast precursors revealed a sophisticated proton export network driving mineralization, a gene expression program organized with the compartmentalization of the osteoblast epithelium that produces the mature bone matrix composite, despite varying serum calcium and phosphate. Key issues not well defined include how new osteoblasts are incorporated in the epithelial layer, replacing those incorporated in the accumulating matrix. Development of bone in vitro is the subject of numerous projects using various matrices and mesenchymal stem cell-derived preparations in bioreactors. These preparations reflect the structure of bone to variable extents, and include cells at many different stages of differentiation. Major challenges are production of bone matrix approaching the in vivo density and support for trabecular bone formation. In vitro differentiation is limited by the organization and density of osteoblasts and by endogenous and exogenous inhibitors.