This paper introduces the irregular N-gon solution, a new geometric method for constructing equilibrium distributions in the Colonel Blotto game with heterogeneous battlefield values, generalising ...known construction methods. Using results on the existence of tangential polygons, it derives necessary and sufficient conditions for the irregular N-gon method to be applied, given the parameters of a Blotto game. The method does particularly well when the battlefield values satisfy some clearly defined regularity conditions. The paper establishes the parallel between these conditions and the constrained integer partitioning problem in combinatorial optimisation. The properties of equilibrium distributions numerically generated using the irregular N-gon method are illustrated. They indicate that the realised allocations, weighted by battlefield value, are less egalitarian and depend more strongly on battlefield values than previously thought. In the context of the US presidential elections, the explicit construction of equilibria provides new insights into the relation between the size of a state and the campaign resources spent there by presidential candidates.
The objective of this study was to compare outcomes after video-assisted thoracoscopic lobectomy or segmentectomy before and after introduction of an enhanced recovery program.
Data from 600 patients ...undergoing video-assisted lobectomy or segmentectomy between April 2014 and January 2017 were analyzed. A comparative analysis was performed between patients undergoing operation before (365 patients) and after (235 patients) the start of the enhanced recovery program. The incidence of cardiopulmonary complications and 30-day and 90-day mortality, postoperative length of stay, and 30-day and 90-day hospital readmission rates were evaluated. Risk-adjusted cardiopulmonary morbidity and 30-day mortality were calculated for each group and compared.
The 2 groups had a similar postoperative length of stay (enhanced recovery pathway median 5 days vs pre–enhanced recovery pathway 4, P = .44), cardiopulmonary complication rates (enhanced recovery pathway 22.6% vs pre–enhanced recovery pathway 22.4%, P = .98), 30-day mortality rates (enhanced recovery pathway 3.8% vs pre–enhanced recovery pathway 2.2%, P = .31), and 90-day mortality rates (enhanced recovery pathway 4.7% vs pre–enhanced recovery pathway 3.0%, P = .37). No differences were noted in terms of 30-day (enhanced recovery pathway 7.2% vs pre–enhanced recovery pathway 7.4%, P = .94) or 90-day readmission rates (enhanced recovery pathway 9.8% vs pre–enhanced recovery pathway 12.3%, P = .34). The risk-adjusted cardiopulmonary morbidity rates were similar in the 2 periods (P = .76), whereas the risk-adjusted 30-day mortality was higher in the enhanced recovery pathway period compared with the pre–enhanced recovery pathway mortality (P = .0004).
We found no benefit conferred by the enhanced recovery program on outcomes such as cardiopulmonary complications, 30- and 90-day mortality, length of stay, and readmissions. Enhanced recovery program elements may be insufficiently different than previous standards of perioperative care to confer detectable benefits in our settings.
This paper adapts the exponential/Poisson bandits framework to a model of reputation concerns. The result is a dynamic signalling game with changing types. We study a decision-maker who must choose ...the stopping time for a project of unknown quality when she is concerned both about social welfare and public beliefs about her ability, which is correlated with the project's quality. The decision-maker privately observes a Poisson process that is informative about whether the project will succeed or fail. In this setting the decision-maker has incentives to experiment for too long, both in the hope of a last-minute success, and because stopping hurts her reputation. We show, however, that exact efficiency can be achieved in equilibrium for a range of reputation concerns, provided they are not too strong. If the private signal is sufficiently informative, this range can be arbitrarily large. When efficiency cannot be achieved, distortions can take the form of excessive continuation.
This paper analyses a two-player stopping game with multiarmed bandits in which each player chooses between learning about the quality of her private risky arm and competing for the use of a single ...shared safe arm. The qualities of the players’ risky arms are independent. A player whose risky arm produces a success no longer competes for the safe arm. We assume that a player observes her opponent’s actions but not his realised payoffs. She is therefore never certain whether her opponent is still competing for the safe arm. When the players’ prior probabilities of success are sufficiently close, there exists no pure strategy equilibrium, and we characterise the unique mixed strategy equilibrium. Otherwise, the unique equilibrium is in pure strategies. The amount of experimentation performed in equilibrium is inefficiently low but, for many priors, higher than if successes are publicly observed.
This paper considers a two-player game of strategic experimentation with competition. Each agent faces a two-armed bandit problem where she continually chooses between her private, risky arm and a ...common, safe arm. Each agent has exclusive access to her private arm. However, the common arm can only be activated by one agent at a time. This congestion creates negative payoff externalities. Our main finding is that congestion gives rise to new strategic considerations: players perceive a strategic option value from occupying the common arm, making it more attractive than in the absence of competition or when switching is irreversible.
Hydroxychloroquine (HC) ± azithromycin (AZ) is widely used for Covid-19. The Qatar Prospective RCT of Expediting Coronavirus Tapering (Q-PROTECT) aimed to assess virologic cure rates of HC±AZ in ...cases of low-acuity Covid-19.
Q-PROTECT employed a prospective, placebo-controlled design with blinded randomization to three parallel arms: placebo, oral HC (600 mg daily for one week), or oral HC plus oral AZ (500 mg day one, 250 mg daily on days two through five). At enrollment, non-hospitalized participants had mild or no symptoms and were within a day of Covid-19 positivity by polymerase chain reaction (PCR). After six days, intent-to-treat (ITT) analysis of the primary endpoint of virologic cure was assessed using binomial exact 95% confidence intervals (CIs) and χ2 testing. (ClinicalTrials.gov NCT04349592, trial status closed to new participants.)
The study enrolled 456 participants (152 in each of three groups: HC+AZ, HC, placebo) between 13 April and 1 August 2020. HC+AZ, HC, and placebo groups had 6 (3·9%), 7 (4·6%), and 9 (5·9%) participants go off study medications before completing the medication course (p = 0·716). Day six PCR results were available for all 152 HC+AZ participants, 149/152 (98·0%) HC participants, and 147/152 (96·7%) placebo participants. Day six ITT analysis found no difference (p = 0·821) in groups’ proportions achieving virologic cure: HC+AZ 16/152 (10·5%), HC 19/149 (12·8%), placebo 18/147 (12·2%). Day 14 assessment also showed no association (p = 0·072) between study group and viral cure: HC+AZ 30/149 (20·1%,), HC 42/146 (28·8%), placebo 45/143 (31·5%). There were no serious adverse events.
HC±AZ does not facilitate virologic cure in patients with mild or asymptomatic Covid-19.
The study was supported by internal institutional funds of the Hamad Medical Corporation (government health service of the State of Qatar).
Objective
The prevalence of sleep disorders in patients with cystic fibrosis (CF) is unknown, and no standardized screening or treatment guidelines exist to address sleep disorders in CF. The ...objective of this study is to characterize current sleep screening practices in adult, pediatric, combined, and affiliate CF programs.
Methods
A survey was developed in Research Electronic Data Capture and distributed to program directors of accredited CF programs in the United States.
Results
Eighty‐eight program directors responded (36% adult, 43% pediatric, 16% combined, 3% affiliate, and 1% unidentified). Of the respondents, 68% were part of an academic institution, 24% were associated with an academic institution, and 8% were part of a community or private program. Program sizes ranged from less than 50 to more than 500 patients. Routine or informal sleep screening was not performed in 44% of adults, 29% of pediatricians, and 35% of combined and affiliate programs. Most programs (>80%) have access to otolaryngology and sleep medicine although not all of these programs refer patients for evaluation of sleep disorders. Most program directors (77%) perceive sleep disorders as a problem in CF and would recommend routine sleep screening. Possible barriers to sleep screening included clinic flow, screening fatigue, and lack of recommendations for sleep screening.
Conclusions
Formal sleep screening is inconsistent among CF care centers although most survey respondents would recommend the inclusion of screening in routine CF care. Future work is needed to further evaluate the impact of sleep disorders in CF and determine best practices for standardization of sleep screening and treatment.
Severe combined immunodeficiency (SCID) is characterized by a major T cell deficiency. Infants with SCID are asymptomatic at birth but die from infections in the first year of life if not treated. ...Survival rates are better for early treatment. SCID therefore meets criteria for newborn screening (NBS). T cell receptor excision circle (TREC) quantification is a reliable marker of T cell deficiency and can be performed using Guthrie cards. The DEPISTREC project was designed to study the feasibility, clinical utility, and cost-effectiveness of generalized SCID screening in France. About 200,000 babies from all over the country were screened at birth with a commercial kit. We determined assay performance and proposed a cutoff for classification of results. Our findings suggest that, given clearly established validation rules and decision-making procedures, the TREC assay is a suitably specific and sensitive method for high-throughput SCID screening. Clinical Trials: NCT02244450
Aims
To explore the lived‐experiences of stroke survivors as expressed in blogs and to discover the role the blogs play in the writers’ lives.
Background
Stroke can be a devastating, life changing ...event. Previous qualitative studies tend to examine one aspect of life after stroke. As stroke often has multiple effects, it is necessary to look widely at its lived‐experience. New resources which can enable researchers to explore the lived‐experience of stroke are blogs.
Design
Phenomenological exploration using an interpretive thematic analysis.
Methods
The Internet was searched for stroke survivors’ blogs (January–March 2016) using pre‐set criteria, seeking blogs with entries over an extended time (>1 year). Suitable blogs were identified and codes of meaning were identified and developed into categories, subthemes and themes.
Findings
Eight blogs were identified for analysis. Of the 40 categories, eight subthemes were assimilated; internal dialogue, emotions, transition, stroke effects, health care, “in the world”, relationships, rehabilitation. Two main themes were identified related to perspectives of lived‐experience; Internal relationship with “self” and External relationship with “the world”. Participants expressed loss and initially strove to regain their “old” lives, their focus being recovery and independence.
Conclusion
Stroke survivors must transition from their previous life to a new and initially unwelcome way of being. Rehabilitation should respect this process and support stroke survivors as they undertake this individual journey.
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