Cost-effectiveness analysis of exenatide once-weekly versus dulaglutide,liraglutide, and lixisenatide for the treatment of type 2 diabetes mellitus: an analysis from the UK NHS perspective

Objective: To assess the cost-effectiveness of exenatide 2?mg once-weekly (EQW) compared to dulaglutide 1.5?mg QW, liraglutide 1.2?mg and 1.8?mg once-daily (QD), and lixisenatide 20?μg QD for the treatment of adult patients with type 2 diabetes mellitus (T2DM) not adequately controlled on metformin.

Methods: The Cardiff Diabetes Model was applied to evaluate cost-effectiveness, with treatment effects sourced from a network meta-analysis. Quality-adjusted life years (QALYs) were calculated with health-state utilities applied to T2DM-related complications, weight changes, hypoglycemia, and nausea. Costs (GBP £) included drug treatment, T2DM-related complications, severe hypoglycemia, nausea, and treatment discontinuation due to adverse events. A 40-year time horizon was used.

Results: In all base-case comparisons, EQW was associated with a QALY gain per patient; 0.046 vs dulaglutide 1.5?mg; 0.102 vs liraglutide 1.2?mg; 0.043 vs liraglutide 1.8?mg; and 0.074 vs lixisenatide 20?μg. Cost per patient was lower for EQW than for liraglutide 1.8?mg (?£2,085); therefore, EQW dominated liraglutide 1.8?mg. The cost difference per patient between EQW and dulaglutide 1.5?mg, EQW and liraglutide 1.2?mg, and EQW and lixisenatide 20?μg was £27, £103, and £738, respectively. Cost per QALY gained with EQW vs dulaglutide 1.5?mg, EQW vs liraglutide 1.2?mg, and EQW vs lixisenatide 20?μg was £596, £1,004, and £10,002, respectively. In the probabilistic sensitivity analysis, the probability that EQW is cost-effective ranged from 76–99%.

Conclusion: Results suggest that exenatide 2?mg once-weekly is cost-effective over a lifetime horizon compared to dulaglutide 1.5?mg QW, liraglutide 1.2?mg QD, liraglutide 1.8?mg QD, and lixisenatide 20?μg QD for the treatment of T2DM in adults not adequately controlled on metformin alone.     

图片新闻报道中图像符号的批评性多模态语篇分析

本文运用费尔克拉夫的三维语篇分析模式和视觉语法理论对《时代》杂志关于新疆的暴力事件的图片新闻报道进行了批评性多模态分析,揭示了图像也是有意识形态的,它对社会现实具有重构功能。     

MATLAB GUIDE在数字图像处理教学中的应用

MATLAB GUIDE(Graphical User Interfaces,图形用户界面)是为表现MATLAB中的基本功能而设计的演示程序。本文通过对数字图像处理中几个常用的设计例子,开发和利用MATLAB GUIDE的教学自动控制系统,展示了MATLAB GUIDE在数字图像处理课程辅助教学的优点。     

Gold and the US dollar: Hedge or haven?

Using a model of dynamic conditional correlations covering 23 years of weekly data for 16 major dollar-paired exchange rates, this paper addresses a practical investment question: Does gold act as a hedge against the US dollar, as a safe haven, or neither? Key findings are as follows. (i) During the past 23 years gold has behaved as a hedge against the US dollar. (ii) Gold has been a poor safe haven. (iii) In recent years gold has acted, increasingly, as an effective hedge against currency risk associated with the US dollar.     

The Global Financial Crises of 2007–2010 and the future of capitalism

This paper presents an analysis of the 2007-2010 Global Financial Crisis which started with the sub-prime crisis in the U.S. and became global very fast. It argues that the financial system in the United States is a complex interlocking structure of markets, institutions and regulators. The causes and culprits of the crisis, the misaligned incentives of participants and exogenous events such as the wars in Afghanistan and Iraq, precipitated failure in key markets: commodities, sub-prime housing, equities, and credit. One of the strategic consequences of this crisis is that the US will lose its dominance in world power, the frequent crises and vulnerabilities of the Neoliberalism and examines the future of capitalism. Of the alternatives to economic system, the capitalism is the most viable economic system. However, it must adopt real and efficient allocation of resources to maximize welfare of all parties and seriously address the income inequality. It must reject crony capitalism, enact true financial regulation of institutions and markets, end corporate socialism and address the system’s structural deficiencies.     

Política de la legislación laboral en el sur de China. Las cámaras de comercio y otros organismos extranjeros ante las leyes sobre negociación colectiva

En 2010, tras la huelga en Honda, hubo protestas laborales en toda China. Los gobiernos de Shenzhen y Guangdong reaccionaron desempolvando los proyectos de Decreto sobre consulta colectiva y de Normativa sobre gestión democrática de las empresas, retirados con anterioridad. Pero tras la oposición frontal de cámaras de comercio y organismos gubernamentales extranjeros, hongkoneses y taiwaneses, volvieron a retirarse. Mediante entrevistas, los autores revelan los medios de influencia en la legislación laboral china de estos actores, cuyas actitudes dependen de la posición de las empresas representadas en las cadenas mundiales de producción y del modelo de relaciones laborales de su país o territorio de origen.     

Promoting Tourism,Projecting Power: The Role of Television Commercials

This paper analyzes television commercials (TVCs) launched by Korea Tourism Organization (KTO) from 1999 to 2012. By repeating shots of traditional and Korean popular (k-pop) culture, high-tech machinery, and sportsmanship, it is fair to say that Korean tourism TVCs both reflected and fueled the fad a target audience has for Korea. Hence the commercials not only promoted tourism, they were also projecting national power in general and cultural power in particular. It is surmised that through power projection the TVCs intend to create a country halo effect so that the country’s products and services may enjoy an aspired added value.     

论鲁迅笔下封建社会的女性悲剧——以《祝福》中的祥林嫂为例

鲁迅《祝福》中塑造的祥林嫂这一形象,代表了旧式中国劳动妇女的共性,她们被封建礼教束缚、压迫,但不失反抗精神;同时也反映了当时中国社会对妇女的蔑视和欺压。像祥林嫂这样的下层女性,即便勤劳、善良、坚韧,但以她的身体从暴烈到干枯的经历实际上是对封建权力暴行的控诉。她在旧式中国不能争取到一丝尊严,不能得到作为一个人的起码的权利,取而代之的却是被践踏、被奴役、遭压迫、受欺凌。     

Designing and evaluating sustainable development pathways for semi‐subsistence crop–livestock systems: lessons from Kenya

Achieving the Sustainable Development Goals (SDGs) in African agriculture requires a better understanding why high levels of poverty and resource degradation persist in African agriculture despite decades of policy interventions and development projects. In this article, we hypothesize that policies need to account for the key features of the semi‐subsistence crop–livestock systems (CLS) in the region to become effective. The semi‐subsistence CLS are characterized by a high degree of biophysical and economic heterogeneity and a complex, diversified production system involving a combination of subsistence and cash crops with livestock. We investigated the potential for interventions proposed by the Government of Kenya to meet the SDGs by 2030. The analysis uses an integrated modeling approach designed to deal with the key features of these systems. A strategy that stimulates rural development, increases farm size to a sustainable level, and reduces distortions and inefficiencies in input and output markets could lead to a sustainable development pathway and achieve the SDGs for rural households dependent on CLS.