bluuebunny/crossref_metadata_2025 huggingface dataset:
Two point-of-care test-based approaches for the exclusion of deep vein thrombosis in general practice: a cost-effectiveness analysis
Authors: Heerink J. S. , Nies J. , Koffijberg H. , Oudega R. , Kip M. M. A. , Kusters R.
Published: February 2023

Background

In the diagnostic work-up of deep vein thrombosis (DVT), the use of point-of-care-test (POCT) D-dimer assays is emerging as a promising patient-friendly alternative to regular D-dimer assays, but their cost-effectiveness is unknown. We compared the cost-effectiveness of two POCT-based approaches to the most common, laboratory-based, situation.

Methods

A patient-level simulation model was developed to simulate the diagnostic trajectory of patients presenting with symptoms of DVT at the general practitioner (GP). Three strategies were defined for further diagnostic work-up: one based on current guidelines (‘regular strategy’) and two alternative approaches where a POCT for D-dimer is implemented at the 1) phlebotomy service (‘DVT care pathway’) and 2) GP practice (‘fast-POCT strategy’). Probabilities, costs and health outcomes were obtained from the literature. Costs and effects were determined from a societal perspective over a time horizon of 6 months. Uncertainty in model outcomes was assessed with a one-way sensitivity analysis.

Results

The Quality-Adjusted Life Years (QALYs) scores for the three DVT diagnostic work-up strategies were all around 0.43 across a 6 month-time horizon. Cost-savings of the two POCT-based strategies compared to the regular strategy were €103/patient for the DVT care pathway (95% CI: -€117–89), and €87/patient for the fast-POCT strategy (95% CI: -€113–67).

Conclusions

Point-of-care-based approaches result in similar health outcomes compared with regular strategy. Given their expected cost-savings and patient-friendly nature, we recommend implementing a D-dimer POCT device in the diagnostic DVT work-up.
A case of ascetic fluid Mycobacterium aubagnense infection in a patient with severe peritoneal effusion
Authors: Du Yuanqin , Huang Jingjing , Nong Yaobin , Zhong Ruixi , Zhu Ronghuo , Song Wenxuan , Huang Hongna , Tan Qinwen , Xu Jian , Xiao Xiyu , Jia Juhong
Published: February 2023

Background

Mycobacterium aubagnense, which was first characterized in 2006, is a non-tuberculosis mycobacterium (NTM) that has only been isolated from respiratory secretions and joint fluid. With only four cases globally, the microbe has rarely been reported in human clinical cases and the strain has not been isolated from ascites.

Case presentation

To the best of our knowledge, this is the first time that M. aubagnense has been isolated from ascites samples of a patient with severe peritoneal effusion and normal liver functions. Anti-NTM therapy with moxifloxacin, ethambutol, and isoniazid combined with furosemide and spironolactone diuretic therapy relieved the symptoms after six months.

Conclusions

Increased puncture and drainage of ascites combined with diuretic treatment did not significantly relieve the ascites, leading to relapse with aggravated symptoms. The subsequent anti-NTM treatment with moxifloxacin, ethambutol, and isoniazid alleviated the degree of ascites. Therefore, we postulated that M. aubagnense infection was the potential cause of the difficult reduction of ascites in this patient. However, the ascites repeatedly occurred in the patient, which was attributed to M. aubagnense resistance due to insufficient medication time and repeated medication. The patient's underlying diseases may also result in ascites. Therefore, there is a need for careful analysis of the clinical significance of M. aubagnense.
Towards the elimination of mother to child transmission of syphilis 2015–2020: practice and progress in Zhejiang province, eastern China
Authors: Wang Hong , Ying Xia , Lin Dan , Uwimana Muhuza Marie Parfaite , Zhang Xiaohui
Published: February 2023

Objectives

To estimate the progress towards elimination of mother-to-child transmission (EMTCT) of syphilis in Zhejiang province.

Methods

Data were obtained from Zhejiang provincial EMTCT network. Childbearing women infected with syphilis during 2015–2020 were recruited. Joinpoint mode was used to analyze changing trends in syphilis screening, treatment and adverse pregnancy outcomes (APOs). Changing trends were presented as the annual percentage of change (APC). Multivariate logistic regression mode was used to analyzerisk factors of APOs.

Results

Of 3,658,266 participants, an average maternal syphilis incidence was 0.38%. From 2015 to 2020, the coverage of syphilis screening in pregnancy (96.31% to 99.24%; P < 0.001) and coverage of antenatal health care (ANC) within 13 gestational weeks (55.27% to 77.82%; P = 0.002) were increased.The coverage of maternal syphilis treatment(88.30% to 98.25%; P = 0.001) and adequate treatment (66.92% to 83.37%; P = 0.001) were also increased. Over the years, the APC was -19.30% (95%CI:-24.33 ~ -13.92, P = 0.001) in perinatal death,-26.55% in congenital syphilis(95%CI:-38.75 ~ -11.92, P = 0.009), and -14.67% in other neonatal complications (95%CI:-23.96 ~ -4.24, P = 0.019).In 2020, 11.58% of women had APOs. The rate of syphilis infection during pregnancy increased among women aged (< 20 years) or (≥ 35 years), multiparous, and with pregnancy complications (all P < 0.05).APOs risk increased in women with higher maternal RPR/TRUST titers while it decreased in women who had (adequate) therapy, early ANC, and aged in 21–34 years (all P < 0.001).

Conclusions

Despite steady progress towards the goal of EMTCT in implementing universal screening and treatment, syphilis continuously affects a large number of pregnant women. Increasing vulnerable women, small proportions of inadequately treated and delay in early ANC should be noticed.
Sarcopenia as a risk factor of progression-free survival in patients with metastases: a systematic review and meta-analysis
Authors: Luo Lingli , Shen Xiangru , Fang Shuai , Wan Teng , Liu Pan , Li Peiling , Tan Haifeng , Fu Yong , Guo Weiming , Tang Xiaojun
Published: February 2023

Background

Metastasis of cancer causes more than 90% of cancer deaths and is severely damaging to human health. In recent years, several studies have linked sarcopenia to shorter survival in patients with metastatic cancer. Several predictive models exist to predict mortality in patients with metastatic cancer, but have reported limited accuracy.

Methods

We systematically searched Medline, EMBASE, and the Cochrane Library for articles published on or before October 14, 2022. Pooled Hazard Ratio (HR) estimates with 95% confidence intervals (CIs) were calculated using a random effects model. The primary outcome was an increased risk of death or tumor progression in patients with metastatic cancer, which is expressed as progression-free survival (PFS). In addition, we performed subgroup analyses and leave-one-out sensitivity analyses to explore the main sources of heterogeneity and the stability of the results.

Results

Sixteen retrospective cohort studies with 1,675 patients were included in the 888 papers screened. The results showed that sarcopenia was associated with lower progression-free survival (HR = 1.56, 95% CI = 1.19–2.03, I2 = 76.3%, P < 0.001). This result was further confirmed by trim-and-fill procedures and leave-one-out sensitivity analysis.

Conclusions

This study suggests that sarcopenia may be a risk factor for reduced progression-free survival in patients with metastatic cancer. Further studies are still needed to explain the reason for this high heterogeneity in outcome.

Trial registration

CRD42022325910.
An exploratory study on the perceptions of rabies and ill-health causations and health seeking behaviours of school children and local communities in southern Bhutan
Authors: Lungten Lungten , Tenzin Tenzin , Thys Severine , Phimpraphai Waraphon , Rinchen Sangay , de Garine-Wichatitsky Michel
Published: February 2023

Background

The perception of illness and health-seeking behaviours, including rabies differ from one culture to another. Depending on the cultural setting of the society in which people live, the definition of the causal factors of illness may range from natural biological causes to supernational causes which greatly influence subsequent health-seeking behaviour. To ensure best health practices and plan effective health interventions for the control of dog-mediated-human rabies, we explored how school children and adult communities perceive and respond to illnesses, including rabies in southern Bhutan.

Methods

We collected quantitative data related to the causes of illness and health-seeking practices of school children using a questionnaire survey (QS). Qualitative data were collected through focus group discussions (FGDs) and in-depth interviews (IDIs) with older members of communities (≥ 18 years) that work closely with school children. Descriptive analysis was performed for the quantitative data and thematic analysis was performed for the qualitative data.

Results

The participants during the FDGsand IDIshave linked the illnesses to past actions, spirits, energy channels, planetary movement, sorcery, black magic, food, physical or environmental factors, individual habits and social factors. The survey of the school children reported microorganisms (75%), past actions (16.8%), spirits (9.6%) and black magic (9.1%) as causal factors for illnesses. Health seeking behaviours reported by the participants included visiting hospitals, performing spiritual or religious rituals and local treatments. Similarly, school children also mentioned that illnesses can be treated by visiting hospitals (98%), performing rituals (59.1%), and seeking traditional treatments practices (18.8%). Both school children and adult members of the communities that we interviewed were well aware on the causes of rabies and need for allopathic treatments rather than seeking spiritual or local treatments.

Conclusion

There is a need for the consideration of the socio-cultural context in the planning and implementation of health-related policies, including the rabies prevention programs in Bhutan, by involving traditional healers and religious entities with “One Health” public health sectors.
Population size estimation of female sex workers using network scale-up method in Kermanshah city
Authors: Olfati Lida , Safari-Faramani Roya , Najafi Farid , Nazar Mehdi Moradi , Shakiba Ebrahim
Published: February 2023

Background

Appropriate estimate of size of the female sex workers as well as the other hard-to-reach-populations plays a crucial role in reaching them with effective preventive measures. This study aimed to estimate the population size of female sex workers in Kermanshah City using the network scale-up method.

Method

In this cross-sectional study, of the 1000 pedestrians aged between 18 and 65 years, selected from the population of Kermanshah City via a multistage sampling, were recruited in the study. Face-to-face interview using a questionnaire including the number of FSWs in the social network of the respondent was used to collect the data.

Results

The overall estimated number of female sex workers in the general population was 4848(UI 95%: 4597, 5074). Accordingly, the prevalence of FSWs among women 18 years and older in Kermanshah in 2018 was about 11.92 (UI 95%: 11.30, 12.47) in one thousand. More than half of the female sex workers in the respondent’s social network were unmarried and were in the age range of 18 to 29, and had a high school or university degree. Among high-risk behaviors, a history of alcohol consumption accounted for the highest percentage.

Conclusion

The number of female sex workers estimated in this study is considerable, which highlights the importance of planning harm reduction interventions in order to alleviate the burden of HIV infection in the population.
PrEP disclosure and discussions within social networks of people who inject drugs experiencing homelessness: a brief report
Authors: Shaw Leah C. , Biello Katie B. , Vahey Seamus , Brody Jennifer K. , Bazzi Angela R.
Published: February 2023

Background

In the context of increasing injection-related HIV outbreaks across the United States, particularly among people who inject drugs (PWID) experiencing homelessness, there is an urgent need to expand access to pre-exposure prophylaxis (PrEP) for HIV prevention. Peer-based interventions for PrEP could be helpful for promoting PrEP uptake, yet the social experiences of using PrEP among PWID experiencing homelessness have not been thoroughly explored.

Methods

To better understand social experiences surrounding PrEP use among PWID experiencing homelessness, we conducted qualitative interviews from March-December 2020 with current and former PrEP patients of an innovative, low-threshold program implemented by Boston Health Care for the Homeless Program (BHCHP) in Boston, MA. Thematic analysis of coded interview data explored participants’ perspectives and experiences with PrEP disclosure and discussions within their social networks.

Results

Among interviews with 21 participants, we identified the following four interrelated aspects of their social experiences using PrEP: (1) participants’ were aware of increasing HIV transmission within their social networks, which motivated their PrEP use and disclosure; (2)  participants generally avoided disclosing their PrEP use within public spaces or casual conversations; (3)  participants expressed greater willingness to discuss PrEP with their close social contacts; and (4)  some participants self-identified as leaders or expressed interest in leading the dissemination of PrEP information within their social networks.

Conclusions

Findings highlight the significance of PrEP disclosure and discussions within the social networks of PWID experiencing homelessness, suggesting a need for continued social network and intervention research—particularly to establish the feasibility and acceptability of peer-based interventions for promoting PrEP—with this marginalized population.
Improving the representativeness of the tribal behavioral risk factor surveillance system through data integration
Authors: Chen Sixia , Campbell Janis , Spain Erin , Woodruff Alexandra , Snider Cuyler
Published: February 2023

Background

Previous literature showed significant health disparities between Native American population and other populations such as Non-Hispanic White. Most existing studies for Native American Health were based on non-probability samples which suffer with selection bias. In this paper, we are the first to evaluate the effectiveness of data integration methods, including calibration and sequential mass imputation, to improve the representativeness of the Tribal Behavioral Risk Factor Surveillance System (TBRFSS) in terms of reducing the biases of the raw estimates.

Methods

We evaluated the benefits of our proposed data integration methods, including calibration and sequential mass imputation, by using the 2019 TBRFSS and the 2018 and 2019 Behavioral Risk Factor Surveillance System (BRFSS). We combined the data from the 2018 and 2019 BRFSS by composite weighting. Demographic variables and general health variables were used as predictors for data integration. The following health-related variables were used for evaluation in terms of biases: Smoking status, Arthritis status, Cardiovascular Disease status, Chronic Obstructive Pulmonary Disease status, Asthma status, Cancer status, Stroke status, Diabetes status, and Health Coverage status.

Results

For most health-related variables, data integration methods showed smaller biases compared with unadjusted TBRFSS estimates. After calibration, the demographic and general health variables benchmarked with those for the BRFSS.

Conclusion

Data integration procedures, including calibration and sequential mass imputation methods, hold promise for improving the representativeness of the TBRFSS.
An emerging master inducer and regulator for epithelial-mesenchymal transition and tumor metastasis: extracellular and intracellular ATP and its molecular functions and therapeutic potential
Authors: Cao Yanyang , Chen Eileen , Wang Xuan , Song Jingwen , Zhang Haiyun , Chen Xiaozhuo
Published: February 2023

Despite the rapid development of therapeutic strategies in cancer treatment, metastasis remains the major cause of cancer-related death and scientific challenge. Epithelial-Mesenchymal Transition (EMT) plays a crucial role in cancer invasion and progression, a process by which tumor cells lose cell-cell adhesion and acquire increased invasiveness and metastatic activity. Recent work has uncovered some crucial roles of extracellular adenosine 5’- triphosphate (eATP), a major component of the tumor microenvironment (TME), in promoting tumor growth and metastasis. Intratumoral extracellular ATP (eATP), at levels of 100–700 µM, is 103–104 times higher than in normal tissues. In the current literature, eATP’s function in promoting metastasis has been relatively poorly understood as compared with intracellular ATP (iATP). Recent evidence has shown that cancer cells internalize eATP via macropinocytosis in vitro and in vivo, promoting cell growth and survival, drug resistance, and metastasis. Furthermore, ATP acts as a messenger molecule that activates P2 purinergic receptors expressed on both tumor and host cells, stimulating downstream signaling pathways to enhance the invasive and metastatic properties of tumor cells. Here, we review recent progress in understanding eATP’s role in each step of the metastatic cascade, including initiating invasion, inducing EMT, overcoming anoikis, facilitating intravasation, circulation, and extravasation, and eventually establishing metastatic colonization. Collectively, these studies reveal eATP’s important functions in many steps of metastasis and identify new opportunities for developing more effective therapeutic strategies to target ATP-associated processes in cancer.
Characterization of the population affiliated to the subsidized health insurance scheme in Colombia: a systematic review and meta-analysis
Authors: Mora-Moreo Laura , Estrada-Orozco Kelly , Espinosa Oscar , Melgarejo Lorena Mesa
Published: February 2023

Background

Some reports suggest there are differences in health needs between the population affiliated to the subsidized health insurance scheme (SS) and those affiliated to the contributory health insurance scheme (CS) in Colombia. The objective of this study was to identify the epidemiological profile of the population affiliated to the SS in Colombia and to compare the main epidemiological features of the SS to the CS.

Methods

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) methodology, the search was carried out from 1993, with no other restriction. The information was synthesized into five categories according to the most important risk populations. We estimated combined incidences from epidemiological surveillance data, prevalence ratio, and other measures to estimate the difference between the studied groups. A 95% confidence interval was considered. A random effects model was used weighted by the inverse of the variance of the cumulative incidence calculated for each disease. The risk of bias was assessed using the Joanna Briggs Institute’s critical appraisal tools.

Results

A total of 16,236 articles were identified; 14,972 were excluded after title and abstract screening, 725 articles were verified as full text, and finally 268 articles were included. The relative risk of non-communicable and communicable diseases was lower in the SS than in the CS (RR: 0.37 and 0.72, respectively,p-value < 0.05). However, the risk of presenting obstetric and maternal conditions in the SS versus the CS was RR 1.55 for frequent conditions during early childhood, and for other diseases it was RR 1.28 with ap-value of < 0.05. The use of health services was different by scheme, with less demand, access, and provision being found in health services in the SS.

Conclusions

This study allowed us to conclude that there are differences in the incidence, prevalence, and use of health services between health affiliation schemes (SS and CS) in Colombia, thereby assisting in decision-making for stakeholders.

Trial registration

PROSPERO Registration number CRD42021279234.
Adoptive cellular immunotherapy for solid neoplasms beyond CAR-T
Authors: Liu Qiaofei , Li Jiayi , Zheng Huaijin , Yang Sen , Hua Yuze , Huang Nan , Kleeff Jorg , Liao Quan , Wu Wenming
Published: February 2023

In recent decades, immune checkpoint blockade and chimeric antigen receptor T cell (CAR-T) therapy are two milestone achievements in clinical immunotherapy. However, both show limited efficacies in most solid neoplasms, which necessitates the exploration of new immunotherapeutic modalities. The failure of CAR-T and immune checkpoint blockade in several solid neoplasms is attributed to multiple factors, including low antigenicity of tumor cells, low infiltration of effector T cells, and diverse mechanisms of immunosuppression in the tumor microenvironment. New adoptive cell therapies have been attempted for solid neoplasms, including TCR-T, CAR-natural killer cells (CAR-NK), and CAR-macrophages (CAR-M). Compared to CAR-T, these new adoptive cell therapies have certain advantages in treating solid neoplasms. In this review, we summarized the 40-year evolution of adoptive cell therapies, then focused on the advances of TCR-T, CAR-NK, and CAR-M in solid neoplasms and discussed their potential clinical applications.
Association of plasma lipid metabolism profiles with overall survival for patients with gastric cancer undergoing gastrectomy based on 1H-NMR spectroscopy
Authors: Qiu Yaopeng , Xu Zhou , Xie Qingfeng , Zhang Renyi , Wang Luyao , Zhao Liying , Liu Hao
Published: February 2023

Background

Lipid metabolism dysregulation is a prominent metabolic alteration in various cancers. The study aimed to explore the association of plasma lipid metabolism profiles with overall survival (OS) for gastric cancer (GC) patients who received gastrectomy.

Methods

GC patients who were treated with gastrectomy and measured with plasma lipid metabolism profiles using proton nuclear magnetic resonance (1H-NMR) spectroscopy in Nanfang Hospital between January 1, 2017, and October 31, 2018, were recruited. The Least Absolute Shrinkage and Selection Operator (LASSO) regression model was used to analyze variables selected by univariate analysis for OS. An index of plasma lipid metabolism profiles, named plasma lipid metabolism index (PLMI), was constructed by variables' coefficients in LASSO regression to explore its association with OS and its role in the prediction model.

Results

A total of 158 GC patients were included in this study. Four of the 110 lipid profiles, including LDL-5 Apo-B, LDL-4 Cholesterol, HDL-4 Apo-A2, and HDL-4 Free Cholesterol, were selected to construct the PLMI. The optimal cut-off value of PLMI for OS was used to classify the population into two subgroups, the high PLMI group (≥ − 0.163) and the low PLMI group (< − 0.163). The high PLMI group had a shorter OS (p = 0.0034) and was the independent risk factor for OS (Hazard Ratio = 2.13, 95% Confidence Interval (CI): 1.07–4.22, p = 0.031) after adjusting for perineural invasion and tumor stage. In subsets of the I–III stage and treating postoperative chemotherapy, high PLMI also had an unfavorable correlation with OS (p = 0.016 and p = 0.0086, respectively). The nomogram prediction models of both the training cohort and validation cohort showed good calibration and discrimination with the concordance indexes of 0.806 (95% CI, 0.732–0.880) in the training cohort and 0.794 (95% CI, 0.725–0.862) in the validation cohort.

Conclusions

This study found that the index derived from the LDL-5 Apo-B, LDL-4 Cholesterol, HDL-4 Apo-A2, and HDL-4 Free Cholesterol, was significantly associated with overall survival, suggesting that regulating lipid metabolisms might improve the prognosis for GC patients.
Three dimensional condylar positional and morphological changes following mandibular reconstruction based on CBCT analysis: a prospective study
Authors: Al-Wesabi Saddam Noman , Abotaleb Bassam , Al-Shujaa Eissa Abdo , Mohamed Abdo Ahmed , Alkebsi Khaled , Telha Wael , Jian Sun , Fuqiang Xie
Published: February 2023

Objective

This study aimed to evaluate the condylar positional changes following mandibular reconstruction with preservation of the condylar head using Cone-Beam Computed Tomography (CBCT). Also, to assess joint space changes and the overall volumetric space compared to the preoperative status.

Methodology

This prospective study included 30 patients (60 joints) subjected to unilateral mandibular resection and reconstruction with preservation of the condylar head. The Helkimo index and preoperative (T1), two weeks postoperative (T2), and follow-up CBCTs (T3) after at least six months were gathered and processed to evaluate the condylar position and TMJ joint space using Anatomage Invivo 6. A student’s t-test and repeated-measures ANOVA statistics were used. A P value of less than 0.05 was considered statistically significant.

Results

Thirty patients (14 males, 16 females) with a mean age of 40.01 ± 12.7 years (a range of 18.1–62.9 years) were included. On the tumor side, there were significant variances in the vertical and mediolateral condylar positions between the three-time points (T1, T2, T3). Immediately after the operation, the condyles were significantly displaced in a downward direction at T2, which became larger after the last follow-up period (T3) (p = 0.007). The condylar positions at the anteroposterior direction were relatively stable without significant differences between the three times points (p = 0.915). On the non-tumor side, the condylar positions were relatively stable in the mediolateral and anteroposterior positions.

In the tumor side, all of the TMJ spaces were significantly increased in size following the mandibular reconstructions (T2 and T3). However, on the non-tumor side, the anterior, posterior, and medial joint spaces were significantly changed postoperatively.

Conclusion

After mandibular reconstruction with condylar preservation, the condylar position and volumetric measurement immediately changed noticeably and continued to be a permanent change over time compared to relatively stable condyles on the non-tumor side. According to Helkimo index, patients become adapted to the postoperative changes without significant differences between the two sides.
Easy surgical explantation technique for sutureless Perceval S prosthesis, ‘lasso technique’: a case report
Authors: Kim Yun Seok , Yoo Jae Suk
Published: February 2023

Background

Due to structural valve deterioration of sutureless aortic prosthesis, there is a need for explantation of the prothesis. We introduce a surgical technique to explant sutureless aortic prosthesis, which has a self-expanding stent incorporated into the aortic wall.

Case presentation

An 82-year-old man who had undergone sutureless aortic valve replacement 6 years previously underwent redo-aortic and mitral valve replacement because of severe prosthetic aortic valve stenosis and mitral regurgitation. The sutureless prosthesis was explanted using ‘lasso technique’. The patient was discharged after 7 days without complications.

Conclusions

We presented a useful technique to explant a sutureless aortic prosthesis.
Age, geographical and socio-economic related inequalities in contraceptive prevalence: evidence from the 1993–2014 Ghana Demographic and Health Surveys
Authors: Mensah Felix , Okyere Joshua , Azure Simon Agongo , Budu Eugene , Ameyaw Edward Kwabena , Seidu Abdul-Aziz , Ahinkorah Bright Opoku
Published: February 2023

Background

Contraceptives afford individuals the opportunity to meet their reproductive needs and reduce maternal mortality. We aimed at assessing the trend and inequalities of contraceptive use in Ghana based on the 1993–2014 Ghana Demographic and Health Surveys.

Methods

We used the World Health Organization’s Health Equity Assessment Toolkit (HEAT) software in analysing the data. We adopted two approaches for the analysis. First, we disaggregated inequalities in contraceptive use using four equity stratifiers: wealth index, education, residence, and region. Second, summary measures (D), (PAR), (R), and (PAF) were also employed. A 95% uncertainty interval (UI) was constructed for point estimates to measure statistical significance.

Results

Contraceptive prevalence increased from 20.3% in 1993 to 26.7% in 2014. The contraceptive prevalence among women aged 20–49 increased from 20.6% [95% UI = 19.1, 22.3] in 1993 to 26.8% [95% UI = 24.9, 28.9] in 2014 and this exceeded the increase that was recorded among those aged 15–19 (from 13% [95 UI = 8.7, 19] to 18% [95% UI = 11.5, 28.6]), in the same period. It was evident that substantial inequality existed with respect to contraceptive use, from 1993 to 2014, with widest inequality occurring in 2003 (PAF = 2.7, 95% UI = -16.6–21.9; D = 17.4, 95% UI = 12.7–22.1). In terms of wealth index, the least inequality was observed in 2014 (PAR = 1.3, 95% UI = -1–3.6; D = 5.9, 95% UI = -0.1–12). Regarding education, the widest inequality occurred in 1993 (PAF = 138.6, UI = 132.1–145.1; D = 40.1, 95% UI = 34.4–45.9). With place of residence, the widest gap in inequality occurred in 1993 (PAF = 51.2, 95% UI = 46.2–56.3; D = 15.3, 95% UI = 11.8–18.7). There was inequality in contraceptive use with respect to sub-national regions. In 2014, the Difference (D = 21, 95% UI = 14.6–27.4) and the PAF (PAF = 20.9, 95% UI = 11.2 − 30.5) measures revealed substantial absolute and relative regional inequality between the regions.

Conclusion

There was a steady increase in contraceptive use from 20.3% in 1993 to 26.7% in 2014. Nevertheless, the percentage change is minimal. The trends of inequality indicate that inequalities in contraceptive use was evident across the dimension of age, place of residence, wealth index, education, and region. Yet, there was a substantial reduction in inequalities related to contraceptive use in 2014. Therefore, targeting adolescents, women in rural areas, low wealth quintile, and those with no formal education is key to substantially improving contraceptive use across the country.
Novel Algorithm for the Estimation of Cancer Incidence Using Claims Data in Japan: A Feasibility Study
Authors: Ogawa Toshio , Takahashi Hirokazu , Saito Hiroshi , Sagawa Motoyasu , Aoki Daisuke , Matsuda Kazuo , Nakayama Tomio , Kasahara Yoshio , Kato Katsuaki , Saitoh Eiko , Morisada Tohru , Saika Kumiko , Sawada Norie , Matsumura Yasushi , Sobue Tomotaka
Published: February 2023

PURPOSE

We developed algorithms to identify patients with newly diagnosed cancer from a Japanese claims database to identify the patients with newly diagnosed cancer of the sample population, which were compared with the nationwide cancer incidence in Japan to assess the validity of the novel algorithms.

METHODS

We developed two algorithms to identify patients with stomach, lung, colorectal, breast, and cervical cancers: diagnosis only (algorithm 1), and combining diagnosis, treatments, and medicines (algorithm 2). Patients with newly diagnosed cancer were identified from an anonymized commercial claims database (JMDC Claims Database) in 2017 with two inclusions/exclusion criteria: selecting all patients with cancer (extract 1) and excluding patients who had received cancer treatments in 2015 or 2016 (extract 2). We estimated the cancer incidence of the five cancer sites and compared it with the Japan National Cancer Registry incidence (calculated standardized incidence ratio with 95% CIs).

RESULTS

The number of patients with newly diagnosed cancer ranged from 219 to 17,840 by the sites, algorithms, and exclusion criteria. Standardized incidence ratios were significantly higher in the JMDC Claims Database than in the national registry data for extract 1 and algorithm 1, extract 1 and algorithm 2, and extract 2 and algorithm 1. In extract 2 and algorithm 2, colorectal cancer in male and stomach, lung, and cervical cancers in females showed similar cancer incidence in the JMDC and national registry data.

CONCLUSION

The novel algorithms are effective for extracting information about patients with cancer from claims data by using the combined information on diagnosis, procedures, and medicines (algorithm 2), with 2-year cancer-treatment history as an exclusion criterion (extract 2).
Design and off-target prediction for antisense oligomers targeting bacterial mRNAs with the MASON web server
Authors: Jung Jakob , Popella Linda , Do Phuong Thao , Pfau Patrick , Vogel Jörg , Barquist Lars
Published: February 2023

Antisense oligomers (ASOs), such as peptide nucleic acids (PNAs), designed to inhibit the translation of essential bacterial genes, have emerged as attractive sequence- and species-specific programmable RNA antibiotics. Yet, potential drawbacks include unwanted side effects caused by their binding to transcripts other than the intended target. To facilitate the design of PNAs with minimal off-target effects, we developed MASON (makeantisenseoligomersnow), a web server for the design of PNAs that target bacterial mRNAs. MASON generates PNA sequences complementary to the translational start site of a bacterial gene of interest and reports critical sequence attributes and potential off-target sites. We based MASON's off-target predictions on experiments in which we treatedSalmonella entericaserovar Typhimurium with a series of 10-mer PNAs derived from a PNA targeting the essential geneacpPbut carrying two serial mismatches. Growth inhibition and RNA-sequencing (RNA-seq) data revealed that PNAs with terminal mismatches are still able to targetacpP, suggesting wider off-target effects than anticipated. Comparison of these results to an RNA-seq data set from uropathogenicEscherichia coli(UPEC) treated with eleven different PNAs confirmed that our findings are not unique toSalmonella. We believe that MASON's off-target assessment will improve the design of specific PNAs and other ASOs.
ATUAÇÃO DA DEFENSORIA PÚBLICA NA ARBITRAGEM AMBIENTAL
Authors: Montes Netto Carlos Eduardo , Lehfeld Lucas De Souza , Ferreira Olavo Augusto Vianna Alves
Published: February 2023

Contextualização: De acordo com a doutrina e o próprio Conselho Nacional de Justiça, o Judiciário não constitui a única via de acesso à Justiça, existindo hoje um sistema denominado multiportas. Nessa perspectiva, nos últimos anos, um dos institutos que mais tem ganhado destaque é a arbitragem, envolvendo as mais diversas áreas do direito, justificando a análise do seu cabimento em disputas relativas também ao meio ambiente, não obstante a consideração, em primeira análise, tratar-se de um direito fundamental difuso e indisponível. Entretanto, há reflexos econômicos e materiais de danos ambientais, o que pode ser tratado pela arbitragem.Objetivo: O objetivo do presente artigo é verificar se é possível em caso positivo, os eventuais contornos da atuação da Defensoria Pública na arbitragem ambiental em favor dos hipossuficientes.Metodologia: O método adotado para a elaboração do presente artigo foi o hipotético-dedutivo, sendo a pesquisa, quanto ao procedimento, bibliográfica e jurisprudencial.Resultados: A pesquisa conclui que a Defensoria Pública deve atuar em todas as fases do procedimento, inclusive antes da sua eleição, proporcionando uma equiparação de “armas” nas searas jurídica e econômica, em decorrência da garantia constitucional da assistência jurídica integral e gratuita aos mais pobres.
Acquirers’ and Targets’ reactions to post-acquisition’s integration process
Authors: Μαυράκη Ευαγγελία-Ζωή
Published: February 2023

Η παρούσα διατριβή χρησιμοποιεί τόσο ποιοτικά όσο και ποσοτικά δεδομένα για να εξετάσει την επιρροή του αντίκτυπου, του πλαισίου, της διαδικασίας και των προσωπικών παραγόντων μιας εξαγοράς στις αντιδράσεις των εργαζομένων απέναντι στην εξαγορά και, με τη σειρά τους, τον αντίκτυπό τους στην επιτυχία της ολοκλήρωσης της εξαγοράς. Ο κύριος σκοπός της ποιοτικής μελέτης είναι η εις βάθος διερεύνηση των γνωστικών αξιολογήσεων, των συναισθηματικών και των συμπεριφορικών αντιδράσεων των εργαζομένων έναντι των εξαγορών, και του τρόπου με τον οποίο αυτά συνδέονται με τη διαδικασία και τα αποτελέσματα της ενσωμάτωσης της εξαγοράς. Επιπλέον, η ποιοτική μελέτη εξετάζει τον τρόπο με τον οποίο οι αντιδράσεις των εργαζομένων μεταβάλλονται με την πάροδο του χρόνου, από τη στιγμή της ανακοίνωσης της επερχόμενης εξαγοράς έως και ένα χρόνο μετά την έναρξη της ενσωμάτωσης, καθώς και τους λόγους και τα αποτελέσματα αυτών μεταβολών. Τέλος, παρέχει μια σύγκριση μεταξύ των αντιδράσεων των εργαζομένων από την εξαγοράστρια και της εξαγορασθείσα εταιρία. Όσον αφορά την ποσοτική μελέτη, κεντρικός στόχος της είναι η διερεύνηση της σχέσης της ταύτισης των εργαζομένων με τον οργανισμό μετά την εξαγορά με την ετοιμότητα τους απέναντι σε άλλες πιθανές μελλοντικές οργανωσιακές αλλαγές. Η ποσοτική μελέτη διερευνά επίσης την επίδραση του αντίκτυπου, της διαδικασίας και του πλαισίου της αλλαγής, καθώς και του προσωπικού παράγοντα στην ενσωμάτωση της εξαγοράς και την απόδοση των εργαζομένων. Μια σημαντική συνεισφορά της ποσοτικής μελέτης είναι η εξέταση των αξιολογήσεων των προϊσταμένων σχετικά με την προσαρμοστική απόδοση των υφισταμένων τους μετά την εξαγορά, σε συνδυασμό με τις αυτό-αναφορές των υπαλλήλων τους σχετικά με τις αντιλήψεις και τις αντιδράσεις τους στην αλλαγή.Τα αποτελέσματα της ποιοτικής και ποσοτικής μελέτης, χρησιμοποιώντας πολλαπλές μεθόδους συλλογής δεδομένων, ρίχνουν πολύτιμο φως στο μυστήριο του υψηλού ποσοστού αποτυχίας των εξαγορών. Συζητούνται επίσης θεωρητικές και πρακτικές επιπτώσεις.
First record of Lepidonotus tenuisetosus (Annelida: Polynoidae) from Tunisia with distributional notes
Authors: CHAIBI MARWA , AZZOUNA ATF , MARTIN DANIEL
Published: February 2023

Four species of the genus Lepidonotus (Annelida, Polynoidae) have been listed in the Mediterranean, including L. carinulatus (Grube, 1869), L. squamatus (Linnaeus, 1758), L. tenuisetosus (Gravier, 1902) and L. clava (Montagu, 1808), although recent studies confirmed only the presence of the two latter. Based on materials collected in the Radès Area (Gulf of Tunis, Western Mediterranean), we provide a characterization of a population of L. tenuisetosus based on key morphological characters and body width/length relationships and conclude that all previously known Mediterranean reports from Israel, Croatia, Greece, Spain and Turkey did not belong to L. tenuisetosus, but either to L. carinulatus , L. clava or to other, non-identified species. Therefore, our finding represents not only the first correct record of L. tenuisetosus for the Tunisian waters and the Western basin, but for the whole Mediterranean Sea, and allows us to discuss on the possible reasons explaining the presence of this and other species of Lepidonotus in the Mediterranean.
First confirmed record of Zu cristatus in the Mediterranean coast of Israel and the eastern shores of the Levant
Authors: GOLANI DANIEL , EDELIST DOR , MOROV ARSENIY R. , STERN NIR
Published: February 2023

In the present paper we report the first substantiated record of the Scalloped ribbonfish Zu cristatus (Bonelli, 1819) from the Mediterranean coast of Israel. The previous unsubstantiated record from Israel was based on a juvenile specimen that was found on the shore over seven decades ago and was not saved. This report constitutes the first confirmed record of this species from the Levant.
Range expansion of the Atlantic fish Zenopsis conchifer (Lowe, 1852), family Zeidae, in the western Mediterranean Sea
Authors: PINTO CECILIA , ROPPO VALENTE GIOVANNI , RASORE NICOLA , OLMI EDOARDO , LANTERI LUCA , GARIBALDI FULVIO , VIVA CLAUDIO , NERI ALESSANDRA , MASSARO ANDREA , De CARLO FRANCESCO , LIGAS ALESSANDRO , SARTOR PAOLO
Published: February 2023

Three specimens of Silver John dory, Zenopsis conchifer, (Lowe, 1852) were observed for the first time in the Ligurian Sea and northern Tyrrhenian Sea (western Mediterranean), one in 2020 and two in 2021. This is the fifth record (up to ten individuals) of Z. conchifer in the Mediterranean Sea, which occurred 11 years after the last observation in 2010 in the southern Tyrrhenian Sea. The present study reports the northernmost record of the species in the western Mediterranean Sea, indicating a potential range expansion of the distribution of this Atlantic species across the area. Morphometric, meristic and biological data of the three specimens are provided and compared with previous published records.
How Resilient Are Firms’ Financial Reporting Processes?
Authors: deHaan Ed , de Kok Ties , Matsumoto Dawn , Rodriguez-Vazquez Edgar
Published: February 2023

The timely flow of financial information is critical for efficient capital market functioning, yet we have little understanding of firms’ and auditors’ collective abilities to maintain timely financial reporting when under duress. We use COVID as a stress test case to examine whether reporting systems can withstand systemic increases in complex economic events and coordination challenges. Despite COVID-related challenges persisting through 2020 and beyond, we document surprisingly modest average delays in financial reports during COVID and only in Q1-2020. Reporting timeliness reverts to pre-COVID levels no later than Q2-2020. We find no evidence of meaningful declines in actual reporting quality during COVID, but we do find some evidence consistent with declines in perceived reporting quality. Overall, our findings indicate that current financial reporting processes are remarkably robust and provide insights about financial reporting more broadly. In particular, given that nearly all firms were able to weather the unprecedented disruptions caused by COVID, our findings imply that most material reporting delays observed outside of COVID are likely a result of either a firm’s strategic choices or exceptionally fragile reporting processes.

This paper was accepted by Ranjani Krishnan, accounting.

Supplemental Material: The data and online appendix are available at https://doi.org/10.1287/mnsc.2023.4670 .
Have telemedicine consultations been beneficial as follow-up appointments for people with multiple sclerosis?
Authors: Tredwell Bethan
Published: February 2023

Introduction:

This study ascertained whether telemedicine appointments have been beneficial for follow-up appointments for people who have multiple sclerosis (MS). The Covid-19 pandemic forced many services to adapt and change the way in which people with long-term conditions were reviewed. Initially, local MS services employed the use of telephone appointments, but quickly introduced telemedicine appointments, which enabled the clinician and patient to see each other via video technology. The initial feedback from the patients was mixed, with some patients preferring face-to-face appointments and others happy with the change. Since, telemedicine appointments have remained part of many MS services. As restrictions in the country have been lifted, the decision needs to be made whether MS teams across the country continue to use technology in the form of telemedicine appointments or return to face-to-face clinics in the hospital outpatient setting.

Methods:

A sample of patients were invited to complete an online questionnaire, which was issued through the member list of a local MS therapy centre. A thematical approach was then used to assess the gathered information.

Results:

The results of the questionnaire showed the preferred type of follow-up appointment was a face-to-face clinical setting, which the majority of participants found more personal, making it easier to communicate with their specialist nurse. However, when asked if they would prefer to be reviewed through face-to-face appointments only, telemedicine appointments only, or a combination of the two, the majority of participants preferred a combination of face-to-face and telemedicine follow ups.

Conclusions:

This study showed that the rapid uptake of telemedicine during the Covid-19 pandemic was useful to maintain regular reviews of people with MS. However, given the small sample size and limited age range, further research will be required to ascertain whether people with MS find telelmedicince follow-up appointments as beneficial as face-to-face appointments.
Financial Analysis of Innovative Wood Products and Carbon Finance to Support Forest Restoration in California
Authors: Elias Micah , Dees John , Cabiyo Bodie , Saksa Phil , Sanchez Daniel L.
Published: February 2023

Traditional funding strategies of grants, congressional appropriations, and income from timber sales are insufficient to complete the level of forest restoration necessary throughout California. Stimulating investment into markets for low-value biomass—such as tops and branches of trees, small trees, and dead trees—will add value to forest raw materials and provide additional revenue streams to pay for forest restoration. We evaluate the investment potential of products made from low-value biomass using a discounted cash-flow analysis of several possible forest products including fuels and nonfuels under various climate policy and market scenarios. We demonstrate the carbon benefits provided by these products, attributed to their substitution for fossil-fuel feedstocks and long-term carbon storage. Our work finds that there is an opportunity to develop several highly profitable products, most notably fuels, many of which are eligible for energy and climate policy programs such as California's Low Carbon Fuel Standard and the federal Renewable Fuel Standard. Nonfuel products have an average internal rate of return (IRR) of 13 percent, whereas fuels have an average IRR of 19 percent in our baseline scenario. Although products ineligible for government incentives are generally less profitable, income from the voluntary carbon market greatly increases the IRR. Fostering investment into these products can encourage critically needed funding for forest management while developing a high-impact carbon removal solution enabled by state, federal, and voluntary climate initiatives. On this basis, we conclude that climate policy can support forest restoration in California.
Rzeczywistość pandemiczna w szkołach w latach 2020 – 2021
Authors: Kust Izabella
Published: February 2023

W płynnej nowoczesności stała jest tylko zmiana. Pojęcie płynna nowoczesność zdefiniowane przez Zygmunta Baumana stało się główną kategorią opisową współczesności, w którą wpisuje się pedagogiczna rzeczywistość. Ambiwalencja, pozytywne i jednocześnie negatywne nastawienie jednostki do otaczającej rzeczywistości, próba zaadoptowania i przystosowania się do zmian z jednoczesną próbą odrzucenia to cecha współczesnej codzienności. Rewolucja przemysłowa 4.0 jest kolejnym w procesie dziejowym, historycznym przykładem konieczności dostosowania się do zmian. Pandemia tylko przyspieszyła ten proces w skali globalnej. Zatem czym jest zmiana? Jaka jest rola nauczyciela w relacji z uczniem w nieustannej, nieprzewidywalnej zmianie? Zmiana sposobu nauczania i kształcenia, konieczność opanowania nowej wiedzy i nowych umiejętności, zmieniające się regulacje prawne oraz zachwiane poczucie bezpieczeństwa spowodowały, iż grupa ta doświadczała wielu problemów. Istotą jest próba odnalezienia się w pandemicznej rzeczywistości szkolnej. To właśnie dyrektor szkoły, nauczyciel, pedagog, wychowawca byli kreatorami procesu kształcenia i wychowania w szczególności wobec wyzwań i zagrożeń sytuacji pandemicznej i postpandemicznej. Zagrożenie wynikało z narażenia na zakażenie wirusem w bezpośrednim kontakcie społecznym. Pandemia wykazała duże umiejętności i kompetencje sprawnego posługiwania się przez uczniów sprzętem IT. Niejednokrotnie nastąpiła zamiana ról. W nowej roli byli również rodzice uczniów wielokrotnie wspierający dzieci. Nagle stała się nowa rzeczywistość. Świat był ten sam ale nie taki sam. Państwa na całym świecie stanęły przed trudnym wyzwaniem. Odpowiedzialność państwa za system kształcenia stał się jednym z priorytetów funkcjonowania systemu oświaty. Zatem czym jest zmiana? Jak znaleźć sposób radzenia sobie w zmieniającej się rzeczywistości? Jaka jest rola nauczyciela w relacji z uczniem w nieustannej zmianie?