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A cast-free approach is described to fabricate an implant-supported interim restoration by using the postoperative cone beam computed tomography (CBCT) scan to locate the placed implant. A postoperative intraoral scan was aligned to the postoperative CBCT scan through a dental implant planning software program. An attached interim abutment and implant analog complex was then scanned and superimposed on the placed implant in the postoperative CBCT scan. Once the best alignment was achieved, a virtual cast was generated, and an interim restoration with bilateral positioning wings was fabricated on the interim abutment and inserted during the second-stage surgery. This technique offers a cast-free approach to inserting an implant-supported interim restoration immediately after the second-stage surgery to guide the healing of the soft tissue that can minimize chairside time and optimize the clinical workflow.

Background Reconstruction of continuity defect of mandible is challenging, and there has been a lot of advancement in this field with variety of options for restoration. However, choice often becomes restricted in resource limited settings due to lack of trained manpower, time, infrastructure, supply of graft materials, etc. In this context, we aim to test the reliability of Kirschner wire (K-wire) with adaptation of looped-end for immediate interim reconstruction of continuity defect of mandible. Materials and method Retrospectively, medical records of 10 years data were reviewed to include 22 patients who underwent immediate interim reconstruction of mandible with K-wire with looped-end adaptation for continuity defect of mandible. Data regarding patient demographic, type and length of mandibular defect, diameter of the wire and complications were recorded. Result Among 22 patients within a follow-up period of 1–60 months (median 7.5), complications developed in 7 (31.8%) patients. Three patients (13.6%) had major complications which required interventions, and 5 patients (22.3%) with minor complications were managed conservatively. Total wire removal in our study is only 9%, which is lowest among the reported literature, migration or extrusion through bone was nil, and overall aesthetic and functional result was good in majority except few where either wire had to be removed or got deformed. Conclusion Kirschner wire (K-wire) should be considered in resource limited setting as an immediate interim reconstructive method of mandible for being cheap and widely available. Our technique of looped-end adaptation results in better stabilisation leading to less removal rate, migration or extrusion.

A university student with a background of atopy presented to her general practitioner (GP) 2 weeks following an episode of throat tightening and dizziness occurring after touching cashew nut to her lip. She took antihistamine medication immediately and went to sleep, fearing for her life. On waking, she felt astounded to be alive. Her symptoms resolved gradually over the following week. She waited 2 weeks for an appointment with her GP, who referred her to allergy clinic. Eight months later, she was still waiting for her clinic appointment, and was left fearing a future fatal reaction, having been provided with no interim treatment. Not all patients who have severe allergic reactions present to the emergency department. Living with the constant fear of anaphylaxis can be overwhelming for patients and their families, and it can negatively impact mental health. Therefore, we advise early allergy counselling and early EpiPen prescription.

The biologically oriented preparation technique (BOPT) uses a vertical tooth preparation and simultaneously a controlled rotary instrumentation of the gingival sulcus. The resulting blood clot is stabilized with the interim restoration. However, accurate transfer of the emergence profile of the interim crown to the definitive restoration is essential to maintain the gingival architecture. This technique article describes clinical and laboratory procedures to predictably transfer the emergence profile of the interim crown to duplicate the gingival architecture in the definitive restoration.

Interim imaging with computed tomography (iCT) to assess response is common during frontline chemoimmunotherapy for follicular lymphoma (FL), but there is little evidence of its utility. We retrospectively reviewed outcomes of iCT in 190 patients with biopsy-proven FL who received first-line chemoimmunotherapy from 2003-2018. Most iCTs showed partial response (PR, 83%), with a minority showing complete response (CR, 8%) or stable disease (5%). Seven patients (4%) had radiographic disease progression (PD) on iCT; on repeat biopsy, four had another malignancy identified and three had transformation to DLBCL. Only one had asymptomatic PD. The 3-year PFS of all patients was 74% (median follow up 75 months). Patients with PR on iCT had similar 3-year PFS and OS as those with CR. In conclusion, iCT has limited utility in identifying patients with asymptomatic early progression during first-line treatment. Patients with PD mid-treatment warrant biopsy to identify histologic transformation or other malignancies.

A new technique of guided implant surgery is presented. A conventional complete denture is converted into both tomographic and surgical guides and later into an interim implant-supported fixed prosthesis. A plate derived from a computed tomography scan becomes the physical link between the virtual planning and tube positioning device. Furthermore, the interim placement of mini-implants adjacent to the symphysis region stabilizes the guide throughout the guided surgery. This technique reduces treatment time and costs.

Individualisés par l’externalisation du travail, les travailleurs forment toujours des collectifs à partir d’activités non institutionnalisées, où la recherche d’emploi fait partie du travail. Cela entraîne un bouche-à-oreille consistant à faire circuler des informations en mobilisant des interconnaissances. Une analyse du bouche-à-oreille dans le travail intérimaire aux chantiers navals de Saint-Nazaire permet d’observer en quoi cette activité est le socle d’un collectif diffus et de mettre en évidence la centralité des phénomènes de réputation dans son fonctionnement. La réputation consiste à juger en permanence les travailleurs et les employeurs, mais aussi les personnes qui font circuler les informations. Elle vise à définir la confiance qu’il est possible d’accorder à ces gens. La constitution d’un certain milieu ouvrier autour du bouche-à-oreille est d’abord présentée à partir d’un double terrain : un bar et un paquebot en construction. Je montre ensuite en quoi les réputations des travailleurs mesurent leur insertion dans des collectifs, en impliquant d’autres scènes sociales que celle du travail. Enfin, les façons dont les travailleurs tentent de contrôler leurs réputations permettront de voir comment certains les utilisent et de mettre au jour des formes d’engrenage, où la réputation peut autant aider le travailleur que le pénaliser. Individualized through the outsourcing of work, workers still form collectives from non-institutionalized activities, where job hunting is part of their activity. This leads to the word-of-mouth circulation of information by mobilizing inter-knowledge. An analysis of word of mouth in temporary work at the Saint-Nazaire shipyards allows us to observe how this activity is the basis of a diffuse collective, and to highlight the centrality of reputation phenomena within its operation. Reputation consists in judging not only workers and employers, but also the people who circulate the information. It aims to define the trust that can be placed in others. First, I present the constitution of a certain working-class environment around word of mouth, on the basis of a double field: a bar and a liner under construction. Secondly, I show how workers’ reputations measure their integration into collectives, by involving social scenes other than that of work. Finally, the ways in which workers attempt to control their reputations will show how some people use them, and reveal forms of gears, where reputation can either help the worker or penalize him.

Nigeria, which is variously described by some people as ‘a geographical expression’, ‘a unique nation’, ‘the giant of Africa’, ‘the most populous black nation on earth’, among several others, had three distinct governments in the year 1993 alone. Against this background of political instability, numerous discourses which should be of interest and significance to linguists, political scientists, historians, social anthropologists and discourse analysts of various persuasions are examined in this work. Notable is the emergence of the metaphorical use of the word child in the farewell speech of the deposed Head-of-State, Chief Ernest Oladeinde Shonekan, when he spoke of the interim regime as ‘a child of circumstance’ and in the inaugural speech of the then new Head-of-State, General Sani Abacha, as ‘a child of necessity’. These expressions were used not only as part of the reasons for either taking up or rather seizing the mantle of leadership but also as descriptive signals both to the state of the nation and the kind of government that they purported to lead. Using articles in some national newspapers, I attempt in this paper a functional-semiotic discourse analysis of the relevant statements, responses and comments on these national, dramatic, political changes. This paper is therefore an analysis of aspects of the linguistic features of discourses engendered by the diverse problematic, economic, socio-cultural and political events within the Nigerian polity and the political implications for putting in place adequate democratic principles in a developing nation.

The Kuwait Association of Rheumatology members met thrice in April 2020 to quickly address and support local practitioners treating rheumatic disease in Kuwait and the Gulf region during the coronavirus disease 2019 (COVID-19) pandemic. Because patients with rheumatic and musculoskeletal disease (RMD) may need treatment modifications during the COVID-19 pandemic, we voted online for the general guidance needed by local practitioners. In this review, we have addressed patients' vulnerability with rheumatic disease and issues associated with their optimum management. Our recommendations were based on the formulation of national/international guidelines and expert consensus among KAR members in the context of the Kuwaiti healthcare system for patients with RMD. The most recent reports from the World Health Organization, the Center for Disease Control, the National Institutes of Health-National Medical Library, and the COVID-19 educational website of the United Kingdom National Health Service have been incorporated. We discuss the management of RMD in various clinical scenarios: screening protocols in an infusion clinic, medication protocols for stable patients, and care for patients with suspected or confirmed COVID infection and whether they are stable, in a disease flare or newly diagnosed. Further, we outline the conditions for the hospital admission. This guidance is for the specialist and non-specialist readership and should be considered interim as the virus is relatively new, and we rely on the experience and necessity more than evidence collection. The guidance presented should be supplemented with recent scientific evidence wherever applicable.

Statement of problem Adjusting an interim screw-retained crown made of acrylic resin for maintenance of peri-implant soft tissues after immediate implant insertion requires accuracy and time. Assessments of these factors by using digital techniques are sparse. Purpose The purpose of this clinical study was to describe a technique to fabricate an acrylic resin interim crown by using the data acquired from a cone beam computed tomography (CBCT) scan. The 3D tomography files were converted to a standard tessellation language (STL) file format used to print or to mill the interim crown with a technique called digital immediate tooth restoration (DITR). Additionally, the chair time spent during the prosthetic phase was evaluated in comparison with a protocol in which a standard interim crown (SIC) was fabricated with an indirect-direct technique. Material and methods Patients who needed to replace a single nonrestorable tooth were treated from February to June 2018 with an immediately placed implant and an acrylic resin screw-retained interim prosthesis that was connected to the implant immediately after placement of the implant. The participants were divided into 2 groups according to the acrylic resin interim crown fabrication technique: group DITR and group SIC. The average time to finalize the prostheses was compared between the groups. The total chair time (TCT) taken for the adaptation of the interim crown was noted and distinguished in 3 different times corresponding to each phase of adaptation of the interim restoration of the interproximal contact areas (CT1), adaption of the postextractive alveolar bone walls (CT2), and adaption of the occlusal contacts (CT3). For each time, the number of changes (N-CT1, N-CT2, N-CT3, and TN) needed to complete each prosthetic phase was also marked and observed. Generalized linear mixed models and generalized linear models were used for data analysis. All the sites were definitively restored with a screw-retained crown after 6 months of healing, and the participants were provided with standard hygiene recall appointments for the next year. Results A total of 82 crowns at sites distributed across the mandible and the maxilla were included in the study. Thirty-five were restored with an SIC and 47 with a DITR interim crown. None of the implants were lost during the 18-month follow-up period. The analysis of the chair times registered for the adaptation of the interim crown to the implant healing abutment and to the neighboring teeth between the 2 groups showed a reduction if a DITR interim crown was used (average CT1 of 15 ±14 seconds, CT2 of 2 ±5 seconds, CT3 of 59 ±19 seconds, and TCT of 76 ±28 seconds for group DITR and average CT1 of 135 ±27 seconds, CT2 of 185 ±30 seconds, CT3 of 73 ±16 seconds, and TCT of 394 ±61 seconds for group SIC). The number of corrections to finalize the interim crown adaptations was lower for the group DITR (0.81 ±0.74 for N-CT1, 0.19 ±0.39 for N-CT2, and 2.81 ±0.74 for N-CT3) when compared with the number of corrections needed for the group SIC (4.37 ±0.81 for N-CT1, 5.57 ±0.77 for N-CT2, and 3.86 ±0.64 for N-CT3). Conclusions The data from CBCT scans led to interim acrylic resin crowns that needed fewer adjustments with the immediate implant placement and interim restoration approach, reducing chair time.

This clinical report describes a completely digital workflow for the rehabilitation of the maxillary and mandibular arches with implant-supported fixed interim prostheses. Computer-assisted implant planning was used to fabricate a multifunctional surgical template for the guided placement of transitional and endosteal dental implants. Advantages of this technique include the integration of a completely digital workflow into the production of a virtual diagnostic tooth arrangement for edentulous patients, the planning of implant placement as per a restorative-driven approach, and the delivery of implant-supported fixed interim prostheses.

The COVID-19 pandemic identified an urgent need to re-evaluate the provision of spirometry for clinical monitoring. Home spirometry offers the opportunity for real-time disease evaluation without risk of nosocomial infection. To determine the utility of home spirometry in interstitial lung disease (ILD), interim data from the ongoing INJUSTIS study was evaluated. High correlation was observed between home and hospital spirometry at baseline(r=0.89) and three-months(r=0.82). Over 90% of home spirometry values were within Bland-Altman agreement limits at both time points, although frequently underestimated hospital values. Home spirometry is feasible in people with fibrotic ILD.

Maintaining natural-looking soft tissues around dental implants is one of the biggest challenges for the restorative team. To achieve this, the emergence profile of the preexisting teeth in the alveolus can be emulated rather than conditioning the soft tissue architecture arbitrarily. The biotransfer technique uses an interim restoration with a biologically driven emergence profile fabricated before the implant surgery.

Background: There exist a limited number of studies demonstrating the benefit of initiating anti-retroviral agents (ARVs) for the treatment of human immunodeficiency virus (HIV) in the critical care setting. However, there are physiological, practical, and ethical arguments against making HIV testing and initiation of ARVs routine practice. Methods: A self-administered, cross-sectional survey of healthcare professionals was conducted with data collected using a questionnaire distributed to delegates of the Critical Care Society of South Africa (CCSSA) 2016 Congress, and members of the society. Results: There were 101 respondents. Eight per cent would not consider testing a critically ill patient for HIV (status previously unknown), largely because they considered this unethical. Sixty-nine per cent would consider commencing ARVs in a patient newly-diagnosed with HIV during an inter-current critical illness. The factor most likely to guide them towards this was severity of illness. In general, the greatest concerns focused around biological/medical issues. However, those clinicians who would not consider initiation of ARVs were more likely than those who would, to be concerned about psychosocial issues. Conclusion: Although the majority of clinicians would consider initiation of ARVs acutely in critically ill patients, it is apparent that the clinical decision-making around this matter is complex. Advocacy is needed to further clarify relevant ethical and legal dilemmas, and in the interim consultative and collaborative care is encouraged.

Background Following the publication of 2014 consensus statement regarding mass critical care during public health emergencies, much has been learned about surge responses and the care of overwhelming numbers of patients during the COVID-19 pandemic.1 Gaps in prior pandemic planning were identified and require modification in the midst of ongoing surge throughout the world. Methods The Task Force for Mass Critical Care (TFMCC) adopted a modified version of established rapid guideline methodologies from the World Health Organization2 and the Guidelines International Network-McMaster Guideline Development Checklist.3 With a consensus development process incorporating expert opinion to define important questions and extract evidence, TFMCC developed relevant pandemic surge suggestions in a structured manner, incorporating peer-reviewed literature, “gray” evidence from lay media sources, and anecdotal experiential evidence. Results Ten suggestions were identified regarding staffing, load-balancing, communication, and technology. Staffing models are suggested with resilience strategies to support critical care staff. Intensive care unit (ICU) surge strategies and strain indicators are suggested to enhance ICU prioritization tactics to maintain contingency level care and avoid crisis triage, with early transfer strategies to further load-balance care. We suggest intensivists and hospitalists be engaged with the incident command structure to ensure two-way communication, situational awareness, and the use of technology to support critical care delivery and families of patients in intensive care units (ICUs). Conclusions A subcommittee from the Task Force for Mass Critical Care offers interim evidence-informed operational strategies to assist hospitals and communities to plan for and respond to surge capacity demands from COVID-19.

The solution concept of a Bayesian equilibrium of a Bayesian game is inherently an interim concept. The corresponding ex ante solution concept has been termed a Harsányi equilibrium; examples have appeared in the literature showing that there are Bayesian games with uncountable state spaces that have no Bayesian approximate equilibria but do admit a Harsányi approximate equilibrium, thus exhibiting divergent behaviour in the ex ante and interim stages. Smoothness, a concept from descriptive set theory, has been shown in previous works to guarantee the existence of Bayesian equilibria. We show here that higher rungs in the countable Borel equivalence relation hierarchy can also shed light on equilibrium existence. In particular, hyperfiniteness, the next step above smoothness, is a sufficient condition for the existence of Harsányi approximate equilibria in purely atomic Bayesian games.

SUMMARY This paper examines the information content of interim review assurance in the Australian mandatory disclosure setting. First, we find a strong negative market reaction to interim going concern conclusions (IGCC) contained in the review of interim financial statements. Second, we find no significant difference between the market reaction to IGCCs and annual going concern opinions (AGCO) received at the annual report audit. Finally, we show IGCCs are significant predictors of subsequent AGCOs, and provide incremental information from the previous annual report audit opinion. Overall, these results contribute to the literature on the benefits of mandatory interim assurance by showing that going concern conclusions contained in interim financial statements provide investors with new and relevant information. JEL Classifications: G38; M42; M48.

Summary This article aims to highlight the mechanisms for avoiding constitutional bottle-necks, in particular if the head of state refuses to fulfill his constitutional duties. Thus, the political will of the heads of state cannot be a source of institutional deadlock. To remove constitutional bottlenecks Both the Parliament and the Prime Minister are to use the in-struments expressly established by the provisions of the Basic Law, in particular the sus-pension of the Head of State and the establishment of an interim function. Therefore, the application of government reshuffles is a solution to eliminate institutional bottlenecks, given that there are currently no alternative mechanisms to overcome a possible institu-tional deadlock, {"references":["1. Iorgovan A. Tratat de drept administrativ, vol. I, București: Ed. All Beck, 2001","2. Muraru I, Tănăsescu E. S. Drept constituțional și instituții politice, ediția a 15. București: Editura C. H. Beck, 2017","3. Selejan-Guțan, B. Drept constituțional și instituții politice, vol. II. Ediția a 3-a revăzută și adăugită. Editura Hamangiu, 2016","4. Legea Republicii Sovietice Socialiste Moldovenești cu privire la instituirea funcției de Președinte al RSS Moldovenești și la introducerea unor modifi-cări și completări în Constituția RSS Moldovenești din 3 septembrie 1990, în legi și hotărâri adoptate la sesiunea a doua, extraordinară a Sovietului Suprem al RSSM de legislatura a douăsprezecea, Chișinău, 1990","5. HCC nr. 28 din 17 octombrie 2017, pct. 72. [citat 16.12.2021]. Disponibil: https://weblex.md/item/view/iddbtype/1/id/64a757a8457f1f6f17174ef8 d465d914","6. Hotărârea Curții Constituționale nr. 2 din 24 ianuarie 2017 pct. 27. [citat 16.12.2021]. Disponibil:https://weblex.md/item/view/iddbtype/1/id/176 7e05e19828ea66ea3604c32bafc3a","7. Muraru I., Tănăsescu E. S. Constituția României. Comentariu pe articole. București: C. H. Beck, 2008","8. Avizul Curții Constituționale nr. 2 din 20 octombrie 2017. [citat 16.12.2021]. Disponibil: https://weblex.md/item/view/iddbtype/1/id/7721496a3cb06 ecf0a14c1a0dd27c7a1","9. Avizul Curții Constituționale nr. 1 din 2 ianuarie 2018, [citat 16.12.2021]. Disponibil: https://weblex.md/item/view/iddbtype/1/id/e1f7b2479c9a-b1f8ff3e3376f0a2b93e","10. Avizul Curții Constituționale nr. 2 din 5 ianuarie 2018. [citat 16.12.2021]. Disponibil: https://weblex.md/item/view/iddbtype/1/id/f50db0fdc1b-c363034373f27a7068072","11. Cîrnaț T. Drept constituțional și instituții politice. Partea II. Chișinău: Ti-pografia \"Print-Caro\", 2020","12.\tHotărârea Curții Constituționale nr. 28 din 17 octombrie 2017 pentru in-terpretarea prevederilor articolului 98 alin.(6) în coroborare cu articolele 1, 56, 91, 135 și 140 din Constituție (neîndeplinirea obligațiilor constituționale de către președinte). [citat 16.12.2021]. Disponibil: https://weblex.md/item/view/iddbtype/1/id/64a757a8457f1f6f17174ef8d465d914","13. Muraru I., Tănăsescu E. S. Constituția României. Comentariu pe articole. București: C. H. Beck, 2008","14.\tLegea privind organizarea și funcționarea Curții Constituționale nr. 47 din 18 mai 1992. În: Monitorul Oficial al României, 22.05.1992, nr.101. [citat 16.12.2021]. Disponibil: http://legislatie.just.ro/Public/DetaliiDocumentAfis/2248","15.\tLegea privind organizarea și funcționarea Curții Constituționale nr. 47 din 18 mai 1992. În: Monitorul Oficial al României, 22.05.1992, nr.101. [citat 16.12.2021]. Disponibil: http://legislatie.just.ro/Public/DetaliiDocumentAfis/2248","16. Hotărârea Curții Constituționale nr. 28 din 17 octombrie 2017, pct. 34-37.[citat 16.12.2021]. Disponibil: https://weblex.md/item/view/iddbtype/1/i d/64a757a8457f1f6f17174ef8d465d914"]}

The East Asia Regional Reanalysis (EARR) system is developed based on the advanced hybrid gain data assimilation method (AdvHG) using Weather Research and Forecasting (WRF) model and conventional observations. Based on EARR, the high-resolution regional reanalysis and reforecast fields are produced with 12 km horizontal resolution over East Asia for 2010–2019. The newly proposed AdvHG is based on the hybrid gain approach, weighting two different analysis for an optimal analysis. The AdvHG is different from the hybrid gain in that 1) E3DVAR is used instead of EnKF, 2) 6 h forecast of ERA5 is used to be more consistent with WRF, and 3) the pre-existing, state-of-the-art reanalysis is used. Thus, the AdvHG can be regarded as an efficient approach to generate regional reanalysis dataset due to cost savings as well as the use of the state-of-the-art reanalysis. The upper air variables of EARR are verified with those of ERA5 for January and July 2017 and the two-year period of 2017–2018. For upper air variables, ERA5 outperforms EARR over two years, whereas EARR outperforms (shows comparable performance to) ERA-I and E3DVAR for January in 2017 (July in 2017). EARR better represents precipitation than ERA5 for January and July in 2017. Therefore, though the uncertainties of upper air variables of EARR need to be considered when analyzing them, the precipitation of EARR is more accurate than that of ERA5 for both two seasons. The EARR data presented here can be downloaded from https://doi.org/10.7910/DVN/7P8MZT for data on pressure levels and https://doi.org/10.7910/DVN/Q07VRC for precipitation.

CEO succession is a critical event in the life of a company. How external stakeholders respond to it, can affect the company's valuation. This study investigates how securities analysts' and investors' reactions to CEO succession are affected by the interplay between the charisma of the new CEO's vision, the new CEO's origin (whether an insider or outsider), and the type of CEO succession (whether routine, dismissal or interim). Drawing on the literature on signaling, we suggest that because a charismatic vision emits a positive signal about the company's future performance, it will affect market actors' reactions by either weakening or strengthening the influence of the signals emitted by other succession context contingencies, namely, CEO origin and succession type. To test our predictions regarding analysts' and investors' reactions, we respectively analyze panel data and conduct an event study. The results support most of our predictions. We discuss the study's contributions and implications.

Background This ongoing follow-up study evaluated the persistence of efficacy and immune responses for 6 additional years in adults vaccinated with the glycoprotein E (gE)-based adjuvanted recombinant zoster vaccine (RZV) at age ≥50 years in 2 pivotal efficacy trials (ZOE-50 and ZOE-70). The present interim analysis was performed after ≥2 additional years of follow-up (between 5.1 and 7.1 years [mean] post-vaccination) and includes partial data for year (Y) 8 post-vaccination. Methods Annual assessments were performed for efficacy against herpes zoster (HZ) from Y6 post-vaccination and for anti-gE antibody concentrations and gE-specific CD4[2+] T-cell (expressing ≥2 of 4 assessed activation markers) frequencies from Y5 post-vaccination. Results Of 7413 participants enrolled for the long-term efficacy assessment, 7277 (mean age at vaccination, 67.2 years), 813, and 108 were included in the cohorts evaluating efficacy, humoral immune responses, and cell-mediated immune responses, respectively. Efficacy of RZV against HZ through this interim analysis was 84.0% (95% confidence interval [CI], 75.9–89.8) from the start of this follow-up study and 90.9% (95% CI, 88.2–93.2) from vaccination in ZOE-50/70. Annual vaccine efficacy estimates were >84% for each year since vaccination and remained stable through this interim analysis. Anti-gE antibody geometric mean concentrations and median frequencies of gE-specific CD4[2+] T cells reached a plateau at approximately 6-fold above pre-vaccination levels. Conclusions Efficacy against HZ and immune responses to RZV remained high, suggesting that the clinical benefit of RZV in older adults is sustained for at least 7 years post-vaccination. Clinical Trials Registration. NCT02723773.

To estimate the time to culture conversion and factors associated with failure to culture conversion, six-month interim outcomes and associated risk factors with poor interim outcomes in multi-drug resistant tuberculosis patients previously treated with second-line drugs.The prospective clinical case series study was conducted from March 2016 to January 2017 at the Indus Hospital Tuberculosis Clinic and seven other sites that are part of the hospital's Programmatic Management of Drug Resistant Tuberculosis initiative. All bacteriologically confirmed multi-drug resistant tuberculosis retreatment patients were enrolled. Data was collected on age, gender, site of enrollment, detailed history of previous treatment with anti-tuberculosis drugs, medical history, history of first-line drugs, history of second-line drugs, treatment outcomes, baseline sputum smear microscopy and monthly follow-up sputum smear microscopy and culture results. Data was subjected to univariate and multiple logistic regression analyses, and risk factors for failure to culture conversion were assessed using Cox Proportional Hazards Model.Out of 266 patients, 143(53.8%) were males, the overall largest age group was 5-24 years 97(36.5%), and 250 (94%) patients had previous history of treatment with first-line drugs. Overall, 101(40.1%) patients experienced poor interim outcome. Poor interim outcomes were significantly associated with higher number of drugs on the regimen, (odds ratio: 1.27; 95% confidence interval: 1.03-1.58) and high sputum smear grading (odds ratio: 4.56; 95% confidence interval: 3.30-18.71). Besides, 186(70.3%) patients experienced culture conversion within the initial six months of treatment.The success rate of re-treatment of multi-drug resistant tuberculosis with conventional regimen was found to be unacceptably low.

BackgroundPeople in substance use disorder (SUD) treatment experience disproportionate rates of tobacco use. California has prioritized smoking cessation among these individuals through the Tobacco-Free for Recovery Initiative, which includes an intervention aimed at supporting programs in implementing tobacco-free grounds. The current study examined changes in client smoking prevalence, tobacco use behaviors, and receipt of cessation services among the first seven programs participating in the initiative.MethodsResidential treatment program clients completed cross-sectional surveys at the start of the intervention (baseline: n=249), at an interim timepoint post-baseline (interim: n=275), and at the end of the intervention 15months later (post-intervention: n=219). All participants reported smoking status. Current smokers reported tobacco use behaviors, and both current smokers and those who quit in treatment reported receipt of cessation services. Univariate analyses explored differences across the three timepoints and multivariate logistic regression assessed change from baseline to interim and baseline to post-intervention.ResultsClient smoking prevalence decreased from 54.2% at pre- to 26.6% at post-intervention (Adjusted Odds Ratio [AOR]=0.25, 95% CI=0.13, 0.45). Current smokers and those who quit while in treatment reported an increase in NRT/pharmacotherapy (11.9% vs. 25.2%; AOR=3.02, CI=1.24, 7.35). When comparing baseline to the interim timepoint (a timepoint before the COVID-19 pandemic), data analyses also demonstrated a significant decrease in smoking prevalence (54.2% vs. 41.8%; AOR=0.62, CI=0.42, 0.92) and increase in NRT/pharmacotherapy (11.9% vs. 24.5%; AOR=3.68, CI=1.11, 12.19).ConclusionAn intervention to promote tobacco-free grounds implemented in residential SUD treatment programs was associated with a significant reduction in client smoking and an increase in NRT/pharmacotherapy. These associations were observed both before the COVID-19 pandemic and in the early stages of the pandemic, suggesting that they may be due to the intervention rather than to the pandemic.

We consider a vertically related market in which an upstream monopolist supplier trades, via interim observable two-part tariff contracts, with two differentiated goods' downstream Cournot competitors. We show that passive partial backward ownership (PPBO) may be pro-competitive and welfare enhancing. PPBO exacerbates the upstream's commitment problem and yields lower wholesale prices, and higher industry output, consumers surplus, and welfare than in the absence of PPBO.