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In this paper, we will see how an eleven-year-old girl discusses and presents her solution to a problem involving fractions and rates. The readers will be able to watch a video of the girl's presentation of a middle school problem. An analysis of the solution and the presentation is discussed in the context of current mathematics education research. [ABSTRACT FROM AUTHOR]

Objective: To describe the characteristics of offenders found not guilty on the grounds of mental illness (NGMI) in New South Wales and rates of NGMI and other homicide verdicts. Method: Demographic, legal and clinical data after referral to the NSW Mental Health Review Tribunal following an NGMI verdict for homicide matched with results from the National Homicide Monitoring Program. Results: Between 1993 and 2016, a total of 2159 homicide offenders were dealt with by the NSW courts, including 169 (7.8%) who were found NGMI. Over this period, the rate of non-NGMI homicide convictions fell from 1.83 per 100,000 per annum to 0.65 per 100,000 per annum (Kendall's tau = −0.79, p ⩽ 0.001) while the rate of NGMI homicide fluctuated, with an average annual rate of about 0.1 per 100,000 per annum (Kendall's tau = 0.17, p = 0.23). There was no association between the annual rates of NGMI and non-NGMI homicides (Pearson r = −0.3, p = 0.16) but falling rate of non-NGMI homicide meant that the proportion of NGMI offences doubled from 5.5% in the first 12 years to 11% in the second 12 years. Nearly all (88.7%) of those found NGMI had a schizophrenia-related psychosis. However, there were high rates of psychiatric comorbidity including substance use disorder (60.7%) and a history of a prior head injury (41.1%). Most (83.4%) of the NGMI offenders had previous contact with mental health services, but only half of these had received treatment with antipsychotic medication. Conclusion: The fall in conviction for homicide offences in the last 24 years has not been matched by a reduction in NGMI homicide verdicts. More assertive treatment of emerging psychosis and comorbid substance use disorders, and improved continuity of care of chronic psychosis might prevent some homicides. [ABSTRACT FROM AUTHOR]

As one of the malignant tumors with rising incidence, early diagnosis and accurate treatment of liver cancer play a crucial role in improving the cure rate of patients. Alpha-fetoprotein (AFP) and carcinoembryonic antigen (CEA) are two important tumor markers in the diagnosis of liver cancer. Although antibody analysis methods such as immunoassay have been developed, they are still challenging considering the sensitivity and operating cost. Here, we describe a fluorescent RNA aptamer-based rolling circle transcription (FRA-RCT) test, which can ultra-sensitively and accurately detect the presence of both AFP and CEA target proteins at the same time. The dual-targets sensor integrating the aptamers of AFP and CEA can be protectively bound to the target proteins in advance, while the remaining complements are bound by the trigger chains. Through the in vitro transcription process of FRA-RCT, the amount of the targets is successfully converted to the amount of the remaining triggers and thus amplified into two fluorescent RNA aptamer products. This collection of modular components greatly improves the signal gain and specificity of the FRA-RCT technology. In addition, we have successfully distinguished the positive serum samples of liver cancer patients from the negative healthy controls, and realized the point of care testing (POCT) of different targets by using portable chips. The differential fluorescence output proved its effectiveness and practicability. Therefore, this dual-targets aptamer sensor has a promising prospect in simultaneous cancer diagnosis at low cost and high efficiency. [Display omitted] • A dual-aptamer biosensor was used for ultrasensitive and simultaneous detection of AFP and CEA. • Quantitative analysis of AFP and CEA was achieved by rolling circle transcription amplification based on fluorescent RNA aptamer. • The chip-based FRA-RCT owns advantages of portability, label-free and low-cost. • The assay can effectively meet the requirements of point-of-care diagnosis of AFP and CEA. [ABSTRACT FROM AUTHOR]

• We study the effect of emergency department crowding due to low severity patients. • We unpack welfare implications for high severity patients along their pathway in ED. • We show the slack in capacity by looking at the distribution of unplanned demand. • Emergency departments efficiently prioritise high severity patients. • Care rationing at very high levels of demand explains crowding effects on outcomes. Unexpected peaks in volumes of attendances at hospital emergency departments (EDs) have been found to affect waiting times, intensity of care and outcomes. We ask whether these effects of ED crowding on patients are caused by poor clinical prioritisation or a quality-quantity trade-off generated by a binding capacity constraint. We study the effects of crowding created by lower-severity patients on the outcomes of approximately 13 million higher-severity patients attending the 140 public EDs in England between April 2016 and March 2017. Our identification approach relies on high-dimensional fixed effects to account for planned capacity. Unexpected demand from low-severity patients has very limited effects on the care provided to higher-severity patients throughout their entire pathway in ED. Detrimental effects of crowding caused by low-severity patients materialise only at very high levels of unexpected demand, suggesting that binding resource constraints impact patient care only when demand greatly exceeds the ED's expectations. These effects are smaller than those caused by crowding induced by higher-severity patients, suggesting an efficient prioritisation of incoming patients in EDs. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the effects of walnut green husk extract on proliferation, apoptosis and epidermal growth factor receptor (EGFR) / mitogen activated protein kinase (MAPK) signaling pathway of breast cancer MCF-7 cells. METHODS: Cell counting kit-8 (CCK-8) was used to screen the proper concentration of walnut husk extract interfering with breast cancer MCF-7 cells. The breast cancer MCF-7 cells were divided into the blank control group, positive control group, walnut husk husk extract low concentration group, walnut green husk extract high concentration group, walnut green husk extract high concentration + EGFR agonist (NSC228155) group. CCK-8 and colony formation experiment were used to detect cell proliferation in each group. TUNEL method and flow cytometry were used to detect cell apoptosis in each group. Western blot was used to detect the expression levels of proliferation, apoptosis and EGFR/ MAPK signaling pathway related proteins of cells in each group. RESULTS: When the concentration of walnut green husk extract was ≥20 μg/ mL, the cell proliferation rate decreased significantly, 20 μg/ mL and 40 μg/ mL were selected as the walnut green husk extract low and high concentration treatment, respectively. Compared with the blank control group, the cell proliferation rate, the number of cell colonies, the expression levels of CyclinD1, proliferating cell nuclear antigen (PCNA) and B cell lymphoma-2 (Bcl-2) protein, the ratio of phosphorylated-EGFR (p-EGFR) / EGFR, phosphorylated extracellular signal-regulated kinase (p-ERK) / extracellular signal-regulated kinase ( ERK ), phosphorylated-p38 MAPK ( p-p38 MAPK ) / p38 MAPK and phosphorylated c-Jun amino-terminal protein kinase (p-JNK) / c-Jun amino-terminal protein kinase (JNK) protein in the positive control group, the walnut green husk extract low concentration group and high concentration group decreased significantly, and the rate of TUNEL positive cells, the apoptosis rate, the expression level of Bcl-2 related X protein (Bax) increased significantly, with statistically significant differences (P<0. 05). Compared with the walnut green husk extract low concentration group, the cell proliferation rate, the number of cell colonies, the expression levels of CyclinD1, PCNA and Bcl-2 protein, the ratio of p-EGFR/ EGFR, p-ERK/ ERK, p-p38 MAPK/ p38 MAPK and p-JNK/ JNK protein in the walnut green husk extract high concentration group decreased, and the rate of TUNEL positive cells, the apoptosis rate, the expression level of Bax protein increased, with statistically significant differences (P<0. 05). There was no significant difference in the above indicators between the walnut green husk extract high concentration group and the positive control group (P >0. 05). Compared with the walnut green husk extract high concentration group, the cell proliferation rate, the number of cell colonies, the expression levels of CyclinD1, PCNA and Bcl-2 protein, the ratio of p-EGFR/ EGFR, p-ERK/ ERK, p-p38 MAPK/ p38 MAPK and p-JNK/ JNK protein in the walnut green husk extract high concentration + NSC228155 group increased, and the rate of TUNEL positive cells, the apoptosis rate, the expression level of Bax protein decreased, with statistically significant differences (P<0. 05). CONCLUSIONS: Walnut green husk extract may inhibit the proliferation of breast cancer MCF-7 cells and induce the apoptosis by inhibiting the EGFR/ MAPK signaling pathway. [ABSTRACT FROM AUTHOR]

Background: Safety data reported from the large-scale clinical trials of the coronavirus disease 2019 (COVID-19) vaccine are extremely limited in patients with decompensated cirrhosis. The vaccination campaign in this specific population could be difficult due to uncertainty about the adverse events following vaccination. We aimed to assessed the COVID-19 vaccination rate, factors associated with unvaccinated status, and the adverse events following vaccination in patients with decompensated cirrhosis. Methods: This is a retrospective study from Ruijin Hospial (Shanghai, China) on an ongoing prospective cohort designed for long-term survival analysis of decompensated cirrhotic patients who recovered from decompensating events or acute-on-chronic liver failure (ACLF) between 2016 and 2018. We assessed the COVID-19 vaccination rate, the number of doses, type of vaccine, safety data, patient-reported reasons for remaining unvaccinated, factors associated with unvaccinated status, and the adverse events of COVID-19 vaccine. Binary logistic regression was used for identifying factors associated with unvaccinated status. Results: A total of 229 patients with decompensated cirrhosis without previous SARS-CoV-2 infection participated (mean age, 56 ± 12.2 years, 75% male, 65% viral-related cirrhosis). Mode of decompensation were grade II‒III ascites (82.5%), gastroesophageal varices bleeding (7.9%), hepatic encephalopathy (7.9%). Eighty-five participants (37.1%) received at least one dose of vaccination (1 dose: n = 1, 2 doses: n = 65, 3 doses: n = 19) while 62.9% remained unvaccinated. Patient-reported reasons for remaining unvaccinated were mainly fear of adverse events (37.5%) and lack of positive advice from healthcare providers (52.1%). The experience of hepatic encephalopathy (OR = 5.61, 95% CI: 1.24–25.4) or ACLF (OR = 3.13, 95% CI: 1.12–8.69) and post-liver transplantation status (OR = 2.47, 95% CI: 1.06–5.76) were risk factors of remaining unvaccinated independent of residential areas. The safety analysis demonstrated that 75.3% had no adverse events, 23.6% had non-severe reactions (20% injection-site pain, 1.2% fatigue, 2.4% rash) and 1.2% had a severe event (development of acute decompensation requiring hospitalization). Conclusions: Patients with decompensated cirrhosis in eastern China are largely remained at unvaccinated status, particularly those with previous episodes of ACLF or hepatic encephalopathy and liver transplantation recipients. Vaccination against COVID-19 in this population is safe. [ABSTRACT FROM AUTHOR]

Academic and government research regarding the affordability of household drinking water and sewer utility (water utility) costs have resulted in the development of several methodologies that have been tested at various geographic levels. A New Jersey study on potential household affordability stresses from water utility costs at or below the Census tract‐level estimates that approximately one‐fifth of all New Jersey households could face affordability stresses, assuming that they directly pay all water utility costs. The methodology is adapted from the Affordability Ratio method of Teodoro. The results show the potential for use of county‐level household essential expenditure estimates in areas with high‐density populations. They also show the value of the methodology as a basis for policy discussions regarding the severity and geographic distribution of affordability stresses, as the analysis clearly indicates that significant affordability stresses exist in many suburban municipalities and rural town centers, not just historic urban cities. [ABSTRACT FROM AUTHOR]

Microbial communities often face external perturbations that can induce lasting changes in their composition and functions. Our understanding of how multispecies communities respond to perturbations such as antibiotics is limited, with susceptibility assays performed on individual, isolated species our primary guide in predicting community transitions. Here, we studied how bacterial growth dynamics can overcome differences in antibiotic susceptibility in determining community resilience: the recovery of the original community state following antibiotic exposure. We used an experimental community containing Corynebacterium ammoniagenes and Lactobacillus plantarum that displays two alternative stable states as a result of mutual inhibition. Although C. ammoniagenes was more susceptible to chloramphenicol in monocultures, we found that chloramphenicol exposure nonetheless led to a transition from the L. plantarumdominated to the C. ammoniagenes-dominated community state. Combining theory and experiments, we demonstrated that growth rate differences between the two species made the L. plantarum-dominated community less resilient to several antibiotics with different mechanisms of action. Taking advantage of an observed cooperativity--a dependence on population abundance--in the growth of C. ammoniagenes, we next analyzed in silico scenarios that could compromise the high resilience of the C. ammoniagenes-dominated state. The model predicted that lowering the dispersal rate, through interacting with the growth at low population densities, could make the C. ammoniagenes state fragile against virtually any kind of antibiotic, a prediction that we confirmed experimentally. Our results highlight that species susceptibility to antibiotics is often uninformative of community resilience, as growth dynamics in the wake of antibiotic exposure can play a dominant role. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the effects of ropivacaine on the proliferation, apoptosis, invasion, migration and the Ras homolog gene family member A(RhoA) / Rho-associated coiled-coil protein kinase 1(ROCK1) signaling pathway in glioma U251 cells. METHODS: Glioma U251 cells were divided into negative control group, positive control group, and ropivacaine low, medium and high dose groups. The negative control group was cultured normally without treatment, the positive control group was given 10 μg / L of cis-platinum, the ropivacaine low, medium and high dose groups were respectively given 25 mg / L, 50 mg / L and 100 mg / L of ropivacaine. After 48 h of culture, the cell proliferation rate, apoptosis rate, cell invasion number and migration distance were detected by tetramethylthiazole blue method, flow cytometry, Transwell and scratch method, the expression of RhoA, ROCK1 and matrix metalloproteinase 2 (MMP-2) protein were detected by Western blotting. RESULTS: Compared with the negative control group, the proliferation rate was decreased, the invasion number decreased, the migration distance was shortened, the expression of RhoA, ROCK1 and MMP-2 protein decreased, the apoptosis rate increased in the positive control and each dose group of ropivacain, with statistically significant differences(P<0. 05), and the ropivacaine was dose-dependent. Compared with the positive control group, the proliferation rate and the cell invasion number increased, the migration distance was prolonged, the expression of RhoA, ROCK1 and MMP-2 proteins increased, the apoptosis rate decreased in each dose group of ropivacaine, with statistically significant differences(P<0. 05). CONCLUSIONS: Ropivacaine can inhibit the proliferation, invasion and migration of glioma U251 cells, promote the apoptosis of glioma U251 cells, and the mechanism may be related to the inhibition of RhoA/ ROCK1 pathway expression. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the effects of apatinib on tumor inhibition rate and tumor cell apoptosis in breast cancer mouse model by regulating extracellular regulated kinase ( ERK) 1 / 2 pathway. METHODS: Human breast cancer cell line MCF-7 cells were inoculated in the right chest wall of nude mice, which were randomly divided into control group, low-dose group[10 mg / (kg·d) of Apatinib] and high-dose group[30 mg / ( kg·d) of Apatinib] after successful modeling, with 12 mice in each group. After intragastric administration once a day for 21 days, the tumor growth curves of three groups were plotted and the tumor inhibition rates were compared. After the last administration, the mice were executed and the tumor tissues were collected, the expression of ERK1 / 2 pathwayrelated proteins [ERK1 / 2, phosphorylated ERK1 / 2(p-ERK1 / 2)] in the tumor tissues was detected by Western blot. The effects of apatinib on MCF-7 cell cycle distribution and cell apoptosis were detected by flow cytometry. RESULTS: After processing with different concentrations of apatinib, the differences in apoptosis rate and the proportion of MCF-7 cells distributed in G0 -G1 phase were statistically significant ( P < 0. 05), among which the apoptosis rate and the proportion of MCF-7 cells distributed in G0 -G1 phase were significantly higher in the group given 20 μmol / L of apatinib than in the other low concentration groups, with statistically significant differences (P<0. 05). The tumor volumes of mice in the high-dose and low-dose groups were significantly lower than that of the control group at the 6th to 21st day of administration, with statistically significant differences (P<0. 05), of which the tumor volumes of mice in the highdose group were the smallest. The mean tumor weights of the high-dose group and low-dose group on the 22nd day were respectively (0. 343±0. 089) g and (0. 658±0. 145) g, which were significantly lower than that of the control group[(1. 163±0. 231) g], with statistically significant differences(P<0. 05). The tumor inhibition rates of the highdose group and low-dose group were respectively 64. 46% and 34. 07%, and there was a dose dependence. The expression levels of ERK1 / 2 and p-ERK1 / 2 in mice in the high-dose group and low-dose group were significantly lower than those in the control group, with statistically significant difference (P<0. 05), of which the expression levels of ERK1 / 2 and p-ERK1 / 2 in mice in the high-dose group were the lowest. CONCLUSIONS: Apatinib can effectively inhibit the ERK1 / 2 signaling pathway in breast cancer cell, induce apoptosis and proliferation of tumor cells, and thus inhibit the growth of tumors in breast cancer mice. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the effects of renal artery embolization combined with Adrenal hydrazone tablets on coagulation function and renal function in patients with acute renal hemorrhage. METHODS: A total of 61 patients with acute renal hemorrhage admitted into the Ninth People’ s Hospital Affiliated to Shanghai Jiaotong University School of Medicine from Sept. 2019 to Sept. 2021 were selected and divided into the single treatment group ( n = 30) and the combined treatment group (n = 31) via random number table. The single treatment group was treated with renal artery embolization, while the combined treatment group received renal artery embolization combined with Adrenal hydrazone tablets. The renal function of two groups was compared. Plasma prothrombin time (PT), activated partial thrombin time ( APTT) and fibrinogen ( FIB) levels were determined by immunoturbidimetry, and tumor necrosis factor α (TNF-α), interleukin ( IL)-1 and IL-22 levels were determined by enzyme-linked immunosorbent assay. The treatment effects and incidence of complications were observed. RESULTS: After treatment, the levels of hematocrit and hemoglobin in the combined treatment group were higher than those in the single treatment group, and the heart rate was lower than that in the single treatment group, with statistically significant differences (P<0. 05). After treatment, the levels of serum creatinine, 24 h urine protein and blood urea nitrogen in the combined treatment group were lower than those in the single treatment group, the differences were statistically significant (P< 0. 05). After treatment, PT and APTT in the combined treatment group were longer than those in the single treatment group, and the levels of FIB, TNF-α, IL-1 and IL-22 were lower than those in the single treatment group, the differences were statistically significant ( P < 0. 05 ). The total effective rate in the combined treatment group was 96. 77% (30 / 31), higher than 76. 67% (23 / 30) in the single treatment group; the incidence of complications in the combined treatment group was 3. 23% (1 / 31), lower than 20. 00% (6 / 30) in the single treatment group, the difference was statistically significant ( P < 0. 05). CONCLUSIONS: Renal arterial embolization combined with Adrenal hydrazone tablets in the treatment of acute renal hemorrhage can improve the renal function and the coagulation function, effectively regulate the inflammatory reaction, with remarkable therapeutic effects. [ABSTRACT FROM AUTHOR]

The paper covers the research into the productivity of sorghum (Sorghum bicolor (L.) Moench) grain for its widest use: nutrition, fodder for animals, and as a bioenergy crop, depending on the rates of mineral fertilisation. The purpose of the experiment was to analyse the effect of the fertiliser rates on the productivity of sorghum grain, its biofuel output, and energy received from it. The following methods were used: the field method, to investigate biological and ecological features of growth and development of the crop productivity and quality; the laboratory method, to determine the correlation between the crop and the environment (plant and soil analysis); the generalised method, to identify common properties and features. The application of fertilisers improved the quality of sorghum grain considerably: protein and fat content increased from 9.7% to 12.4% and from 3.37% to 3.62%, respectively; with higher fertiliser rates, starch content increased from 67.1% to 70.1% for cultivar 'Dniprovskyi 39' and from 65.8% to 68.8% for cultivar 'Vinets'. Compared with the control treatment (without fertilisers) and under the effect fertiliser rates, grain yield capacity and above-ground mass increased. In the case of 'Dniprovskyi 39', at fertiliser rates N90P90K90, N120P120K120 and estimated rate of N50P40K70, grain yield capacity increased reliably, compared with the control treatment, and it amounted to 7.1, 7.9, and 7.3 tha-1; grain yield capacity of 'Vinets' was 7.2, 7.8 and 7.0 tha-1, respectively. Biomass yield capacity of 'Dniprovskyi 39' and 'Vinets' increased reliably only at the highest and estimated fertiliser rates. When 'Dniprovskyi 39' was grown, the highest total energy output was equal to 181.0 and 187.8 GJ ha-1; this indicator was 169.8 and 178.3 GJ ha-1 for 'Vinets'. This was due to the estimated and maximal fertiliser rates. More than 80% of this energy is concentrated in solid biofuel and only 20% in bio-ethanol. The decrease in fertiliser rates led to a lower energy output of 1 ha. [ABSTRACT FROM AUTHOR]

This study uses an embedded survey experiment to evaluate the effects of issue framing on willingness to pay water and sewer rate increases. Government‐owned utilities require public support for financial resources, and so managers must communicate the value of their services to their customers. Water and wastewater utilities provide several benefits; little systematic evidence exists on which resonate with the public. In this study, respondents in a U.S. national survey were randomly assigned to one of four framing treatments in a question about support for a hypothetical rate increase: reduced pollution, safer drinking water, better tasting drinking water, and low‐income affordability. Compared with the other treatments, the safer drinking water framing yielded 11.2% greater average willingness to pay a rate increase. Multivariate analysis shows that Republican partisans and women responded especially positively to safe drinking water framing. Results have important implications for utilities' outreach and public communications efforts. [ABSTRACT FROM AUTHOR]

Background: Clostridioides difficile infection (CDI) frequently complicates allogeneic hematopoietic stem cell (allo‐HCT) and solid organ transplantation (SOT). Methods: We retrospectively analyzed risk factors and outcomes of CDI occurring within 30 days of transplant. Results: Between March 2010 and June 2015, 466 allo‐HCT and 1454 SOT were performed. The CDI cumulative incidence (95% CI) was 10% (8–13) and 4% (3–5), following allo‐HCT and SOT, respectively (p <.01), occurring at a median (range) 7.5 days (1–30) and 11 (1–30), respectively (p =.18). In multivariate analysis, fluoroquinolones use within 14 days pre‐transplantation was a risk factor for CDI following allo‐HCT (HR 4.06 [95% CI 1.31–12.63], p =.02), and thoracic organ(s) transplantation was a risk factor for CDI following SOT (HR 3.03 [95% CI 1.31–6.98]) for lung and 3.90 (1.58–9.63) for heart and heart/kidney transplant, p =.02. Compared with no‐CDI patients, the length of stay (LOS) was prolonged in both allo‐HCT (35 days [19–141] vs. 29 [13–164], p <.01) and SOT with CDI (16.5 [4–101] vs. 7 [0–159], p <.01), though not directly attributed to CDI. In allo‐HCT, severe acute graft‐versus‐host disease (aGVHD) occurred more frequently in patients with CDI (33.3% vs. 15.8% without CDI, p =.01) and most aGVHD (87.5%) followed CDI. Non‐relapse mortality or overall survival, not attributed to CDI, were also similar in both allo‐HCT and SOT. Conclusions: Early post‐transplant CDI is frequent, associated with fluoroquinolones use in allo‐HCT and the transplanted organ in SOT, and is associated with longer LOS in both the groups without difference in survival but with increased aGVHD in allo‐HCT. [ABSTRACT FROM AUTHOR]

Anaerobic microbial respiration in suboxic and anoxic environments often involves particulate ferric iron (oxyhydr-)oxides as terminal electron acceptors. To ensure efficient respiration, a widespread strategy among iron-reducing microorganisms is the use of extracellular electron shuttles (EES) that transfer two electrons from the microbial cell to the iron oxide surface. Yet, a fundamental understanding of how EES-oxide redox thermodynamics affect rates of iron oxide reduction remains elusive. Attempts to rationalize these rates for different EES, solution pH, and iron oxides on the basis of the underlying reaction free energy of the two-electron transfer were unsuccessful. Here, we demonstrate that broadly varying reduction rates determined in this work for different iron oxides and EES at varying solution chemistry as well as previously published data can be reconciled when these rates are instead related to the free energy of the less exergonic (or even endergonic) first of the two electron transfers from the fully, two-electron reduced EES to ferric iron oxide. We show how free energy relationships aid in identifying controls on microbial iron oxide reduction by EES, thereby advancing a more fundamental understanding of anaerobic respiration using iron oxides. [ABSTRACT FROM AUTHOR]

Pooled testing increases efficiency by grouping individual samples and testing the combined sample, such that many individuals can be cleared with one negative test. This short paper demonstrates that pooled testing is particularly advantageous in the setting of pandemics, given repeated testing, rapid spread, and uncertain risk. Repeated testing mechanically lowers the infection probability at the time of the next test by removing positives from the population. This effect alone means that increasing frequency by x times only increases expected tests by around √ x. However, this calculation omits a further benefit of frequent testing: Removing infections from the population lowers intragroup transmission, which lowers infection probability and generates further efficiency. For this reason, increasing testing frequency can paradoxically reduce total testing cost. Our calculations are based on the assumption that infection rates are known, but predicting these rates is challenging in a fast-moving pandemic. However, given that frequent testing naturally suppresses the mean and variance of infection rates, we show that our results are very robust to uncertainty and misprediction. Finally, we note that efficiency further increases given natural sampling pools (e.g., workplaces, classrooms) that induce correlated risk via local transmission. We conclude that frequent pooled testing using natural groupings is a cost-effective way to provide consistent testing of a population to suppress infection risk in a pandemic. [ABSTRACT FROM AUTHOR]

Objective. To describe the time trends of mortality attributable to malnutrition in Colombia in the period 2005- 2019, overall and disaggregated by age and sex. Methods. Ecological study based on secondary data on mortality due to undernutrition as the underlying cause of death according to vital statistics. Crude, age- and sex-specific, and age-standardized annual mortality rates per 100 000 population were calculated. The direct method was used, and the reference population was that proposed by the World Health Organization for 2000-2025. A segmented linear regression or changepoint analysis was performed. Results. A total of 26 200 records of deaths due to undernutrition were analyzed for the study period, which corresponds to 0.84% of the total number of deaths in Colombia. The mortality rate in the 0-to-4-year age group was 9.9 per 100 000 population; in the 85-and-older age group, it reached 137 deaths per 100 000 population. All significant adjustments had a negative impact on the model trend, indicating a reduction in mortality rates. The annual percent change was significant for the period 2007-2017, when the mortality rate decreased 2.8% in men (95% confidence interval [95%CI]: -4.3, -1.3) and 3.2% in women (95%CI: -5.0, -1.4). Conclusions. The overall prevalence of mortality attributable to undernutrition in Colombia is low, increasing at the extremes of age, and has been following a downward trend, especially among younger age groups and women. [ABSTRACT FROM AUTHOR]

In terms of the Local Government: Municipal Property Rates Act 6 of 2004 (MPRA), metropolitan and local municipalities in South Africa may levy property rates on property. The MPRA provides for only one tax base, namely "market value". Given the paucity of skills and capacity to prepare credible valuation rolls and given the costs of doing so, especially B3 and B4 local municipalities situated in rural areas are struggling to comply with the valuationrelated provisions of the MPRA. A brief review of property tax base options utilised globally indicates that some countries allow for different tax bases (or even different taxes) based on the location and/or use of property and some jurisdictions apply simplified methodologies (such as value banding, points-based assessment or even self-assessment) to assess properties for property tax purposes. In the light of there being viable alternatives to market value and of the challenges faced by many rural local municipalities, the South African government should revisit the policy decision to have only market value as the tax base across vastly different types of municipalities. [ABSTRACT FROM AUTHOR]

Background: Refractive and ocular biometric changes after silicone oil tamponade (SOT) in phakic eyes have been studied thoroughly; however, similar studies amongst Sudanese patients with vitreoretinal conditions were not carried out. Aim: This study aimed to assess post-operative changes in refraction, corneal power and axial length after pars plana vitrectomy (PPV) with SOT in phakic patients. Setting: The study was conducted at Sudan Eye Center, Khartoum, Sudan. Methods: A cross-sectional retrospective hospital-based study was performed at Sudan Eye Center. The study included all phakic patients who underwent PPV with SOT for a variety of vitreoretinal conditions from October 2018 to January 2019. Clinical investigations included uncorrected visual acuity (VA), best-corrected VA, refraction, corneal power and axial length pre- and post-surgery. Differences in these parameters were assessed using a paired sample t -test with a significance level of < 0.05. Results: Medical records of 59 consecutive patients (59 eyes, 41 men and 18 women) with ages ranging from 22 years to 75 years were studied. The findings revealed a statistically significant hypermetropic change (pre: –0.17 ± 2.44 dioptre [D] and post: +4.43 ± 2.04 D) with a p -value of < 0.001. In terms of axial length, there was a significant increase (pre: 23.61 ± 1.17 mm and post: 23.82 ± 1.27 mm; p < 0.001). However, no significant change was found in corneal power (pre: –43.60 ± 1.96 D and post: 43.63 ± 2.03 D; p = 0.45). Conclusion: A hypermetropic shift in refraction, longer axial length and non-considerable increase in corneal power were observed amongst Sudanese phakic patients after PPV with instillation of silicone oil. [ABSTRACT FROM AUTHOR]

• First time we identified three unique heterozygous nonsynonymous variations at exon 8 in the ABCB6 gene. • One synonymous SNV at exon8 of ABCB6 gene was observed. • One homozygous stop-gain SNV at exon5 position in GRN gene was found. Protease inhibitors (PIs) are associated with an incidence of lipodystrophy among people living with HIV (PLHIV). Lipodystrophies are characterised by the loss of adipose tissue. Evidence suggests that a patient's lipodystrophy phenotype is influenced by genetic mutation, age, gender, and environmental and genetic factors, such as single-nucleotide variants (SNVs). Pathogenic variants are considered to cause a more significant loss of adipose tissue compared to non-pathogenic. Lipid metabolising enzymes and transporter genes have a role in regulating lipoprotein metabolism and have been associated with lipodystrophy in HIV-infected patients (LDHIV). The long-term effect of the lipodystrophy syndrome is related to cardiovascular diseases (CVDs). Hence, we determined the SNVs of lipid metabolising enzymes and transporter genes in a total of 48 patient samples, of which 24 were with and 24 were without HIV-associated lipodystrophy (HIVLD) using next-generation sequencing. A panel of lipid metabolism, transport and elimination genes were sequenced. Three novel heterozygous non-synonymous variants at exon 8 (c.C1400A:p.S467Y, c.G1385A:p.G462E, and c.T1339C:p.S447P) in the ABCB6 gene were identified in patients with lipodystrophy. One homozygous non-synonymous SNV (exon5:c.T358C:p.S120P) in the GRN gene was identified in patients with lipodystrophy. One novel stop-gain SNV (exon5:c.C373T:p.Q125X) was found in the GRN gene among patients without lipodystrophy. Patients without lipodystrophy had one homozygous non-synonymous SNV (exon9:c.G1462T:p.G488C) in the ABCB6 gene. Our findings suggest that novel heterozygous non-synonymous variants in the ABCB6 gene may contribute to defective protein production, potentially intensifying the severity of lipodystrophy. Additionally, identifying a stop-gain SNV in the GRN gene among patients without lipodystrophy implies a potential role in the development of HIVLD. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the effect of Compound cantharis capsules on gastrointestinal hormone and Th1/Th2 immune balance in patients with hilar cholangiocarcinoma after surgery. METHODS: Totally 86 patients with hilar cholangiocarcinoma received surgery admitted into the Affiliated Hospital of Hebei University of Engineering from Jun. 2018 to Jul. 2020 were selected and divided into observation group and control group via random number table, with 43 cases in each group. The control group was given conventional processing after surgery, while the observation group was treated with Compound cantharis capsules for 2 weeks since the second day after treatment based on the control group. Recovery of gastrointestinal function after surgery, levels of gastrointestinal hormone, peripheral blood Th1-like cytokines[including interleukin 2 (IL-2), interferon-γ (IFN-γ) and tumor necrosis factor α (TNF-α) ], Th2-like cytokines[including interleukin 4 (IL-4) and interleukin 10 ( IL-10) ], proportion of Th1 cell and Th2 cell, Th1/Th2, incidences of postoperative complications and adverse drug reactions during treatment were observed. RESULTS: After surgery of cholangiocarcinoma, the recovery time of bowel sounds, the first anal venting and defecation time of patients in the observation group were shorter than those in the control group, with statistically significant differences (P < 0. 05). After treatment, the motilin (MTL) and gastrin (GAS) levels of both groups were significantly higher than those of before treatment, the MTL and GAS levels of observation group were significantly higher than those of the control group; the vasoactive intestinal peptide (VIP) levels of both groups were significantly lower than those of before treatment, and the VIP level of observation group was significantly lower than that of the control group, with statistically significant differences (P < 0. 05). After treatment, the peripheral blood IL-2, IFN-γand TNF-α levels, proportion of Th1 cell and Th1/Th2 value of both groups were significantly higher than those of before treatment, and those of the observation group were significantly higher than the control group; the IL-4 and IL-10 levels and proportion of Th2 cell of both groups were significantly lower than those of before treatment, and those of the observation group were significantly lower than the control group, with statistically significant differences (P <0. 05). The incidence of complications was 32. 56% (14/43) in the observation group, which was slightly lower than41. 86% (18/43) in the control group, the difference was not statistically significant (P > 0. 05). During treatment, the incidences of adverse drug reactions were respectively 60. 47% ( 26/43) in the observation group and 58. 14% (25/43) in the control group, the difference was not statistically significant (P > 0. 05). CONCLUSIONS: The application of Compound cantharis capsules on patients with hilar cholangiocarcinoma after surgery can promote the recovery of gastroenteric function, regulate gastrointestinal hormones, increase the proportions of Th1-like cytokines and Th1 cell, decrease the proportions of Th2-like cytokines and Th2 cell, improve the Th1/Th2 immune balance and reduce postoperative complications, with good safety. [ABSTRACT FROM AUTHOR]

The cost of providing water services is increasing, placing greater financial burdens on individual households and utilities. Five metrics were calculated at multiple volumes of water usage and were applied to 1791 utilities, estimating bills from 2020 rates data, to gauge financial burdens in four states. More than a fifth of the population in 77% of utilities was experiencing poverty, suggesting widespread poverty is a major contributor to utility financial capability challenges. The Income Dedicated to Water Service metric was developed to understand how many households share a similar financial burden, exploring both the depth and prevalence of affordability challenges. Depending on water use, a tenth to a third of households work more than a day each month to afford water bills. This approach and an interactive visualization tool bring greater transparency to understand the scale of affordability and financial capability challenges (https://nicholasinstitute.duke.edu/water-affordability/water-affordability-dashboard). [ABSTRACT FROM AUTHOR]

In this paper, we present the following new asymptotic formula of factorial n ... depending on Ramanujan's approximation formula for n! and we deduce the following upper bound for gamma function ... [ABSTRACT FROM AUTHOR]

Background: During the early phases of the COVID-19 pandemic pandemic, stay-at-home orders and fear of acquiring COVID-19 may have led to an avoidance of care for medical emergencies, including acute myocardial infarction (AMI). We evaluated whether a decline in rates of AMI occurred during the COVID-19 stay-at-home order. Methods: Rates of AMI per 100,000 member-weeks were calculated for Kaiser Permanente Southern California patients from January 1 to March 3, 2020 (prepandemic period) and from March 20 to July 31, 2020 (pandemic period), and during the same periods in 2019. Rate ratios (RRs) were calculated comparing the time periods using Poisson regression. Case fatality rates (CFRs) were also compared. Results: Rates of AMI were lower during the pandemic period of 2020 compared to the same period of 2019 [3.20 vs 3.76/100,000 member-weeks; RR, 0.85; 95% confidence interval (CI) 0.80-0.90]. There was no evidence that rates of AMI differed during the 2020 prepandemic period compared to the same period in 2019 (4.45 vs 4.24/100,000 member-weeks; RR, 0.95; 95% CI, 0.88-1.03). AMI rates were lower during the early pandemic period (March 20-May 7: RR, 0.70; 95% CI, 0.66-0.77), but not during the later pandemic period (May 8-July 31: RR, 0.95; 95% CI, 0.88-1.02) compared to 2019. In-hospital and 30-day case fatality rates were higher during the pandemic period of 2020 compared to 2019 (8.8% vs 6.1% and 6.5% vs 5.0%, respectively). Conclusion: AMI rates were lower during the COVID-19 pandemic compared to the same period in 2019. During stay-athome orders, public health campaigns that encourage people to seek care for medical emergencies are warranted. [ABSTRACT FROM AUTHOR]

Background Recent studies have suggested that Kaposi sarcoma (KS) rates might be increasing in some racial/ethnic groups, age groups, and US regions. We estimated recent US trends in KS incidence among people living with human immunodeficiency virus (HIV; PLWH). Methods Incident KS patients aged 20–59 years were obtained from 36 cancer registries and assumed to be living with HIV. The number of PLWH was obtained from national HIV surveillance data from 2008 to 2016. Age-standardized KS rates and annual percent changes (APCs) in rates were estimated by age, sex, race/ethnicity, state, and region. Results Between 2008 and 2016, the age-adjusted KS rate among PLWH was 116/100 000. Rates were higher among males, in younger age groups, and among white PLWH. Washington, Maine, and California had the highest KS rates among PLWH. KS rates among PLWH decreased significantly (average APC = −3.2% per year, P  < .001) from 136/100 000 to 97/100 000 between 2008 and 2016. There were no statistically significant increases in KS rates in any age, sex, or racial/ethnic group or in any geographic region or state. However, there were nondecreasing trends in some states and in younger age groups, primarily among black PLWH. Conclusions KS incidence rates among PLWH have decreased nationally between 2008 and 2016. Though there were no statistically significant increases in KS rates in any demographic or geographic group, nondecreasing/stagnant KS trends in some states and among younger and black PLWH highlight the need for early diagnosis and treatment of HIV infection. [ABSTRACT FROM AUTHOR]

This paper introduces the event-probability function, a measure of occurrence of an event of interest over time, defined as the instantaneous probability of an event at a given time point conditional on having survived until that point. Unlike the hazard function, the event-probability function is a proper probability. This paper describes properties and interpretation of the event-probability function, presents its connection with other popular functions, such as the hazard and survival functions, proposes practical flexible proportional-odds models for estimating conditional event-probabilities given covariates with possibly censored and truncated observations, discusses the theoretical and computational aspects of parameter estimation, and applies the proposed models for assessing mortality in patients with metastatic renal carcinoma from a randomized clinical trial. [ABSTRACT FROM AUTHOR]

The paper analysed the Nigerian manufacturing sector performance under trade globalization. In line with the objectives of the study, secondary data covering the period 1986 - 2018 were obtained from the Central Bank of Nigeria Statistical Bulletin and was used to analysed the relationship between Manufacturing Sector Output as the dependent variable and Degree of Openness, Foreign Exchange Rate, Gross Capital Formation and Interest Rate as the independent variables. The Unit Root Test was employed to ascertain the level of stationarity of the variables. The Auto Regressive Distributed Lag Bound Test for Cointegration was also employed while the Short-run Dynamic ARDL Model was conducted to check the speed of adjustment. Based on our findings, the study recommends that for an improvement in the output of manufacturing sector in Nigeria, there is a need to match the embracement of innovation and modern manufacturing processes with action so as to improve the capacity to produce and make the sector producers of goods and services for both local and international use. There is also the need to encourage investment in the sector through the promotion of positive trade openness of the economy so as install/restore confidence of investors in the activities of the manufacturing output while policies to control the continuous fluctuation of the exchange rate should be enacted as a volatile exchange rate will discourage investment in the sector thereby leading to a fall in the sector's output. [ABSTRACT FROM AUTHOR]

Over the years, there has been an increasing debate over the role of the Central Bank in targeting the policy objectives and the extent to which the targets can anchor the expectations. The present study seeks to identify the linkage between monetary policy and financial stability in India. The study, based on quarterly data from January 2001 to July 2018, finds that the financial sector allied variables (BSE SENSEX index, Exchange Rate and Index of Industrial Production) have shown significant response to shocks in the policy rate, that is, reverse repo rate, except for exchange rate variable that was taken as a proxy for external sector stability. Also in the short‐run, when a shock is imparted to the policy rate, the response of the exchange rate is insignificant. Other than that, the corporate sector along with real output growth and banking sector variables induces a significant change in policy rate when a shock is introduced. With variables responding in the ideal direction to shock in the policy rate, it is inferred that the movement is in line with what ideally should hold over time. This leads us to conclude that the monetary policy safeguards financial stability in India. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the effects of liraglutide and glimepiride in the treatment of patients with inadequately glycemic controlled type 2 diabetes with insulin pump and its adverse drug reactions. METHODS: Totally166 patients with type 2 diabetes admitted into Hengshui People’s Hospital from Aug. 2018 to Aug. 2020 were extracted, after 7 d of continuous treatment with subcutaneous insulin pump ( insulin dosage ＞ 0. 7 IU/kg), the blood glucose was still not up to standard. All patients were divided into the research group ( n = 84) and the control group ( n = 82) via the random number table. The control group was treated with glimepiride, while the research group received liraglutide. Peripheral blood biochemical indicators [glycated hemoglobin ( HbA1 c), fasting blood glucose ( FBG), 2 h postprandial blood glucose ( 2 h PG), triglycerides ( TG), total cholesterol ( TC), high-density lipoprotein cholesterol ( HDL-C), low-density lipoprotein cholesterol ( LDL-C), lipoprotein-related phospholipase A2 ( Lp-PLA2) and high-sensitivity C-reactive protein ( hs-CRP) ], insulin-related indicators [fasting insulin ( FINS), homeostasis model assessment of insulin resistance ( HOMA-IR) ], renal function indicators [serum uric acid ( SUA), creatinine ( SCr), urinary protein excretion rate ( UAER) and urine microalbumin/urinary creatine liver ( ACR) ]and vascular function of both lower limbs [intravascular median membrane thickness ( IMT), peak systolic velocity ( PSV)and stenosis rate] and adverse drugs reactions of two groups were recorded before treatment and after treatment of3 months. RESULTS: After treatment of 3 months, the levels of HbA1 c, FBG, 2 h PG, TG, TC, LDL-C, Lp-PLA2 and hs-CRP in two groups were significantly lower than those before treatment, while the levels of HDL-C were significantly higher than those before treatment; compared with the control group, the levels of HbA1 c, FBG, 2 hPG, TG, TC, LDL-C, Lp-PLA2, hs-CRP and other biochemical indicators in the research group decreased significantly, while the levels of HDL-C increased significantly, with statistically significant difference ( P ＜ 0. 05). After treatment of 3 months, the levels of FINS, HOMA-IR and other indicators in two groups were significantly lower than those before treatment, and the levels of FINS and HOMA-IR in the research group were significantly lower than those in the control group, and the differences were statistically significant ( P ＜ 0. 05). After treatment of 3 months, the levels of renal function indicators such as UAER, SCr, SUA and ACR, and vascular function indicators such as IMT, PSV and stenosis rate of two groups were significantly lower than those before treatment; and the levels of the above renal function indicators and vascular function indicators of the research group were significantly lower than those of the control group, the differences were statistically significant ( P ＜ 0. 05). There were no severe adverse drug reactions in two groups after treatment. CONCLUSIONS: The efficacy of insulin pump combined with liraglutide is better than glimepiride in the treatment of patients with type 2 diabetes. Liraglutide has a more significant effect on blood glucose, blood lipids, islet function and renal function, and has higher safety. [ABSTRACT FROM AUTHOR]

Two split trials with four replications were conducted at the Bangar El- Sukar region, Burg El- Arab, Alex. Governorate, Egypt during 2018/19 and 2019/20 seasons to study the effect of two nitrogen sources fertilizers (ammonium sulphate 20.6% and urea 46%) with three rates (80, 100 and 120 Kg N/ fed.) on growth, yield components and quality characters and nitrogen use efficiency of sugarbeet grow on a clay loam soil. Results showed that significant differences were reported between sources of nitrogen fertilizer in the most plant growth characters, yield components, quality parameters and impurity parameters as well as nitrogen use efficiency (NUE) in the two seasons. Beet plants fertilized with ammonium sulphate as compared with urea significantly exceeded root and top fresh weight, root length, root diameter, leaf area index and total dry matter accumulation per plant as growth parameters, roots, top, gross sugar and white sugar as yield components, percentage of gross sugar, white sugar, quality index as quality parameters and NUE for yields of roots, gross sugar, white sugar and loss sugar in both seasons, and chlorophyll “a” in first season only. On contrary, also, ammonium sulphate significantly decreased concentrations of K, Na, α- amino- N as impurities and loss sugar% as compared with urea in both seasons. Application of different rates of nitrogen fertilizer in the two seasons, significantly affected all tested traits, except loss sugar yield and quality index in the first season only. Application of 120 Kg N/fed. rate recorded the highest values of all tested plant characters, photosynthetic contents, yield components, quality parameters and NUE for gross sugar and white sugar yields. In addition, the same nitrogen rate produced the lowest values for all impurity parameters measured (K, Na, α- amino- N and AC), loss sugar percent, NUE for roots and loss sugar yields in the both seasons. The interaction between sources and rates of nitrogen fertilizer were significant effect on root length and fresh weight/ plant in first season only, root diameter, chlorophyll “b”, gross sugar yield/ fed., all quality parameters and NUE for loss sugar yield in the second season only. However, in the two seasons, roots, top and white sugar yields/ fed. and all impurities as well as NUE for roots, gross sugar and white sugar yields were significantly affected by the interaction between sources and rates of nitrogen fertilizer. In general, application ammonium sulphate fertilizer at the rate of 120 Kg N/ fed. was recommended because it recorded the highest root characterse, chlorophyll "b", most yield components and quality traits as well as NUE for gross sugar and white sugar yields, and the lowest loss sugar yield, loss sugar%, NUE for roots yield and all impurities traits. [ABSTRACT FROM AUTHOR]

BJECTIVE: To systematically evaluate the risk factors for severe thrombocytopenia or bleeding induced by tirofiban.METHODS: PubMed,EMBase,the Cochrane Library,CNKI,CBM,Wanfang and VIP database were retrieved to collect the literature of risk factors for severe thrombocytopenia or bleeding induced by tirofiban.The retrieval time was from the establishment of the database to Feb. 2020. Two researchers independently screened the literature according to the inclusion and exclusion criteria,extracted the data and evaluated the quality. RevMan 5. 3 software was used for Meta-analysis. RESULTS: A total of 10 literature were included,including 2 foreign language literature and 8 Chinese literature,and 10 141 patients were enrolled.A total of 13 exposure factors were screened out.The univariate Meta-analysis results showed that patients’ old age (MD = 6. 23,95% CI = 4. 58-7. 88),emergency percutaneous coronary intervention (OR = 3. 48,95%CI = 2. 25-5. 38),hypertension (OR = 1. 37,95%CI = 1. 08-1. 72),reduced platelet aggregation rate (MD =-8. 91,95% CI =-11. 17--6. 66),reduced platelet count (MD =-21. 93,95%CI =-32. 81--11. 04),reduced serum creatinine (MD = 10. 01,95% CI = 1. 75-18. 27),reduced creatinine clearance (MD =-32. 16,95% CI =-36. 06--28. 25),reduced glomerular filtration rate (MD =-15. 19,95% CI =-19. 11--11. 26) and the combined application of multiple anticoagulants (OR = 0. 89,95%CI = 0. 53-1. 25) were risk factors for severe thrombocytopenia or bleeding induced by tirofiban (P ＜ 0. 05) . Multivariate Meta-analysis results showed that old age (＞65 years),hypertension,emergency percutaneous coronary intervention and reduced glomerular filtration rate (＜60 ml/min) were independent risk factors for severe thrombocytopenia or bleeding induced by tirofiban (P＜ 0. 01) . The results of sensitivity analysis indicated that the stability of the results was good. CONCLUSIONS:Patients should be alert to severe thrombocytopenia or bleeding when using tirofiban. For patients with risk factors,individualized evaluation should be carried out in advance to reduce the occurrence of adverse drug reactions. [ABSTRACT FROM AUTHOR]

The paper is concerned with the semilinear wave equations with time‐dependent damping γ(t)=α/(1+t) (α>0), under the effect of nonlinear source f behaving like a polynomial, and subject to Neumann boundary conditions. Constructing appropriate auxiliary functions, we obtain an explicit uniform decay rate estimate for the solutions of the equation in terms of the exponent of f, when α is large enough. On the other hand, via a new hyperbolic version of Dirichlet quotients, we show that the upper estimate is optimal in some case, which implies the existence of slow solutions. [ABSTRACT FROM AUTHOR]

• Fewer Latin American and Caribbean nations achieving 90% coverage for some vaccines. • Caribbean sub-region accounts for much of the decline in vaccine coverage. • Moderate association between gross national income per capita and vaccine coverage. • Weak to moderate associations between immunization expenditures and coverage rates. • Latin America and Caribbean countries self-reliant in funding vaccine expenditures. From 2006 to 2011 nearly 174,000 deaths were prevented in Latin America and the Caribbean through vaccination of children under five, which is widely attributed to the Expanded Program on Immunization (EPI). Despite near global adoption of EPI recommendations, vaccination coverage shows substantial variation across world regions. Causes for low immunizations within regions are multifaceted and include vaccination program costs. To date, publications regarding vaccine coverage across Latin America and the Caribbean are not readily available. This study aimed to: (1) compare vaccine coverage trends across nations within the region; and (2) assess whether national immunization program expenditures are correlated with vaccine coverage. Coverage for nine vaccines were collected by nation using publicly available data from WHO. National immunization program expenditures for each country were collected from the World Bank Index. The proportion of countries achieving 90% coverage in the years 2013 and 2017 for each vaccine were compared. Pearson correlation coefficients were calculated to measure the relationship between financing variables and DTP3 coverage for 2017. In 2017, fewer Latin American and Caribbean nations were able to achieve 90% vaccine coverage for five vaccines compared to 2013. Mostly weak to moderate positive relationships were found between national immunization program expenditures and DTP3 coverage for 2017. Excluding Haiti, a weak negative relationship was found between total government expenditure on vaccines per infant and DTP3 coverage for 2017. Countries across Latin America and the Caribbean were largely self-reliant in funding vaccine expenditures. Fewer countries across Latin America and the Caribbean are currently achieving optimum national vaccine coverage and weak to moderate relationships between routine immunization and vaccine expenditures and coverage were observed. Additional factors contributing to national vaccine coverage should be concomitantly examined to implement strategies which optimize delivery of childhood immunizations. [ABSTRACT FROM AUTHOR]

Periodic operational results of companies and hence financial performances related to these results concern a wide range of people called “interest groups or stakeholders of the enterprise”. It is essential for businesses to operate successfully in a dynamic environment with intense competition and to sustain their endlessly accepted lifetimes, to check the results of the activities and to measure performance constantly. Financial performance measurement is done with generally accepted financial ratios. However, measurements using a large number of financial ratios have limitations in terms of time, cost and effectiveness. Due to these constraints, many Multi-Criteria Decision Making Techniques have been developed that provide the same level of success by using fewer rates. In the study, financial performances of 7 firms whose shares are traded in Borsa İstanbul (BİST) retail sector and similar in their fields of activity, for the period of 2017-2019; measured using intuitionistic fuzzy EDAS (IF-EDAS) method, which is one of the multi-criteria decision making techniques, using 10 generally accepted financial ratios. The findings show that effective performance measurement can be made with a small number of rates over a 2-3 year period. [ABSTRACT FROM AUTHOR]

The article discusses Hospital funding: constitutionality the additional service discount, which includes the parties are arguing about the legality of the hospital fee law, social service providers and their working group in the hospital care, rates and in the hospital charges mentioned in this provision and agreement does not include a discount for additional services.

In this paper we prove an estimate for the total variation distance, in the framework of the Breuer–Major theorem, using the Malliavin–Stein method, assuming the underlying function g to be once weakly differentiable with g and g ′ having finite moments of order four with respect to the standard Gaussian density. This result is proved by a combination of Gebelein's inequality and some novel estimates involving Malliavin operators. [ABSTRACT FROM AUTHOR]

We consider so-called univariate unlinked (sometimes "decoupled," or "shued") regression when the unknown regression curve is monotone. In standard monotone regression, one observes a pair (X; Y) where a response Y is linked to a covariate X through the model Y = m0(X) + ffl, with m0 the (unknown) monotone regression function and ffl the unobserved error (assumed to be independent of X). In the unlinked regression setting one gets only to observe a vector of realizations from both the response Y and from the covariate X where now Y d= m0(X) + ffl. There is no (observed) pairing of X and Y. Despite this, it is actually still possible to derive a consistent non-parametric estimator of m0 under the assumption of monotonicity of m0 and knowledge of the distribution of the noise ffl. In this paper, we establish an upper bound on the rate of convergence of such an estimator under minimal assumption on the distribution of the covariate X. We discuss extensions to the case in which the distribution of the noise is unknown. We develop a second order algorithm for its computation, and we demonstrate its use on synthetic data. Finally, we apply our method (in a fully data driven way, without knowledge of the error distribution) on longitudinal data from the US Consumer Expenditure Survey. [ABSTRACT FROM AUTHOR]

The determination of rate constants for consecutive irreversible reactions is a difficult and time‐consuming problem, especially when the research extends up to many subsequent products. Thus, the derivation of proper mathematical expressions would greatly facilitate the determination of these rate constants when only the rate constant of the first consecutive reaction is known. Many authors have dealt with this problem in the past but the issue is still of interest to the scientific community judging from recent publications. This paper aims at extending our knowledge of mathematical expressions for rate constant ratios of consecutive reactions to more than three reactions, as is the situation now, and offering a simple graphical estimation of the rate constant ratios exploiting the maxima of each intermediate product. Furthermore, the method extends to the derivation of a generic formula for the estimation of the rate constant ratios based on this graphical approach. This approach for the estimation of rate constant ratios based on mathematical expressions and graphical estimations was validated against experimental data found in the literature. [ABSTRACT FROM AUTHOR]

• Suicide rates decrease in the 65 and older age groups and have a heterogeneous pattern in the others. • In women, the age-standardized risk of death by suicide increased by 2.5 % between 1998 and 2021. • In men, the age-standardized risk of death by suicide decreased by 13.7 % between 1998 and 2021. • Men have had suicide mortality rates 3–4 times higher than women in any given year. • In comparison to the years 2018 and 2019, suicide mortality in Spain appears to undergo a slight increase following the COVID-19 pandemic. In the European Union, a rate of 11.9 cases per 100,000 was estimated in 2019.In Spain, suicide is the leading cause of external death. Social crises can have an impact on suicide rates. We analyzed changes in suicide mortality trends in Spain following the COVID-19 pandemic. We used statistical data from the National Institute of Statistics of Spain (1998–2021). We calculated age-specific rates, age and sex-adjusted rates, and analyzed trends and changes using joinpoint-regression models. Rates decrease in both sexes at the ages of 65 and older. In women, they increase in the ages of 1–29 years and 45–59 years. In men, they decrease in the ages of 15–39 years. Among women, age-adjusted rates remained stable between 1998 and 2021, with a non-significant annual decrease of 0.4 %. Among men, there was a significant annual decrease of 0.7 %. The years 2020 and 2021 had 8 % higher mortality compared to the two years prior to the COVID-19 pandemic. Suicide mortality in Spain slightly decreased among men and remained stable among women between 1998 and 2021, but there seems to be an increase following the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

A quantity of studies have documented how greater condition and older age of individual fish enhances reproductive success via a variety of processes from egg production to larval survival. If these relations translate into relationships between stock demography and recruitment, maintaining a "healthy" age composition may be a key step towards ensuring stock productivity. We examined the correlation between indicators of the age and size composition and the residual-variation from the stock-recruitment relationship (i.e. the variation not explained by the spawning stock biomass) in eleven commercially exploited fish stocks in the North Sea. We also analyzed to what extent spawner age and size composition responded to variations in fishing mortality. Before detrending to accommodate any temporal patterns, recruitment residuals correlated negatively with the relative age composition in all eleven stocks (plaice, whiting, and saithe being significant). However, after detrending the recruitment residuals, the correlations weakened and only nine out of eleven stocks correlated negatively. Lastly, we also conducted a delay difference analysis, which yielded a more or less even distribution between negative and positive correlations, and in addition two stocks (cod and Norway pout) came out showing significant positive correlations between recruitment residuals and age composition. In contrast, eight of the eleven stocks showed positive correlations between spawner weight and recruitment residuals and correlations were significant for plaice, cod, and saithe. After detrending the data, the significant correlations disappeared, but the overall tendency towards positive correlations between spawner weight and recruitment residuals prevailed. Overall, these results suggest that fish condition is more likely to show positive relationships with recruitment success than age composition. Lastly, it was found that the majority of stocks showed a strong link between fishing mortality and the two indicators of age composition, and when looking across stocks, the age composition appears to have returned to the same level as in the 1960 s. Conversely, spawner weight at age have not recovered, and considering the indications of a positive link between spawner weight and recruitment, recruitment success of the North Sea stocks may remain low in spite of the apparently successful rebuilding of the age composition. • A large proportion of old fish coincided with increased recruitment in Atlantic cod and Norway pout. • Individual weight of old fish in the spawning stock was often positively correlated with recruitment. • As expected, the age composition responded directly to changes in fishing pressure. • There was a general declining trend over time in the individual weight of fish in the spawning stock. [ABSTRACT FROM AUTHOR]