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Abstract Objective To collate and critically review international evidence on the direct health system costs of children and adolescents and young adults (AYA) with cancer. Methods We conducted searches in PubMed, MEDLINE, CINAHL, and Scopus. Articles were limited to studies involving people aged 0–39 years at cancer diagnosis and published from 2012 to 2022. Two reviewers screened the articles and evaluated the studies using the Consolidated Health Economic Evaluation Reporting Standards checklist. The reviewers synthesized the findings using a narrative approach and presented the costs in 2022 US dollars for comparability. Results Overall, the mean healthcare costs for all cancers in the 5 years post diagnosis ranged from US$36,670 among children in Korea to US$127,946 among AYA in the USA. During the first year, the mean costs among children 0–14 years ranged from US$34,953 in Chile to over US$130,000 in Canada. These were higher than the costs for AYA, estimated at US$61,855 in Canada. At the end of life, the mean costs were estimated at over US$300,000 among children and US$235,265 among adolescents in Canada. Leukemia was the most expensive cancer type, estimated at US$50,133 in Chile, to US$152,533 among children in Canada. Overall, more than a third of the total cost is related to hospitalizations. All the included studies were of good quality. Conclusions Healthcare costs associated with cancer are substantial among children, and AYA. More research is needed on the cost of cancer in low‐ and middle‐income countries and harmonization of costs across countries.

Abstract Background The AZTEC trial is a multi-centre, randomised, placebo-controlled trial of azithromycin to improve survival without development of chronic lung disease of prematurity (CLD) in preterm infants. The statistical analysis plan for the clinical outcomes of the AZTEC trial is described. Methods and design A double-blind, randomised, placebo-controlled trial of a 10-day course of intravenous azithromycin (20 mg/kg for 3 days; 10 mg/kg for 7 days) administered to preterm infants born at

Reliable quantitative vegetation reconstructions for Europe during the Holocene are crucial to improving our understanding of landscape dynamics, making it possible to assess the past effects of environmental variables and land-use change on ecosystems and biodiversity, and mitigating their effects in the future. We present here the most spatially extensive and temporally continuous pollen-based reconstructions of plant cover in Europe (at a spatial resolution of 1° × 1°) over the Holocene (last 11.7 ka BP) using the ‘Regional Estimates of VEgetation Abundance from Large Sites’ (REVEALS) model. This study has three main aims. First, to present the most accurate and reliable generation of REVEALS reconstructions across Europe so far. This has been achieved by including a larger number of pollen records compared to former analyses, in particular from the Mediterranean area. Second, to discuss methodological issues in the quantification of past land cover by using alternative datasets of relative pollen productivities (RPPs), one of the key input parameters of REVEALS, to test model sensitivity. Finally, to validate our reconstructions with the global forest change dataset. The results suggest that the RPPs.st1 (31 taxa) dataset is best suited to producing regional vegetation cover estimates for Europe. These reconstructions offer a long-term perspective providing unique possibilities to explore spatial-temporal changes in past land cover and biodiversity.

The transnational turn in U.S. literary and cultural studies has led to a new consideration of the Atlantic world, particularly of the circumCaribbean, which has been the theatre for some of the most dramatic events of Atlantic history. Haiti, as a nexus for revolution, racial turmoil, and colonial and postcolonial struggle, has always been a lodestar for Southern and circumCaribbean writers. This paper briefly considers links between the U.S. South and the Caribbean, and then examines many examples of the ways in which the Haitian Revolution was reflected in both well-known and more obscure works of U.S. Southern and Caribbean literature, focusing on writers such as Séjour, Cable, Bontemps, Faulkner, Carpentier, Glissant, and James. The concluding section demonstrates how the contemporary Southern writer Madison Smartt Bell drew on this rich literary vein to create his magnificent trilogy on the Haitian Revolution, which begins with the text considered here, All Souls Rising. I also argue that this new configuration of region and cultural history has had and will have future consequences for the status of “durable” and “transient” notions of literary canons.

Introduction Chronic lung disease of prematurity (CLD), also known as bronchopulmonary dysplasia (BPD), is a cause of significant respiratory morbidity in childhood and beyond. Coupled with lung immaturity, infections (especially by Ureaplasma spp) are implicated in the pathogenesis of CLD through promotion of pulmonary inflammation. Azithromycin, which is a highly effective against Ureaplasma spp also has potent anti-inflammatory properties. Thus, azithromycin therapy may improve respiratory outcomes by targeting infective and inflammatory pathways. Previous trials using macrolides have not been sufficiently powered to definitively assess CLD rates. To address this, the azithromycin therapy for chronic lung disease of prematurity (AZTEC) trial aims to determine if a 10-day early course of intravenous azithromycin improves rates of survival without CLD when compared with placebo with an appropriately powered study.Methods and analysis 796 infants born at less than 30 weeks’ gestational age who require at least 2 hours of continuous respiratory support within the first 72 hours following birth are being enrolled by neonatal units in the UK. They are being randomised to receive a double-blind, once daily dose of intravenous azithromycin (20 mg/kg for 3 days, followed by 10 mg/kg for a further 7 days), or placebo. CLD is being assessed at 36 weeks’ PMA. Whether colonisation with Ureaplasma spp prior to randomisation modifies the treatment effect of azithromycin compared with placebo will also be investigated. Secondary outcomes include necrotising enterocolitis, intraventricular/cerebral haemorrhage, retinopathy of prematurity and nosocomial infections, development of antibiotic resistance and adverse reactions will be monitored.Ethics and dissemination Ethics permission has been granted by Wales Research Ethics Committee 2 (Ref 18/WA/0199), and regulatory permission by the Medicines and Healthcare Products Regulatory Agency (Clinical Trials Authorisation reference 21323/0050/001–0001). The study is registered on ISRCTN (ISRCTN11650227). The study is overseen by an independent Data Monitoring Committee and an independent Trial Steering Committee. We shall disseminate our findings via national and international peer-reviewed journals, and conferences. A summary of the findings will also be posted on the trial website.

BackgroundMany but not all studies suggest an association between air pollution exposure and infant mortality. We sought to investigate whether pollution exposure is differentially associated with all-cause neonatal or postneonatal mortality, or specific causes of infant mortality.Methods and findingsWe separately investigated the associations of exposure to particulate matter with aerodynamic diameter ≤ 10 μm (PM10), nitrogen dioxide (NO2), and sulphur dioxide (SO2) with all-cause infant, neonatal, and postneonatal mortality, and with specific causes of infant deaths in 7,984,366 live births between 2001 and 2012 in England and Wales. Overall, 51.3% of the live births were male, and there were 36,485 infant deaths (25,110 neonatal deaths and 11,375 postneonatal deaths). We adjusted for the following major confounders: deprivation, birthweight, maternal age, sex, and multiple birth. Adjusted odds ratios (95% CI; p-value) for infant deaths were significantly increased for NO2, PM10, and SO2 (1.066 [1.027, 1.107; p = 0.001], 1.044 [1.007, 1.082; p = 0.017], and 1.190 [1.146, 1.235; p < 0.001], respectively) when highest and lowest pollutant quintiles were compared; however, neonatal mortality was significantly associated with SO2 (1.207 [1.154, 1.262; p < 0.001]) but not significantly associated with NO2 and PM10 (1.044 [0.998, 1.092; p = 0.059] and 1.008 [0.966, 1.052; p = 0.702], respectively). Postneonatal mortality was significantly associated with all pollutants: NO2, 1.108 (1.038, 1.182; p < 0.001); PM10, 1.117 (1.050, 1.188; p < 0.001); and SO2, 1.147 (1.076, 1.224; p < 0.001). Whilst all were similarly associated with endocrine causes of infant deaths (NO2, 2.167 [1.539, 3.052; p < 0.001]; PM10, 1.433 [1.066, 1.926; p = 0.017]; and SO2, 1.558 [1.147, 2.116; p = 0.005]), they were differentially associated with other specific causes: NO2 and PM10 were associated with an increase in infant deaths from congenital malformations of the nervous (NO2, 1.525 [1.179, 1.974; p = 0.001]; PM10, 1.457 [1.150, 1.846; p = 0.002]) and gastrointestinal systems (NO2, 1.214 [1.006, 1.466; p = 0.043]; PM10, 1.312 [1.096, 1.571; p = 0.003]), and NO2 was also associated with deaths from malformations of the respiratory system (1.306 [1.019, 1.675; p = 0.035]). In contrast, SO2 was associated with an increase in infant deaths from perinatal causes (1.214 [1.156, 1.275; p < 0.001]) and from malformations of the circulatory system (1.172 [1.011, 1.358; p = 0.035]). A limitation of this study was that we were not able to study associations of air pollution exposure and infant mortality during the different trimesters of pregnancy. In addition, we were not able to control for all confounding factors such as maternal smoking.ConclusionsIn this study, we found that NO2, PM10, and SO2 were differentially associated with all-cause mortality and with specific causes of infant, neonatal, and postneonatal mortality.

X' theory was a major milestone in the history of the development of generative grammar.1 It enabled important insights to be made into the phrase structure of human language, but it had a number of weaknesses, and has been essentially replaced in Chomskyan generativism by Bare Phrase Structure (BPS), which assumes fewer theoretical primitives than X0 theory, and also avoids several of the latter’s weaknesses. However, Bare Phrase Structure has not been widely adopted outside the Minimalist Program (MP), rather, X0 theory remains widespread. In this paper, we develop a new, fully formalized approach to phrase structure which incorporates insights and advances from BPS, but does not require the Minimalist-specific assumptions that come with BPS. We formulate our proposal within Lexical-Functional Grammar (LFG), providing an empirically and theoretically superior model for phrase structure compared with standard versions of X0 theory current in LFG.

Being born very preterm is associated with later deficits in lung function and an increased rate of respiratory symptoms compared with term-born children. The rates of early respiratory infections are higher in very preterm-born subjects, which may independently lead to deficits in lung function in later life. As with very preterm-born children, deficits in lung function, increased respiratory symptoms and an increased risk of respiratory infections in early life are observed in late ­preterm-born children. However, the rates of respiratory symptoms are lower compared with very preterm-born children. There is some evidence to suggest that respiratory outcomes may be improving over time, although not all the evidence suggests improvements. Male sex appears to increase the risk for later adverse respiratory illness. Although not all studies report that males have worse long-term respiratory outcomes than females. It is essential that preterm-born infants are followed up into childhood and beyond, and that appropriate treatment for any lung function deficits and respiratory symptoms is prescribed if necessary. If these very preterm-born infants progress to develop chronic obstructive airway disease in later life then the impact, not only on the individuals, but also the economic impact on healthcare services, is immense. Educational aims To report the effect of the sex of the preterm baby on respiratory outcomes. To explore the short- and long-term respiratory outcomes of preterm birth.

This study was conducted in Florida among two urban Native American youth programs that are sponsored by urban Native American community organizations. Convenience and snowballing were used as a sample recruitment strategy. Assignment to the experimental condition (UTC) and the control condition (SE) was established by randomizing the two community youth program sites to the two conditions. Utilization of a culturally relevant theory, Native-Reliance, guided the intervention approach for the prevention of substance use among urban Native American youth. Results of this study provided evidence that a culturally based intervention was significantly more effective for the reduction of substance use interest and general well-being than a non-culturally based intervention for urban Native American youth. Prevention programs for urban Native American early adolescent youth that utilize Native American strengths, values, and beliefs to promote healthy behavior and reduce the harm associated with high-risk behaviors such as substance use are strongly recommended.

The Eemian was the last interglacial period (~130 to 115 ka BP) to precede the current interglacial. In Eastern Mediterranean marine sediments, it is marked by a well-developed and organic-rich “sapropel” layer (S5), which is thought to reflect an intensification and northward migration of the African monsoon rain belt over orbital timescales. However, despite the importance of these sediments, very little proxy-independent stratigraphic information is available to enable rigorous correlation of these sediments across the region. This paper presents the first detailed study of visible and non-visible (cryptotephra) layers found within these sediments at three marine coring sites: ODP Site 967B (Levantine Basin), KL51 (South East of Crete) and LC21 (Southern Aegean Sea). Major element analyses of the glass component were used to distinguish four distinct tephra events of Santorini (e.g., Vourvoulos eruption) and possible Anatolian provenance occurring during the formation of S5. Interpolation of core chronologies provides provisional eruption ages for the uppermost tephra (unknown Santorini, 121.8 ± 2.9 ka) and lowermost tephra (Anatolia or Kos/Yali/Nisyros, 126.4 ± 2.9 ka). These newly characterised tephra deposits have also been set into the regional tephrostratigraphy to illustrate the potential to precisely synchronise marine proxy records with their terrestrial counterparts, and also contribute to the establishment of a more detailed volcanic history of the Eastern Mediterranean.

We provide a formal model for the interaction of syntax and pragmatics in the interpretation of anaphoric binding constraints on personal and reflexive pronouns. We assume a dynamic semantics, where e-type expressions introduce discourse referents, and contexts are assignments of individuals to discourse referents. We adopt the Partial Compositional Discourse Representation Theory (PCDRT) of Haug (2014b),which models anaphoric resolution in terms of a pragmatically-established relation between discourse referents. We integrate PCDRT into the constraint-based grammatical framework of Lexical-Functional Grammar (LFG), and show how it is possible to state syntactic constraints on the pragmatic resolution of singular and plural anaphora within this framework.