Calendar Month Research Articles

Associations between greenness and predicted COVID-19-like illness incidence in the United States and the United Kingdom.

The study population includes participants enrolled in the COVID Symptom Study smartphone application in the United Kingdom and the United States (March-November 2020). All participants were encouraged to report their current health condition and suspected risk factors for COVID-19. We used a validated symptom-based classifier that predicts COVID-19-like illness. We estimated the Normalized Difference Vegetation Index (NDVI), for each participant's reported neighborhood of residence for each month, using images from Landsat 8 (30 m2). We used time-varying Cox proportional hazards models stratified by age, country, and calendar month at study entry and adjusted for the individual- and neighborhood-level risk factors. We observed 143,340 cases of predicted COVID-19-like illness among 2,794,029 participants. Neighborhood NDVI was associated with a decreased risk of predicted COVID-19-like illness incidence in the fully adjusted model (hazard ratio = 0.965, 95% confidence interval = 0.960, 0.970, per 0.1 NDVI increase). Stratified analyses showed protective associations among U.K. participants but not among U.S. participants. Associations were slightly stronger for White individuals, for individuals living in rural neighborhoods, and for individuals living in high-income neighborhoods compared to individuals living in low-income neighborhoods. Higher levels of greenness may reduce the risk of predicted COVID-19-like illness incidence, but these associations were not observed in all populations.

Confounding by Conception Seasonality in Studies of Temperature and Preterm Birth: A Simulation Study.

Seasonal patterns of conception may confound acute associations between birth outcomes and seasonally varying exposures. We aim to evaluate four epidemiologic designs (time-stratified case-crossover, time-series, pair-matched case-control, and time-to-event) commonly used to study acute associations between ambient temperature and preterm births. We conducted simulations assuming no effect of temperature on preterm birth. We generated pseudo-birth data from the observed seasonal patterns of birth in the United States and analyzed them in relation to observed temperatures using design-specific seasonality adjustments. Using the case-crossover approach (time-stratified by calendar month), we observed a bias (among 1,000 replicates) = 0.016 (Monte-Carlo standard error 95% CI: 0.015-0.018) in the regression coefficient for every 10°C increase in mean temperature in the warm season (May-September). Unbiased estimates obtained using the time-series approach required accounting for both the pregnancies-at-risk and their weighted probability of birth. Notably, adding the daily weighted probability of birth from the time-series models to the case-crossover models corrected the bias in the case-crossover approach. In the pair-matched case-control design, where the exposure period was matched on gestational window, we observed no bias. The time-to-event approach was also unbiased but was more computationally intensive than others. Most designs can be implemented in a way that yields estimates unbiased by conception seasonality. The time-stratified case-crossover design exhibited a small positive bias, which could contribute to, but not fully explain, previously reported associations.

Disease trends after Helicobacter pylori eradication based on Japanese nationwide claims and the health check-up database.

Helicobacter pylori (H. pylori) infection is a risk factor for many diseases, including peptic ulcer disease and gastric cancer. While H. pylori eradication therapy can prevent these diseases, potentially unfavorable effects of eradication therapy have also been reported in some diseases, such as gastroesophageal reflux disease (GERD), Barrett's esophagus (BE), inflammatory bowel disease (IBD), allergic diseases, and metabolic diseases. Consequently, both positive and negative impacts should be considered when assessing the effects of H. pylori eradication therapy. To compare the incidence of these diseases before and after H. pylori eradication and to comprehensively assess its effects. This retrospective cohort study used a Japanese nationwide health claims database (April 2009-March 2020), developed by the Japanese Ministry of Health, Labour and Welfare. The database contained almost all health insurance claims data issued in Japan, and specific health check-up data for individuals who took the check-ups. Descriptive statistics were used for the analyses. Patients who received primary eradication therapy were defined as those prescribed medi-cation for H. pylori eradication. New diagnoses, defined as incidence of upper gastrointestinal diseases and IBD, and prevalence of allergic diseases were compared before and after eradication. The incidence and prevalence of each disease were also compared between the 3-year period before eradication (from the 4th to the 2nd year prior to the year of eradication) and the 3-year period after eradication (from the 1st to the 3rd year after the year of eradication) based on the age category and calendar year and month. Changes in body mass index and proportion of patients with metabolic syndrome (MS) were examined before and after eradication. We identified 5219731 patients who received primary eradication therapy. The 65-69 years age group had the greatest number of patients in both sexes. There was no significant increase in the incidence of GERD after eradication when considering the effects of aging and reporting period. However, the incidence of BE was higher in the 3-year period after eradication than in the 3-year period before eradication for all age categories (0.02%-0.10% vs < 0.01%-0.05%). The incidence of IBD and prevalence of allergic disease were also higher after eradication. In contrast, the incidence of gastric and duodenal ulcers and gastritis was reduced after eradication. In patients with at least one entry of health check-up data (1701111 patients), the percentage of patients with MS showed a slight increase following eradication (11.0% in the year of eradication and 12.2% after 5 years). The results suggest that H. pylori eradication therapy reduces peptic ulcers and gastritis; however, it is associated with increased incidence of several other chronic diseases.

Vaccine Effectiveness Against the SARS-CoV-2 B.1.1.529 Omicron Variant in Solid Organ and Islet Transplant Recipients in England: A National Retrospective Cohort Study.

The effectiveness of vaccines against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) B.1.1.529 Omicron variant in immunosuppressed solid organ and islet transplant (SOT) recipients is unclear. National registries in England were linked to identify SARS-CoV-2 positive tests, noninjury hospitalization within 14 d, and deaths within 28 d between December 7, 2020, and March 31, 2022 in adult SOT recipients. Incidence rate ratios (IRRs) for infection, and hospitalization or death, were adjusted for recipient demographics and calendar month for the Omicron-dominant period (December 20, 2021, to March 31, 2022). Mortality risk following SARS-CoV-2 infection was adjusted for recipient demographics and dominant variant using a Cox proportional-hazards model for the entire time period. During the Omicron-dominant period, infection IRRs (95% confidence intervals) were higher in those receiving 2, 3, and 4 vaccine doses than in unvaccinated patients (1.25 [1.08-1.45], 1.46 [1.28-1.67], and 1.79 [1.54-2.06], respectively). However, hospitalization or death IRRs during this period were lower in those receiving 3 or 4 vaccine doses than in unvaccinated patients (0.62 [0.45-0.86] and 0.39 [0.26-0.58], respectively). Risk-adjusted analyses for deaths after SARS-CoV-2 infection between December 7, 2020, and March 31, 2022, found hazard ratios (95% confidence intervals) of 0.67 (0.46-0.98), 0.46 (0.30-0.69), and 0.18 (0.09-0.35) for those with 2, 3, and 4 vaccine doses, respectively, when compared with the unvaccinated group. In immunosuppressed SOT recipients, vaccination is associated with incremental, dose-dependent protection against hospitalization or death after SARS-CoV-2 infection, including against the Omicron variant.

Calendar month variation in the diagnosis and severity of pulmonary embolism.

Pulmonary embolism (PE) is the third-leading cause of cardiovascular death in the United States, and several studies suggest PE shows seasonal variation. Variation in monthly PE diagnosis may be due to pathophysiologic factors or confounding/bias. However, severe PE may be less prone to diagnostic bias. To address this gap, we analyzed two registries from 1/2013-12/2018 with the aim of describing temporal trends in PE diagnosis and severity. We performed a retrospective analysis of two existing databases containing: (1) consecutive patients diagnosed with PE in the emergency departments (EDs) of two large, urban teaching hospitals, and (2) severe PEs requiring PE Response Team (PERT) activation at one of the above hospitals. The primary outcome was to assess variation in PE diagnosis and severity by calendar month. Separate analysis of these two databases sought to control for workup bias by trainee experience across the academic year. One-way ANOVA and Poisson regression were performed to assess for cyclical variation across calendar months, using Stata v16.1. The PE diagnosis database contained 1324 patients over 36months. One-way ANOVA did not reveal a statistically significant (p = 0.713) association between calendar month and PE number. The PERT activation database contained 1082 patients over 72months. One-way ANOVA revealed a statistically significant (p = 0.024) association between calendar month and activations, repeated year-on-year. Our results indicate correlation between calendar month and PERT activation; however, this pattern was not observed for PE diagnoses. This finding warrants further investigation into the causes of calendar month variation of PERT activations.

Replanning Buildings In Surabaya Case Study of Office Buildings On Jalan Basuki Rachmat Surabaya

Infrastructure development is an important aspect in boosting the economic growth of the Indonesian people, with the stages of infrastructure development which include building facilities and infrastructure can overcome economic inequality, the opening of new jobs, per capita income will increase. Referring to Law No. 28 of 2002 concerning building buildings in article 3 states that to realize a building that is functional and in accordance with the building layout that is harmonious and in harmony with the environment, it must ensure the reliability of the building in terms of safety, health, comfort and convenience. Problems: Based on the description above in the explanation in the background, the researcher formulated the following problem: How to plan a building structure that is strong in withstanding loading according to SNI 1726-2019 and SNI 2847-2013? How to plan building structures according to annual costs. The results of the planning of the Office Building on Jln Basuki Rachmat Surabaya as stated in Chapter IV, from the planning of the floor slab to the foundation in accordance with the elements in the 8-story Building Building and require a cost of Rp. 94,965,401,000, - and the implementation time takes 35 weeks or ± 8 calendar months.

De-implementing intrapartum maternal vitals monitoring to reduce alarm fatigue: an L&D quality and safety initiative

Many L&D units likely overuse continuous and automated maternal physiologic monitors. Given national attention to reducing alarm fatigue in healthcare, which adversely impacts response times and patient outcomes, this study evaluates vital sign monitoring and alarm patterns before and after implementing a vital sign protocol to reduce overmonitoring in low-risk obstetric patients. This is a quality improvement study conducted at an academic, tertiary hospital (4200 deliveries/year). The lack of guidance for maternal vital sign assessment in low-risk patients was identified as a safety challenge. A vital sign protocol was developed with multidisciplinary input and implemented. Total vital signs and alarm rates for all patients delivered during designated calendar days were assessed and compared across baseline, peri-intervention, and follow-up periods. Data were examined in p-type statistical process control charts as well as with time-series analysis. Patient characteristics and severe maternal morbidity (SMM, defined according to the CDC), used as a balancing metric, were compared peri-intervention. 35 individual 24-hour periods of vital sign and alarm volume were evaluated surrounding implementation of the protocol (10 baseline, 20 peri-intervention, 5 delayed follow-up). There was a decrease from a mean of 208.3 to 135.5 vitals/patient after implementation (incidence rate ratio [IRR] 0.65, p < 0.01) and in alarms/patient from a mean of 14.3 to 10.5 (IRR 0.73, p = 0.045) [Figures]. There were no significant differences in patient characteristics aggregated over the 2 calendar months of the immediate pre/post implementation periods (6-7/2021, 8-9/2021), or in SMM with and without transfusion (p = 0.34, 0.45). Introducing a maternal vital sign protocol for low-risk patients on L&D decreased vital signs measured as well as alarms, which may ultimately reduce alarm fatigue. This strategy should be considered on L&D units widely to improve patient safety and optimize outcomes.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Conservation of the surface-nesting Kermadec Petrel Pterodroma neglecta neglecta in the South Pacific: clarifying breeding ecology and the threat of avian ground predators

Summary Understanding population dynamics and impacts on island ecology remain top priorities for the conservation management of seabirds, particularly when attempting species-recovery for island restoration. Identifying suitable nesting habitat is a keystone detail in seabird restoration which can be complicated when predator pressures impact colony productivity and population viability. The surface-nesting Kermadec Petrel Pterodroma neglecta neglecta is dispersed on remote islands through the tropics and subtropics. We examined their breeding ecology on Phillip Island, Norfolk Group in the South Pacific and considered the limitations to re-establishment at their previous breeding location on Lord Howe Island (900 km south-east). On Phillip Island, the petrels were mostly monogamous with nesting locations generally within the vicinity of the previous season’s attempts. Breeding sites were limited to sloping terrain 182–228 m above the shoreline and up to 85 m from the coast in small sub-colonies under low scrubby woodland. Based on observations of 56 pairs and data gleaned from Global Light Sensing devices, we determined that breeding (incubation and provisioning) occurs in all calendar months of the year, with a laying peak in the late austral spring. Breeding success in the first year of study was 25% but improved to 56% once management of Purple Swamphens Porphyrio melanotus was implemented. Successful nests were located at sites with naturally limited egress from cleared or lightly vegetated areas. Prudent management of the petrel population on Phillip Island could aid in the regional recovery of the species and, in the process, assist the island’s restoration by significantly increasing transfers of marine-derived nutrient. Their reintroduction to Lord Howe Island is also possible but will likely rely upon consistent productivity of the Phillip Island population for founding immigrants. Moreover, successful establishment will require adaptive management of selected sites to ensure native avian predators do not overly impact breeding.

Factors affecting the income of paddy field farm management in Kerinci Regency, Jambi Province

The productivity of paddy field farming during the last five years has decreased so that it has an impact on farmers' revenue. The purpose of this study was to analyze the level of income and feasibility of paddy field farming and the factors that affect the income of paddy field farming. The research was conducted in Kerinci Regency, Jambi Province, for eight calendar months. Research data is sourced from primary data and secondary data. Primary data were collected through structured interviews using instruments or questionnaires to all respondents. Respondents or farmer units of analysis were taken by random sampling with 225 respondents. The research data were analyzed by descriptive and statistical tests using the Multiple Regression Test tool. The results showed that the average income of paddy field farming in the study area was Rp. 8.646.552,00 per growing season with an R/C ratio &gt; 1 (3.9). Farmers' income is influenced by land area and the number of workers. In contrast, the age of farmers, number of family members, farming experience, and capital do not show a significant effect.

Statistical Analysis on the Number of Discoveries and Discovery Scenarios of Near-Earth Asteroids

Near-Earth asteroids (NEAs) are a kind of small solar system bodies that may lead to potential hazard to the safety of the Earth. Currently, most of the NEAs are discovered with ground-based telescopes and the number is still growing. In order to provide references and experience to our future near-Earth asteroid discovery and monitoring, we perform a multi-dimensionally statistical analysis on the discovery data of NEAs with public database obtained from the website of Minor Planet Center (MPC). We find the constraint of observation ability can lead to selection effect on the discoveries, which causes a yearly dependence trend and a size-dependence characteristic of the relative proportion for different orbit types of discovered NEAs. Besides, combined with the orbits obtained from numerical simulations, we revisit the discovery scenarios of these objects. The position distribution of the objects under different celestial coordinate systems are obtained, and the dependence on seasons, observatory latitudes, and the diameters are analyzed. Finally, we quantify the impact of the Sun, the Moon, and the galactic plane on the discoveries by analyzing the observation data, and find that ground-based telescopes generally have difficulty in discovering NEAs within 90∘ from the Sun direction, and that this limitation generally has a greater impact on smaller-sized objects. The lunar position also has a significant effect on the discoveries, with the restriction on the nights before and after the full Moon resulting in 29% of NEAs being undiscovered, and analysis shows that objects found in the first half of the lunar calendar month are generally more difficult to be followed than those found in the second half. The galactic plane, especially the direction near the galactic center, also has an effect on the discoveries, resulting in a season-dependent “blind spot” for observations near the ecliptic.

ANALYSIS OF TIME, PLACE AND METHOD OF SUICIDE IN THE AREA OF BJELOVAR-BILOGORA COUNTY IN THE 1988-2017 PERIOD.

The aim of the study was to analyze changes in the number of suicides associated with seasonal variables, calendar month, time of day versus variable location and method of suicide. Data were obtained from the Analytical Police Department of Bjelovar-Bilogora County for the 1988-2017 period. The process of Croatian application process into the European Union, accompanied by economic and social changes, was a significant socioeconomic event, which divided the analyzed period into two parts. Significant changes in the impact of the analyzed variables on the suicides committed in the two observed periods were tested with the χ2-test and Fisher exact test. Consistency of the results, as well as absence of the impact of significant changes would show less susceptibility of the covariate variable to the effect of socioeconomic factors. In the case of time of day and location of the suicides, there was no significant difference when comparing results between the 1988-2004 and 2005-2017 periods; however, a statistically significant difference was confirmed when considering the month of suicide (February) and season (winter, borderline result for autumn). Statistically, the most significant changes were found in the methods of suicide. The two observed periods differed in the mean suicide rate.

INFLUENCES OF FEED AND SEASON ON BREED AND REPRODUCTIVE TRAITS IN WEST AFRICAN DWARF AND SAHEL BUCKS IN TARABA STATE

The study evaluated the influence of feed on the reproductive parameters of West African Dwarf and Sahel goats at theTeaching and Research farm of the Federal Polytechnic Bali, Taraba State. A total of 8 bucks from two goats breeds (West African Dwarf and Sahel) were used for the experiment. The 8 bucks were later moved to Vom, for semen collection, using electro-ejaculator. The study lasted for 12 calendar months. They were fed Gmelina and cassava peel meal, Gmelina and cowpea husk, Ficus and cassava peel meal and, Ficus and cowpea husk as experimental treatments (T1-T4), respectively. Goats according to breed were allotted to treatments randomly and treated as factorial experiments. Season had significant (P&lt;0.01) influence on buck parameters (scrotal length and semen qualities). The overall samples collected was 192 on both the breeds on the following parameters; scrotal circumference, semen volume, semen pH, sperm concentration, sperm motility and live cells and the results were 11.91cm, 0.47ml, 6.78ph, 414.92x106, 83.02% and 92.33% respectively. The result was significant for breed, season and treatment for all parameters except live and dead cells for breeds and treatment. Feeding Ficus containing diets resulted in higher semen quality values. Also, semen colour using likert scale was analyzed which resulted to three types of colour (creamy, milky and watery). The colour was evaluated under based on breed, seasons and treatment diets (feeds). The overall results show insignificant differences for all the parameters (feeds, seasons, breeds and reproductive traits) observed.&#x0D;

Change in health outcomes for First Nations children with chronic wet cough: rationale and study protocol for a multi-centre implementation science study

BackgroundIn children, chronic wet cough may be a sign of underlying lung disease, including protracted bacterial bronchitis (PBB) and bronchiectasis. Chronic (> 4 weeks in duration) wet cough (without indicators pointing to alternative causes) that responds to antibiotic treatment is diagnostic of PBB. Timely recognition and management of PBB can prevent disease progression to irreversible bronchiectasis with lifelong consequences. However, detection and management require timely health-seeking by carers and effective management by clinicians.We aim to improve (a) carer health-seeking for chronic wet cough in their child and (b) management of chronic wet cough in children by clinicians. We hypothesise that implementing a culturally integrated program, which is informed by barriers and facilitators identified by carers and health practitioners, will result in improved lung health of First Nations children, and in the future, a reduced the burden of bronchiectasis through the prevention of the progression of protracted bacterial bronchitis to bronchiectasis.MethodsThis study is a multi-centre, pseudorandomised, stepped wedge design. The intervention is the implementation of a program. The program has two components: a knowledge dissemination component and an implementation component. The implementation is adapted to each study site using a combined Aboriginal Participatory Action Research and an Implementation Science approach, guided by the Consolidated Framework of Implementation Research. There are three categories of outcome measures related to (i) health (ii) cost, and (iii) implementation. We will measure health-seeking as the proportion of parents seeking help for their child in a 6-month period before the intervention and the same 6-month period (i.e., the same six calendar months) thereafter. The parent-proxy, Cough-specific Quality of Life (PC-QoL) will be the primary health-related outcome measure.DiscussionWe hypothesise that a tailored intervention at each site will result in improved health-seeking for carers of children with a chronic wet cough and improved clinician management of chronic wet cough. In addition, we expect this will result in improved lung health outcomes for children with a chronic wet cough.Trial registrationAustralian New Zealand Clinical Trials Registry; ACTRN12622000430730, registered 16 March 2022, Retrospectively registered.

Facial Trauma Operative Volume Demonstrates Consistent and Significant Yearly Periodicity

Facial trauma requiring operative care increases during the summer and fall months, which is colloquially referred to as trauma season. The purpose of this study is to determine if there is a quantifiable and statistically significant yearly periodicity of operative facial trauma volume. To confirm the existence and quantify the magnitude of trauma season, we conducted a retrospective cohort study. The Plastic Surgery divisional billing database was queried for Current Procedural Terminology (CPT) codes related to acute facial trauma. The outcome variable is monthly CPT code volume and calendar month is the predictor. Monthly CPT volume was tabulated for 120 consecutive months. Raw data were plotted as a time series and transformed as a ratio to the moving average. Autocorrelation was applied to the transformed dataset to detect yearly periodicity. Multivariable modeling quantified the proportion of volume variability (R2) attributable to yearly periodicity. Subanalysis assessed presence and strength of periodicity in 4 age groups. Patient identifiers, demographic information, surgeon, and date of surgery were collected as covariates. One thousand six hundred fifty eight CPT codes obtained through Plastic Surgery billing records were included. Mean age at presentation was 32.5±16.3 years (range=85.05). Monthly trauma-related CPT volume was highest in June-September and lowest in December-February. Time series analysis revealed yearly oscillation, in addition to a growth trend. Autocorrelation revealed statistically significant positive and negative peaks at a lag of 12 and 6months, respectively, confirming the presence of yearly periodicity. Multivariable linear modeling revealed R2 attributable to periodicity of 0.23 (P=.008). Periodicity was strongest in younger populations and weaker in older populations. R2=0.25 for ages 0-17, R2=0.18 for ages 18-44, R2=0.16 for ages 45-64, and R2=0.034 for ages ≥ 65. Operative facial trauma volumes peak in the summer and early fall and reach a winter nadir. This periodicity is statistically significant and accounts for 23% of overall trauma volume variability at our Level 1 trauma hospital. Younger patients drive the majority of this effect. Our findings have implications for operative block time and personnel allocation, in addition to expectation management over the course of the year.

Benefit of vertical localization for sea surface temperature assimilation in isopycnal coordinate model

Sea surface temperature (SST) observations are a critical data set for long-term climate reconstruction. However, their assimilation with an ensemble-based data assimilation method can degrade performance in the ocean interior due to spurious covariances. Assimilation in isopycnal coordinates can delay the degradation, but it remains problematic for long reanalysis. We introduce vertical localization for SST assimilation in the isopycnal coordinate. The tapering functions are formulated empirically from a large pre-industrial ensemble. We propose three schemes: 1) a step function with a small localization radius that updates layers from the surface down to the first layer for which insignificant correlation with SST is found, 2) a step function with a large localization radius that updates layers down to the last layer for which significant correlation with SST is found, and 3) a flattop smooth tapering function. These tapering functions vary spatially and with the calendar month and are applied to isopycnal temperature and salinity. The impact of vertical localization on reanalysis performance is tested in identical twin experiments within the Norwegian Climate Prediction Model (NorCPM) with SST assimilation over the period 1980–2010. The SST assimilation without vertical localization greatly enhances performance in the whole water column but introduces a weak degradation at intermediate depths (e.g., 2,000–4,000 m). Vertical localization greatly reduces the degradation and improves the overall accuracy of the reanalysis, in particular in the North Pacific and the North Atlantic. A weak degradation remains in some regions below 2,000 m in the Southern Ocean. Among the three schemes, scheme 2) outperforms schemes 1) and 3) for temperature and salinity.

788. Risk Factors for Severe COVID-19 Breakthrough Infections: A Retrospective, Nationwide Cohort Study

Abstract Background COVID-19 vaccines reduce the incidence of severe clinical outcomes, however, some patients remain at risk of severe disease. The primary aim of this large, nationwide retrospective cohort was to identify risk factors for severe disease despite vaccination. Methods Nationwide cohort study of US Veteran patients with laboratory-confirmed SARS-CoV-2 infection after vaccination. The primary outcome was development of severe COVID-19 disease, defined as a hospitalization within 14 days of a positive SARS-CoV-2 diagnostic test and either SpO2 ≤ 94%, receipt of supplemental oxygen, mechanical ventilation, or death within 28 days. Exposure variables included demographic and clinical risk factors, receipt of an additional vaccine dose, and calendar months since initial vaccination series. Data were analyzed using logistic regression, and adjusted odds ratios (aORs) are presented. Results Among 111,151 breakthrough infections, 110,760 had disease severity assessments and were included. 14,690/110,790 (13.3%) were hospitalized with severe COVID-19 or died. Risk factors for severe disease are presented in Figure 1. The strongest risk factor for severe disease despite vaccination was age. Immunocompromising conditions, including immunosuppressive medications (Cytokine-blocking, aOR, 1.73, CI, 1.37–2.18; receipt of glucocorticoids, aOR, 2.41, CI, 2.25, 2.58; leukocyte inhibitory, aOR 2.44, CI, 1.98–2.99; lymphocyte-depleting, aOR, 2.12, 1.61–2.79), cytotoxic chemotherapy within 6 months (aOR, 2.69; CI, 2.25, 3.21), and leukemias/lymphomas were also associated with increased risk (aOR, 1.84, CI, 1.59–2.14), as were chronic conditions associated with end-organ disease. Receipt of an additional (booster) dose of vaccine was associated with reduced odds of severe disease, with risk reduction from vaccination and boosting strongest during the months immediately following vaccine doses. Variables with aOR &amp;lt;1 are associated with reduced odds of severe breakthrough infections and variables with aOR &amp;gt;1 are associated with increased odds of severe breakthrough infections. Referent groups for multicategory variables are listed in bold. Presented with a logarithmic scale. Conclusion In this nationwide cohort, we identified risk factors for severe disease despite vaccination. Findings can be used to inform outreach efforts for booster vaccinations and to inform clinical decision making about risk and to identify patients who would benefit from interventions in addition to vaccination, such as pre-exposure prophylaxis and antiviral therapy. Disclosures Westyn Branch-Elliman, MD, MMSc, DLA Piper,LLC/Medtronic: Advisor/Consultant|Gilead Pharmaceuticals: Grant/Research Support Paul Monach, MD, PhD, Celgene / Bristol-Myers Squibb: Advisor/Consultant|ChemoCentryx: Advisor/Consultant|Gilead: Grant/Research Support|Kiniksa: Advisor/Consultant.

Features of the formation of reserves for dubious debts in tax accounting by medical organizations

The article is devoted to the specifics of the formation by medical organizations of a reserve for doubtful debts in accounting and tax accounting regarding receivables arising from the sale of products or services. Analysis of the norms of the Tax Code of the Russian Federation made it possible to determine that the creation of a reserve is the right of taxpayers who recognize tax income and expenses by the accrual method, which does not prescribe the obligation to fulfill it. The procedure for creating the amounts of created reserves is determined. It is noted that сontributions to the reserve of medical organizations are taken as part of non-operating expenses falling on the last day of the reporting (tax) period (for example, a calendar month or a year), and depend on the period of occurrence of non-fulfillment of contractual obligations by counterparties. It is emphasized that the total amount of provisions for the reporting period, taken for the fulfillment of tax purposes, has a maximum amount and cannot exceed 10% of the taxpayer’s revenue excluding VAT. Practical examples of the determination of the amount of reserves are given, allowing to identify the logic and specifics when forming a reserve for doubtful debts by healthcare organizations. Simulated situations describes the timing and limit amounts of reserves formed by medical companies.

Świadectwo pracy – wybrane problemy

Employment certificate: selected problems The purpose of the article is to draw attention to the selected problems pertaining to the proper issue of the employment certificate with regard to the recent changes that have entered into force. In a situation when an employment relationship has ended, every employer has a legal obligation to issue an employment certificate. It is a document containing information necessary to establish employees’rights in the next place of employment, with pension authorities or in a job center. Starting from 1 January 2019 the employer, apart from an employment certificate, is also obliged to render to the employee, either in a paper or an electronic form, information on: the period of legal documentation storage, the possibility to receive employee documentation till the end of a calendar month following the lapse of time of employee documentation storage as well as information on employee documentation destruction in the case it was not picked up within the prescribed period.

Clinical and anamnestic analysis of in-patients with COVID-19 infection hospitalized during one month

Aim to analyze the clinical and anamnestic data of the patients with a confirmed diagnosis of COVID-19 who were hospitalized in the emergency department of the designated COVID-19 hospital of the Clinics of Samara State Medical University during one month and to compare the results with published registries data.&#x0D; Material and methods. A retrospective anonymous data sample included patients hospitalized in the emergency department of the designated hospital of the Clinics of Samara State Medical University during a calendar month (01.03.202131.03.2021) with a confirmed diagnosis of COVID-19. A total of 126 patients (57.9% women) were included in the study, the average age was 65.912.8 years.&#x0D; Results. Statistically significant differences (p0.05) in age and body mass index, as well as in the proportion of obese patients were obtained depending on the gender of the patients. Almost every hospitalized person had at least one comorbidity, among which the diseases of the cardiovascular system and gastrointestinal tract prevailed. In general, the obtained data are comparable with the international registries. The differences can be explained by the fact that there were no universal criteria for inclusion, except for the confirmed diagnosis of COVID-19, in the analyzed data samples.&#x0D; Conclusion. The high frequency of some diseases makes it possible to significantly expand the possibilities of analysis and increase the reliability in identifying the causes affecting the prognosis in a particular region. The clinical and anamnestic features of a patient may allow individualizing the prognostic assumptions.

A New Predictability Pattern in the US Stock Market Returns

This article documents a new stock market anomaly that seems to have escaped the attention of both investment professionals and academics. For more than a century, the monthly market return has been predicted by the monthly market return at lag 5. This predictability is marketwide and is most evident in the returns of portfolios of large and growth stocks. The trading strategy incorporating this predictability yields superior performance that cannot be attributed to common risk factors. A closer investigation of the new anomaly reveals that not each calendar month possesses predictive ability. Therefore, there is a link between the new anomaly and calendar effects in stock returns.