Comparative Data Research Articles

Bibliometric Analysis in the Development of Public Sector Digitalization

Public sector modernization has long been on the political agenda of governments around the world. This study aims to provide an overview of the development of scientific research with the theme of public sector digitalization in the last ten years, from 2014 to 2023. The researcher used the qualitative method with a literature approach. The data source was obtained by accessing journals in the Scopus database with high citation counts. The data obtained was then analyzed using VOSviewer. The results showed that 417 journals studied public sector digitalization from 2014 to 2023. It is widely assumed that the United Kingdom and the United States are the most influential countries in digitalization research in the public sector. The results showed a significant difference in research topics between the UK and the US. Even though this study provides information about public sector digitalization, it has its limitations. The main limitation is that the articles only come from the Scopus database, with no other comparative data. Future research should continue to use data from other databases to contribute more comprehensive knowledge.

Rainwater runoff regulation effect in sponge reconstruction area based on rainstorm flood management model

The study adopts the rainwater regulation strategy based on the rainstorm water management model, and designs a set of rainwater runoff regulation system by monitoring the amount of water, collecting rainfall data, and evaluating the quality of rainwater and natural rainwater, aiming at conserving groundwater, restoring hydrological cycle, reducing urban waterlogging, and optimizing rainwater resources. In the implementation method, the effectiveness of this strategy is evaluated by simulating various scenarios such as without LID facilities, with LID facilities, and secondary rainwater pipe network regulation. The results showed that the Nash efficiency coefficient of the overall model was 0.89, and the changes in chemical oxygen demand, total nitrogen, and total phosphorus water quality indicators were very close to the actual monitoring results. The comparative data before and after the renovation showed that the three water quality indicators were much higher before the renovation. The peak flow rate and outflow time significantly decreased, for example, the peak flow rate decreased from 0.41 m³ /s to 0.39 m³ /s. The outflow time was reduced from 9 min to 6 min. It can be seen that the strategies proposed in the study have effectively improved the quality of urban environment and residents' lives, providing important reference basis for urban rainwater management and water resource protection.

Reading Twitter as a marketplace of ideas: how attitudes to COVID-19 are affecting attitudes to migrants in Ireland

Abstract Attitudes to language and attitudes to ethnic groups have long been shown to be related to one another. In recent history, significant events have also been shown to negatively affect attitudes to specific groups who are deemed to be responsible. The current paper looks at how the COVID-19 pandemic has emboldened those who hold far right attitudes to migrants in an Irish context. Through a Twitter scraping exercise, conducted in August 2020, we show that far right framings of migrants as (a) contagion or disease, (b) criminals, and (c) favoured or elites are clearly evident and considerably on the rise in these Irish data. This would seem to run contrary to a concurrent study in Germany. Thus, we then pair this quantitative Twitter data with qualitative observations of anti-mask protests as indicative of a broadening of the allure of far right political groups, with COVID-19 as the “leading edge”. Taken together, these data seem to run contrary to European Social Survey and comparative data, leading us to question how attitudes are elicited, measured, and reported.

Country statistical capacity: A recent assessment tool and further reflections on the way forward

A country’s statistical capacity takes an indispensable part in its development. We offer a comprehensive comparison between the World Bank’s Statistical Performance Indicators and Index (SPI) and its predecessor, the Statistical Capacity Index (SCI) regarding different conceptual and empirical aspects. We further examine the relationships of the two indexes with some agriculture development indicators such as food security, food sustainability and productivity as well as other key indicators including headcount poverty, GDP per capita, and an SDG progress index. Our analysis employs the latest SPI data update in 2022, which were not available in previous studies. We also propose clear guidelines on how the SPI can be maintained and updated in the future to ensure that this process is transparent, replicable, safeguarded with high quality, and provides comparable data over time.

Outcomes of transfemoral TAVR using two new-generation devices in patients with horizontal aorta.

Challenging anatomies and comorbidities have impact on success in transcatheter aortic valve replacement (TAVR). There is controversy whether the extent of the aortic angle (AA) has an impact on procedural outcomes. Matched comparative outcome data of new generation transcatheter heart valves (THVs) in horizontal aorta (HA) are scarce. A total of 1582 patients with severe native aortic stenosis (AS) treated with the SAPIEN3 Ultra (Ultra; n = 526) or ACURATE Neo2 (Neo2; n = 1056) THVs from January 2017 to January 2023 were analyzed. Patients with non-horizontal aortas (AA < 51.7°, n = 841) were excluded. The population was matched by 1-to-1 nearest-neighbor matching (Ultra, n = 246; Neo2, n = 246). Clinical and procedural outcome were evaluated according to VARC-3 recommendations. Technical success (93.1% vs. 94.7%, p = 0.572) was high after Ultra and Neo2. Device success (80.5% vs. 89.8%, p = 0.05) was inferior with Ultra. Neo2 reveals superior hemodynamic properties with lower rate of severe prosthesis patient mismatch (12.0% vs. 3.7%, p = 0.001) and elevated gradients ( 20 mmHg: 11.9% vs. 1.7%, p < 0.001). Ultra showed a lower rate of relevant paravalvular regurgitation ( mild paravalvular regurgitation or Valve-in-Valve due to paravalvular regurgitation: 0.0% vs. 3.7%, p = 0.004). The rate of procedural bailout maneuvers (0.8% vs. 0.4%, p = 1.000) and thirty-day all-cause mortality (1.3% vs. 2.2%, p = 0.496) was similar. Transfemoral TAVR in patients with severe aortic stenosis and HA, using the balloon expandable Sapien3 Ultra and self-expanding ACURATE Neo2 prosthesis, is feasible and safe. Therefore, valve selection between these platforms should be made irrespective of the aortic angle by a team experienced with both valves based on their specific advantages. Large, randomized trials in this sub-group of patients would be necessary to compare long term outcomes.

Proactive health behavior in middle-aged and older adult females with urinary incontinence: A grounded theory study.

To develop a conceptual framework for proactive health behavior among middle-aged and older adult females with urinary incontinence. Qualitative grounded theory study. There is a growing body of research emphasizing the pivotal significance of proactive health behavior. Proactive health behavior can empower patients to actively manage their illnesses and facilitate disease recovery. Clearly defining patients' relevant beliefs and assumptions regarding proactive health behavior can effectively promote their adoption. However, there is currently a lack of relevant research in this area. We conducted in-depth interviews with middle-aged and older adult females with urinary incontinence (n = 17) and nursing caregivers (n = 9). We used theoretical sampling, whlie conducting continuous comparative analysisi and data collection. The study has yielded a substantive theory to facilitate healthcare professionals' comprehension of proactive health behavior in middle-aged and older adult females with urinary incontinence. The foundation for middle-aged and older adult females to adopt proactive health behavior is having a certain level of health literacy regarding their conditions. Patients' internal motivation to engage in proactive health behavior includes a sense of health responsibility and health demands. Additionally, external support received by patients can also facilitate their adoption of proactive health behavior. The proactive health behavior practices of middle-aged and older adult females mainly include proactive medical care behavior and establishing a healthy lifestyle. The conceptual framework established in this study offers theoretical support for middle-aged and older adult females with urinary incontinence to adopt proactive health behavior. It provides a basis for future exploration of proactive health behavior among this demographic and informs the development of more effective health interventions and support measures tailored to their needs. The study specifically elucidates the mechanisms and manifestations of proactive health behavior adopted by middle-aged and older adult females with urinary incontinence, laying the foundation for clarifying the level of proactive health among patients and implementing corresponding intervention measures. Additionally, it can also serve as a reference for related research on other diseases.

A mat based on PVA doped with TiO2 nanoparticles for removal of methylene blue dye from aqueous solution and improving the carbon footprint.

Water supply is the great challenge for climate change and overpopulation. A Nanofiber mat consisting of Poly vinyl alcohol (PVA), nanoTiO2, and citric acid (PTC) was prepared using an electrospinning technique at a constant flow rate (0.5 ml/h). The morphology of the mat was detected using (FESEM) technique and image J software; they show that the mat has a Nanofiber morphology with an average diameter of 170 nanometers. This mat was used to remove methylene blue (MB) from water in two ways, the adsorption process and by photodegradation using UV light. The kinetic study of the adsorption of methylene blue MB on a PTC mat was carried out. results show that the pseudo-second order is best to describe the adsorption, of MB and the Intra- particle diffusion is the rate determining step. Seven isotherm models; four of two-parameters and three of three-parameters were used to examine the adsorption experimental data by applying linear and non-linear regression method using six error functions. The results showed comparable data between linear and non-linear regression methods for two parameters isotherms, and the best isotherm fitting with the data were Freundlich and Temkin models. On the contrary, three parameters isotherms showed distracted data between linear and non-linear regression methods. In addition, the results appear that the best predictive error function was ꭓ2.

Comparison of multiple bioanalytical assay platforms for the quantitation of siRNA therapeutics.

Aim: Oligonucleotide therapeutics can be quantified using various bioanalytical methods, and these methods have been compared extensively. However, few comparisons exist where the same analyte is evaluated by multiple assay platforms.Materials & methods: Hybrid LC-MS, SPE-LC-MS, HELISA and SL-RT-qPCR methods were developed for an siRNA analyte, and samples from a pharmacokinetic study were analyzed by all four methods.Results: All assay platforms provided comparable data, though higher concentrations were observed using the non-LC-MS assays. Hybrid LC-MS and SL-RT-qPCR were the most sensitive methodologies, and SL-RT-qPCR and HELISA demonstrated the highest throughput.Conclusion: Each assay platform is suitable for oligonucleotide bioanalysis, and the ultimate choice of methodology will depend on the prioritization of needs such as sensitivity, specificity and throughput.

Heterologous survey of 130 DNA transposons in human cells highlights their functional divergence and expands the genome engineering toolbox

Experimental studies on DNA transposable elements (TEs) have been limited in scale, leading to a lack of understanding of the factors influencing transposition activity, evolutionary dynamics, and application potential as genome engineering tools. We predicted 130 active DNA TEs from 102 metazoan genomes and evaluated their activity in human cells. We identified 40 active (integration-competent) TEs, surpassing the cumulative number (20) of TEs found previously. With this unified comparative data, we found that the Tc1/mariner superfamily exhibits elevated activity, potentially explaining their pervasive horizontal transfers. Further functional characterization of TEs revealed additional divergence in features such as insertion bias. Remarkably, in CAR-T therapy for hematological and solid tumors, Mariner2_AG (MAG), the most active DNA TE identified, largely outperformed two widely used vectors, the lentiviral vector and the TE-based vector SB100X. Overall, this study highlights the varied transposition features and evolutionary dynamics of DNA TEs and increases the TE toolbox diversity.

Subjective Well-Being and Bullying Victimisation: A Cross-National Study of Adolescents in 64 Countries and Economies

Bullying is a recognised serious public problem affecting many students worldwide. Despite the well-established empirical evidence for the negative consequences of bullying on adolescents? mental and physical health and educational outcomes, little is known about the link between bullying victimisation and adolescents? subjective well-being. Moreover, empirical studies using comparative large-scale survey data are particularly scarce. This study explores this question using nationally-representative data from 329,015 adolescents across 64 high and middle-income countries and economies from the 2018 PISA survey. Two measures of subjective well-being were considered: overall life satisfaction and positive affect. Multilevel regressions were estimated at three levels (student, school, and country). Results showed that bullying victimisation was negatively and significantly related to overall life satisfaction and positive affect after controlling for a wide set of factors affecting subjective well-being. Moreover, this negative relationship was more pronounced for top performing students. Locally adapted intervention programmes are needed to tackle the issue of school bullying and foster positive school climate and student well-being. Practical and policy implications are discussed in detail.

Comparative study of antioxidant activities of Allium sativum (a novel variety, HG17) and Allium ampeloprasum (SMG): Revealing the higher potential of HG17 and analyzing its phytochemicals.

Garlic, belonging to the genus Allium, is renowned for its rich antioxidant potential. Snow Mountain garlic (SMG) (Allium ampeloprasum) has been traditionally used for medicinal purposes because of its higher antioxidant potential. Considering its potential in medical therapies, we compared the antioxidant activity of SMG with a novel variety of Allium sativum, Hisar garlic 17 (HG17). Comparative antioxidant activity data (2,2-diphenyl-1-picrylhydrazyl and 2,2-azinobis (3-ethylbenzothiazoline-6-sulfonic acid) revealed the higher antioxidant activity of HG17 than SMG, which prompted us to conduct a comprehensive phytochemical investigation to elucidate the factors contributing to antioxidant potential of HG17. To get a detailed antioxidant and phytoconstituents profiling, we differentially extracted HG17 by processing it in different forms (fresh, dry, heated, and aged) with two solvents (50% methanol and n-butanol). Our data (antioxidant activities, total phenolics, and flavonoids) showed that dry garlic methanolic extract (DgM) had maximum potential than other HG17 forms/solvents, which concludes that different extraction techniques had direct impact on the phenolics/flavonoids and antioxidant potential of the extracts. Further, phytochemical analysis of HG17 extracts by high resolution liquid chromatograph mass spectrometer quadrupole time of flight validated the maximum potential of DgM. LCMS revealed the presence of garcimangosone C, osmanthuside A, and protoaphin aglucone polyphenols exclusively in DgM compared to other HG17 extracts, which possibly contributing in its high antioxidant potential. The overall differential extraction and LCMS data of HG17 strongly depict that it may be used as an alternative of SMG under diverse medical applications. HG17 higher antioxidant potential and rich array of unique phytochemicals make it valuable for food and pharmaceutical industries to integrate into functional foods/therapeutics. PRACTICAL APPLICATION: Garlic unique phytochemical composition and its remarkable ability to scavenge different radicals make it valuable therapeutic asset to mitigate diseases associated with oxidative stress. SMG is well known for its anti-arthritic and anti-inflammatory properties. HG17 showed higher antioxidant potential than SMG and can be used as an alternative of SMG for anti-arthritic properties.

Clinical effects of cannabis compared to synthetic cannabinoid receptor agonists (SCRAs): a retrospective cohort study of presentations with acute toxicity to European hospitals between 2013 and 2020

Introduction Cannabis is the most common recreational drug worldwide and synthetic cannabinoid receptor agonists are currently the largest group of new psychoactive substances. The aim of this study was to compare the clinical features and outcomes of lone acute cannabis toxicity with lone acute synthetic cannabinoid receptor agonist toxicity in a large series of presentations to European emergency departments between 2013-2020. Methods Self-reported drug exposure, clinical, and outcome data were extracted from the European Drug Emergencies Network Plus which is a surveillance network that records data on drug-related emergency department presentations to 36 centres in 24 European countries. Cannabis exposure was considered the control in all analyses. To compare the lone cannabis and lone synthetic cannabinoid receptor agonist groups, univariate analysis using chi squared testing was used for categorical variables and non-parametric Mann-Whitney U- testing for continuous variables. Statistical significance was defined as a P value of <0.05. Results Between 2013-2020 there were 54,314 drug related presentations of which 2,657 were lone cannabis exposures and 503 lone synthetic cannabinoid receptor agonist exposures. Synthetic cannabinoid receptor agonist presentations had statistically significantly higher rates of drowsiness, coma, agitation, seizures and bradycardia at the time of presentation. Cannabis presentations were significantly more likely to have palpitations, chest pain, hypertension, tachycardia, anxiety, vomiting and headache. Discussion Emergency department presentations involving lone synthetic cannabinoid receptor agonist exposures were more likely to have neuropsychiatric features and be admitted to a psychiatric ward, and lone cannabis exposures were more likely to have cardiovascular features. Previous studies have shown variability in the acute toxicity of synthetic cannabinoid receptor agonists compared with cannabis but there is little comparative data available on lone exposures. There is limited direct comparison in the current literature between lone synthetic cannabinoid receptor agonist and lone cannabis exposure, with only two previous poison centre series and two clinical series. Whilst this study is limited by self-report being used to identify the drug(s) involved in the presentations, previous studies have demonstrated that self-report is reliable in emergency department presentations with acute drug toxicity. Conclusion This study directly compares presentations with acute drug toxicity related to the lone use of cannabis or synthetic cannabinoid receptor agonists. It supports previous findings of increased neuropsychiatric toxicity from synthetic cannabinoid receptor agonists compared to cannabis and provides further data on cardiovascular toxicity in lone cannabis use.

MELODY: A prospective non-interventional multicenter cohort study to evaluate different imaging-guided methods for localization of malignant breast lesions (EUBREAST-4/iBRA-NET).

TPS623 Background: In the last decades, the proportion of breast cancer patients receiving breast-conserving surgery has increased, reaching 70-80% in developed countries. In case of non-palpable lesions, surgical excision requires some form of breast localization. While wire-guided localization has long been considered gold standard, it carries several limitations, including logistical difficulties, the potential for displacement and patient discomfort, and re-excision rates reaching 21%. Other techniques (radioactive seed or radio-occult lesion localization, intraoperative ultrasound, magnetic, radiofrequency, and radar localization) have been developed with the aim of overcoming these disadvantages. However, comparative data on the rates of successful lesion removal, negative margins, and re-operations are limited. In most studies, the patient perspective, addressing e.g. discomfort and pain, has not been evaluated. The aim of MELODY (Methods for Localization of Different Types of Breast Lesions) is to evaluate different imaging-guided localization methods with regard to oncological safety, patient-reported outcomes, and surgeon and radiologist satisfaction. Methods: The EUBREAST and the iBRA-NET have initiated the MELODY study to assess breast localization techniques and devices from several perspectives (NCT05559411, http://eubreast.org/melody ). MELODY is a prospective intergroup cohort study which enrolls female and male patients. planned for breast-conserving surgery with imaging-guided localization for invasive breast cancer or DCIS. Multiple or bilateral lesions and neoadjuvant chemotherapy are allowed. Primary outcomes are: 1) Intended target lesion and/or marker removal and 2) Negative resection margin rates. Secondary outcomes are, among others: rates of second surgery and secondary mastectomy, Resection Ratio (defined as actual resection volume divided by the calculated optimum specimen volume), duration of surgery, marker dislocation rates, rates of marker placement or localization failure, patient-reported outcomes, rates of “lost markers”, radiologist and surgeon satisfaction, and health economic evaluation of the different techniques. Target accrual: 7,416 patients. The study will be conducted in 30 countries. Clinical trial information: NCT05559411 .

Clinical features and outcomes of mpox in people with and without HIV: a national comparative study.

People who live with HIV (PWLH) have been one of the most affected groups during the current mpox outbreak. They are hypothesized to have a more severe clinical course than people without HIV but comparative data is scarce. We aimed to compare clinical features and outcomes of mpox in people with and without HIV in Mexico. Country-wide study in Mexico. We performed an observational study using nation-wide epidemiological data. We included all people with confirmed mpox diagnosed between May and November 2022 in Mexico. Clinical and sociodemographic characteristics were compared between people with and without HIV. Multivariable logistic regression models were preformed to determine the association between HIV, clinical features, and outcomes and reported with odds ratios (ORs) and 95% confidence intervals (95% CI). ORs for rare outcomes were interpreted as risk ratios. Among 3291 people with mpox, 59% were PWLH. PWLH had an increased risk of severe mpox (OR 2.6, 2.4-2.9) and death (OR 10.8, 9.7-11.9). They also had a higher risk of otalgia, proctitis, and urethritis. Eleven individuals died, of whom ten were PWLH. All deaths were directly attributed to mpox. People with HIV have a higher risk of severe mpox and death due to mpox.

Cost-effectiveness study of atezolizumab (ATZ) vs. durvalumab (DUR): Real-world data (RWD) on first-line chemotherapy combined with immune-checkpoint inhibitors (Chemo-ICIs) for extensive disease small-cell lung cancer (ED-SCLC).

8097 Background: Chemo-ICI is the standard of care in first-line therapy for ED-SCLC. Although there is no comparative data on ATZ vs. DUR, their efficacies appear to be equivalent based on results from IMpower133 and CASPIAN trials. On the other hand, the drug price of DUR is higher than that of ATZ, suggesting a different cost-effectiveness. Methods: This is a multicenter retrospective study of RWD. Clinical outcomes and safety information of ED-SCLC patients (pts) who had received Chemo-ICIs were collected from electronic medical records, and the total cost incurred during ICIs was obtained from the receipts of each hospital. Propensity score matching (PSM) was performed to adjust difference of pts' backgrounds of two groups (ATZ-G vs. DUR-G). The total monthly medical costs incurred during ICI administration for both groups were compared by cost minimization analysis to evaluate cost-effectiveness. Results: From August 2018 to December 2022, 274 pts (ATZ/DUR: 176/98) were extracted from 8 hospitals in Japan. After PSM and exclusion of cisplatin-treated pts, total 128 pts: 64 pts in each group were evaluated. The mean total medical costs per month during ICIs were 1,003,922 (±310,192) JPY (6,783 USD) in the ATZ-G and 1,596,511 (±371,405) JPY (10,787 USD) in the DUR-G (Wilcoxon rank sum test: p &lt; 0.001). Mean ICI drug costs per month during ICIs were 799,079 (±89,555) JPY (5,399 USD) in the ATZ-G and 1,570,744 (±371,405) JPY (10,163 USD) in the DUR-G (p &lt; 0.001). Response rate was 73.4% for ATZ-G and 75.0% for DUR-G. Median overall survivals (OSs) of ATZ-G vs. DUR-G were 13.9 (95% confidence interval [CI]: 11.7-17.5) vs. 13.6 (95% CI: 11.0-20.0) months, respectively (p = 0.919). Median progression-free survivals of ATZ-G vs. DUR-G were 4.9 (95% CI: 4.4-5.6) vs. 5.6 (95% CI: 5.0-6.7) months, respectively (p = 0.060). Cox-proportional hazard model identified poor performance status (hazard ratio [HR]: 5.5, p &lt; 0.001) and bone metastases (HR: 1.8, p = 0.029) as significant factors for shorter OS, while ATZ vs. DUR was not significant. ATZ-G revealed lower incidences of immune-related adverse events (irAEs) ≥grade 2 (10.9 vs. 31.3%, p = 0.009) and any grade interstitial lung disease (ILD) (3.1 vs. 20.3%, p = 0.004) than DUR-G. Number of hospitalizations in ATZ-G (median 1, range 0-6) was lower than that in DUR-G (median 2, range 0-7) (p = 0.005). Conclusions: Our RWD demonstrated a superior cost-effectiveness of ATZ to that of DUR. Total efficacies were similar, whereas the safety profiles, including irAE and ILD were more favorable in ATZ-G. Further discussion is required regarding not only cost-effectiveness but also clinical practicality such as: dose schedule of 3 weeks vs. 4 weeks; regimen flexibility of carboplatin vs. cisplatin; and etoposide dose adjustment of 100 mg/m2 vs. 80 mg/m2. Clinical trial information: 000053483.

Factors influencing the clinical added value (CAV) in France over more than a decade.

e23102 Background: The rise of cancer drug prices has raised alarm over the need to base pricing decisions on the clinical added value (CAV). The French National Authority for Health (HAS) is responsible for health technology assessment (HTA) in France. For each indication retained for reimbursement, the HAS assesses the CAV on a 5-point scale ranging from I (Major) to V (absence of clinical added value). This assessment is primarily based on medical evidence. The CAV score is one of the factors contributing to price negotiations between the French ministry and pharmaceutical companies. Methods: A retrospective and descriptive study analysis of all indications in oncology (hematology and solid tumors), excluding accelerated approvals for innovative treatments, was conducted by the HAS comparing the 2010-2015 and 2016-2022 periods. For each assessment, information relative to the level of evidence and the clinical effect of the drug from the HAS opinion were collected and focused on the study’s conclusive endpoints and design. Results: The global distribution of CAV score between the two studied periods (2010-2015 and 2016-2022) was similar. However, the distribution of CAV score based on study design differed between the two periods. Regarding non comparative studies, the proportion of indications that were attributed a CAV score V increased 1.7 times between 2010-2015 and 2016-2022 and those with a CAV score I-III was nearly divided by 3. Differences were equally observed for the distribution of CAV score between the two periods based on the conclusive endpoints in the pivotal study. For the studies with a conclusive endpoint on overall survival, the rate of CAV I-III was multiplied by 1.68 (an increase from 6 to 36 cases). Concerning the cases with a progression-free survival endpoint, an observed increase of 1.3 times was noted for the CAV I-III. Lastly, studies with a conclusive overall response rate (ORR) saw an increase of 1.4 times for the CAV V as well as a decrease of 0.76 times for the CAV I-III. Over the most recent period (2016-2022), the conclusive endpoints identified in the evaluated studies were predominantly the overall response rate (93%, n = 42/45) for phase II studies. For phase III studies, progression-free survival and overall survival were respectively identified in 45% and 30% of the cases. Conclusions: Thisstudy shows that the number of indications evaluated has increased and that the assessment of the CAV is closely correlated with the choices of the study design (comparative or not) and the primary endpoint (clinically relevant or not). However, other elements underpin and qualify its valuation such as the medical need. These elements are reviewed in the HAS Guidance which emphasises overall survival as a primary endpoint and comparative data.

A Targeted Review of Worldwide Indirect Treatment Comparison Guidelines and Best Practices

ObjectivesControls and governance over the methodology and reporting of indirect treatment comparisons (ITCs) have been introduced to minimize bias and ensure scientific credibility and transparency in healthcare decision making. The objective of this study was to highlight ITC techniques that are key to conducting objective and analytically sound analyses and to ascertain circumstantial suitability of ITCs as a source of comparative evidence for healthcare interventions. MethodsOvid MEDLINE was searched from January 2010 through August 2023 to identify publicly available ITC-related documents (ie, guidelines and best practices) in the English language. This was supplemented with hand searches of websites of various international organizations, regulatory agencies, and reimbursement agencies of Europe, North America, and Asia-Pacific. The jurisdiction-specific ITC methodology and reporting recommendations were reviewed. ResultsSixty-eight guidelines from 10 authorities worldwide were included for synthesis. Many of the included guidelines were updated within the last 5 years and commonly cited the absence of direct comparative studies as primary justification for using ITCs. Most jurisdictions favored population-adjusted or anchored ITC techniques opposed to naive comparisons. Recommendations on the reporting and presentation of these ITCs varied across authorities; however, there was some overlap among the key elements. ConclusionsGiven the challenges of conducting head-to-head randomized controlled trials, comparative data from ITCs offer valuable insights into clinical-effectiveness. As such, multiple ITC guidelines have emerged worldwide. According to the most recent versions of the guidelines, the suitability and subsequent acceptability of the ITC technique used depends on the data sources, available evidence, and magnitude of benefit/uncertainty.

Long-term exposure to ambient fine particulate matter (PM2.5) and attributable pulmonary tuberculosis notifications in Ningxia Hui Autonomous Region, China: a health impact assessment

IntroductionLong-term exposure to fine particulate matter (≤2.5 µm (PM2.5)) has been associated with pulmonary tuberculosis (TB) notifications or incidence in recent publications. Studies quantifying the relative contribution of long-term PM2.5...

Safety of Gadoxetate Disodium for Hepatobiliary MRI in Children and Adolescents.

Background Despite a proven role in the characterization of liver lesions, use of the gadolinium-based contrast agent (GBCA) gadoxetate disodium at MRI is limited in children due to a lack of comparative safety data. Purpose To evaluate the safety of the GBCA gadoxetate disodium (a linear ionic hepatobiliary contrast agent [HBA]) in children and adolescents, compared with extracellular contrast agents (ECA). Materials and Methods A retrospective analysis was conducted in children and adolescents aged 18 years or younger who underwent HBA-enhanced MRI at one of three tertiary hospitals from January 2010 to December 2022. The incidence of GBCA-associated acute adverse events was compared between MRI examinations with a HBA and those with ECA. Severity was categorized according to American College of Radiology guidelines (mild, moderate, or severe). (a) Propensity score matching using multivariable logistic regression models and (b) inverse probability of treatment weighting analysis based on nine covariates (age, sex, asthma, allergic rhinitis, chronic urticaria or atopy, food allergy, drug allergy, premedication, and history of GBCA-associated adverse events) were used for confounder adjustment. Results A total of 1629 MRI examinations (ECA, n = 1256; HBA, n = 373) in 1079 patients were included (mean age, 8.6 years ± 6.5; 566 girls). The per-examination incidence of GBCA-associated acute adverse events showed no evidence of a difference, with rates of 0.9% (11 of 1256 examinations) for ECA and 1.3% (five of 373 examinations) for HBA (odds ratio [OR], 1.55 [95% CI: 0.54, 4.46]; P = .42). Acute adverse events were all mild with ECA, whereas with HBA, they were mild for four patients and moderate for one patient. There was no evidence of a difference in the incidence of acute adverse events, even in propensity score matching (OR, 1.33 [95% CI: 0.30, 5.96]; P = .71) and inverse probability of treatment weighting analysis (OR, 0.84 [95% CI: 0.25, 2.86]; P = .78). Conclusion Gadoxetate disodium showed no difference in acute adverse events compared with ECA in children and adolescents, with further large-scale pediatric studies required to confirm its safety. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Otero in this issue.

Single-stage correction of severe scoliosis with syringomyelia: performed with traction assistance without prophylactic neurosurgical decompression.

There is still controversy about whether it is necessary to perform prophylactic neurosurgical decompression for severe scoliosis (SS) with syringomyelia (SM) to reduce the risk of neurological complications during subsequent spinal correction. This study aimed to explore the safety and effectiveness of using traction-assisted single-stage spinal correction as a treatment for patients who had SS with SM (SS-SM). The patients who had SS-SM without previous neurosurgical intervention and who underwent traction-assisted single-stage posterior spinal correction at a single center were included, and the initial, posttraction, and postoperative clinical data were reviewed. Based on preoperative MRI, the included patients were divided into two categories: those with versus those without Chiari malformation type I (CM-I-related SM [CS] vs idiopathic SM [IS]), and those with a moderate syrinx (MS) versus those with a large syrinx (LS). Different groups' traction and operation contributions were calculated for comparisons (CS vs IS, MS vs LS). A total of 28 patients were included. The initial mean major scoliosis was 101.0° with a mean flexibility of 21.4%. After the operation, the mean total correction rate for scoliosis was 63.9%. The mean traction and operation contributions were 61.5% and 38.5%, respectively. Most of the patients (75%) underwent spinal corrections without 3-column osteotomies, and only 1 patient reported postoperative regional numbness without motor deficits. No differences were found in the mean total correction rates, traction, and operation contributions when comparing CS versus IS and MS versus LS with the comparable initial clinical data (p > 0.05). More than 50% of the total corrections were achieved by preoperative traction in all groups. Traction-assisted single-stage spinal correction can safely and effectively correct SS-SM without prophylactic neurosurgical decompression under strict patient selection. Additionally, traction can achieve more than half of the final spinal correction, even for patients with varying sizes of SMs.