Percent Decline Research Articles

Political representation of women in legislative assembly elections of Assam

The representation of women in legislative assembly elections of Assam have not improved since independence. Although Assam has a dignified history of women but they are not included in decision making and party politics of the state. Assam had witnessed a decline of percentage of women elected members of legislative assembly (MLA). In 2021 lowest number of women MLA’s are elected in comparison to other consecutive years. Here in this study, an attempt is made to observe political party-wise change in percentage of elected women MLA’s of Assam from 2001 to 2021. Moreover, the study had tried to bring percentage comparison between elected male and female MLA’s of Assam. Further, the study had also observed difference between contested and won women candidates in Assam legislative assembly elections. The result of the study shows that there is need of further improvement in representation of women in Assam politics. The study also shows huge difference between male and female elected MLA’s in legislative assembly elections of Assam. Regional political parties of Assam should give more candidature to women candidates in legislative elections in comparison to national political parties of the country.

Long-term evaluation of the safety and efficacy of recombinant human pentraxin-2 (rhPTX-2) in patients with idiopathic pulmonary fibrosis (IPF): an open-label extension study

BackgroundRecombinant human pentraxin-2 (rhPTX-2) significantly decreased decline in percent predicted forced vital capacity (FVC) and stabilized 6-min walk distance (6MWD) in patients with idiopathic pulmonary fibrosis (IPF) during the 28-week, placebo-controlled, randomized period of the Phase II PRM-151–202 study. Interim (76-week) data from the open-label extension (OLE) demonstrated sustained safety and efficacy with rhPTX-2 treatment. Here, we present the entire long-term OLE safety and efficacy data to 128 weeks.MethodsPatients who completed the randomized PRM-151–202 study period were eligible for the OLE, during which all patients received rhPTX-2, having started rhPTX-2 (i.e., crossed from placebo) or continued rhPTX-2 after Week 28. rhPTX-2 was administered in 28-week cycles, with 10 mg/kg intravenous infusions (60 min) on Days 1, 3, and 5 in the first week of each cycle, then one infusion every 4 weeks up to Week 128. The OLE primary objective was to assess the long-term safety and tolerability of rhPTX-2. Other outcomes included FVC, 6MWD, and patient-reported outcomes (descriptive analysis).ResultsAll 111 patients who completed the randomized period entered the OLE (n = 37 started rhPTX-2; n = 74 continued rhPTX-2); 57 (51.4%) completed to Week 128. The treatment-emergent adverse event (TEAE) profile was consistent with the randomized period, with the majority of TEAEs graded mild or moderate. Serious TEAEs occurred in 47 patients (42.3%), most frequently IPF (n = 11; 9.9%), pneumonia (n = 7; 6.3%), and acute respiratory failure (n = 3; 2.7%). Three patients underwent lung transplantation. Most serious TEAEs (and all 14 fatal events) were considered unrelated to rhPTX-2 treatment. For patients starting vs continuing rhPTX-2, mean (95% confidence interval) changes from baseline to Week 128 were, respectively, − 6.2% (− 7.7; − 4.6) and − 5.7% (− 8.0; − 3.3) for percent predicted FVC and − 36.3 m (− 65.8; − 6.9) and − 28.9 m (− 54.3; − 3.6) for 6MWD; however, conclusions were limited by patient numbers at Week 128.ConclusionsLong-term treatment (up to 128 weeks) with rhPTX-2 was well tolerated in patients with IPF, with no new safety signals emerging in the OLE. The limited efficacy data over 128 weeks may suggest a trend towards a treatment effect.Trial registration NCT02550873; EudraCT 2014-004782-24.

Prescribing of common outpatient antibiotics for respiratory infections in adults amid the COVID-19 pandemic in Brazil

Background: Inappropriate antibiotic use for SARS-CoV-2 infection has the potential to increase the burden of antibiotic resistance. Brazil experienced spread of a new SARS-CoV-2 variant in the fourth quarter (Q4) of 2020, resulting in the highest case counts in Latin America, raising concerns of antibiotic overuse. To better understand antibiotic use during the COVID-19 pandemic, we evaluated prescribing changes in antibiotics commonly used for outpatient respiratory infections (amoxicillin-clavulanate, azithromycin, and levofloxacin or moxifloxacin [AALM]) among adults aged ≥20 years in Brazil in 2020 versus 2019. Methods: We analyzed the IQVIA MIDAS medical data set for AALM prescribing by age group (20–39, 40–59, 60–64, 65–74, ≥75 years), comparing Q4 2020 rates to those in Q4 2019. We estimated crude rate ratios and 95% CIs using prescription number as the numerator (assuming Poisson counts) and age-adjusted population as the denominator. We also determined the most common prescribing specialties for each antibiotic across both time points. Results: Compared to Q4 2019, Q4 2020 azithromycin prescribing increased among all ages, ranging from 90.7% (95% CI, 90.0%–91.4%) in those aged 20–39 years to 927.2% (95% CI, 912.9%–941.7%) in those aged 65–74 years (Fig. 1). Amoxicillin-clavulanate prescribing decreased for most ages, ranging from −78.4% (95% CI, −78.7% to −78.1%) in those aged 60–64 years to −25.8% (95% CI, −26.6% to −25.0%) in those aged 65–74 years. Prescribing of levofloxacin or moxifloxacin decreased for most ages, ranging from −39.1% (95% CI, −39.4% to −38.8%) in those aged 20–39 years to −16.9% (95% CI, −18.1% to −15.7%) in those aged 60–64 years. For those aged ≥75 years, prescribing of amoxicillin-clavulanate and levofloxacin or moxifloxacin increased by 13.2% (95% CI, 11.9%–14.5%) and 43.1% (95% CI, 41.7%–44.5%), respectively. In Q4 2019 and Q4 2020, the 2 most common prescribing specialties for azithromycin were general practice (48%–50% of prescriptions) and gynecology (19%–25%). Compared to Q4 2019, infectious disease specialists in Q4 2020 saw the largest decline in percentage of azithromycin prescriptions (10% to 1%) and surgeons saw the largest increase (0% to 7%). General practitioners were also the most common prescribers of the remaining antibiotics (43%–54%), followed by gynecology for levofloxacin or moxifloxacin (25%–29%) and otolaryngology for amoxicillin-clavulanate (14%–20%). Conclusions: Despite decreases in prescribing of amoxicillin-clavulanate and respiratory fluoroquinolones for most adults, azithromycin prescribing increased dramatically across all adults during the COVID-19 pandemic. Targeting inappropriate outpatient antibiotic use in Brazil, particularly azithromycin prescribing among general practitioners, gynecologists, and surgeons, may be high-yield targets for antibiotic stewardship.Funding: NoneDisclosures: None

The Demand for Insurance and Rationale for a Mandate: Evidence from Workers' Compensation Insurance.

Workers' compensation insurance, which provides no-fault coverage for work-related injuries, is mandatory in nearly all states. We use administrative data from a unique market without a coverage mandate to estimate the demand for workers' compensation insurance, leveraging regulatory premium updates for identification. We find that a 1 percent increase in premiums leads to approximately a 0.3 percent decline in coverage. Drawing upon these estimates and data on costs, we examine potential justifications for government intervention to increase coverage. This analysis suggests that several forms of market failure-such as adverse selection, market power, and externalities-may not justify a mandate in this setting.

Black Land Loss: 1920–1997

Black agricultural land ownership was at a peak just after the turn of the twentieth century; however, there was a nearly 90 percent decline in ownership from 1910 to 1997. In this paper, we use US Census of Agriculture data to estimate that the present, compounded value of the Black land loss from 1920 to 1997 is roughly $326 billion.

Influence of Non-Thermal Plasma (DBD) On Infertility Male Semen with Low Sperm Motility and Dna Damage

Non-thermal plasma(Dielectric barrier discharge) has many uses including living tissue sterilization, inactivation of the bacteria, excimer formation, angiogenesis, and surface treatment. This research aim is to use cold plasma as a tool to search the effect of the dielectric barrier discharge system at room temperature on human sperm motility and DNA integrity. This work was performed on 60 human semen samples suffering from low motility; each sample was prepared by centrifugation method, then each semen sample was divided into two sections, the first section is before significant exposure to the plasma system (DBD) and the second section is after treatment with the DBD system at ambient temperature. Before and after exposure to non-thermal Plasma (DBD), DNA integrity and sperm motility were assessed, patients suffered from asthenospermia has a high level of DNA fragmentation than fertile male, ( 24.16±4.14) p<0.001 for untreated and after treatment the semen slide with dielectric barrier discharge the percentage decreases to (9.16±1.76) p>0.006, and the comet slide was (35.44±4.15) then the percentage decline to (19.86 ±2.44) these results have shown that cold plasma improves sperm motility and decreases from DNA damage in patients with medium and high level of DNA damage.

Factors associated with renal function change after unilateral adrenalectomy in patients with primary aldosteronism.

Decreased glomerular filtration rate has been reported in patients with primary aldosteronism after unilateral adrenalectomy. Glomerular hyperfiltration has been assumed to mask the preoperative subtle renal impairment. In this study, we investigated predictors for decreased estimated glomerular filtration rate after adrenalectomy in patients with primary aldosteronism. From January 2006 through September 2018, 328 patients with confirmatory diagnoses of primary aldosteronism received unilateral laparoscopic adrenalectomy and subsequent follow-up for 12 months. We prospectively collected related parameters of the clinical outcomes and renal function to identify predictors of renal function impairment at 12 months after surgery. Patients were stratified into three groups by preoperative estimated glomerular filtration rate level: 144 (43.9%) with estimated glomerular filtration rate ≥90, 130 (39.6%) with estimated glomerular filtration rate within 60-89.9, and 54 (16.5%) with estimated glomerular filtration rate <60 mL/min/1.73 m2 . The estimated glomerular filtration rate decreased significantly at the 6th month and remained stable at the 12th month, postoperatively. Patients with estimated glomerular filtration rate ≥90 had better clinical outcome with 59.6% success rate (P = 0.006) among three groups. Multivariate logistic regression analysis indicated that preoperative estimated glomerular filtration rate (odds ratio 1.012, P = 0.02) and hypokalemia (odds ratio 2.018, P = 0.024) were associated with renal impairment at 12th month after adrenalectomy. Multivariate linear regression analysis revealed high preoperative estimated glomerular filtration rate (β = 0.261, P < 0.001), high preoperative systolic blood pressure (β = 0.168, P = 0.003), high level of microalbuminuria (β = 0.024, P = 0.001), and low level of serum potassium (β = -4.883, P = 0.007) were associated with estimated glomerular filtration rate percentage decline at 12th month after adrenalectomy. Estimated glomerular filtration rate declined significantly after adrenalectomy in patients with estimated glomerular filtration rate ≥90. The study provided important information to identify primary aldosteronism patients with higher risk of estimated glomerular filtration rate decline after adrenalectomy and might help to adopt early interventions to improve the outcomes.

Reduction in malaria burden following the introduction of indoor residual spraying in areas protected by long-lasting insecticidal nets in Western Kenya, 2016-2018.

Long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) are the main malaria vector control measures deployed in Kenya. Widespread pyrethroid resistance among the primary vectors in Western Kenya has necessitated the re-introduction of IRS using an organophosphate insecticide, pirimiphos-methyl (Actellic® 300CS), as a pyrethroid resistance management strategy. Evaluation of the effectiveness of the combined use of non-pyrethroid IRS and LLINs has yielded varied results. We aimed to evaluate the effect of non-pyrethroid IRS and LLINs on malaria indicators in a high malaria transmission area. We reviewed records and tallied monthly aggregate of outpatient department (OPD) attendance, suspected malaria cases, those tested for malaria and those testing positive for malaria at two health facilities, one from Nyatike, an intervention sub-county, and one from Suba, a comparison sub-county, both located in Western Kenya, from February 1, 2016, through March 31, 2018. The first round of IRS was conducted in February-March 2017 in Nyatike sub-county and the second round one year later in both Nyatike and Suba sub-counties. The mass distribution of LLINs has been conducted in both locations. We performed descriptive analysis and estimated the effect of the interventions and temporal changes of malaria indicators using Poisson regression for a period before and after the first round of IRS. A higher reduction in the intervention area in total OPD, the proportion of OPD visits due to suspected malaria, testing positivity rate and annual malaria incidences were observed except for the total OPD visits among the under 5 children (59% decrease observed in the comparison area vs 33% decrease in the intervention area, net change -27%, P <0.001). The percentage decline in annual malaria incidence observed in the intervention area was more than twice the observed percentage decline in the comparison area across all the age groups. A marked decline in the monthly testing positivity rate (TPR) was noticed in the intervention area, while no major changes were observed in the comparison area. The monthly TPR reduced from 46% in February 2016 to 11% in February 2018, representing a 76% absolute decrease in TPR among all ages (RR = 0.24, 95% CI 0.12-0.46). In the comparison area, TPR was 16% in both February 2016 and February 2018 (RR = 1.0, 95% CI 0.52-2.09). A month-by-month comparison revealed lower TPR in Year 2 compared to Year 1 in the intervention area for most of the one year after the introduction of the IRS. Our findings demonstrated a reduced malaria burden among populations protected by both non-pyrethroid IRS and LLINs implying a possible additional benefit afforded by the combined intervention in the malaria-endemic zone.

SNP-Based Genome-Wide Association Mapping of Pollen Viability Under Heat Stress in Tropical Zea mays L. Inbred Lines.

Global environmental changes with more extreme episodes of heat waves are major threats to agricultural productivity. Heat stress in spring affects the reproductive stage of maize, resulting in tassel blast, pollen abortion, poor pollination, reduced seed set, barren ears and ultimately yield loss. As an aneamophelous crop, maize has a propensity for pollen abortion under heat stress conditions. To overcome the existing challenges of heat stress and pollen abortion, this study utilized a broad genetic base of maize germplasm to identify superior alleles to be utilized in breeding programs. A panel of 375 inbred lines was morpho-physiologically screened under normal and heat stress conditions in two locations across two consecutive planting seasons, 2017 and 2018. The exposure of pollen to high temperature showed drastic decline in pollen germination percentage. The average pollen germination percentage (PGP) at 35 and 45°C was 40.3% and 9.7%, respectively, an average decline of 30.6%. A subset of 275 inbred lines were sequenced using tunable genotyping by sequencing, resulting in 170,098 single nucleotide polymorphisms (SNPs) after filtration. Genome wide association of PGP in a subset of 122 inbred lines resulted in ten SNPs associated with PGP35°C (p ≤ 10−5), nine with PGP45°C (p ≤ 10−6–10−8) and ten SNPs associated with PGP ratio (p ≤ 10−5). No SNPs were found to be in common across PGP traits. The number of favorable alleles possessed by each inbred line for PGP35°C, PGP45°C, and the PGP ratio ranged between 4 and 10, 3–13 and 5–13, respectively. In contrast, the number of negative alleles for these traits ranged between 2 and 8, 3–13 and 3–13, respectively. Genetic mapping of yield (adjusted weight per plant, AWP−1) and flowering time (anthesis-silking interval, ASI) in 275 lines revealed five common SNPs: three shared for AWP−1 between normal and heat stress conditions, one for ASI between conditions, and one SNP, CM007648.1-86615409, was associated with both ASI and AWP−1. Variety selection can be performed based on these favorable alleles for various traits. These marker trait associations identified in the diversity panel can be utilized in breeding programs to improve heat stress tolerance in maize.

Impaired Cold-Stimulated Supraclavicular Brown Adipose Tissue Activity in Young Boys With Obesity.

Childhood obesity is a growing worldwide problem. In adults, lower cold-induced brown adipose tissue (BAT) activity is linked to obesity and metabolic dysfunction; this relationship remains uncertain in children. In this cross-sectional study, we compared cold-induced supraclavicular (SCV) BAT activity (percent change in proton density fat fraction [PDFF]) within the SCV region after 1 h of whole-body cold exposure (18°C), using MRI in 26 boys aged 8-10 years: 13 with normal BMI and 13 with overweight/obesity. Anthropometry, body composition, hepatic fat, visceral adipose tissue (VAT), and pre- and postcold PDFF of the subcutaneous adipose tissue (SAT) in the posterior neck region and the abdomen were measured. Boys with overweight/obesity had lower cold-induced percent decline in SCV PDFF compared with those with normal BMI (1.6 ± 0.8 vs. 4.7 ± 1.2%, P = 0.044). SCV PDFF declined significantly in boys with normal BMI (2.7 ± 0.7%, P = 0.003) but not in boys with overweight/obesity (1.1 ± 0.5%, P = 0.053). No cold-induced changes in the PDFF of either neck SAT (-0.89 ± 0.7%, P = 0.250, vs. 0.37 ± 0.3%, P = 0.230) or abdominal SAT (-0.39 ± 0.5%, P = 0.409, and 0.25 ± 0.2%, P = 0.139, for normal BMI and overweight/obesity groups, respectively) were seen. The cold-induced percent decline in SCV PDFF was inversely related to BMI (r = -0.39, P = 0.047), waist circumference (r = -0.48, P = 0.014), and VAT (r = -0.47, P = 0.014). Thus, in young boys, as in adults, BAT activity is lower in those with overweight/obesity, suggesting that restoring activity may be important for improving metabolic health.

Vitamin D Supplementation and Genetic Polymorphisms Impact on Weight Loss Diet Outcomes in Caucasians: A Randomized Double-Blind Placebo-Controlled Clinical Study.

Vitamin D deficiency or insufficiency is common in obese people, with some studies suggesting that low vitamin D level might be an independent predictor of obesity. Thus, the purpose of the present randomized, double-blind, placebo-controlled study was to investigate the effect of oral spray vitamin D3 3000 IU supplementation along with personalized weight-loss diet on obesity markers in overweight and obese Caucasians with vitamin d deficiency or insufficiency. The impact of vitamin D receptor (VDR) and adrenergic receptors (ADRs) genetic variants on vitamin D levels and weight loss diet outcomes was also investigated. After signing informed consent, a total of 125 eligible volunteers were randomly assigned into vitamin D (vitamin D3 3000 IU/d oral spray supplementation, n = 76) or placebo (xylitol, water, mint, n = 49) group following a weight loss program (600 calories less than the total energy expenditure of each volunteer) for 3 months. Fat mass, BMI, REE and 25(OH)D serum level were monitored on baseline and each month. DNA samples were extracted from buccal swabs and genotyped for the rs2228570 (VDR), rs1544410 (VDR), rs731236 (VDR), rs1800544 (ADRA2A), rs1801252 (ADRB1), rs1042713 (ADRB2), and rs4994 (ADRB3) polymorphisms. Statistical analysis was performed using SPSS package (v.23). Between group comparisons revealed significant improvement in serum 25(OH)D level and greater reduction in weight, BMI and fat percentage in the vitamin D group compared to placebo group (p < 0.05). In the vitamin D group, carriers of the rs2228570 T allele tended to have greater vitamin D level improvement compared with the homozygous C allele (p = 0.067). Furthermore, heterozygous (CT) for the rs731236 tended to have lesser weight loss (p = 0.068) and for the rs1042713, a lower decline in fat percentage was observed for homozygous AA carriers compared to the heterozygous (p = 0.051). In the control group, differences in weight loss (p = 0.055) and BMI (p = 0.045) were observed between rs1544410 AA and GG homozygous. In conclusion, vitamin D oral spray supplementation seems to improve vitamin D status and decrease obesity markers during a weight-loss intervention in overweight/obese Caucasians with vitamin D deficiency or insufficiency. Also, the results of the present study indicate that VDR and ADRs genetic polymorphisms seem to influence vitamin D supplementation response and obesity markers.

An Initial Field Intelligent Correcting Algorithm for Numerical Forecasting Based on Artificial Neural Networks under the Conditions of Limited Observations: Part I—Focusing on Ocean Temperature

For the numerical forecasting of ocean temperature, the effective fusion of observations and the initial field under the conditions of limited observations has always been a significant problem. Traditional data assimilation methods cannot make full use of limited observations to correct the initial field. In order to obtain an optimal initial field with limited observations, this study proposed an intelligent correcting (IC) algorithm based on artificial neural networks (ANNs). The IC algorithm can fully mine the correlation laws between the grid points using historical data, and this process essentially replaces the estimation of background error covariance in traditional data assimilation methods. Experimental results show that the IC algorithm can lead to superior forecasting accuracy, with a lower root mean square error (around 0.7 °C) and higher coefficient of determination (0.9934) relative to the optimal interpolation method. Through the IC algorithm, the largest reduction in mean forecasting error can reach around −0.5 °C and the maximum percentage decline in mean forecasting error can reach 30% compared with the original numerical forecasting results. Therefore, the experiments validate that the IC algorithm can effectively correct the initial field under the conditions of limited observations.

Plantar stimulation prevents the decrease in fatigue resistance in rat soleus muscle under one week of hindlimb suspension

Support afferentation in recent years was shown to be a key physiological stimulus controlling postural muscle function, structure and phenotype. Lack of support afferentation under various types of muscle disuse leads to a decline of size and percentage of slow-type fatigue-resistant muscle fibers, which can negatively affect muscle performance and life quality. In this study we simulated support afferentation during rat hindlimb unloading and investigated its effect on postural soleus muscle functional properties and signaling. Plantar mechanical stimulation prevented the unloading-induced muscle fatigue increase, maintained the level of mitochondrial DNA copy number and the percent of slow-type muscle fibers and partially prevented the increase of CpG methylation in pgc 1α promoter region and decline in myonuclear content of several transcriptional activators of slow myosin and PGC1 α expression. So, support afferentation under hindlimb suspension leads to maintaining of a slow-twitch oxidative and fatigue-resistant soleus muscle fibers phenotype.

Graft function and pregnancy outcomes after kidney transplantation

BackgroundAfter kidney transplantation, pregnancy and graft function may have a reciprocal interaction. We evaluated the influence of graft function on the course of pregnancy and vice versa.MethodsWe performed a retrospective observational study of 92 pregnancies beyond the first trimester in 67 women after renal transplantation from 1972 to 2019. Pre-pregnancy eGFR was correlated with outcome parameters; graft function was evaluated by Kaplan Meier analysis. The course of graft function in 28 women who became pregnant after kidney transplantation with an eGFR of < 50 mL/min/1.73m2 was compared to a control group of 79 non-pregnant women after kidney transplantation during a comparable time period and with a matched basal graft function.ResultsLive births were 90.5% (fetal death n = 9). Maternal complications of pregnancy were preeclampsia 24% (graft loss 1, fetal death 3), graft rejection 5.4% (graft loss 1), hemolytic uremic syndrome 2% (graft loss 1, fetal death 1), maternal hemorrhage 2% (fetal death 1), urinary obstruction 10%, and cesarian section. (76%). Fetal complications were low gestational age (34.44 ± 5.02 weeks) and low birth weight (2322.26 ± 781.98 g). Mean pre-pregnancy eGFR was 59.39 ± 17.62 mL/min/1.73m2 (15% of cases < 40 mL/min/1.73m2). Pre-pregnancy eGFR correlated with gestation week at delivery (R = 0.393, p = 0.01) and with percent eGFR decline during pregnancy (R = 0.243, p = 0.04). Pregnancy-related eGFR decline was inversely correlated with the time from end of pregnancy to chronic graft failure or maternal death (R = -0.47, p = 0.001). Kaplan Meier curves comparing women with pre-pregnancy eGFR of ≥ 50 to < 50 mL/min showed a significantly longer post-pregnancy graft survival in the higher eGFR group (p = 0.04). Women after kidney transplantation who became pregnant with a low eGFR of > 25 to < 50 mL/min/1.73m2 had a marked decline of renal function compared to a matched non-pregnant control group (eGFR decline in percent of basal eGFR 19.34 ± 22.10%, n = 28, versus 2.61 ± 10.95%, n = 79, p < 0.0001).ConclusionsAfter renal transplantation, pre-pregnancy graft function has a key role for pregnancy outcomes and graft function. In women with a low pre-pregnancy eGFR, pregnancy per se has a deleterious influence on graft function.Trial registrationSince this was a retrospective observational case series and written consent of the patients was obtained for publication, according to our ethics’ board the analysis was exempt from IRB approval. Clinical Trial Registration was not done. The study protocol was approved by the Ethics Committee of Hannover Medical School, Chairman Prof. Dr. H. D. Troeger, Hannover, December 12, 2015 (IRB No. 2995–2015).

GENDER AND REGIONAL DISPARITIES IN EMERGENCY ARRHYTHMIA PROCEDURES DURING COVID-19 LOCKDOWN

Objectives: Worldwide reduction in emergency procedures has been observed during the current COVID-19 pandemic. The effects of the pandemic and its associated lockdown on arrhythmia related emergency procedures is not known. This study was done to see the effects of the COVID-19 pandemic lockdown on provision of emergency arrhythmia procedures and to identify vulnerable patient groups that may be disproportionately affected during lockdown. Methodology: Data for patients requiring emergency intracardiac devices including temporary and permanent pacemakers was collected from three public sector hospitals of Sindh, Pakistan, for the COVID-19 lockdown period of March to May 2020. This was compared to the data for the same period for 2019. Results: Patients presenting during lockdown decreased by 32.8% (from 250 to 168) compared to the same period without lockdown. The decline was across all emergency procedures considered. There was a more than fivefold reduction in the number of patients in patients from outside the metropolitan area of the hospital (64.3%) compared to those residing within the city (12.5%) (p=0.001). There was a trend showing women to be more effected, with the percentage decline in women being statistically significant in the rural setting (-93.8% vs. -52.9%, p=0.043). All age groups were equally affected (p=0.152). Conclusion: A marked reduction in the number of patients who presented for emergency intra cardiac devices and TPM procedures was seen during COVID-19 lockdown. The patients who presented from outside the city of the hospital and women in rural setting were significantly more effected.

Finally a Smoking Gun? Compensating Differentials and the Introduction of Smoking Bans

Using the staggered introduction of smoking bans in the German hospitality industry over 2007–2008, I find a robust 2.4 percent decline in the daily earnings of workers in bars and restaurants associated with the most comprehensive smoking ban. This effect is unlikely to be driven by a decline in hospitality revenues or hours worked but is consistent with a simple model of compensating differentials. (JEL I12, I18, J22, J31, J81, L83)

The Impact of Health on Wealth: Empirical Evidence

This paper empirically evaluates the impact of health on wealth. Using the frailty index as a measure of health and carefully accounting for the dynamic relationship between frailty and wealth, I find that su˙ering one more health deficit leads, on average, to a 2.45 percent decline in the household net worth of individuals between age 50 and 100. The household net worth of individuals with no college degree, poor health, and over the age of 70 is significantly negatively a˙ected by poor health. The results pass the tests of instrument validity and are consistent across several alternative definitions of wealth. Using financial net worth as a definition of wealth, I find that the average impact of frailty on wealth is the largest, while it is the smallest when wealth is defined to include only housing net worth.

Estimating the repercussions from China's export value‐added tax rebate policy*

AbstractOur study shows that China's export value‐added tax (VAT) rebate system is a major industrial policy that affects its exports. We use export data at the HS6 product level for a panel of 329 Chinese cities over the 2003–2012 period to assess how changes in the export VAT tax have affected China's export performance. We consider different trade margins in terms of volumes, prices, and the number of countries served. To counter endogeneity, we exploit variations in the expected impact of the export VAT rebates by trade regime, which come from an eligibility rule disqualifying certain export flows from the rebates. Our results suggest that a 1 percent decline in the export VAT tax leads to a 7.2 percent relative increase in eligible export values at the city level. This effect is due to an adjustment of quantities and the number of foreign markets served while the average unit values of exports remain unchanged.

POSA420 Trends in Thrombotic and Cardiovascular Events Among Hospitalized Patients with COVID-19 in the US: Findings from a Large Electronic Health Records Database

Patients with the coronavirus disease 2019 (COVID-19) have an increased risk of thrombotic and cardiac events. We assessed the incidence and trends in selected thrombotic and cardiac events among hospitalized COVID-19 patients from a large, geographically diverse US electronic health records (EHR) database. This retrospective study analyzed Optum® de-identified COVID-19 EHR dataset to identify patients hospitalized between 03/01/2020 and 10/31/2020 with a COVID-19 diagnosis code. Patients were members of an integrated delivery network with ≥1 encounter during the 12 months prior to admission. Events of interest, including acute coronary syndrome (ACS), venous thromboembolism (VTE), stroke and myocarditis, were identified by diagnosis codes during hospitalization. Patients with any such events in their 12-month baseline were excluded. A composite event was defined by the occurrence of any of these events. Events were reported as proportions, in total as well as by month of admission and age group. Among 25,574 hospitalized COVID-19 patients, the median age was 60 years (IQR: 44-72), and 54.5% were female. The composite event occurred in 3,052 (11.9%) patients (ACS=6.4%, VTE=4.1%, stroke=2.4%, myocarditis=0.6%) and its incidence increased with age (≤19=4.6%, 20-49=6.2%, 50-59=11.7%, 60-69=13.4%, ≥70=17.3%). In the youngest age group, myocarditis (2.2%) and VTE (1.7%) contributed to the majority of events, while in the oldest, ACS (10.9%), VTE (4.2%) and stroke (4.1%) were observed most often. Patients admitted during March had the highest incidence (20.6%), which decreased to 9.1% by July and remained steady through October (9.6%). The percentage decline in the composite event incidence during the study period was higher in younger versus older patients (≤19=77.0% 20-49=61.9%, 50-59=66.0%, 60-69=58.6%, ≥70=44.1%). The incidence of the composite event was highest among patients hospitalized early in the pandemic. The composite event occurred in almost 5% patients ≤19 years old and this group experienced the largest decline during the study period.

Evaluating the Effect of Homicide Prevention Strategies in São Paulo, Brazil: A Synthetic Control Approach

Although Brazil remains severely affected by civil violence, the state of São Paulo has made significant inroads into fighting criminality. In the last decade, São Paulo has witnessed a 70 percent decline in homicide rates, a result that policy-makers attribute to a series of crime-reducing measures implemented by the state government. While recent academic studies seem to confirm this downward trend, no estimation of the total impact of state policies on homicide rates currently exists. The present article fills this gap by employing the synthetic control method to compare these measures against an artificial São Paulo. The results indicate a large drop in homicide rates in actual São Paulo when contrasted with the synthetic counterfactual, with about 20,000 lives saved during the period. The theoretical usefulness of the synthetic control method for public policy analysis, the role of the Primeiro Comando da Capital as a moderating variable, and the practical implications of the security measures taken by the São Paulo State government are also discussed.