Higher Rate Of Increase Research Articles

Burden of Hand Osteoarthritis in the Middle East and North Africa (MENA): An Epidemiological Analysis From 1990 to 2019

Hand osteoarthritis (OA) is a common cause of disability in older people. Although often underemphasized, it may affect quality of life and imposes a considerable burden on the health system. This study evaluated the epidemiology of hand OA in the Middle East and North Africa (MENA) region. This epidemiological study was performed based on the Global Burden of Disease study from 1990 to 2019. The incidence, prevalence, and years lived with disability (YLD) in all 21 MENA countries during the study period were reported in rate, age-standardized, and percentage. Hand osteoarthritis in MENA increased 2.7-fold, from 1.6 million cases to 4.3 million from 1990 to 2019 with an age-standardized incidence rate of 50.2 (95% CI, 38.2-66.4) per 100,000 people in 2019. Saudi Arabia had the highest age-standardized prevalence in both 1990 (2.3%) and 2019 (2.3%), whereas Turkey had the lowest (0.3%) in both years. Total YLDs due to hand osteoarthritis increased by more than 2.7-fold, from 50,335 to 135,336 during the study period. The highest rate of increase in YLD rate from 1990 to 2019 was in Iran (3.3) and the largest decrease was in Qatar (-11.5). In contrast to the global trend, MENA hand OA prevalence and YLDs did not decrease between 1990 and 2019 and remained constant over time. Aging and increasing obesity rates, particularly among women, might be the contributing factors. Hand OA epidemiology varies by country, possibly due to genetic, ethnic, and environmental factors. Prognostic II.

Patient-specific finite element simulation of peripheral artery percutaneous transluminal angioplasty to evaluate the procedure outcome without stent implantation.

The purpose of this work is to present a patient-specific (PS) modeling approach for simulating percutaneous transluminal angioplasty (PTA) endovascular treatment and assessing the balloon sizing influence on short-term outcomes in peripheral arteries, i.e. without stent implantation. Two 3D PS stenosed femoral artery models, one with a dominant calcified atherosclerosis while the other with a lipidic plaque, were generated from pre-operative computed tomography angiography images. Elastoplastic constitutive laws were implemented within the plaque and artery models. Implicit finite element method (FEM) was used to simulate the balloon inflation and deflation for different sizings. Besides vessel strains, results were mainly evaluated in terms of the elastic recoil ratio (ERR) and lumen gain ratio (LGR) attained immediately after PTA. Higher LGR values were shown within the stenosed region of the lipidic patient. Simulated results also showed a direct and quantified correlation between balloon sizing and LGR and ERR for both patients after PTA, with a more significant influence on the lumen gain. The max principal strain values in the outer arterial wall increased at higher balloon sizes during inflation as well, with higher rates of increase when the plaque was calcified. Results show that our model could serve in finding a compromise for each stenosis type: maximizing the achieved lumen gain after PTA, but at the same time without damaging the arterial tissue. The proposed methodology can serve as a step toward a clinical decision support system to improve angioplasty balloon sizing selection prior to the surgery.

Determination of the dynamics of the increase in the absolute mass of the chambers of a multicameral stomach in different age periods of growth and development of sheep of the Edilbaev breed

In the process of evolution, the multicameral stomach acquires a unique morphological structure, which is predetermined by the influence of various natural and environmental factors. The pre-ventricle, which consists of three chambers, serves as a reservoir for storing and preparing the resulting food coma from plant food. The aim of the study is to determine the dynamics of the increase in the absolute mass of the chambers of the multicameral stomach in sheep of the Edilbaevsky breed at different age periods of growth and development. The material for the study was corpses and organ complexes obtained from sheep of the Edilbaevsky breed from the farm “Slaughter point” IP Yusubov O.M. of the Leningrad region in the amount of 13 pieces. The age of the animals from which the biomaterial was obtained varied and ranged from 10 days to 14 months. During the study, a complex of modern measures was applied, including various research methods: fine anatomical dissection; morphometry; the absolute mass of the multicameral stomach was determined on an electronic scale “MS-K07” with an accuracy of 0.10 g. It was found that by 5-6 months of age, the absolute mass of the book increases most actively, this is due to a change in diet and the transition from the dairy period to feeding with coarse feeds. From 5-6 months of age to 12-14 months, the highest rate of increase in absolute mass is developed in the mesh, this is due to an increase in the functional load on this camera. During the same period, the absolute mass of the scar, the book and the abomasum increases relatively evenly. Over the entire period of studies of multicameral stomachs in different age groups of sheep of the Edilbaev breed, we note that the absolute mass of the abomasum increases evenly, this is due to the initial functional activity of this chamber from birth. At the same time, the greatest increase in absolute mass over the entire period of research is noted in the book.

Justification of the opportunities of obtaining silicate materials based on clay waste adsorbents

The physicochemical composition of the used waste clay adsorbents was studied to justify the possibility of obtaining other silicate new products, and it was found that they did not differ from the original ones. It was determined that the chemical composition of all samples met the requirements for porous materials. It was determined that bentonites have the highest rate of increase.

‘It’s a people problem, not a goat problem.’ Mitigating human–mountain goat interactions in a Canadian Provincial Park

Context Wildlife viewing is a primary reason people visit parks and protected areas. However, high rates of visitation increase the potential for interactions between humans and wildlife. This close proximity of humans and wildlife can lead to habituation to human presence and pose a threat to both animals and humans. Aims We describe human–mountain goat interactions in Cathedral Provincial Park (CPP), in British Columbia (BC), Canada, and examine management and mitigation strategies to reduce these interactions. Methods This project was a collaboration with BC Parks. We used community-based participatory research methodologies, conducting interviews and surveys from July 2020 to November 2021 with park visitors, staff, and researchers. Key results Most respondents encountered mountain goats in the park and understood the park’s messaging; however, not all respondents took the necessary steps to reduce encounters. We recommend further education efforts focused on formal staff training and improved infrastructure in the park. Conclusions Our results can be used to inform management decisions related to human–wildlife interactions, primarily in parks and protected areas. On a proximate level, we suggest further educational efforts and improved infrastructure in the park to help overcome perceived lack of action by some participants. Ultimately, there is a need to incorporate human aspects of human–wildlife interactions into management decisions aimed at addressing potential and existing problems. Implications Using a multitude of approaches to management, informed by biological, social, and cultural knowledge, can improve responses and mitigation strategies in human–wildlife interactions. Collaboration among different stakeholders allows for the exchange of ideas and innovations that can contribute to positive movement towards coexistence of humans and wildlife in parks and recreational areas.

Photoinduced radicals modulated NIR photothermal conversion in a photochromic inorganic–organic complex

A UV induced photochromic inorganic–organic complex can modulate a near-infrared photothermal effect to achieve precise control of temperatures with good recyclability, a high conversion efficiency and a high temperature increase rate.

S-DETECT FUNCTION AS THE LATEST METHOD OF ULTRASOUND EXAMINATION
 OF MAMMARY GLAND FORMATIONS:
 COMPARATIVE CHARACTERISTICS

Relevance: Breast masses remain a public health dilemma worldwide. Breast cancer (BC) is one of the leading causes of cancer mortality. So,
 in Kazakhstan in 2018-2019. Breast cancer ranked 3rd in the structure of mortality from malignant diseases, with a share of 8.7-8.1%.
 Breast cancer is the most common cancer among women. According to the WHO, over 2.2 million breast cancer cases were registered in 2020.
 In the world, breast cancer ranks fifth among the causes of death (685,000 deaths per year).
 On average, about 3000 breast cancer cases are detected in the Republic of Kazakhstan annually, and more than 1380 women die from this
 disease. The high rate of increase in morbidity and mortality, which is ahead of most other tumors, puts the problem of breast cancer in the lead.
 The rapid progress of technological developments in medicine has positively influenced the diagnosis of breast formations. Samsung Medison
 introduced the S-Detect function for the breast, which allows you to highlight the formation and characterize the affected area. Previously, reliable
 assessments were made using sonoelastography methods.
 The study aimed to determine the role of the S-Detect function in the differential diagnosis of breast masses.
 Methods: A comparative analysis of images taken with the S-Detect function and the sonoelastography method was carried out in 50 patients.
 Results: The S-Detect program made it possible to make a correct diagnosis in 87-93% (46 out of 50) of cases, confirmed by the results of
 morphological verification (histology, cytology). The sonoelastography method showed correct results in 75-80% (40 out of 50) cases.
 Conclusion: The use of S-Detect technology in analyzing the nature of formations in the mammary glands showed good agreement with
 B-mode, color (CFM) and power Doppler. S-Detect technology can be effectively used by novice radiologists when writing conclusions.

Effects of Land Cover Change and Deforestation on Rainfall and Surface Temperature in New Capital City of Indonesia

Land cover change and deforestation have a significant impact on climate change. This study investigates the effect of land cover change and deforestation on surface temperatures and extreme rainfall in the New Capital City of Indonesia (IKN), particularly in Samboja and Sepaku Subdistricts, East Kalimantan Province. Land cover change and deforestation were analyzed from Landsat 5 TM, 7 ETM+, and 8 OLI satellite data during 2001-2020. Land cover is divided into four classes: built-up land, water bodies, vegetation, and agricultural area. Rainfall data were obtained from the Integrated Multi-satellite Retrievals for GPM (IMERG) version 6 satellite, and extreme temperatures were taken from fifth-generation ECMWF reanalysis (ERA5) data. A significant decrease in vegetated land area is observed every year, followed by an increase in residential land and buildings (built-up area) and agricultural land. The highest rate of increase was observed in the area of ​​agricultural land. Such change is correlated with an increase in surface temperature in the IKN. The strongest correlation is shown by increased built-up area and agricultural land. The relationship between rainfall and land cover is weak, and the body of water shows a relatively strong relationship. The extreme number of very wet days (R95p), ​​consecutive dry days (CDD), and max 1-day precipitation (RX1day) rain index showed a decreasing trend during 2001-2020. However, the consecutive wet days (CWDs) index showed an increase. This needs to be a concern because consecutive precipitation extremes may cause more catastrophability than occasional extreme events.

Effect of Toxicity on Behavioral Changes in Freshwater Fish

Malathion, the earliest nonsystemic, wide-spectrum insecticide may additionally be found in formulations with several alternative pesticides, is found to be extremely noxious to varied non-targeted aquatic organisms together with fish. Conducive issues to the sensitivity of fish to insecticide Malathion exposure look to be its high rate of gill absorption because of the lipophilicity. Further, it can induce neurotoxicity, capability aerophilous stress, or alteration of inhibitor system and lipid peroxidation. In recent years, the high rate of increase in human population and speedy pace of manufacturing have created drawbacks of disposal of wastewaters. Domestic wastes and untreated or partly treated industrial effluents, supplemented with pollutants like significant metals, pesticides, and lots of organic compounds, have greatly contributed to huge aquatic ecosystem toxicity.

TRENDS AND VARIABILITY OF TEMPERATURE TIME SERIES OVER THE KANSHI CATCHMENT IN THE POTOHAR REGION OF PUNJAB-PAKISTAN

The variabilities and changing trends of temperature in the Potohar region have been examined in this study for the period of 1950-2018. Monthly data of mean, maximum and minimum temperature were acquired from Pakistan Meteorological Department (PMD) and slope method was opted to calculate the variation rate of temperature for the period under investigation. The results of the study revealed the rising trend of temperature over the Kanshi catchment in northern Punjab, for the period under study. Trends of maximum temperature significantly increased to a rate of 0.0134 °C/ year, while minimum temperature was also found to have increased at the rate of 0.0334 °C / year. Such high rate of temperacture increase can be attributed to settlement expansion an outcome of rapid urbanization, in Jhelum city. In comparison to maximum temperature (Tmax), the rate of increase of minimum temperature was identified to be more rapid. Correspondingly, a sum of 1 to 2°C increase in minimum temperature was observed, in the study area, for the period under study. The identified temperature changes are anticipated to have adverse consequences particularly for the agriculture and livestock sectors and food security in the region.

Hubungan Antara Shift Kerja, Masa Kerja Dengan Kelelahan Kerja Pada Perawat Daerah Surakarta Saat Pandemi Covid-19

The current end of the Covid-19 pandemic cannot be determined. The increasing number of patients in several hospitals has forced nurses to do more care for these patients. This study aims to determine the relationship between work shifts, length of work and work fatigue among nurses in the Surakarta area during the Covid-19 pandemic. This study used a descriptive analytic method with a sample of 30 nurses in Surakarta. The location was chosen because Surakarta has a fairly high rate of increase in cases infected with Covid-19. The data analysis method used is the independent t-test and chi square test. Based on the results of the independent t-test, it has a significance value of 0.025, which means there are differences in working hours before and after the Covid-19 pandemic. Chi-Square test at a value of 0.024 and 0.005 so that the work shift and length of work affect the work fatigue experienced by nurses. The results of the study also stated that there were differences in working hours for nurses. There was a relationship between work shifts and length of work on work fatigue experienced by nurses. It is better for the hospital management to be able to manage working time and rest time as best as possible so that nurses can remain optimal when working.

Longitudinal increase of sTREM2 in CSF and its relationship with other biomarkers and cognition along the evolution of autosomal dominant Alzheimer’s disease

AbstractBackgroundTherapeutic modulation of TREM2‐dependent microglial function provides an additional strategy to slow progression of Alzheimer’s disease (AD). Although studies on animal models suggest that TREM2 is protective, clinical biomarker studies reach different conclusions regarding TREM2 effect on tau pathology and its potential beneficial role in human AD. The longitudinal study of cerebrospinal fluid (CSF) soluble TREM2 (sTREM2) as a biomarker of TREM2 signalling during the evolution of autosomal dominant AD and its relationship with different biomarkers shed additional light on these controversies.MethodWe measured sTREM2 by a novel MSD‐immunoassay selectively detecting ADAM10/17 generated sTREM2 in longitudinal CSF samples from 93 non‐carriers (NC) and 155 mutation carriers (MC) ‐presenilin 1, presenilin 2 and amyloid precursor protein genes‐, participating in the Dominantly Inherited Alzheimer Network (DIAN) observational study, and with available longitudinal data on amyloid‐β (Aβ) and tau‐related CSF biomarkers, structural MRI, Pittsburgh compound B PET (PIB‐PET) and cognition. We based our statistical analysis on univariate and bivariate linear mixed effects models.ResultOur recent results showed that longitudinal sTREM2 increase was predicted by the earliest Aβ‐aggregation captured by lower CSF‐Aβ42, but not yet by a higher cortical uptake in PiB‐PET. In line with previous cross‐sectional studies, higher sTREM2 increase rate was associated with slower Aβ‐deposition, as measured by CSF Aβ42 in presymptomatic MC, and by PIB‐PET in symptomatic MC. Furthermore, MC with high or low sTREM2 increase rates had opposite associations between CSF Aβ42 and PiB‐PET longitudinal changes, further suggesting that TREM2 modifies Aβ‐plaque deposition and compaction. Regarding tau‐related pathology, we found that lower sTREM2 increase rate enhanced the increase of CSF p‐tau associated with PiB‐PET signal increase. Finally, higher sTREM2 increase rate in presymptomatic MC was associated with slower cortical shrinkage in the precuneus and slower cognitive decline.ConclusionThe most novel results on longitudinal sTREM2 in CSF position the TREM2 response right after the first pathological changes in Aβ‐aggregation and support its beneficial effect on Aβ‐deposition, Aβ‐dependent tau pathology, cortical shrinkage, and cognitive decline. These findings strongly support ongoing efforts to develop TREM2‐boosting therapies and suggest sTREM2 as a key marker for clinical trial design and interpretation.

Real-time PCR assay for Tetranychus evansi and multiplex with three other Tetranychus species

Spider mites are significant agricultural and horticultural pests. Among them, Tetranychus urticae Koch (Acari: Tetranychidae) is the most important one and has a cosmopolitan distribution. The tomato red spider mite (TRSM), T. evansi Baker and Pritchard is a worldwide pest of solanaceous crops and has become a major invasive agricultural pest. Tetranychus evansi originates from South America and has recently invaded many other parts of the world, including countries of Africa, Europe, Asia and North America. Recently, it has spread to Australia and New Zealand. TRSM has a high intrinsic rate of increase and completes a generation in less than 15 days. It is reported that T. evansi has replaced T. uritcae and other endemic spider mites as the dominant pest and also colonised new host plants in the invaded countries. Furthermore, T. urticae, T. ludeni and T. lambi shared the same host as T. evansi. Tetranychus species are difficult to distinguish using traditional morphological methods, and the molecular techniques such as mitochondrial COI and ITS sequences have greatly assisted in the diagnosis of those species. However, the methods include post-PCR steps and are time-consuming. In contrast, real-time PCR assays which omit those post-PCR steps can provide rapid detection. The real-time PCR assay to identify T. urticae, T. ludeni and T. lambi were already developed and validated by us (Li et al., 2015) and by Australian scientists (Chen et al., 2020), but no assay targeting T. evansi is available. Therefore, we developed and validated a TaqMan real-time PCR protocol for rapid detection of T. evansi, by targeting ITS1 gene region. The assay specificity was tested against the closely related species, i.e., T. collyerae, T. lambi, T. ludeni, T. kanzawai, T. parakanzawai, pueraicola, T. truncatus, T. turkestani and T. urticae. Plasmid DNA containing ITS1 sequence of T. evansi was used as standards for sensitivity tests of the real-time PCR assay. The detection limit of the assay is 10 copy of the target region, indicating that it can detect DNA from different life stage of the target species, i.e. an egg, a larva, a nymph or an adult. Furthermore, multiplex assay targeting T. evansi, T. ludeni, T. lambi and T. urticae have been validated for detection of the four species. The validation showed that the assay against T. evansi can run as singleplex and also as multiplex by targeting the four species simultaneously. This multiplex assay has been used in the surveillance programme in New Zealand and demonstrated its efficiency in detection of the target species. Moreover, the assay will be very useful for the quick identification of intercepted specimens at border and post border.

Television-viewing time and bodily pain in Australian adults with and without type 2 diabetes: 12-year prospective relationships

BackgroundBodily pain is a common presentation in several chronic diseases, yet the influence of sedentary behaviour, common in ageing adults, is unclear. Television-viewing (TV) time is a ubiquitous leisure-time sedentary behaviour, with a potential contribution to the development of bodily pain. We examined bodily pain trajectories and the longitudinal relationships of TV time with the bodily pain severity; and further, the potential moderation of the relationships by type 2 diabetes (T2D) status.MethodData were from 4099 participants (aged 35 to 65 years at baseline) in the Australian Diabetes, Obesity and Lifestyle Study (AusDiab), who took part in the follow-ups at 5 years, 12 years, or both. Bodily pain (from SF36 questionnaire: a 0 to 100 scale, where lower scores indicate more-severe pain), TV time, and T2D status [normal glucose metabolism (NGM), prediabetes, and T2D] were assessed at all three time points. Multilevel growth curve modelling used age (centred at 50 years) as the time metric, adjusting for potential confounders, including physical activity and waist circumference.ResultsMean TV time increased, and bodily pain worsened (i.e., mean bodily pain score decreased) across the three time points. Those with T2D had higher TV time and more-severe bodily pain than those without T2D at all time points. In a fully adjusted model, the mean bodily pain score for those aged 50 years at baseline was 76.9(SE: 2.2) and worsened (i.e., bodily pain score decreased) significantly by 0.3(SE: 0.03) units every additional year (p <0.001). Those with initially more-severe pain had a higher rate of increase in pain severity. At any given time point, a one-hour increase in daily TV time was significantly associated with an increase in pain severity [bodily pain score decreased by 0.69 (SE: 0.17) units each additional hour; p <0.001], accounting for the growth factor (age) and confounders’ effects. The association was more-pronounced in those with T2D than in those without (prediabetes or NGM), with the effect of T2D on bodily pain severity becoming more apparent as TV time increases, significantly so when TV time increased above 2.5 hours per day.ConclusionBodily pain severity increased with age in middle-aged and older Australian adults over a 12-year period, and increments in TV time predicted increased bodily pain severity at any given period, which was more pronounced in those with T2D. While increasing physical activity is a mainstay of the prevention and management of chronic health problems, these new findings highlight the potential of reducing sedentary behaviours in this context.

Racial Disparities in Mortality Trends from Acute Myeloid Leukemia: A Population-Based Study in the United States between 2000 and 2019

Background: Acute myeloid leukemia (AML) results from the clonal alteration of hematopoietic progenitors and is the most prevalent form of acute leukemia in adults. Despite breakthroughs in therapeutic regimens and advancements in overall survival, the improvement has not been equally distributed among racial and ethnic groups, and the 5-year survival rate for adults with AML remains at 27%. Interestingly, the incidence is greater among whites when adjusted for age compared to other races. Racial inequalities in patients with solid malignancies are well-studied, but studies assessing racial disparities in hematologic malignancies are lacking. Therefore, we conducted a retrospective analysis of mortality trends among all racial groups in the United States from 2000 to 2019. Methods: We conducted a retrospective analysis employing the Centers for Disease Control and Prevention's (CDC) WONDER database, which covers the entire US population. Using the multiple cause of death database (International Classification of Disease - 10th revision), we identified all patients who died of AML (C92.0.x listed as the underlying cause of death) of all races (White, Black, Asian, or Pacific Islander, and American Indian or Alaska Native) between 2000 and 2019 in the United States, regardless of ethnicity and gender. Age-adjusted mortality rates were calculated per 1000,000 persons (PMP), standardized to the US census data from 2000, and stratified by race. Results: A total of 176,526 AML deaths were identified in all races, with an overall age-adjusted mortality of 26.7 PMP between 2000 and 2019. Over the same period, we identified a total of 156,453 deaths, 14,079 deaths, 5,280 deaths, and 714 deaths in the White, Black, Asian or Pacific Islander, and American Indian or Alaska Native populations, respectively. The overall age-adjusted mortality were 27.7 PMP, 20.9 PMP, 19 PMP, and 13.6 PMP in the White, Black, Asian or Pacific Islander, and American Indian or Alaska Native populations, respectively. Over this period, the age-adjusted mortality increased by 3 % in White (from 26.1 PMP in 2000 to 27 PMP in 2019), 3 % in Black (from 20.8 PMP in 2000 to 21.4 PMP in 2019), and 25 % in Asian or Pacific Islander (from 15 PMP in 2000 to 18.7 PMP in 2019), and decreased by 29 % in American Indian or Alaska Native (from 18 PMP in 2000 to 12.7 PMP in 2019). Conclusion: This is one of the largest subgroup-based racial population studies analyzing AML mortality trends. Between 2000 and 2019, the AML mortality was the highest in Whites and the lowest in American Indians or Alaska Natives. Furthermore, the American Indian or Alaska Native is the only race that showed a decline in the mortality trends. The mortality trends increased equally in White and Black American. The highest rate of increase was seen in the Asian or Pacific Islander. Multiple variables might contribute to the inequalities, including but not limited to the interaction of genetics, risk factors, response to therapy, socioeconomic status, and disparate access to health care and novel treatment regimens. Further studies are warranted to evaluate the causes of racial disparities and develop methods to reduce the gap.

Evaluation of daily average temperature trends in Kerala, India, using MERRA-2 reanalysis data: a climate change perspective.

Modern-Era Retrospective Analysis for Research and Applications, version 2 (MERRA-2) data for a period of 40years (1980-2019) was used to detect the trend characteristics of daily average temperature in the state of Kerala, India. Data extracted from a total of fifty locations in the state were statistically processed using Mann-Kendall (MK) and Spearman's Rho (SR) tests to detect the trend, Pettitt test to identify the single change point, and Theil-Sen's method for the calculation of the rate of change. The MERRA-2 product is validated for the study region according to statistical indicators. The daily average temperature in the state during the period of study varies between 16.56 and 32.64°C. The spatial pattern of daily average maximum temperature shows higher temperature domains in the central and southern parts of the state. Trend characteristics of daily average temperature assessed through MK and SR tests show a significant increasing trend in all stations, with maximum values in stations located in the northern part of the state. Change point detected through the Pettitt test divided the sampling stations into three groups based on the change in daily average temperature characteristics in the years 2002 (north zone), 2009 (south zone), and 2012 (central zone), indicating nonunique spatial variability in temperature characteristics in the state. The rate of change in the daily average temperature assessed indicates an increase at the rate of an average of 0.013°C.year-1. During the whole study period, the daily average temperature showed an overall increase of 0.54°C, and for the 100-year futuristic prediction, the daily average temperature in the state shows an average increase of 1.35°C. Among the stations, a higher rate of increase in daily average temperature is shown by stations located in the eastern part of the Pathanamthitta, Idukki, and Kollam districts. Though the rise in daily average temperature is not much higher, its spatial characteristics require more attention because, in recent times, the study area has faced repeated, severe, and long drought conditions along with sunburn incidents. As an agrarian state, a change in the temperature domain will adversely affect the overall agricultural production and will evoke not only a food crisis but also economic as well as water resources issues. The result obtained can be used as holistic basic information for understanding the impending effect of climate change in the state to frame better mitigation as well as management strategies.

Budget cap and pay-back model to control spending on medicines: A case study of Bulgaria.

Central and Eastern European countries (CEEC) have among the highest rates of increase in healthcare expenditure. External reference pricing, generics and biologics price capping, regressive scale for price setting, health technology assessment (HTA), and positive drug lists for reimbursed medicines are among the variety of implemented cost-containment measures aimed at reducing and controlling the rising cost for pharmaceuticals. The aim of our study was to analyze the influence of a recently introduced measure in Bulgaria-budget capping in terms of overall budget expenditure. A secondary goal was to analyze current and extrapolate future trends in the healthcare and pharmaceutical budget based on data from 2016 to 2021. The study is a retrospective, observational and prognostic, macroeconomic analysis of the National Health Insurance Fund's (NHIF) budget before (2016-2018) and after (2019-2021) the introduction of the new budget cap model. Subgroups analysis for each of the three new budget groups of medicines (group A: medicines for outpatient treatment, prescribed after approval by a committee of 3 specialists; group B: all other medicines out of group A; and group C: oncology and life-saving medicines out of group A) was also performed, and the data were extrapolated for the next 3 years. The Kruskal-Wallis test was applied to establish statistically significant differences between the groups. During 2016-2021, healthcare services and pharmaceutical spending increased permanently, observing a growth of 82 and 80%, respectively. The overall healthcare budget increased from European €1.8 billion to 3.3 billion. The subgroup analysis showed a similar trend for all three groups, with similar growth between them. The highest spending was observed in group C, which outpaced the others mainly due to the particular antineoplastic (chemotherapy) medicines included in it. The rising overall healthcare cost in Bulgaria (from European €1.8 billion to 3.3 billion) reveals that implementation of a mechanism for budget predictability and sustainability is needed. The introduced budget cap is a relatively effective measure, but the high level of overspending and pay-back amount (from European €34 billion to 59 billion during 2019-2021) reveals that the market environmental risk factors are not well foreseen and practically implemented.

In-situ measurement of combustion characteristics and potassium release concentration during torrefied biomass burning based on spontaneous emission spectroscopy

The orthogonal experiment designed in this paper investigated the effect of changes in experimental parameters such as biomass species, torrefaction temperature, torrefaction time, torrefaction oxygen concentration on the physicochemical properties and combustion characteristics of the torrefaction products. Two optical fiber spectrometers were used to capture the spontaneous emission spectra of the combustion flame of compressed pellets of torrefied biomass, and the in-situ measurement of pellet combustion temperature and K release concentration at high heating rate was realized by multi-spectral analysis algorithm. The experimental results indicate that for biomass, torrefaction will lead to a decrease of volatile and moisture content and an increase of fixed carbon and ash content in components, a decrease of O and H and an increase of C content in elements, a certain loss of biomass quality, an increase of high heat value, and each indicator move closer to coal. The effects of various experimental parameters on the volatile content, mass yield, high heat value increase rate and energy yield in biomass torrefaction products have similar laws, i.e., biomass species / torrefaction oxygen concentration > torrefaction temperature > torrefaction time. The mild torrefaction product pellets have a shorter ignition delay, increased volatile combustion flame height and peak temperature, longer volatile and char combustion duration, but lower peak char combustion temperature, among which the selected torrefaction products of rice straw and pine wood showed an increase in peak temperature of 0.56 % (11 K) and 0.61 % (12 K) for the volatile stage respectively, and a decrease of and 1.29 % (20 K) and 1.29 % (21 K) for the char stage respectively. In addition, the peak K release concentration during combustion of the mild torrefaction product pellets was reduced, among which the peak K release concentrations during the volatile and char stage were reduced by 43.22 % (3.89 ppm) and 52.93 % (51.55 ppm) of the rice straw torrefaction product respectively, and by 73.14 % (1.28 ppm) and 62.08 % (15.01 ppm) for the pine wood torrefaction product respectively. Biomass torrefaction products have fuel properties closer to coal, less K released from the combustion process, which have the potential to become an alternative to coal.

Projecting Changes in Rainfall Extremes for the Huai River Basin in the Context of 1.5 °C and 2 °C Global Warming

It is indisputable that global warming has triggered more frequent extreme weather and in turn led to severe flood disasters. To understand the trend of extreme rainfall under 1.5 °C and 2 °C warming, we investigated the historical variation and future trends in extreme rainfall for the Huai River basin, which has frequently been hit by floods, using recorded meteorological data and a projection of five General Circulation Models in the Coupled Model Intercomparison Project 6. We used the years 1995–2014 as the baseline period to study the temporal and spatial changes in extreme rainfall under 1.5 °C and 2.0 °C warming scenarios. The results indicated that (1) temperatures in the Huai River basin have risen significantly from 1995 to 2014, but there are insignificant variation trends in annual precipitation (AP), intensive precipitation (R95P), maximum daily precipitation (Rx1d) and heavy rain days (Rr50) during the same time span. (2) From 2015 to 2100, both temperature and extreme rainfall indices show increase trends, with a higher rate of increase under a higher emission scenario. (3) Under the warming scenario of 1.5 °C, AP, R95P, Rx1d and Rr50 in the basin will likely increase by 4.6%, 5.7%, 6.2% and 13.4%, respectively, compared with that in the baseline period. Under the warming scenario of 2.0 °C, AP, R95P, Rx1d and Rr50 will probably increase by 7.3%, 7.4%, 10.9% and 19.0%, respectively. (4) Spatially, the changes in extreme rainfall indices under the warming scenarios of 1.5 °C and 2.0 °C generally tend to increase from north to south. Higher intensity extreme rainfall will likely extend to the whole of the Huai River basin. It is therefore essential to study adaptive measures to cope with flooding in the Huai River basin induced by the increase in future rainfall extremes.

Formation of Production Technological Efficiency in the Agricultural Enterprises of Ukraine

Nowadays in Ukraine there is a high increase rate of technological efficiency in agricultural production. However, there are a number of problems related to the distortion of the efficiency indicators for individual branches of agriculture as well as for groups of agricultural enterprises. The purpose of this paper is to determine specific aspects for the formation of certain parameters of production technological efficiency in agricultural enterprises of Ukraine. The relation of technological efficiency with other types of agricultural production efficiency has been investigated. The technological efficiency computation methods required for achieving the desired profitability rates at agricultural enterprises and their practical importance have been presented. Reliance of production technological efficiency and agricultural enterprises' innovation activity has been investigated. The necessity to improve the system of introduction the innovations into agricultural production has been grounded.