International Data Research Articles

Beyond access: (re)designing archival guides for changing landscapes

AbstractIn 2013, the authors of this article and their colleague Gavan McCarthy published Stories in Stone: an annotated history and guide to the collections of Ernest Westlake (1855–1922). The guide provided contextual information and digital access to the entire paper archives relating to the three large stone collections formed by Westlake during his lifetime: French and English geological specimens housed in the Oxford University Museum of Natural History from 1924, and a collection of Tasmanian Aboriginal stone tools stored in the Pitt Rivers Museum since 1923. The Tasmanian collections, formed by Westlake from 1908 to 1910, are highly significant to the Palawa (or Pakana or Tasmanian Aboriginal) community because they include objects made by ancestors, and words spoken by ancestors to Westlake and recorded in his field notebooks. Stories in Stone was created to improve access to Westlake’s Tasmanian collections for the Palawa community with whom author Rebe Taylor had worked closely since 1999. Nonetheless, the structural and technical design of Stories in Stone was not Palawa-led. It was driven by Australian and international archiving standards; by stipulations set out by the collecting institutions; and by the stories of collecting and subsequent scholarship on the collections. In 2023, Stories in Stone is offline, and the authors are planning a relaunch. This time they aim to reach beyond their original aim of providing archival access to the Palawa community, and work with Palawa community to co-design how that access is delivered. This consultative work will be done at the University of Tasmania, where Palawa advisors and other Indigenous scholars have been integral to developing international Indigenous data sovereignty principals. This article precedes those formal discussions and thus offers a timely reflection on the original aims and design of Stories in Stone as well as an extensive analysis of broader changes in the management and dissemination of First Nations collections and culture. Such changes include: international human rights frameworks; movements supporting data and archival sovereignty; co-designed archival technologies; and increased focus on archives as process not merely product. These developments will lay the foundations for the next version of Stories in Stone, which aims to go beyond access, scholarship, and standards by helping to facilitate First Nations’ aspirations for dignity, sovereignty, and self-determination.

Hyperthermic intraperitoneal chemotherapy in colorectal cancer.

This study evaluated the efficacy of hyperthermic intraperitoneal chemotherapy (HIPEC) in colorectal cancer with peritoneal metastases (pmCRC) in a large international data set of patients. Patients with pmCRC from 39 centres who underwent cytoreductive surgery with HIPEC between 1991 and 2018 were selected and compared for the HIPEC protocols received-oxaliplatin-HIPEC versus mitomycin-HIPEC. Following analysis of crude data, propensity-score matching (PSM) and Cox-proportional hazard modelling were performed. Outcomes of interest were overall survival (OS), recurrence-free survival (RFS) and the HIPEC dose-response effects (high versus low dose, dose intensification and double drug protocols) on OS, RFS and 90-day morbidity. Furthermore, the impact of the treatment time period was assessed. Of 2760 patients, 2093 patients were included. Median OS was 43 months (95% c.i. 41 to 46 months) with a median RFS of 12 months (95% c.i. 12 to 13 months). The oxaliplatin-HIPEC group had an OS of 47 months (95% c.i. 42 to 53 months) versus 39 months (95% c.i. 36 to 43 months) in the mitomycin-HIPEC group (P = 0.002), aHR 0.77, 95% c.i. 0.67 to 0.90, P < 0.001. The OS benefit persisted after PSM of the oxaliplatin-HIPEC group and mitomycin-HIPEC group (48 months (95% c.i. 42 to 59 months) versus 40 months (95% c.i. 37 to 44 months)), P < 0.001, aHR 0.78 (95% c.i. 0.65 to 0.94), P = 0.009. Similarly, matched RFS was significantly higher for oxaliplatin-HIPEC versus others (13 months (95% c.i. 12 to 15 months) versus 11 months (95% c.i. 10 to 12 months, P = 0.02)). High-dose mitomycin-HIPEC protocols had similar OS compared to oxaliplatin-HIPEC. HIPEC dose intensification within each protocol resulted in improved survival. Oxaliplatin + irinotecan-HIPEC resulted in the most improved OS (61 months (95% c.i. 51 to 101 months)). Ninety-day mortality in both crude and PSM analysis was worse for mitomycin-HIPEC. There was no change in treatment effect depending on the analysed time period. Oxaliplatin-based HIPEC provided better outcomes compared to mitomycin-based HIPEC. High-dose mitomycin-HIPEC was similar to oxaliplatin-HIPEC. The 90-day mortality difference favours the oxaliplatin-HIPEC group. A trend for dose-response between low- and high-dose HIPEC was reported.

The Troll Observing Network (TONe): plugging observation holes in Dronning Maud Land, Antarctica

Antarctica and the Southern Ocean play vital roles in the Earth system, exerting significant influence on global atmospheric, cryospheric, and oceanic processes. Understanding the ongoing changes in Antarctica and their broader impact on global dynamics is imperative. Achieving this understanding necessitates dedicated and coordinated observations of environmental parameters in the region. The Troll Observing Network (TONe) is Norway's proactive initiative to the call for sustained, coordinated, complementary, geographically spread, and societally relevant long-term observations from Antarctica. Centered around the Troll Research Station in Dronning Maud Land, a region characterized by limited data availability, TONe constitutes a comprehensive state-of-the-art observatory network, specifically designed for environmental observations for studying and monitoring of the atmosphere, terrestrial, and marine environments. TONe aims to facilitate broad and open access to observational data and shared services to the international research communities as a foundation for acquiring knowledge of societal significance. TONe will, however, be a limited contribution the broader international data gathering effort required to underpin a strengthened understanding of Antarctica in the Earth system. TONE is an important initiative focused on a data sparse region of Antarctica, but has only substantial added value when seen in the context of similar ongoing and future efforts around the continent.

Perceptions on the Ethical and Legal Principles that Influence Global Brain Data Governance

Advances in neuroscience and other disciplines are producing large-scale brain data consisting of datasets from multiple organisms, disciplines, and jurisdictions in different formats. However, due to the lack of an international data governance framework brain data is currently being produced under various contextual ethical and legal principles which may influence key stakeholders involved in the generation, collection, processing and sharing of brain data thereby raising ethical and legal challenges. In addition, despite the demand for a brain data governance framework that accounts for culture, there is a gap in empirical research and actions to understand how key stakeholders around the world view these issues using neuroscientists who are affected by these ethical and legal principles. Therefore, using the research question how do ethical and legal principles influence data governance in neuroscience? we attempt to understand the perceptions of key actors on the principles, issues and concerns that can arise from brain data research. We carried out interviews with 21 leading international neuroscientists. The analytical insights revealed key ethical and legal principles, areas of convergence, visibility, and the contextual issues and concerns that arise in brain data research around these principles. These issues and concerns circulate around intimately connected areas which include ethics, human rights, regulations, policies and guidelines, and participatory governance. Also, key contextual insights around animal research and ethics were identified. The research identifies key principles, issues, and concerns that need to be addressed in advancing the development of a framework for global brain data governance. By presenting contextual insights from neuroscientists across regions, the study contributes to informing discussions and shaping policies aimed at promoting responsible and ethical practices in brain data research. The research answers the call for a cross cultural study of global brain data governance and the results of the study will assist in understanding the issues and concerns that arise in brain data governance.

Hospital-acquired bloodstream infections in critically ill cirrhotic patients: a post-hoc analysis of the EUROBACT-2 international cohort study

BackgroundHospital-acquired bloodstream infections are common in the intensive care unit (ICU) and have a high mortality rate. Patients with cirrhosis are especially susceptible to infections, yet there is a knowledge gap in the epidemiological distinctions in hospital-acquired bloodstream infections between cirrhotic and non-cirrhotic patients in the ICU. It has been suggested that cirrhotic patients, present a trend towards more gram-positive infections, and especially enterococcal infections. This study aims to describe epidemiological differences in hospital-acquired bloodstream infections between cirrhotic and non-cirrhotic patients hospitalized in the ICU regarding infection sources, microorganisms and mortality.MethodsUsing prospective Eurobact-2 international cohort study data, we compared hospital-acquired bloodstream infections sources and microorganisms in cirrhotic and non-cirrhotic patients. The association between Enterococcus faecium and cirrhosis was studied using a multivariable mixed logistic regression. The association between cirrhosis and mortality was assessed by a multivariable frailty Cox model.ResultsAmong the 1059 hospital-acquired bloodstream infections patients included from 101 centers, 160 had cirrhosis. Hospital-acquired bloodstream infection source in cirrhotic patients was primarily abdominal (35.6%), while it was pulmonary (18.9%) for non-cirrhotic (p < 0.01). Gram-positive hospital-acquired bloodstream infections accounted for 42.3% in cirrhotic patients compared to 33.2% in non-cirrhotic patients (p = 0.02). Hospital-acquired bloodstream infections in cirrhotic patients were most frequently caused by Klebsiella spp (16.5%), coagulase-negative Staphylococci (13.7%) and E. faecium (11.5%). E. faecium bacteremia was more frequent in cirrhotic patients (11.5% versus 4.5%, p < 0.01). After adjusting for possible confounding factors, cirrhosis was associated with higher E. faecium hospital-acquired bloodstream infections risk (Odds ratio 2.5, 95% CI 1.3–4.5, p < 0.01). Cirrhotic patients had increased mortality compared to non-cirrhotic patients (Hazard Ratio 1.3, 95% CI 1.01–1.7, p = 0.045).ConclusionsCritically ill cirrhotic patients with hospital-acquired bloodstream infections exhibit distinct epidemiology, with more Gram-positive infections and particularly Enterococcus faecium.

Forecasting global stock market volatilities: A shrinkage heterogeneous autoregressive (HAR) model with a large cross-market predictor set

We propose a shrinkage heterogeneous autoregressive (HAR) model to explore the predictability of global stock market volatilities. To this end, we construct a big data environment using international stock market data, which comprises over 200 cross-market predictors, including realized variances (RVs), continuous components, jumps, leverages, overnight returns, and uncertainty indices. Two shrinkage models (LASSO and ENet) are considered for volatility modeling and forecasting. The results demonstrate that these models, notably LASSO, consistently improve predictive performance across global stock markets and daily, weekly, and monthly horizons. Their superiority extends to directional and density forecasting as well as asset allocation. There are several empirical findings of shrinkage: (i) the shrinkage degree varies significantly across forecast horizons, with longer horizons implying more predictors are needed for accurate estimation; (ii) no country/region's predictors show absolute superiority and utilize cross-market information leads to larger predictive gains, particularly for longer horizons; (iii) the predictors except for RVs and continuous components are more powerful, especially over longer horizons; and (iv) the uncertainty indices are the strongest predictors for all horizons.

Abstract PO2-29-02: Towards Precision Medicine in Breast Imaging: A Novel Open Mammography Database with Tailor-Made 3D Image Retrieval for Artificial Intelligence and Teaching

Abstract Objectives: According to the World Health Organization (WHO), breast cancer is the most frequent malignant neoplasia and leading cause of cancer death among women worldwide. Low- and middle-income countries hold the worst survival rates mainly owing to a lack of access to appropriate diagnosis and treatment related resources. For proper early diagnosis, it is established that besides the physical structure itself (e.g., mammography units), there's a need for adequate interpretation of imaging and that might be a particularly major problem in low-income societies once there is a tendency of greater education setbacks. Mammography datasets can improve this resource-driven gap by enabling the development of artificial intelligence technologies (AI) which can make breast cancer diagnosis more accurate in a cost-effective and scalable way. We aim to create a new database of high quality digital mammography images suitable for AI development and education. Methods: Our mammography database was developed by means of retrospective selection of 100 exams performed by Hospital São Paulo - Federal University of São Paulo ranging from 2019 to 2023. The project is assumed to be safe, versatile, and usable, and required an extensive search for the appropriate tool. Ambra Health, an American company, has developed cloud-based software for medical image management and stood out as a viable alternative. Their platform meets international data security criteria, they also made the intended careful customization possible, in addition to the possibility of associating image and text attachments. The categories were created in accordance with the BI-RADS® descriptors, a wide range of clinical scenarios and additional materials available, and they served as the basis for the advanced search feature, which intuitively filters exams that meet the selected criteria simultaneously. The platform was integrated with an automatic anonymization system upon upload, ensuring data privacy. After submission, the exams are retained in a restricted area for anonymization verification, categorization, and attachment management, before being released to the end-user. So as to broaden geographic coverage, the descriptors were entered in American English, respecting the origin of the BI-RADS® lexicon, as for the website structure, automatic translation to the accessing browser standard language was selected. Results: Our website is active and available at http://mamografia.unifesp.br, with access granted upon a simple registration process. 941 mammography images from 100 anonymized cases, 62% of which include 3D images, can be filtered based on the combination of 113 clinical and imaging variables, as well as attachment availability. The language is adaptable to the user's native language, and categorized searches can be accessed directly from the browser or downloaded as customized datasets. Additionally, features such as saved searches or starred exams are also available. Conclusion: We have developed an online and free mammography database that is completely innovative by integrating various resources into a single platform. We provide high-resolution and 3D digital images that can be searched using an advanced search system. Moreover, we offer supplementary clinical information in various attachment formats, favoring a rich clinical correlation. In this way, we have achieved the ambivalence of our goal, which was to promote education and research. *"images speak louder than words" Database: https://mamografia.unifesp.br Tutorials: https://www.youtube.com/@Mamografiaunifesp e-mail: acesso@mamografia.unifesp.br password: acesso@mamografia12 (valid until dec/23) Citation Format: Natália Cordeiro, Gil Facina, Afonso Nazário, Vanessa Sanvido, Joaquim Araujo Neto, Morgana Silva, Simone Elias. Towards Precision Medicine in Breast Imaging: A Novel Open Mammography Database with Tailor-Made 3D Image Retrieval for Artificial Intelligence and Teaching [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-29-02.

Abstract PO4-18-01: International Validation of a Staging Model for de novo Metastatic Breast Cancer

Abstract Background Given the heterogeneity in outcomes for de novo metastatic breast cancer (dnMBC), a staging system was recently developed that refines prognostic estimates for patients presenting with distant metastases (JCO 2023;10:2546). This staging model was developed using the National Cancer Database and stratified patients into 4 subgroups, termed IVA, IVB, IVC, and IVD based on 3-year overall survival (OS): IVA &amp;gt;70%, IVB 50-70%, IVC 25-&amp;lt; 50%, and IVD &amp;lt; 25%; the primary factors affecting higher stage grouping were negative for ER, PR, and HER2 expression and a higher number of involved organ sites. Here, we aim to validate this model using an international data set. Methods Data for dnMBC patients were obtained from the Netherlands Cancer Registry (NCR, hosted by IKNL), Epidemiological Strategy and Medical Economics (ESME) by Unicancer, British Columbia Cancer (BCCan), Instituto Nacional de Cancerología, México (INCan), and Grupo Español de Investigación en Cáncer de Mama (GEICAM); the diagnosis years included varied by organization (range 2002-2021). Stage groups were assigned based on previously published criteria, defined by T-category, grade, ER, PR, HER2, histology, organ system site of metastases (bone-only, brain-only, visceral), and number of organ systems involved. For each cohort, followup time and OS were estimated using the reverse Kapan-Meier and Kaplan-Meier method, respectively. Median rates were estimated across all cohorts by weighting on cohort sample size or number at risk. Cox proportional hazards models were used to estimate the association of stage with OS after adjustment for age at diagnosis (treatment data not available for all cohorts). For the ESME cohort, a subgroup multivariable analysis was used to estimate the association of stage with OS after adjustment for age, local (surgery or radiotherapy) and first line systemic treatments. Results The final validation cohort was comprised of N=11,199 patients from 5 international organizations: n=5063 (45.2%, IKNL), n=4139 (37.0%, ESME), n=774 (6.9%, BCCan), n=757 (6.8%, INCan), and n=466 (4.2% GEICAM). Median followup across all cohorts was 77.5 months (95% CI 74.3-80.2). Median followup (in months) for the IKNL, ESME, BCCan, INCan, and GEICAM cohorts was 45.3 (95% CI 43.6-47.1), 77.5 (95% CI 74.3-80.2), 105.0 (95% CI 95.9-106.5), 93.0 (95% CI 86.5-102.1), and 49.5 (95% CI 46.5-53.4), respectively. Patients were stratified into stage groups: IVA, n=603 (5.4%); IVB, n=5704 (50.9%); IVC, n=3356 (30.0%); IVD, n=1536 (13.7%). For all cohorts combined, the weighted average OS rates consistently decreased with increasing stage group; similar findings were noted for individual cohorts (all p&amp;lt; 0.001; Table). On multivariable subgroup analysis including age at diagnosis, stage group was significantly associated with OS, and the risk of death increased with increasing stage (all p&amp;lt; 0.001; Table). On multivariable subgroup analysis for n=4139 patients (ESME cohort), stage group remained significantly associated with OS [IVA: reference; IVB: HR 1.51 (95% CI 1.17-1.93); IVC: HR 2.11 (95% CI 1.64-2.72); IVD: HR 3.60 (95% CI 2.75-4.70)] after adjusting for age and treatment. Conclusions These findings provide external validation of the previously published staging guidelines for dnMBC. This may guide future revisions of the AJCC staging guidelines for patients with dnMBC and provide patients and providers valuable information in planning therapy and goals of care as they approach the end-of-life. Table. Citation Format: Jennifer Plichta, Samantha Thomas, Sabine Siesling, Linda de Munck, Amélie Lusque, Thomas Grinda, Lovedeep Gondara, Stephen Chia, Paula Cabrera-Galeana, Nancy Reynoso-Noverón, Sara López-Tarruella, Isabel Álvarez López, Stephen Edge, Gabriel Hortobagyi. International Validation of a Staging Model for de novo Metastatic Breast Cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-18-01.

Listening to patients, for the patients: The COVAD Study-Vision, organizational structure, and challenges.

The pandemic presented unique challenges for individuals with autoimmune and rheumatic diseases (AIRDs) due to their underlying condition, the effects of immunosuppressive treatments, and increased vaccine hesitancy. The COVID-19 vaccination in autoimmune diseases (COVAD) study, a series of ongoing, patient self-reported surveys were conceived with the vision of being a unique tool to gather patient perspectives on AIRDs. It involved a multinational, multicenter collaborative effort amidst a global lockdown. Leveraging social media as a research tool, COVAD collected data using validated patient-reported outcomes (PROs). The study, comprising a core team, steering committee, and global collaborators, facilitated data collection and analysis. A pilot-tested, validated survey, featuring questions regarding COVID-19 infection, vaccination and outcomes, patient demographics, and PROs was circulated to patients with AIRDs and healthy controls (HCs). We present the challenges encountered during this international collaborative project, including coordination, data management, funding constraints, language barriers, and authorship concerns, while highlighting the measures taken to address them. Collaborative virtual models offer a dynamic new frontier in medical research and are vital to studying rare diseases. The COVAD study demonstrates the potential of online platforms for conducting large-scale, patient-focused research and underscores the importance of integrating patient perspective into clinical care. Care of patients is our central motivation, and it is essential to recognize their voices as equal stakeholders and valued partners in the study of the conditions that affect them.

Rapid cost-effectiveness analysis: hemodialysis versus peritoneal dialysis for patients with acute kidney injury in Rwanda

BackgroundTo ensure the long-term sustainability of its Community-Based Health Insurance scheme, the Government of Rwanda is working on using Health Technology Assessment (HTA) to prioritize its resources for health. The objectives of the study were to rapidly assess (1) the cost-effectiveness and (2) the budget impact of providing PD versus HD for patients with acute kidney injury (AKI) in the tertiary care setting in Rwanda.MethodsA rapid cost-effectiveness analysis for patients with AKI was conducted to support prioritization. An ‘adaptive’ HTA approach was undertaken by adjusting the international Decision Support Initiative reference case for time and data constraints. Available local and international data were used to analyze the cost-effectiveness and budget impact of peritoneal dialysis (PD) compared with hemodialysis (HD) in the tertiary hospital setting.ResultsThe analysis found that HD was slightly more effective and slightly more expensive in the payer perspective for most patients with AKI (aged 15–49). HD appeared to be cost-effective when only comparing these two dialysis strategies with an incremental cost-effectiveness ratio of 378,174 Rwandan francs (RWF) or 367 United States dollars (US$), at a threshold of 0.5 × gross domestic product per capita (RWF 444,074 or US$431). Sensitivity analysis found that reducing the cost of HD kits would make HD even more cost-effective. Uncertainty regarding PD costs remains.Budget impact analysis demonstrated that reducing the cost of the biggest cost driver, HD kits, could produce significantly more savings in five years than switching to PD. Thus, price negotiations could significantly improve the efficiency of HD provision.ConclusionDialysis is costly and covered by insurance in many countries for the financial protection of patients. This analysis enabled policymakers to make evidence-based decisions to improve the efficiency of dialysis provision.

THE IMPACT OF THE SHADOW ECONOMY ON THE REDUCTION OF TAX REVENUES TO THE STATE BUDGET

The aim of the study was to assess and analyse the shadowing of the national economy, as well as to determine the impact of its shadowing on the reduction of tax revenues to the state budget. The research employed general scientific, economic, and mathematical assessment methods, such as regression analysis, correlation analysis, interval forecasts, as well as econometric models of Lacko's household electricity approach, as well as modelling of the shadowing level using the multiple indicators-multiple-causes (MIMIC) model. The calculations and analysis gave grounds to determine the level of the shadow economy of Ukraine based on the state statistics of shadowing trends. There is currently an upward trend estimated to be 37.1% of GDP in 2022 compared with international data, which indicates a rapid growth of the shadow economy from 27% in 2019 to 44% in 2022. An alternative method of assessing the shadowing level was proposed in order to level the peculiarities of calculating the level of shadowing of the economy. According to the calculations, it was 43% in 2022. It was determined that the rapid growth of the shadow economy is an indicator of a reduction in tax revenues, especially in 2022 — by almost 8%. The correlation analysis proved that the increased shadowing level is an indicator of the reduction of tax revenues to the budget of Ukraine. The conducted analysis has certain limitations, therefore it is advisable to further test the hypothesis regarding the indicator of tax revenue reduction on a larger range of data and to apply an alternative method of assessing the shadowing level for developed economies, such as the countries of the European Union (EU).

Medication adherence and costs of medical care among patients with Parkinson's disease: an observational study using electronic medical records.

Adherence to antiparkinsonian drugs (APDs) is critical for patients with Parkinson's disease (PD), for which medication is the main therapeutic strategy. Previous studies have focused on specific disorders in a single system when assessing clinical factors affecting adherence to PD treatment, and no international comparative data are available on the medical costs for Chinese patients with PD. The present study aimed to evaluate medication adherence and its associated factors among Chinese patients with PD using a systematic approach and to explore the impact of adequate medication adherence on direct medical costs. A retrospective analysis was conducted using the electronic medical records of patients with PD from a medical center in China. Patients with a minimum of two APD prescriptions from January 1, 2016 to August 15, 2018 were included. Medication possession ratio (MPR) and proportion of days covered were used to measure APD adherence. Multiple linear regression analysis was used to identify factors affecting APD adherence. Gamma regression analysis was used to explore the impact of APD adherence on direct medical costs. In total, 1,712 patients were included in the study, and the mean MPR was 0.68 (± 0.25). Increased number of APDs and all medications, and higher daily levodopa-equivalent doses resulted in higher MPR (mean difference [MD] = 0.04 [0.03-0.05]; MD = 0.02 [0.01-0.03]; MD = 0.03 [0.01-0.04], respectively); combined digestive system diseases, epilepsy, or older age resulted in lower MPR (MD = -0.06 [-0.09 to -0.03]; MD = -0.07 [-0.14 to -0.01]; MD = -0.02 [-0.03 to -0.01], respectively). Higher APD adherence resulted in higher direct medical costs, including APD and other outpatient costs. For a 0.3 increase in MPR, the two costs increased by $34.42 ($25.43-$43.41) and $14.63 ($4.86-$24.39) per year, respectively. APD adherence rate among Chinese patients with PD was moderate and related primarily to age, comorbidities, and healthcare costs. The factors should be considered when prescribing APDs.

Safety of Cyclists in Poland in the Context of European Road Traffic

The growing interest in cycling as a means of urban transport has led to an increased focus on cyclist safety as a key aspect of urban planning and transport policy. Simulation studies conducted by the International Transport Forum have demonstrated that reductions in CO2 and other pollutants can be achieved in the context of urban transport, thus realising the goals of decarbonising road transport. The spread of modal transport in cities is a potential reality within the next decade. Bicycles play a significant role in this context. This article presents an analysis of data on accidents involving cyclists. National and international data were analysed to identify the main risk factors. The aim of the paper is to analyse the risk to cyclists with an attempt to identify and map the five biggest risks to cyclists in urban traffic. The aim of the research is to raise awareness of cyclist safety issues and to identify directions for further action to reduce accidents and improve overall road safety. The results of the conducted analyses indicate that the risk for cyclists in road traffic (including urban traffic) has been on a noticeable downward trend over the past five to ten years. This trend allows for the mapping of the most significant types/risks in cycling in urban environments, thereby enabling the implementation of risk management strategies based on the method of risk mapping.

Parental acceptability of silver diamine fluoride: The UK and US experiences.

International data suggest that parents may have reservations about the use of silver diamine fluoride (SDF). The aims of this study were to: (1) examine the acceptance of parents/carers towards the use of SDF for the management of caries in children's primary teeth in secondary care dental settings in the UK and the United States and (2) determine which factors may affect the acceptance of the use of SDF. This was a cross-sectional questionnaire of SDF acceptability, completed by parents of young children. It was validated and adapted to local populations. Data were analysed with descriptive and inferential statistics. Of the 113 Sheffield parents, 73% reported that they would accept SDF treatment of children's posterior teeth, with 58% reporting this for anterior teeth. Parents having less concern about posterior aesthetics had a statistically significant effect on reported acceptance of SDF (p = .013). In the Colorado sample (n = 104), 72% reported that they would accept SDF on posterior teeth, and 58% reported that they would accept SDF on anterior teeth. Concerns about aesthetics had an effect on decreasing SDF acceptance overall (p = .0065) in anterior (p = .023) and posterior teeth (p = .108). The majority of parents in the two study populations accepted the treatment using SDF. However, concern about aesthetics had an influence on acceptability.

The glass ceiling effect in Spanish advertising creative departments

The representation of women in advertising creative departments has been studied worldwide. The findings have shown a low representation that does not favor the emergence of a critical mass of women, who could contribute with alternative visions to make advertising more inclusive. The underrepresentation, above all, occurs in managerial positions where they do not usually reach 35%. This study aims to update and report quantitatively on the phenomenon of the glass ceiling in Spain. In addition, in order to contextualize the level of segregation, these departments are compared with available international data. The results of a content analysis of the credit forms of 839 Spanish campaigns published in 2019 (a sample of 1,311 creatives) revealed gender dynamics, with a balanced starting group of creatives in non-managerial positions (just over 40% are women), but a figure of just 18% of women in managerial roles A higher glass ceiling effect was also found when European and global data were compared. The results analyzed through the perspective of the proportional representation theory (Kanter, 1977a, 1977b, 1987), suggest the need to raise awareness of gender inequalities within creative departments; this would foster the equality demanded by today’s society, of which advertising should not be oblivious.

Chemistry-Focused Conceptual Understanding Research Trends: A Systematic Review

Research related to conceptual understanding is often carried out, such as the influence of a model on conceptual understanding, or knowing students' level of understanding of chemistry concepts. However, there has been no systematic reflection on chemistry research focused on conceptual understanding. Based on this, this research aims to systematically synthesize articles related to chemistry focused on research trends in conceptual understanding with the year range of articles used 2014-2023. After conducting a national and international data search using keyword patterns (e.g., Pattern 1: conceptual and chemical understanding), 48 research papers emerged for systematic review. Then, primary and secondary codes were created by the authors for the research paper. The systematic review showed a variety of research scopes (e.g., relevance of chemistry education models) and dominant research focus for different themes (e.g., competencies and variables related to objectives, variables, samples, chemistry concepts, and conclusions). Furthermore, it was revealed that research on understanding chemical concepts includes various research fields.

Соціально-економічні виклики інтеграції та просторового розподілу внутрішньо переміщених осіб унаслідок війни

The full-scale Russian military aggression against Ukraine launched on February 24, 2022 has led to a massive flow of forced migrants, both external and internal, which is unprecedented and the most massive forced displacement in Europe since World War II. So far, there is a significant inequality of attention to the socio-economic needs of internally displaced persons (IDPs) and refugees, because most activities of international institutions and scientific attention are devoted to the needs and study of refugees, while the needs of IDPs are often “ignored” or understudied in terms of disproportionate spatial distribution of IDPs, challenges of integration into host communities, problems of consolidation of IDPs and local population, etc. The analysis of the existing body of literature on Ukrainian IDPs showed that the study of their current socio-economic situation, problems with integration into host communities and features of spatial distribution is poorly represented for the period of a full-scale Russo-Ukrainian war against the background of a huge body of pre-2022 literature. Taking into account such an insignificant body of literature on post-2022 Ukrainian IDPs, the main tasks of this study are twofold: (1) to fill the gap and expand the spectrum of knowledge about the current socio-economic situation of Ukrainian IDPs and the key problems of their integration into host communities in the conditions of a full-scale Russo-Ukrainian war; (2) analyze positive and negative international practices of IDP integration and develop recommendations for Ukraine. This article is devoted to the analysis of trends and the identification of the main socio-economic challenges of the integration and spatial distribution of Ukrainian IDPs, as well as the development of proposals for using their migration potential for the resilient development of Ukraine and host communities. The novelty of the research lies in the highlighting of positive and negative international practices of IDP integration and, as a result, the necessity of forming long-term solutions regarding the urgent socio-economic needs of Ukrainian IDPs and their spatial placement is emphasized. The dataset of the study was formed on the basis of data from reports of various international organizations and data from official state statistics. To achieve the goal of the article, quantitative methods are used, in particular, descriptive statistics and ranking. It was established that in the global context, Ukraine ranks third in the world by the number of IDPs, and their number is almost 6 million people (7 times more than before the full-scale Russian invasion), which definitely impacts the course of global migration processes. In the national context, it was found that the pattern of the spatial distribution of IDPs within the country indicates that most IDPs gravitate to the regions where the role of the regional centre is performed by one of the five metropolises of Ukraine (not including temporarily occupied Donetsk) — Kyiv, Kharkiv, Odesa, Dnipro and Lviv, which are powerful socio-economic centres and flagships of the country’s settlement system. It was found that the biggest challenges for the socioeconomic integration of IDPs into host communities are high unemployment, financial difficulties in meeting basic needs, housing problems, social stigmatization, as well as conflicts between IDPs and the population of host communities. The analysis showed that the current situation with Ukrainian IDPs requires from the government of Ukraine and the authorities of the host communities not short-term, but longterm solutions to the urgent problems of IDPs: in particular, social housing and proper housing conditions, social protection, avoiding shameful international practices of spatial placement of IDPs and much more.

Primary Ovarian Insufficiency: A Case of the Cart before the Horse

Primary Ovarian Insufficiency: A Case of the Cart before the Horse

Proliferation activity and hormonal status of atypical hyperplasia and endometrioid adenocarcinoma of the endometrium

Atypical hyperplasia of the endometrium is a precancerous condition for endometrioid adenocarcinoma of the endometrium, which is the largest group among malignant neoplasms of the uterine body, according to the Cancer Registry, the mortality rate from which took the 3rd place in 2021. The absence of specific clinical manifestations complicates diagnostics at the early stages of the process, which necessitates the study of histological and immunohistochemical criteria to verify the diagnosis. The aim of the study. To improve the differential diagnostic morphological and immunohistochemical criteria for the diagnosis of atypical hyperplasia and endometrioid adenocarcinoma of the endometrium, using the latest international classification data. Materials and methods. Retrospective analysis of 76 cases of postoperative material of women for the period from 2020 to 2022 with a diagnosis of “endometrioid adenocarcinoma of the endometrium” – 61 cases and “endometrial hyperplasia with atypia” – 15 included an assessment of histological, immunohistochemical features, followed by statistical processing of the obtained results. Results. The incidence of endometrioid adenocarcinoma of the endometrium and atypical endometrial hyperplasia occurs in the premenopausal and menopausal periods. The expression level of the Ki-67 marker is directly proportional to the degree of tumor malignancy (p &lt; 0.05). Estrogen receptors decrease as the degree of tumor malignancy increases. Progesterone receptors are equally present in endometrioid adenocarcinomas and atypical endometrial hyperplasia (p &lt; 0.05). Conclusions. The necessity of using the Ki-67 marker and determining the hormonal status in endometrioid adenocarcinomas of the endometrium and atypical hyperplasia of the endometrium is argued.

A Review Study of the Impact of Music Therapy on Adolescent Mental Health

According to the latest national statistics, one in seven adolescents in primary and secondary schools around the world are suffering from mental disorders such as anxiety, depression and shyness. In recent years, a number of clinical data at home and abroad have reflected the obvious efficacy of music therapy in alleviating adolescent mental disorders. This has led many domestic scholars to pay attention to music therapy as a therapeutic method. From the viewpoint of educational psychology, the adolescent stage is an important period of human physiological and psychological development and 80% of the time in this period is spent in school every day. Therefore, combining social hotspots and inspiration from music psychology, this paper analyses domestic and international research data and literature, and explores the influence of different music styles in receptive music therapy, and the three most commonly used music therapies in China, namely, ethnic instruments and Orff music therapy, on adolescents' psychology from the perspective of the field of music. Instead of discussing them from a traditional medical perspective and music therapy theory, this paper presents readers with data on the impact of music materials, instrumentation, and forms of music therapy in primary and secondary schools on adolescents' psychological problems, and provides strong scientific evidence of their effectiveness. The aim is to find out what kind of music therapy is used in primary and secondary schools and what kind of music is suitable for the treatment of adolescents' psychological problems.