National Aggregate Research Articles

Modelling and projecting regional electricity demand for Saudi Arabia

AbstractWe address the shortcomings associated with modelling national aggregate electricity consumption in a large and diverse country with unique regional characteristics. Focusing on Saudi Arabia, we employ an econometric approach to analyse the distinct responses of its regions to electricity prices and income levels. The study employs a general to specific modelling approach, utilizing data from 1990 to 2019 within the conventional energy demand theoretical framework. Our region‐specific estimations reveal income and price as the primary drivers, with the southern region exhibiting a higher sensitivity to income, while the eastern region shows a comparatively smaller response to prices attributed to its significant industrial presence. Elasticities for the central and western regions align with previous research, while eastern and southern regions exhibit larger elasticities. Weather impacts are observed only in the warmest western region, characterised by a substantial share of residential electricity consumption. Furthermore, we utilise our estimated model to project a regional baseline demand for electricity in Saudi Arabia and demonstrate how prices affect regions differently. This information is important for an oil‐exporting country like Saudi Arabia, considering the diverse fuel mix used for electricity generation across regions. Assuming moderate economic growth and no price change, our baseline projections indicate a total electricity demand of 366 terawatt hours (TWh) by 2030.

P-713 Proposal of model to calculate the trend in the cumulative live birth rate in IVF cycles using Spanish National Register data from 2009 to 2021

Abstract Study question Is it possible to estimate the trend in the cumulative rate of live births in IVF over 12 years, using data from the Spanish Registry? Summary answer With the proposed formula, a constant increase of 1.7% in the cumulative live birth rate is verified throughout the 12 years of study. What is known already The progressive increase in elective freeze-all cycles no longer allows the use of live birth data by fresh transfer, especially in time series. Cumulative live birth rate (CLBR) has been proposed as an appropriate way of reporting success of an IVF program, incorporating both, fresh and frozen embryos. Nevertheless, views on the most appropriate parameters required to calculate such an outcome have been inconsistent and difficult for national aggregate registries. Furthermore, there is not unanimous definition for its calculation and although IVF Register is mandatory in Spain, an analysis of the CLBR has not been carried out. Study design, size, duration Data from the Spanish National Register of Assisted Reproduction including 456302 women undergoing IVF/ICSI (563000 ovarian stimulation cycles started, 359587 fresh transfers, and 36400 cryotransfer) using autologous gametes performed in Spain from 2009 to 2021 were analyzed. Oocyte donation and PGT-a cycles were excluded. Participants/materials, setting, methods The main outcomes of present study were live birth rate per cycle (LBR) and cumulative live birth rate (CLBR). To obtain the CLBR, the probability of achieving at least one live birth for each cycle started was calculated. This includes both live births after fresh transfer and those achieved after cryotransfer of the embryos obtained from each cycle until they have run out, or a full-term pregnancy is obtained. Main results and the role of chance The live birth rate (LBR) per fresh transfer remains steady (around 24%) throughout the period analyzed. However, LBR for started cycle, which remains constant (17%) until 2013, shows a marked decline since then at a rate of 1% per year. In this same period was observed: a progressive increase in the percentage of cycles with frozen embryos (from 29% to 48%), a greater number of cryopreserved embryos (from 0.9 to 1.6 embryos per started cycle), and a constant decrease in the number of embryos in each cryotransfer (from 2.39 to 1.42). LBR after cryotransfer per started cycle has increased exponentially from 4% to 24%. It was also found a steady increase of the percentage of births after a cryotransfer cycle (from 19 to 70%), surpassing since 2017 those obtained after fresh transfer. To calculate the cumulative live birth rate (CLBR), an algorithm has been developed including all pregnancies that can be achieved with the use of all the embryos obtained after each cycle started until alive child is born. CLBR shows a constant increase in the cumulative delivery rate of 1.7% annually since 2012, rising from 22 % to 35% of births per cycle started. Limitations, reasons for caution One of the main weaknesses of the study is that some patients have not attempted a second or third cryotransfer during the timeframe (for unknown reasons), though they had supernumerary embryos available. However, this model reflects the potential capacity to have at least one living child for each cycle started. Wider implications of the findings The LBR per cycle based only on fresh transfers is not useful for a historical analysis of the effectiveness of the technique. Only the calculation of the CLBR per cycle allows us to understand the real progress of IVF effectiveness in recent years. Trial registration number not applicable

Improving Election Integrity: Blockchain and Byzantine Generals Problem Theory in Vote Systems

In the digital age, maintaining election integrity is critical, especially in Africa, where the security of electronic elections is often questioned. This study presents a blockchain-based vote counting and validation (BBVV) system developed using a mixed methods approach that combines stakeholder questionnaires to capture system specification and randomized historical election data analysis, following the Design Science Research strategy. Using the theory of the Byzantine General Problem, the BBVV protocol is proposed, which provides an accurate local count of votes at polling stations before national aggregation. The system was tested with randomized historical election data on the Algorand blockchain TestNet and confirmed that a local consensus on the vote count could be reached before it is added to the national tally on the blockchain. Our results show that in the cases where consensus was reached, this was the instance in only about 5% of the voting scenarios, with only 10% of the total vote being considered valid due to the strict consensus requirements. In addition, significant discrepancies were found between officials, with no consensus reached in 95% of cases which was due to the rogue values generated by a randomized dataset. The performance of the BBVV system was evaluated using transaction metrics, saturation, throughput, traffic, and latency to assess its efficiency, scalability, and reliability. The results suggest that blockchain technology can significantly improve the integrity of elections by ensuring a transparent, secure, and accurate vote-counting process. Future work will focus on improving the adaptability and scalability of the BBVV system for different electoral situations.

Reviving Antiquity in the Digital Era: Digitization, Semantic Curation, and VR Exhibition of Contemporary Dresses

In this paper, we present a comprehensive methodology to support the multifaceted process involved in the digitization, curation, and virtual exhibition of cultural heritage artifacts. The proposed methodology is applied in the context of a unique collection of contemporary dresses inspired by antiquity. Leveraging advanced 3D technologies, including lidar scanning and photogrammetry, we meticulously captured and transformed physical garments into highly detailed digital models. The postprocessing phase refined these models, ensuring an accurate representation of the intricate details and nuances inherent in each dress. Our collaborative efforts extended to the dissemination of this digital cultural heritage, as we partnered with the national aggregator in Greece, SearchCulture, to facilitate widespread access. The aggregation process streamlined the integration of our digitized content into a centralized repository, fostering cultural preservation and accessibility. Furthermore, we harnessed the power of these 3D models to transcend traditional exhibition boundaries, crafting a virtual experience that transcends geographical constraints. This virtual exhibition not only enables online exploration but also invites participants to immerse themselves in a captivating virtual reality environment. The synthesis of cutting-edge digitization techniques, cultural aggregation, and immersive exhibition design not only contributes to the preservation of contemporary cultural artifacts but also redefines the ways in which audiences engage with and experience cultural heritage in the digital age.

The Risk of Optic Neuritis following mRNA Coronavirus Disease 2019 Vaccination Compared to Coronavirus Disease 2019 Infection and Other Vaccinations

Purposeto determine the risk of optic neuritis (ON) after mRNA COVID-19 vaccine administration. DesignU.S. National aggregate database retrospective cohort study SubjectsPatients were placed into cohorts based on mRNA COVID-19 vaccination status (no vaccine and positive history of COVID-19 infection, one vaccine, or two vaccines received) from December 2020-June 2022. Two control cohorts were created with patients vaccinated against influenza or tetanus diphtheria and pertussis (Tdap) from June 2018-December 2019. Patients with any history of ON or significant risk factors for ON development including infectious, inflammatory, and neoplastic diseases were excluded. MethodsA large de-identified database was queried for the Common Procedural Technology (CPT) codes for immunization encounters specific to first dose and second dose of mRNA COVID-19 vaccine, influenza, or Tdap. Cohorts were 1:1 propensity score matched on age, sex, race, and ethnicity. The risk of ON development following vaccination was calculated and compared for all five cohorts with 95% confidence intervals (CIs) reported. Main outcome measuresrisk ratio (RR) of optic neuritis 21 days after vaccination (or COVID-19 infection) and incidence of ON per 100,000 individuals. ResultsAfter matching, the first dose COVID-19 and influenza vaccine cohorts (n=1,678,598, mean age [standard deviation] at vaccination of 45.5[23.3] and 43.2[25.5], 55% female) had a 0.44 risk reduction of developing ON (95% CI 0.28-0.80). The first dose COVID-19 and Tdap (n=797,538, mean age 38.9[20.0], 54.2% female) cohort had 10 and 16 patients develop ON (RR 0.63, 0.28-1.38). Comparison of COVID-19 vaccinated patients (n=3,698,848, 48.2[21.5] years, 54.7% female) to unvaccinated and COVID-19 infected patients (n=3,698,848, 49.6[22.0] years, 55.2% female) showed 49 and 506 patients developing ON respectively (RR 0.10, 0.07-0.13). The incidence per 100,000 for ON was 1 in the first dose COVID-19 vaccine cohort, 2 in the influenza and Tdap cohorts, and 14 in the COVID-19 infected and unvaccinated cohort. ConclusionRisk of ON following mRNA COVID-19 vaccination is rare and is comparable to Tdap vaccination, decreased compared to influenza vaccination, and decreased compared to COVID-19 infection in the absence of vaccination.

China's Prosperous Middle Class and Consumption-led Economic Growth: Lessons from Household Survey Data

AbstractCan the expansion of a prosperous middle class help China to rebalance to consumption-led growth? We address this question through analysis of macro- and micro-level data. Using macro statistics, we examine trends in national aggregate consumption and GDP growth from 2000 through 2019. We observe growth in aggregate consumption but do not find convincing evidence of consumption-led growth. Using micro-level household survey data from 2002, 2007, 2013 and 2018, we estimate the size of China's prosperous middle class and its contribution to aggregate consumption growth. We find that the prosperous middle class expanded rapidly but contributed less to aggregate consumption growth than expected. We discuss features of this class that diminished its contribution to consumption-led growth, including its low propensity to consume out of income and its limited expansion beyond urban subgroups. We conclude that the expansion of the prosperous middle class is necessary but not sufficient to bring about rebalancing.

Assessing the FAIR Digital Object Framework for Global Biodiversity Research

In the first decades of the 21st century, there has been a global trend towards digitisation and the mobilisation of data from natural history museums and research institutions. The development of national and international aggregator systems, which focused on data standards, made it possible to access millions of museum specimen records. These records serve as an empirical foundation for research across various fields. In addition, community efforts have expanded the concept of natural history collection specimens to include physical preparations and digital resources, resulting in the Digital Extended Specimen (DES), which also includes derived and related data. Within this context, the paper proposes using the FAIR Digital Object (FDO) framework to accelerate the global vision of the DES, arguing that FDO-enabled infrastructures can reduce barriers to the discovery and access of specimens, help ensure credit back to contributors and increase the amount of research that incorporates biodiversity data.

Characterization of combined endoscopies and aerodigestive care: An analysis of utilization and financial feasibility.

Aerodigestive care is one model of multi-disciplinary care, which is a valuable tool for both providers and patients. Aerodigestive care models are associated with improved outcomes, reduced anesthesia exposure, reduction in hospital admissions, and fewer days of missed work or school. This is the first study to explore national usage and cost trends in combined endoscopy utilization to identify gaps in care and the potential for financial resource optimization. Data from the Healthcare Cost and Utilization Project (HCUP) Kid's Inpatient Sample (KID) was used from 2016 and 2019. Diagnoses and procedures were identified using ICD-10 codes, for patients with hospital length of stay less than 1 day. Demographic data were identified, and survey-weighted means and proportions were computed. Bivariate comparisons were made using Rao Scott Chi-Square tests. National estimates of charges were computed with discharge weights, developed using the American Hospital Association (AHA) universe. White, high-income patients, and those at urban teaching hospitals received the greatest proportion of combined endoscopic procedures. The cost/charges associated with combined endoscopies are less than for separate gastrointestinal (GI) or airway only endoscopies combined. However, combined procedures comprise a smaller share of national aggregate cost. National utilization trends highlight racial and socioeconomic disparities and suggest differences in access based on hospital characteristics, despite the reduced cost/charges of the combined procedure. For patients with a need for combined aerodigestive procedures, there appears to be a cost-savings opportunity to increase efforts for combined procedures at the level of the clinician or hospital.

Unobserved effects of monetary policy in the Peru’s departments output and unemployment

This is the first article in a series of two. A NAIRU-Keynesian model is developed for Peru’s departments (regions) to analyse whether there is a stable relationship between inflation and unemployment, and inflation and the output gap as documented in the Peruvian literature. I applied GLS for model estimation. My results document a positive relationship between future inflation rates and the gap in departmental unemployment rates concerning national unemployment rates, I evidence the Phillips curve flattening at the departmental level when estimating with the output gap, which is consistent with the national aggregate models, but there is a more elastic relationship when estimating with departmental unemployment rates. This represents unobserved effects for the monetary policy maker and requires further research.

Knowledge organisation in institutional repositories: a case study on policies and procedures manuals in the Ibero-American environment

PurposeThe purpose of this study is to analyse the recommendations on knowledge organisation from guidelines, policies and procedure manuals of a sample of institutional repositories and networks within the Latin American area and observe the level of follow-up of international guidelines.Design/methodology/approachPresented is an exploratory and descriptive study of repositories’ professional documents. This study comprised four steps: definition of convenience sample; development of data codebook; coding of data; and analysis of data and conclusions drawing. The convenience sample includes representative sources at three levels: local institutional repositories, national aggregators and international network and aggregators. The codebook gathers information from the repositories’ sample, such as institutional rules and procedure manuals openly available, or recommendations on the use of controlled vocabularies.FindingsThe results indicate that at the local repository level, the use of controlled vocabularies is not regulated, leaving the choice of terms to the authors’ discretion. It results in a set of unstructured keywords, not standardised terms, mixing subject terms with other authorities on persons, institutions or places. National aggregators do not regulate these issues either and limit to pointing to international guidelines and policies, which simply recommend the use of controlled vocabularies, using URIs to facilitate interoperability.Originality/valueThe originality of this study lies in identifying how the principles of knowledge organisation are effectively applied by institutional repositories, at local, national and international levels.

P-292 It is feasible to carry out a large-scale multi-national Assisted Reproductive Technology Real World Data (RWD) collection prospectively, encompassing collected patient and treatment cycle information

Abstract Study question Is it feasible to carry out a large-scale multi-national Assisted Reproductive Technology Real World Data (RWD) collection prospectively, encompassing collected patient and treatment cycle information? Summary answer The creation of an international database collecting RWD is feasible. The quality and quantity of the data allow them to be used for research purposes. What is known already Real World Evidence (RWE) may help to answer clinical research questions that are relevant to a broad population of patients. For 40 years, Assisted Reproductive Technology (ART) treatment cycle data have been collected in national registries. The aggregated national data are further collated on an international level. These data are useful for describing secular trends in ART utilization and associated outcomes. However, registries often fall short in providing patient-level and treatment-cycle-level information for data collation and analysis. Furthermore, national registries may restrict access of raw data for open research, for political, infrastructural, or legal reasons. Study design, size, duration In a first phase, the OPERA database (Observational retrospective ProjEct for a Research database for ART procedures) included data from cycles recorded between January 2016 and December 2020 in eighteen clinics, providing a robust sample size for Real World Data analyses. Fondazione per la Ricerca Ospedale di Bergamo (FROM), together with expert clinicians in the ART field, promoted the OPERA project with the financial support from two pharmaceutical companies (Merck KGaA, IBSA SA). Participants/materials, setting, methods The Eighteen clinics located in Germany and Italy joining the OPERA data collection, have proven expertise in ART procedures and use MedITEX® DB. The study protocol was reviewed by the competent Ethic Committees and Data Protection Officers. Among the outcomes collected were the mean number of cycles, the pregnancy and birth rate per Embryo Transfer, and the pregnancy and birth rates as a function of female age. The first extraction was scheduled for December 2022. Main results and the role of chance Around 75,000 ART cycles were collected from the first ten participating centers. Among the around 45,000 cycles that have available fertilization information , 11,553 (25.7%) were the In-Vitro Fertilization treatments (IVF), 31,202 (69.3%) Intracytoplasmic Sperm Injection treatments (ICSI), and 2,282 (5.1%) a combination of the two techniques. Of the adopted stimulation protocols, 38.43% (10,538) of the total were with variable antagonists, 31.27% (8,574) were with a single antagonist, 24.31% (6,665) were with a long agonist, 5.51% (1,511) were with a short agonist, and 0.35% (96) were with fixed antagonists. The average number of oocytes retrieved is 11.28, with a median of 10.0. The average number of 2 Pronuclear Oocytes (2PN) obtained is 3.7, with a median of 3.0. Moreover, the average number of 8 cell embryos at day 3 is 2.0, with a median of 2.0. It was also recorded the rate of unsuccessful cycles with no oocytes retrieved (4.8%). Among the cycles collected, 2.9% of the total were from frozen oocytes. Most of the ET (40.0%) were performed 5 days after the oocyte retrieval. Limitations, reasons for caution Amassing ART cycle information does not compensate for the well-known insufficiencies of primary data quality, of information on confounders and of access to patient level data. Moreover, the technical risk of this project is the potential loss of participant confidentiality, mitigated through a full anonymization. Wider implications of the findings The OPERA project may facilitate the transition of ART surveillance from a national aggregate level to a large-scale individual patient and treatment cycle level. Furthermore, as an evolutionary path, the OPERA project may help building large and longitudinal databases, suitable for appropriate epidemiological research in ART. Trial registration number not applicable

The Impact of Malpractice Damage Caps on C-section Rates and Alternative Approaches.

About half of the states in the United States have had noneconomic damage caps in place for at least 8 years. National aggregate data shows that women are just as likely to give birth by cesarean section (C-section) in states with damage caps as in ones without. For the most recent year studied, the national C-section rate for births in states with damage caps was 33.04% compared with a 32.10% ratefor births in states without caps. Other initiatives (malpractice insurance reform, accessible public disclosure of hospital C-section rates, and improved compensation for vaginal delivery) should be considered to reduce C-section rates.

Factors related to women’s use of health insurance cover in Navakholo, Kakamega County, Kenya: sub-county level results based on community household register

BackgroundIn concert with international commitments, the Government of Kenya identified Universal Health Coverage (UHC), mainly through the National Health Insurance Fund (NHIF), as one of its four priority agenda to enable its populations access health care without financial duress. Nevertheless, only about 19.5% of the Kenyan population is enrolled in any insurance health cover. Since 2016, Amref Health Africa and PharmAccess Foundation have been implementing the Innovative Partnership for Universal and Sustainable Healthcare (iPUSH) programme in Navakholo sub-county of Kakamega County. The main objective of this study is to examine use of health insurance cover among Women of Reproductive Age (WRA) in Navakholo sub-county, Kakamega County.MethodsWe analysed data captured during household registration conducted in February 2021 which embraced a question on use of health insurance cover including NHIF. The dataset consisted 148,957 household members within 32,262 households, 310 villages, and 32 community health units. The data had been collected using mobile phones by trained Community Health Volunteers (CHVs) and transmitted using the Amref electronic data management platform and reposited in a server. Data were analysed through frequency distributions and logistic regression (descriptive and causal methods) using STATA software.ResultsInsurance coverage, all providers included, in Navakholo sub-county stood at 11% among women aged 15–49 years. This is much lower than the national aggregate reported from sample surveys, but higher than the 7% found in the same survey for the region where Navakholo is situated. Social determinant variables – age, perceived condition of the household, and wealth ranking – are highly significant in the relationship with use of health insurance cover while measures of reproductive health and health vulnerability are not.ConclusionIn Navakholo sub-county of Western Kenya, all—health-insurance coverage is lower than the national aggregate estimated from sample surveys. Age, perception of household condition, and wealth ranking are very significantly related to use of a health insurance cover. Frequent household registrations should be conducted to help monitor the trends and impact of health insurance campaigns. Training – upstream and downstream – on community household registration and data processing should be conducted to arrive at better quality data.

Higher fees and out-of-pocket costs in radiotherapy point to a need for funding reform.

ObjectiveTo elucidate the policy implications of recent trends in the funding of radiotherapy services between 2009-10 and 2021-22.MethodWe use national aggregate claims data to determine time trends in the fees, benefits and out-of-pocket (OOP) costs of radiotherapy and nuclear therapeutic medicine claims funded through the Medicare Benefits Schedule (MBS) program. All dollar figures are expressed in constant 2021 Australian dollars.ResultsRadiotherapy and nuclear therapeutic medicine MBS claims increased by 78% whereas MBS funding increased by 137% between 2009-10 and 2021-22. The main driver of Medicare funding growth has been the Extended Medicare Safety Net, which has increased by 404%. Over the 13 year observation period, the percentage of bulk-billed claims peaked in 2017-18 at 76.1% but fell to 69.8% in 2021-22. For non-bulk billed services, average OOP costs per claim increased from $20.40 in 2009-10 to $69.78 in 2021-22.ConclusionDespite increased Medicare funding, patients face increasing financial barriers to access radiation oncology services. Policies with regard to funding radiotherapy services should be reviewed to ensure that services are easily accessible and affordable for all those needing treatment and at a reasonable cost to Government.

An Empirical Analysis of the Supply Response of Coconut by Vector Error Correction Approach: Cross Country Comparison

This study estimates the output supply response of coconut in major producing countries using the cointegration approach. Regional variations in the domestic coconut production in Sri Lanka, India (represented by the state of Kerala), and the Philippines were captured by applying a Vector Error Correction Model (VECM). National aggregate time series data for the period 1970-2019 were used in the analysis. The empirical results show that unique long-run equilibrium relationships exist among coconut production, the coconut price, and the climate variable in three individual markets and the panel estimation. The regional disparities are revealed by the short-run dynamics throughout the analysis. Altogether, the econometric estimates provide strong evidence that the coconut producers respond rationally to the changes in own price and other supply determinants. However, both short and long-run price elasticities of the coconut supply response are rather low amidst its significance, suggesting that any pricing policy requires a comparatively long lead time for it to become effective in accelerating production. Furthermore, the estimated panel VECM can be further developed and validated to be used as a tool to analyze the regional deviances for assisting the policymakers in making comprehensive strategies to ensure the industry’s long-term sustainability.

Open Science for the agricultural sector: a navigator for open educational resources

Introduction. The global concept of "sustainable development", aimed at preserving civilization, defines the social significance of education and building of the information society as its most important constituent elements. The pandemic and other global challenges state the important role of education as a means of human survival, designating knowledge as public goods. The movement towards sustainable development of the society is similar to the formation of a new educational reality based on new approaches and principles, including open science. Purpose setting. The current trend in the development of higher education is the course towards the openness of content, the use of digital educational technologies, which is reflected in the documents of the international movement for the creation and dissemination of open educational resources. An analysis of domestic scientific publications shows that open access to scientific and educational information is of particular importance, since the transformation of the education system is taking place against the backdrop of restricting our state’s access to world information resources, sanctions, and import substitution. The agricultural sector, which has a special mission to provide the population with food, has faced the task of filling the shortage of highly qualified specialists. In the current period of transformation of the educational system, open educational resources are becoming innovative tools; the experience of agricultural universities in their use during the pandemic has shown good results in the quality of education. However, the global and highly fragmented volume of information on the Internet in the absence of standardization of open educational resources makes the process of finding information for learning complex and time-consuming. Methodology and methods of the study. The results of the analysis give grounds to speak about the need to create a national information aggregator system in order to ensure constant open access to information resources for participants in the educational process of the agricultural industry. Results. The results of the study made it possible to prepare a guide to open sectoral information resources of the agro-industrial complex – open educational resources "Navigator of Open Educational Resources for the Agricultural Industry", which is presented on the "Library for Open Science" platform (available at: http://lib-os.ru/obrazovatelnye-resursy/navigator-oor-apk/) and allow users to find the information they need faster and more efficiently. Conclusion. The results of the study give reason to talk about the need to create a national data aggregation system to provide permanent open access to the information resources of participants in the educational process of the agricultural industry.

The Path of Remittances to Consumption or Saving! Albania Case Study

Since the change of the political systems in the 1990-s in Albania, massive emigration has been a continuous phenomenon of different scales in Albania. The outflow migration phenomenon is associated with the inflow of remittances to the origin families. Remittances have been a vital financial source of living for a considerable number of households. Therefore, they constitute an important financial mechanism for funding the country's economy. Empirical regression analysis in emerging economies suggests ambiguous results of remittances in the economy. Therefore, it is the purpose of this paper to investigate the effect of remittances on macroeconomic variables such as aggregate consumption, national saving, and the economic growth rate in Albania. Econometric models based on the ordinary least squared method (OLS) are performed to analyze the effect among the variables, and time series data are retrieved from the World Bank and Institute of Statistics of Albania databases. Model results based on data from the period 1992-2019 show that most of the remittance income is consumed by the recipient families contributing to the aggregate consumption demand. According to the model’s results, a 1 percent increase in remittances contributes to a 3.2 percent increase in aggregate consumption in the country. While remittances have neither a significant effect on a country's national aggregate saving nor the country's economic growth rates.

Does It Pay to Wait? Quantifying the National Longitudinal Morbidity and Healthcare Use after Emergent Paraesophageal Hernia Repair

INTRODUCTION: Elective paraesophageal hernia repair (PEHR) is a relatively safe intervention. Current guidelines recommend an expectant approach toward asymptomatic PEH, but many patients present with acute symptoms requiring emergent surgery. We quantified the longitudinal morbidity and healthcare use after emergent PEHR relative to elective cases nationwide. METHODS: Adult patients undergoing repair for symptomatic PEH with follow-up >6 months were identified using the Nationwide Readmission Database (2010 to 2019). Postoperative complication, mortality, unplanned readmission, reintervention, and cost within 1 year were compared by acuity (emergent vs elective) using risk-adjusted regression modeling. The association of outcomes by approach (minimally invasive [MI-PEHR] vs open-PEHR) was also explored. RESULTS: There were 43,243 PEHR cases: 76.0% emergent and 78.2% MI-PEHR. Most undergoing emergent PEHR were aged >65 years (58.5%), female (71.3%), and underwent operation at high-volume centers (>p75th 60.1%). Risk-adjusted analyses showed increased complication (hazard ratio [HR] 1.14 [1.04 to 1.24]), readmission, (HR 1.14 [1.03 to 1.26]), and cost for emergent PEHR (Ref. elective; all p < 0.05; Table 1). Within risk-adjusted regression models, emergent open-PEHR was associated with increased complication (HR 1.27 [1.2 to 1.36]), mortality (HR 1.25 [1.02 to 1.54]), and costs (Ref. MI-PEHR; (all p < 0.01). Estimated national aggregate cost for index admission and subsequent hospitalization after PEHR was $257 million/y with 81.4% related to emergent cases.Table 1CONCLUSION: Emergent PEHR is associated with increased morbidity and healthcare use due to postoperative complication and readmission, but MI-PEHR is associated with decreased morbidity even in the emergent setting. The need to prevent emergent cases should warrant further work aimed at clarifying the current indications for elective PEHR.

Shining Light on Labels in the Dark: Guidelines for Offensive Collections Materials

The natural history collections community has made significant strides in the past decade in the digitization of their holdings. Digitization has made the data and corresponding images of collections publicly available to researchers, students, and the public. Data and images are served online by institutions’ local databases, and regional, national, and international aggregators. One challenging aspect in digitizing natural history collections is the presence of offensive language, such as racial slurs in collection and location data. We present findings from a community survey and analysis of data from relevant aggregators to assess the presence of and approach to offensive language in collections data. We also suggest initial guidelines for data warning statements and disclaimers and transcription guidelines to help preserve historical integrity of data while also supporting inclusive and safe workspaces. Please note that in writing about offensive terms found in natural history collections, we use and refer to offensive terms and include images of labels and documents to provide examples.

The Socio-Economic Determinants of Anemic Pregnancies in South Asia – Empirical Evidence from National Aggregates

Anaemia is the most common and prevalent maternal health issue in developing countries. It is a global challenge, not only for poorer populations of the world but also for developed countries. South Asia is part of the developing world and is severely affected by the problem of anaemia in pregnant women. The region also stands out in the pervasiveness of child marriages; in fact, it accounts for about half of the total child marriages occurring globally. The high incidence stems from socio-economic misery, prevalent in the form of gender inequality, male-dominated family culture, orthodox ethnic norms and inaccessibility to information on reproductive health. Unlike earlier studies which sought evidence more from cross-sectional data sets, this study investigates the explanatory power of adolescent fertility and low health expenditure on exceptionally high rates of anaemic pregnancies using modern econometric techniques with longer data sets comprising national aggregates. The results strongly suggest that for seven regional states, the proposed relationship holds valid. The robustness of short-run individual country estimates is challenged by testing the relationship through modern long-run pooled data estimators. The results are reasonably encouraging, recognizing the significant role of adolescent fertility and low levels of health spending, thus determining trend patterns of anaemic pregnancies region-wide.