National Reports Research Articles

Russian Studies of Atmospheric Electricity in 2019–2022

This review contains the most significant results of Russian studies in the field of atmospheric electricity in 2019–2022. It is part of the Russian National Report on Meteorology and Atmospheric Sciencesto the International Association of Meteorology and Atmospheric Sciences (IAMAS). The report was presented and approved at the XXVIII General Assembly of the International Union of Geodesy and Geophysics (IUGG)2.The review is followed by a list of the main published works on the studies of atmospheric electricity of Russian scientists in 2019–2022.

Russian Research in 2019–2022 of Polar Meteorology

This publication is an overview of the results of Russian polar research in 2019–2022, based on paper prepared by the Commission on Polar Meteorology of the National Geophysical Committee for the National Report on Meteorology and Atmospheric Sciences to the XXVIII General Assembly of the International Union of Geodesy and Geophysics (Berlin, Germany, July 11–20 2023).

Russian Studies on Clouds and Precipitation in 2019–2022

Results of Russian studies on cloud physics, precipitation, and weather modification in 2015–2018 are presented based on a survey prepared for the Russian National Report on Meteorology and Atmospheric Sciences to the 28th General Assembly of the International Union of Geodesy and Geophysics. Results concerning general issues of observation and modeling of clouds and precipitation, including convective clouds, issues of studying microphysical and optical characteristics of clouds, and weather modification are discussed.

Russian Studies of the Middle Atmosphere in 2019–2022

A review of the results of Russian studies of the middle atmosphere in 2019–2022 prepared by the Commission of the Middle Atmosphere of the Meteorology and Atmospheric Sciences Section (MASS) of the Russian National Geophysical Committee for the National Report on Meteorology and Atmospheric Sciences to the XXVIII General Assembly of the International Union of Geodesy and Geophysics (Germany, 2023)* is presented.

Smart Cities: Challenges and Opportunities

The concept of smart cities has received a significant interest recently among researchers. United Nations reports that more than half of the world population currently lives in urban environment, and is estimated to increase to about 70% by 2050. This trend needs serious attention by governments to create solutions that will make sure that their citizens will continue to have sustainable and improved quality of life. Smart cities use all the available technologies to achieve that goal and to improve the efficiency of their operations. This massive undertaking of making existing cities smart and building the new smart cities, comes with many opportunities as well as some challenges. Digitization of services, smart operations, and connectivity are essential parts of smart cities. The smart cities will certainly promote cohesive, connected, healthier, and happier communities. This paper elaborates the opportunities and the challenges in moving the smart cities concept forward.

Estimating the Adverse Reaction Among Iranian Blood Donors: The First National Report

Background: The aim of this study was to estimate the incidence of reactions caused by blood donations in Iran as well as exploring three potential scenarios of the worst, moderate, and the best situations for adverse reactions among Iranian blood donations by specifying the under-reporting rate.
 Methods: There are two different designs; first, the ecological study was coducted to estimate the blood donation adverse effects by using the data registered in the donor vigilance part of Iranian Blood Transfusion Organization (IBTO). Second, the cross-sectional study was conducted to estimate under-reporting in the data. For the cross-sectional study, 2408 donors were selected randomly in three cities.
 Results: In general, based on the estimations of this study, adverse reactions to blood donation in Iran is 2%(CI 95%, 1.4-2.6%). Local and systemic reactions estimated are 1.7%(CI 95%, 1.2-2.2) and 0.3%(0.1-0.5), respectively. Based on the national report, in general, adverse reactions to blood donation in Iran is 0.5(CI 95% 0.4-0.6). Local and systemic reactions estimated are 0.38%(CI 95% 0.28-0.48) and 0.03%(0.0.02-0.04), respectively.
 Conclusion: Adverse reactions may vary from region to region in Iran, but in total, there is a lot of under-reporting in the incidence of adverse reactions to blood donation in Iran, most of which are related to local reactions.

Survival Analysis of Adults with Acute Lymphoblastic Leukemia in Ecuador

Background Acute lymphoblastic leukemia (ALL) is the second most common acute leukemia in adults. Unfortunately, in Ecuador there are no survival studies in patients ≥15 years with ALL, thus, this is the first national report. The aim of the study was to describe clinical-demographic characteristics and overall survival (OS). Methods Medical records of 628 patients from 8 reference hospitals in Ecuador with acute lymphoblastic leukemia (ALL) aged ≥15 years, diagnosed between January/2015 and December/2022, were retrospectively reviewed. A high-risk group was defined as: age ≥ 35 years ; ≥ 30,000/mm3 leukocytes in B-cell acute lymphoblastic leukemia (B-ALL) or ≥ 100,000/mm3 leukocytes in T-cell acute lymphoblastic leukemia (ALL- T) ; CNS infiltration at diagnosis, and/or if EMR was not reached (<0.01%) negative at the end of induction. If none of these factors were present, it was classified as standard risk. OS and treatment-related mortality were evaluated. Before carrying out this study, the approval of a national research ethics committee was obtained, as well as the approval of the 8 participating centers. Results 628 patients with ALL were included in the study. Summary of clinical and demographic data Table 1. In this cohort of patients, 9 different regimens of intensive chemotherapy were used. 454/517 (87.8%) patients with B-ALL were considered high risk. 595/628 (94.5%) patients received intensive chemotherapy. 150/595 (25.2%) and 54/595 (9.0%) patients died during the induction and consolidation phase respectively, reaching a mortality related to the treatment of 34.2%. In 290/401 (72.3%) with B-ALL achieved a complete response (CR) after induction, also 199/401 (49.1%) patients achieved minimal residual disease (MRD) negative (<0.01%). 16/235 (6.8%) patients with B-ALL considered high risk who achieved CR received allogeneic hematopoietic stem cell transplantation (HSCT). 32/35 (91.4%) patients with T-cell acute lymphoblastic leukemia (T-ALL) received intensive chemotherapy, of which 17/24 (70.8%) achieved CR, MRD negative (<0.01%), in 8/20 (40.0%) and 3/17 (17.6%) who achieved CR received HCT. The median OS was 12 months (95% CI 9.8-14.1) with a 5-year OS of 25.6%. The median OS for intensive chemotherapy patients with B-ALL was 12 months (95% CI 9.8 - 14.1) with a 5-year OS of 25.8% and 8 months (95% CI 5.9 - 10.0) with a 5-year OS of 23.5% for T-ALL. The 5-year OS for patients with HSCT was 78.4% (median survival not reached). The median OS for patients with B-ALL who received intensive high-risk chemotherapy was 12 months (95% CI 9.7-14.2) while median survival was not reached in the standard-risk group (p=<0.01). Figure 1. In patients with ALL-B, regimens with or without L-asparaginase achieved a 5-year OS of 26.4% vs 22.9% (p=0.588), respectively. In multivariate analysis for patients with ALL-B on intensive chemotherapy, age [HR 1.02 (95% CI 1.00 - 1.04) p=0.014] was significantly associated with OS, as well as those patients who did not achieve negative an MRD [HR 1.82 (95% CI 1.23-2.69) p=<0.01]. Otherwise, the adolescent and young adults (AYA) group, BCR:ABL fusion, CNS infiltration and leukocyte number at debut, L-asparaginase chemotherapy regimens, and being classified as high-risk group did not show statistical differences associated with OS . Conclusion The reported OS rates in this cohort are considerably low when compared to with international available data, being mainly negatively affected by the high treatment-related mortality rate, and the small number of patients who reach a HSCT.

The applicability of the Polluter Pays Principle in the field of nuclear energy in the EU

This article will examine whether the Polluter Pays Principle is formulated and applied in EU versus nuclear (Euratom) law and what consequences such application could have for the EU Member Countries, e.g., when deciding on new nuclear projects or life time extension of nuclear installations. The ECJ had already clearly accepted the Polluter Pays Principle’s function of internalization of all environmental costs. It is crystal clear that EU Institutions are required to apply the PPP, together with the Precautionary and the Proportionality Principles. The application of the PPP in the nuclear field has been emphasized in an EU Commission Recommendation of 24 October 2006. On the other hand, with Council Directive 2011/70/EURATOM of 19 July 2011, a Community framework for the responsible and safe management of spent fuel and radioactive waste was launched. In its Article 5(1) the duty to establish and maintain a national framework was formulated, but no mention is made of the application of the PPP, not in this Directive nor in the national reports and the EU follow up reports. The terminology used therein, ‘adequate financial resources’, falls short of an unambiguous adherence to the Polluter Pays Principle. The PPP should hold that ALL costs for decommissioning, waste conditioning and final disposal should be carried by the polluter. A cap on the nuclear waste costs as decided in Belgium seems to be in full contradiction with the earlier decisions of the ECJ and with the EU Commission’s Recommendation of 2006. Furthermore, the EU General Environmental Principles are made applicable to the nuclear energy sector by the ECJ in the Hinkley Point C case. As argued in the present article, the Polluter Pays Principle will be a heavy burden to bring the EU legal acquis in line with all the uncertainties on the costs of closing the cycle of nuclear energy production. Accepting a ‘cap’ on the nuclear waste costs leaves a blank cheque for later generations, which is not only against the Polluter Pays Principle, but is also completely in contradiction with the EU Green Deal regarding fair competition in the field of energy production and limiting the effect of subsidies for costs which have to be borne by the nuclear waste producers.

Monitoring SARS-CoV-2 Using Infoveillance, National Reporting Data, and Wastewater in Wales, United Kingdom: Mixed Methods Study.

The COVID-19 pandemic necessitated rapid real-time surveillance of epidemiological data to advise governments and the public, but the accuracy of these data depends on myriad auxiliary assumptions, not least accurate reporting of cases by the public. Wastewater monitoring has emerged internationally as an accurate and objective means for assessing disease prevalence with reduced latency and less dependence on public vigilance, reliability, and engagement. How public interest aligns with COVID-19 personal testing data and wastewater monitoring is, however, very poorly characterized. This study aims to assess the associations between internet search volume data relevant to COVID-19, public health care statistics, and national-scale wastewater monitoring of SARS-CoV-2 across South Wales, United Kingdom, over time to investigate how interest in the pandemic may reflect the prevalence of SARS-CoV-2, as detected by national testing and wastewater monitoring, and how these data could be used to predict case numbers. Relative search volume data from Google Trends for search terms linked to the COVID-19 pandemic were extracted and compared against government-reported COVID-19 statistics and quantitative reverse transcription polymerase chain reaction (RT-qPCR) SARS-CoV-2 data generated from wastewater in South Wales, United Kingdom, using multivariate linear models, correlation analysis, and predictions from linear models. Wastewater monitoring, most infoveillance terms, and nationally reported cases significantly correlated, but these relationships changed over time. Wastewater surveillance data and some infoveillance search terms generated predictions of case numbers that correlated with reported case numbers, but the accuracy of these predictions was inconsistent and many of the relationships changed over time. Wastewater monitoring presents a valuable means for assessing population-level prevalence of SARS-CoV-2 and could be integrated with other data types such as infoveillance for increasingly accurate inference of virus prevalence. The importance of such monitoring is increasingly clear as a means of objectively assessing the prevalence of SARS-CoV-2 to circumvent the dynamic interest and participation of the public. Increased accessibility of wastewater monitoring data to the public, as is the case for other national data, may enhance public engagement with these forms of monitoring.

US air pollution is associated with increased incidence of non-syndromic cleft lip/palate

The incidence of NSCLP and NSCP per 1000 live births from 2016 to 2020 was extracted from the Centers for Disease Control and Prevention Vital Statistics Database and merged with national reports on air pollution using the Environmental Protection Agency Air Quality Systems annual data. The most commonly reported pollutants were analyzed including benzene, sulfur dioxide (SO2), particulate matter (PM) 2.5, PM 10, ozone (O3), and carbon monoxide (CO). Multivariable negative binomial and Poisson log-linear regression models evaluated the incidence of NSCLP and NSCP as a function of the pollutants, adjusting for race. All p-values are reported with Bonferroni correction. The median NSCLP incidence was 0.22/1000 births, and isolated NSCP incidence was 0.18/1000 births. For NSCLP, SO2 had a coefficient estimate (CE) of 0.60 (95% CI [0.23, 0.98], p<0.007) and PM 2.5 had a CE of 0.20 (95% CI [0.10, 0.31], p<0.005). Among isolated NSCP, no pollutants were found to be significantly associated. SO2 and PM 2.5 were significantly correlated with increased incidence of NSCLP. The American people and perinatal practitioners should be aware of the connection to allow for risk reduction and in utero screening.

Single or pluralistic? The game and balance of China's community governance policy tools.

Policy tools embody policy concepts and are essential to achieving policy objectives. The effective allocation of policy tools directly impacts the effectiveness of community governance and determines the modernization process of grassroots governance. We aim to analyze the logic of community governance policy tool selection, and then provide assistance for the modernization of grassroots governance. We selected 100 national and provincial government work reports and 63 policy documents related to community governance during China's "12th Five-Year Plan" to "14th Five-Year Plan" period as analysis samples. And build an analysis framework based on the three dimensions of time, space, and tools. We used Nvivo.20 software for text encoding analysis. Based on the model framework, we analyze the results as follows. From the perspective of the time dimension, among the five types of policy tools, the proportion of command-type policy tools used showed a downward trend, from 88.16% in the 12th Five-Year Plan to 83.50% in the 14th Five-Year Plan. However, motivation-type and persuasion-type tools showed an upward trend, rising from 1.34% and 5.26% in the 12th Five-Year Plan period to 3.40% and 8.74% in the 14th Five-Year Plan respectively. The system-change-type policy tools decreased from 1.32% in the 12th Five-Year Plan to 0.97% in the 14th Five-Year Plan. The proportion of capacity-building-type policy tools has gradually increased from 2.63% in the 12th Five-Year Plan to 4.85% in the 14th Five-Year Plan. From the perspective of spatial dimension, apart from command and persuasion policy tools, the usage frequency of the other three types of policy tools in the three major regions all display a "growth-decline-growth" trend. From the perspective of tool dimension, command-type policy tools are dominant in China's community governance, with a cumulative frequency of 1405 times and a high proportion of 81.75%. Apart from command policy tools, persuasive policy tools and capacity-building policy tools have a relatively high proportion, with usage frequencies of 186 and 78 respectively. We found that current community governance policy tools mainly consist of command tools. However, there is a trend towards combining tools such as command, persuasion, incentive, capacity building, and system change in the future. There is a typical contradiction between instrumental rationality and value rationality, indicating an evolution from instrumental rationality to the integration of instrumental and value rationality. This study addresses the conflict of policy tools through rational guidance of values, the rational guarantee of tools, and cooperation to achieve the goal of high-quality development of community governance.

Fuel Performance Analysis of Fast Flux Test Facility MFF-3 and -5 Fuel Pins Using BISON with Post Irradiation Examination Data

Using the BISON fuel-performance code, simulations were conducted of an automated process to read initial and operating conditions from the Pacific Northwest National Laboratory (PNNL) database and reports, which contain metallic-fuel data from the Fast Flux Test Facility (FFTF) MFF Experiments. This work builds on previous modeling efforts involving 1977 EBR-II metallic fuel pins from experiments. Coupling the FFTF PNNL reports to BISON allowed for all 338 pins from MFF-3 and MFF-5 campaigns to be simulated. Each BISON simulation contains unique power and flux histories, axial power and flux profiles, and coolant-channel flow rates. Fission-gas release (FGR), fuel axial swelling, cladding profilometry, and burnup were all simulated in BISON and compared to available post-irradiation examination (PIE) data. Cladding profilometry, FGR, and fuel axial swelling simulation results for full-length MFF metallic pins were found to be in agreement with PIE measurements using FFTF physics and models used previously for EBR-II simulations. The main two peaks observed within the cladding profilometry were able to be simulated, with fuel-cladding mechanical interaction (FCMI), fuel-cladding chemical interaction (FCCI), and thermal and irradiation-induced creep being the cause. A U-Pu-Zr hot-pressing model was included in this work to allow pore collapse within the fuel matrix. This allowed better agreement between BISON-simulated cladding profilometry and PIE measurements for the peak caused by FCMI. This work shows that metallic fuel models used to accurately represent fuel performance for smaller EBR-II pins may be used for full-length metallic fuel, such as FFTF MFF assemblies and the Versatile Test Reactor (VTR). As new material models and PIE measurements become available, FFTF MFF assessment cases will be reassessed to further BISON model development.

Trends in orthopaedic surgery resident case volume and the impact of COVID-19 on resident education

IntroductionCOVID-19 had numerous objective and subjective effects on resident physician education. We intended to examine objective changes in orthopedic education that occurred during the COVID pandemic and other trends from 2018 to 2022 by analyzing surgical case logs from Accreditation Counsel for Graduate Medical Education (ACGME) approved American orthopedics programs. We hypothesized that surgical case load during the COVID pandemic would remain similar to pre-pandemic levels and case logs would show a general upward trend. MethodsWe analyzed 3146 resident case-logs from the ACGME national case-log report from academic years (AY) 2018–2022. Surgical cases were classified by their Current Procedural Terminology (CPT) codes and grouped by anatomical location (shoulder, hand, etc.). ResultsFrom AY 18–19 to “peak pandemic” AY 19–20, resident caseloads either had no change or increased in every orthopedic discipline with few exceptions. Residents performed fewer shoulder (p < 0.0001), wrist (p = 0.0023), knee (p < 0.0001) and leg/ankle (p = .0019) arthroscopies in AY 19–20 than AY 18–19. Hip arthroscopy was notably unchanged. Oncology, Spine, and Foot/Toes did not see any change from AY 18–19 to 21–22 while Microsurgeries decreased (p = .0061). There were substantial differences between high volume (90th percentile) residents, and low volume (10th percentile) residents. All other anatomic areas saw significant increases in caseload over those four academic years. Discussion/conclusionCOVID had numerous effects on the orthopedic residency experience, however, any decreases in operative load were small, and largely isolated to the 19–20 AY. Microscopic and arthroscopic surgeries decreased during peak pandemic AY 19–20 when elective surgeries experienced cancellations. This illustrates that these areas of orthopedic education may be supplemented outside of the operating room if similar circumstances arise in the future. Otherwise, resident surgical caseloads continue to rise and show no signs of slowing.

European governments’ electromobility plans: an assessment with a focus on infrastructure targets and vehicle estimates until 2030

Electromobility offers great potentials to the decarbonisation of the transport sector. The purpose of this study is to analyse the development of electromobility in the European Union (EU) and in the United Kingdom (UK) by 2030. The study is based on the objectives provided by the EU Member States and UK in their national implementation reports, as foreseen by the Directive 2014/94/EU on the deployment of alternative fuels infrastructure. As the initial data coverage was not full, in order to produce a complete data set on registered electric vehicles and public recharging points, we estimated missing values with different statistical techniques and critical analysis of the initial data. A set of proposed indicators, namely the share of electric vehicles, the density of publicly accessible recharging points, the electric vehicles and recharging points annual growth rates and the sufficiency index, were averaged at EU27+UK level to depict the envisaged evolution of electromobility in the present decade. The results show that the objectives of the countries’ governments are overall less ambitious than the goals defined in the EU Green Deal for 2025 and in the Sustainable and Smart Mobility Strategy for 2030. Most of the indicators vary significantly in the 2016–2030 period, often revealing an increased divergence between the development of electric vehicles and public recharging points. Two policy implications are derived: (i) the use of a combined set of indicators to assess the governments’ electromobility plans could be pursued, while the ratio of ten electric vehicles per recharging point may no longer be a useful benchmark; and (ii) measures supporting the uptake of recharging infrastructure are still needed to mitigate the divergence with electric vehicles and to meet the ambitious objectives of the EU Green Deal and Sustainable and Smart Mobility Strategy.

Patient safety incidents in endoscopy: a human factors analysis of nonprocedural significant harm incidents from the National Reporting and Learning System (NRLS).

Despite advances in understanding and reducing the risk of endoscopic procedures, there is little consideration of the safety of the wider endoscopy service. Patient safety incidents (PSIs) still occur. We sought to identify nonprocedural PSIs (nPSIs) and their causative factors from a human factors perspective and generate ideas for safety improvement. Endoscopy-specific PSI reports were extracted from the National Reporting and Learning System (NRLS). A retrospective, cross-sectional human factors analysis of data was performed. Two independent researchers coded data using a hybrid thematic analysis approach. The Human Factors Analysis and Classification System (HFACS) was used to code contributory factors. Analysis informed creation of driver diagrams and key recommendations for safety improvement in endoscopy. From 2017 to 2019, 1181 endoscopy-specific PSIs of significant harm were reported across England and Wales, with 539 (45.6%) being nPSIs. Five categories accounted for over 80% of all incidents, with "follow-up and surveillance" being the largest (23.4% of all nPSIs). From the free-text incident reports, 487 human factors codes were identified. Decision-based errors were the most common act prior to PSI occurrence. Other frequent preconditions to incidents were focused on environmental factors, particularly overwhelmed resources, patient factors, and ineffective team communication. Lack of staffing, standard operating procedures, effective systems, and clinical pathways were also contributory. Seven key recommendations for improving safety have been made in response to our findings. This was the first national-level human factors analysis of endoscopy-specific PSIs. This work will inform safety improvement strategies and should empower individual services to review their approach to safety.

Intersectionality and COVID-19: Academic Medicine Faculty's Lived Experiences of Well-Being, Workload, and Productivity During the Pandemic.

Purpose: The aim of this study was to utilize an intersectional framework to examine academic faculty's lived experiences during COVID-19. Specifically, we set out to: (1) describe the multiple intersectional identities (e.g., gender, race/ethnicity, rank, caregiver status, disability status) represented by the faculty, (2) examine potential disparities in well-being, workload, and productivity linked to these intersectional factors, and (3) identify qualitative themes endorsed by faculty as they relate to lived experiences during COVID-19. Methods: This was a cross-sectional mixed-methods research study. The Center for Women in Medicine and Science (CWIMS) at the University of Minnesota developed and implemented a survey between February-June of 2021 in response to national reports of disparities in the impacts of COVID-19 on faculty with lived experiences from multiple intersections. Results: There were 291 full-time faculty who participated in the study. Quantitative findings indicated that faculty with multiple intersectional identities (e.g., woman+assistant professor+caregiver+underrepresented in medicine) reported greater depression symptoms, work/family conflict, and stress in contrast to faculty with fewer intersectional identities. Furthermore, faculty with more intersectional identities reported higher clinical workloads and service responsibilities and lower productivity with regard to research article submissions, publications, and grant submissions in contrast to faculty with fewer intersectional identities. Qualitative findings supported quantitative findings and broadened understanding of potential underlying reasons. Conclusions: Findings confirm anecdotal evidence that faculty with lived experiences from multiple intersections may be disproportionately experiencing negative outcomes from the pandemic. These findings can inform decisions about how to address these disparities moving into the next several years with regard to promotion and tenure, burnout and well-being, and faculty retention in academic medical settings. Given these findings, it is also important to intentionally plan responses for future public health crises to prevent continued disparities for faculty with multiple intersectional identities.

FELASA Working Group report: Capture and transport of live cephalopods - recommendations for scientific purposes.

On 1 January 2013, research using cephalopod molluscs, from hatchlings to adults, became regulated within Directive 2010/63/EU. There are significant difficulties in captive breeding in the great majority of currently utilised species. Thus, scientific research relies upon the use of wild-caught animals. Furthermore, live cephalopods are shared and transported between different stakeholders and laboratories across Europe and other continents. Despite existing European and national legislation, codes, guidelines and reports from independent organisations, a set of recommendations specifically addressing the requirements for the capture and transport of animals belonging to this taxon are missing. In addition, although training and development of competence for all people involved in the supply chain are essential and aim to ensure that animals do not suffer from pain, distress or lasting harm, the requirements for those capturing and transporting wild cephalopods have not been considered. This Working Group reviewed the current literature to recognise scientific evidence and the best practice, and compiled a set of recommendations to provide guidance on the 'techniques' to be used for the capture and transport of live cephalopods for their use in scientific procedures. In addition, we propose to (a) develop standardised approaches able to assess recommended methods and objectively quantify the impact of these processes on animals' health, welfare and stress response, and (b) design a training programme for people attaining the necessary competence for capture and transportation of live cephalopods, as required by Directive 2010/63/EU.

Transboundary water cooperation under SDG indicator 6.5.2: disaggregating data to provide additional insights at the aquifer level

Abstract The acceleration of transboundary water cooperation is essential to support water security and ensure mutual benefits of sustainable development. The way existing Sustainable Development Goal (SDG) monitoring data is used to raise its importance further up political agendas and inform future reporting rounds is therefore crucial to acceleration. Using data extracted from national country reports of SDG indicator 6.5.2 on transboundary water cooperation, we showcase the level of cooperation, as reported, per aquifer to compliment the national approach currently followed by the official SDG framework. Our analysis uncovers a variety of insights and challenges to transboundary aquifer (TBA) cooperation that otherwise might be difficult to visualize through official national reports. Reported aquifer cooperation is often not harmonized across international borders. A lack of groundwater data and information is a major contributing factor to uncoordinated reporting, highlighting the importance of a sound scientific baseline. However, harmonization issues are also interlinked to a national-focused reporting process where Member States have the right to disagree over the status of their joint cooperation. These results can assist in improving future indicator coverage, both as an awareness raising tool for co-custodian agencies and by countries through direct interventions and coordination with neighbours.

Cancer screening and socioeconomic insecurity in FQHCs: The COVID-19 pandemic and state Medicaid expansion.

112 Background: Previous studies reported improvements in multiple care quality measures, including cancer screening, in patients served in federally qualified health centers (FQHCs) located in Medicaid expansion states compared to non-expansion states. However, the COVID-19 pandemic disrupted delivery of routine primary care. Little is known about whether the COVID-19 pandemic disrupted or worsened cancer screening and socioeconomic insecurity in FQHC patients. Methods: Data on breast, cervical and colorectal cancer screening, and socioeconomic insecurity (food insecurity, financial strain, and lack of transportation to care) were obtained from the 2020 and 2021 Uniform Data System (UDS), a national report of care delivered by FQHCs. To balance clinic characteristics, the inverse probability of treatment weighting method was employed. Using a propensity score, the probability of being in a state that expanded Medicaid as of January 1, 2020, was measured. Clinics were then weighted conditional on the proportion best served in a language other than English and privately insured as well as rural location and which funding streams were received from section 330 of the Public Health Service Act. A weighted generalized estimating equation adjusted for random clustering of FQHCs within state with a Poisson distribution produced the prevalence ratios. Results: Between 2020-2021, approximately 2700 and 1300 clinics reported on cancer screening and socioeconomic insecurity. In 2020 and 2021, FQHCs in Medicaid expansion states had a higher patient screening prevalence for colorectal (2020: aPR: 1.16, 95% CI: 1.1-1.23; 2021: 1.13, 1.07-1.19) and breast (2020: 1.1, 1.05-1.17; 2021: 1.09, 1.03-1.14) cancer compared to clinics in non-Medicaid expansion states. Additionally, patient food (2021: 0.59, 0.36-0.97) and financial (2020: 0.57, 0.38-0.86; 2021: 0.58, 0.41-0.82) insecurity prevalence was lower in clinics in Medicaid expansion v. non-expansion states. Conclusions: State Medicaid expansion status was associated with higher cancer screening and lower socioeconomic insecurity within FQHCs during the COVID-19 pandemic. It remains an important policy intervention for vulnerable populations to receive care and mitigate disparities.[Table: see text]

Evaluation of nutrition information system: A national study report

Evaluation of nutrition information system: A national study report