Percent Decline Research Articles

Findings from the Longitudinal CINRG Becker Natural History Study.

Becker muscular dystrophy is an X-linked, genetic disorder causing progressive degeneration of skeletal and cardiac muscle, with a widely variable phenotype. A 3-year, longitudinal, prospective dataset contributed by patients with confirmed Becker muscular dystrophy was analyzed to characterize the natural history of this disorder. A better understanding of the natural history is crucial to rigorous therapeutic trials. A cohort of 83 patients with Becker muscular dystrophy (5-75 years at baseline) were followed for up to 3 years with annual assessments. Muscle and pulmonary function outcomes were analyzed herein. Age-stratified statistical analysis and modeling were conducted to analyze cross-sectional data, time-to-event data, and longitudinal data to characterize these clinical outcomes. Deletion mutations of dystrophin exons 45-47 or 45-48 were most common. Subgroup analysis showed greater pairwise association between motor outcomes at baseline than association between these outcomes and age. Stronger correlations between outcomes for adults than for those under 18 years were also observed. Using cross-sectional binning analysis, a ceiling effect was seen for North Star Ambulatory Assessment but not for other functional outcomes. Longitudinal analysis showed a decline in percentage predicted forced vital capacity over the life span. There was relative stability or improved median function for motor functional outcomes through childhood and adolescence and decreasing function with age thereafter. There is variable progression of outcomes resulting in significant heterogeneity of the clinical phenotype of Becker muscular dystrophy. Disease progression is largely manifest in adulthood. There are implications for clinical trial design revealed by this longitudinal analysis of a Becker natural history dataset.

Effect on Physical Position of Peak Inspiratory Flow in Stable COPD: An Observational Study.

We examined the effect of physical position on peak inspiratory flow (PIF) in patients with chronic obstructive pulmonary disease (COPD) using dry-powder inhalers (DPIs) with low‑medium internal resistance (R2) and/or high internal resistance (R5). This prospective study in stable, ambulatory patients with spirometry-confirmed COPD evaluated the effect of 3 physical positions on maximal PIF achieved. Participants had PIFs of 30-90L/min (R5) or 60-90L/min (R2 DPIs) using the In-Check™ DIAL. PIF was measured in triplicate randomly in 3 positions that patients might be in while using their inhaler (standing, sitting, and semi-upright [supine position with the head of the bed at 45°, neck flexed forward]) against prescribed DPI resistance (R2/R5/both). Correlations between PIF and percentage decline in PIF between positions and differences in participant characteristics with >10% versus ≤10% PIF decline standing to semi-upright were calculated. A total of 76 participants (mean age, 65.2 years) had positional measurements; 59% reported seated DPI use at home. The mean (standard deviation) PIF standing, sitting, and semi-upright was 80.7 (13.4), 77.8 (14.3), and 74.0 (14.5) L/min, respectively, for R2 and 51.1 (9.52), 48.6 (9.84), and 45.8 (7.69) L/min, respectively, for R5 DPIs. PIF semi-upright was significantly lower than sitting and standing (R2; P < 0.0001) and standing (R5; P= 0.002). Approximately half of the participants had >10% decline in PIF from standing to semi-upright. Patient characteristics exceeding the 0.10 absolute standardized difference threshold with the decline in PIF for both the R2 and R5 DPIs were waist-to-hip ratio, modified Medical Research Council dyspnea score, and postbronchodilator percentage predicted forced vital capacity and PIF by spirometry. PIF was significantly affected by physical position regardless of DPI resistance. PIF was highest when standing and lowest when semi-upright. We recommend that patients with COPD stand while using an R2 or R5 DPI. Where unfeasible, the position should be sitting rather than semi-upright. ClinicalTrials.gov identifier NCT04168775.

Effect of Countermovement Depth on the Neuromechanics of a Vertical Jump.

The purpose of this study was to examine kinematic, kinetic, and muscle activation metrics during countermovement jumps (CMJs) with varying countermovement depths. The hypothesis was that a shallow countermovement depth would compromise jump height by disrupting neuromechanical control. Ten healthy men (age 26 ± 8 yr, height 1.81 ± 0.08 m, mass 83.5 ± 9.0 kg) performed maximal CMJs at self-selected countermovement depth (self-selected CMJ), at reduced countermovement depth (shallow CMJ), and at increased countermovement depth (deep CMJ). Three jumps were performed in each condition on force plates with ankle, knee, and hip motion recorded and electromyograms (EMG) recorded from the gluteus maximus (GM), vastus lateralis (VL), and medial gastrocnemius (MG) muscles. During CMJs, the knee flexion angle was recorded with an electrogoniometer. Jumpers were instructed to flex at least 15% less (shallow CMJ) and at least 15% more (deep CMJ) than the self-selected CMJs. Kinematic, kinetic, and EMG metrics were compared between the different CMJ depths using repeated measures ANOVA. Compared with self-selected CMJs, shallow CMJs had 26% less countermovement depth (P < 0.001, effect size 1.74) and the deep CMJs had 28% greater countermovement depth (P < 0.001, effect size 1.56). Jump height was 8% less for the shallow vs. self-selected CMJs (P = 0.007, effect size 1.09) but not different between self-selected and deep CMJs (P = 0.254). Shallow CMJs differed from self-selected CMJs at the initiation of the countermovement (unweighting). For self-selected CMJs, force dropped to 43% of body weight during unweighting but only to 58% for shallow CMJs (P = 0.015, effect size 0.95). During unweighting, VL EMG averaged 5.5% of MVC during self-selected CMJs versus 8.1% for shallow CMJs (P = 0.014, effect size 0.97). Percent decline in jump height with shallow versus self-selected CMJs was correlated with the difference in VL EMG during unweighting between shallow and self-selected CMJs (r = 0.651, P = 0.041). A deep countermovement prolonged the time to execute the jump by 38% (P < 0.010, effect size 1.04) but did not impair CMJ force metrics. In conclusion, self-selected countermovement depth represents a tradeoff between dropping the center of mass sufficiently far and executing the jump quickly. Unweighting at the initiation of a CMJ appears to be a critical element in the neuromechanics of the CMJ.

Malmquist Productivity Change of Mutual Funds in Tanzania

This study utilized Data Envelopment Analysis to assess the efficiency of six mutual funds in Tanzania spanning from 2018 to 2022. The analysis explores efficiency changes, technical advancements, scale efficiency, and total factor productivity. The results revealed significant trends of Mutual funds, on average, demonstrate a 3 percent increase in total factor productivity, signifying enhanced output relative to inputs attributed to improved management practices, technology integration, and operational enhancements. Conversely, technical efficiency change experiences by 2.7 percent decline, indicating that certain funds struggle to optimize inputs, potentially due to shifts in management strategies, resource allocation, or market variations. Further differentiation between large and small mutual funds reveals that larger entities exhibit more favorable productivity changes. This disparity is ascribed to economies of scale, improved investment prospects, and reduced transaction costs for larger funds. The study underscores substantial implications for mutual fund managers and the industry. Positive improvements in efficiency change, scale efficiency change, and total factor productivity indicated an overall positive trend in the mutual fund industry. Emphasizing economies of scale can enhance efficiency and overall outcomes, urging regulatory bodies to provide guidance on achieving economies of scale and fostering better practices. This research offers valuable insights into the mutual fund landscape, emphasizing the critical importance of adapting to evolving market dynamics and incorporating technology to maximize efficiency and success.

HOW MUCH IS WORKPLACE FLEXIBILITY WORTH TO OLDER WORKERS? AN ANALYSIS OF MONETARY AND NONMONETARY TRADE-OFFS

Abstract To what extent are older workers willing to forgo wages to obtain a flexible work arrangement when transitioning from career employment later in life? Older workers generally, and pension-eligible workers in particular face a plethora of trade-offs when it comes to continued work later in life. In this paper, we examine the components of older workers’ total compensation and explore how the mix of compensation changes as workers transition out of the labor force. Specifically, we focus on the relationship between monetary compensation (wages, fringe benefits) and workplace flexibility (phased retirement, hours flexibility), and explore the degree to which workers, by their choices, are willing to accept lower wages in return for increased flexibility on their job. To estimate this relationship, we use longitudinal, biennial data on thousands of older Americans representing four different cohorts available from the nationally-representative Health and Retirement Study (HRS). The HRS began in 1992 and, therefore, contains 30 years of follow-up data for the oldest cohort. For each respondent, we construct individual work histories and examine individuals’ evolving wage and hours arrangements from career employment to complete labor force withdrawal. Using multivariate techniques, we find that, all else equal, individuals experience a modest 5.7 percent decline in hourly compensation in return for a 20 percent reduction in hours worked. The findings from this paper can inform policymakers interested in continued work later in life about the degree to which older workers are willing to forgo the financial benefits of work in return for flexible schedules.

SKELETAL MUSCLE ENERGETICS ARE ASSOCIATED WITH PERFORMANCE FATIGABILITY

Abstract Performance fatigability manifests as insufficient energy to complete daily physical tasks and worsens with aging, exacerbating vulnerability to disability. Skeletal muscle energetics also declines with aging. Thus, we hypothesized muscle energetics may be an important contributor to performance fatigability. In the Study of Muscle, Mobility and Aging (SOMMA), participants completed a usual-paced 400m walk while wearing a wrist-worn ActiGraph, from which raw data were used to derive the Pittsburgh Performance Fatigability Index (PPFI, higher=more severe fatigability) that quantifies percent decline in the entire individual cadence-versus-time trajectory. Maximal oxidative phosphorylation (maxOXPHOS) in skeletal muscle mitochondria was quantified in vitro using high-resolution respirometry in permeabilized fiber bundles from vastus lateralis muscle biopsies. Maximal adenosine triphosphate production (ATPmax) was assessed in vivo by 31P magnetic resonance spectroscopy. We conducted separate tobit regressions to examine associations of maxOXPHOS and ATPmax with PPFI, adjusting for technician/site, age, sex, race, height, weight, and mins/day moderate-to-vigorous physical activity measured by ActiGraph in free-living, in N=795 participants with complete PPFI scores and &amp;gt;1 energetics measure (70-94 yrs, 58% women). Median PPFI scores were 1.4% [IQR: 0-2.9%]. After adjustment, each SD (18.4 pmol/(s*mg)) lower maxOXPHOS was associated with 0.55% (95% CI: 0.26, 0.85) higher PPFI scores, while each SD (0.2 mM/sec) lower ATPmax was associated with 0.54% (95% CI: 0.27, 0.81) higher PPFI scores. Our results indicate that lower skeletal muscle energetics were associated with more severe performance fatigability. This suggests that therapeutics targeting muscle energetics may thereby potentially mitigate fatigability and lessen susceptibility to disability among older adults.

Breast Cancer Awareness

Breast Cancer (BC) is a global health issue and it impacts women around the world. Breast Cancer accounts for 11.7% of all newly diagnosed cancer cases and has become the leading cause of cancer worldwide. In the earliest stages, the survival rate is nearly 100 percent. However, for tumors detected in later stages, that rate drops to around 25 percent. Breast Cancer Research Foundation indicated that due to the progress in advocacy, awareness, early intervention, prompt diagnosis and treatment, there has been an overall 40 percent decline in breast cancer deaths over the last 30 years.

RETRACTED: An assessment of photovoltaic module degradation for life expectancy: A comprehensive review

Determining the life expectancy of a photovoltaic (PV) system involves many factors, including the assessment of photovoltaic module degradation. Degradation of PV modules is a normal process that develops over time as a result of a number of factors, including UV radiation exposure, thermal cycling, and weathering. The degradation rate, which is the percentage decline in module efficiency per year, is an often-used indicator for evaluating PV module deterioration. Depending on the type of module (crystalline silicon (c-Si), copper indium gallium selenide (CIGS) and cadmium telluride (CdTe) and the environment, degradation rates can vary greatly, although studies have indicated that most modules degrade at a rate of 0.5% to 1% per year. Additionally, the review focuses on developing PV technologies, like dye-sensitized solar cells (DSSCs), organic PVs (OPVs), and metal halideperovskite (MHP) solar cells, where relevant long-term degradation strategies have not yet entirely developed and the majority principles are not completely understood owing to their lower to medium technological maturity levels. Nonetheless, a thorough overview of the established stability issues related to every new photovoltaic technology is provided. There are a number of techniques that can be employed, including visual inspection, electrical performance testing, and infrared imaging, to evaluate the degradation of a PV module. Through the use of accelerated stress testing (AST), photovoltaic (PV) modules can be subjected to the consequences of years of operation in a fraction of the time. The goal of AST is to assess how well PV modules hold up over the long term in situations like high temperatures, humidity, and UV exposure. A PV module is put through a series of environmental circumstances that are more demanding than ordinary working conditions in order to perform an accelerated stress test on it. To calculate the module's rate of deterioration over time, data from an accelerated stress test can be used. This data is crucial for estimating the module's long-term performance and dependability as well as formulating plans to increase the lifespan of PV systems. Manufacturers, researchers, and designers of PV systems might benefit from using AST to assess the performance of PV modules in challenging environments and make sure they adhere to industry standards for toughness and dependability. Therefore, in this study, degradation factors, along with other parameters like the accelerated-stress tests linked to PV module degradation, to predict the life expectancy of various PV system especially matured PV systems, has been examined. This paper concludes by reviewing the lessons learnt from established photovoltaic technologies and discussing potential applications for these insights in the research and development of forthcoming technologies. Specifically, industry-standard accreditation tests must ultimately be passed by any developing PV technology, and advanced c-Si-based module warranties may be prolonged beyond the 25-year limit.

Risk Prediction for Atherosclerotic Cardiovascular Disease With and Without Race Stratification

Use of race-specific risk prediction in clinical medicine is being questioned. Yet, the most commonly used prediction tool for atherosclerotic cardiovascular disease (ASCVD)-pooled cohort risk equations (PCEs)-uses race stratification. To quantify the incremental value of race-specific PCEs and determine whether adding social determinants of health (SDOH) instead of race improves model performance. Included in this analysis were participants from the biracial Reasons for Geographic and Racial Differences in Stroke (REGARDS) prospective cohort study. Participants were aged 45 to 79 years, without ASCVD, and with low-density lipoprotein cholesterol level of 70 to 189 mg/dL or non-high-density lipoprotein cholesterol level of 100 to 219 mg/dL at baseline during the period of 2003 to 2007. Participants were followed up to 10 years for incident ASCVD, including myocardial infarction, coronary heart disease death, and fatal and nonfatal stroke. Study data were analyzed from July 2022 to February 2023. Discrimination (C statistic, Net Reclassification Index [NRI]), and calibration (plots, Nam D'Agostino test statistic comparing observed to predicted events) were assessed for the original PCE, then for a set of best-fit, race-stratified equations including the same variables as in the PCE (model C), best-fit equations without race stratification (model D), and best-fit equations without race stratification but including SDOH as covariates (model E). This study included 11 638 participants (mean [SD] age, 61.8 [8.3] years; 6764 female [58.1%]) from the REGARDS cohort. Across all strata (Black female, Black male, White female, and White male participants), C statistics did not change substantively compared with model C (Black female, 0.71; 95% CI, 0.68-0.75; Black male, 0.68; 95% CI, 0.64-0.73; White female, 0.77; 95% CI, 0.74-0.81; White male, 0.68; 95% CI, 0.64-0.71), in model D (Black female, 0.71; 95% CI, 0.67-0.75; Black male, 0.68; 95% CI, 0.63-0.72; White female, 0.76; 95% CI, 0.73-0.80; White male, 0.68; 95% CI, 0.65-0.71), or in model E (Black female, 0.72; 95% CI, 0.68-0.76; Black male, 0.68; 95% CI, 0.64-0.72; White female, 0.77; 95% CI, 0.74-0.80; White male, 0.68; 95% CI, 0.65-0.71). Comparing model D with E using the NRI showed a net percentage decline in the correct assignment to higher risk for male but not female individuals. The Nam D'Agostino test was not significant for all race-sex strata in each model series, indicating good calibration in all groups. Results of this cohort study suggest that PCE performed well overall but had poorer performance in both BM and WM participants compared with female participants regardless of race in the REGARDS cohort. Removal of race or the addition of SDOH did not improve model performance in any subgroup.

Effect of government revenue on economic growth of sub-Saharan Africa: Does institutional quality matter?

Following the approval of sustainable development goals at the global level, the link between fiscal policy, institutional quality, and economic growth has attracted special attention in economic literature. This study scrutinizes the effect of government revenue-institutional quality interaction on the economic growth of 43 Sub-Saharan Africa countries for the period of 2012-2022. Methodology-wise, the study employed the System Generalized Method of Moment (SGMM) to analyze the panel data gained from dependable data sources; the World Development Indicator and the Heritage Economic Freedom Index. The novelty of this study emanates from the estimation technique designated and the introduction of revenue-institutional quality into the economic growth model of SSA. The result of the study reveals that government revenue adversely affects economic growth while institutional quality positively enhances economic growth before interacting with each other. However, the interactive coefficient of government revenue and economic growth positively affected the real GDP growth rate of SSA countries over the study periods. Precisely, before interacting with institutional quality, a percentage change in government revenue, keeping all other things constant, leads to a 0.0866 percent decline in economic growth while it marks a 0.2329 percent upsurge in economic growth in the presence of institutional quality. The result of the study further shows that government revenue promotes the economic growth of the region when combined with institutional quality. On the other hand, foreign direct investment and openness to trade were the key sources of economic growth whereas the population growth rate adversely impacted economic growth in SSA countries. The policy implication of the study is that SSA needs to strengthen government revenue management. Further, the finding of the study implies that SSA countries need to improve institutional quality through promoting efficiency of the regulatory quality and the size of the SSA governments. In addition to this, the fast real GDP growth rate of SSA countries demands improved institutional quality indicators such as the rule of law and extended access to the open market.

Changing trends in Chlamydia and gonorrhea infections among female sex workers in Southern China: a surveillance data analysis spanning 2019 to 2022.

Female sex workers (FSW) are particularly vulnerable to chlamydia and gonorrhea infections. However, there were few studies that detail the evolving patterns of chlamydia and gonorrhea among Chinese FSW. Therefore, our study endeavors to assess the prevalence of chlamydia and gonorrhea epidemics within FSW, investigate their changing trends and scrutinize associated factors. In 2019, China instituted a sentinel surveillance network focused on FSW in Guangdong Province. This network conducted an annual serial cross-sectional survey spanning from April to August. All analyses are predicated on surveillance data accumulated between 2019 and 2022. The prevalence of chlamydia increased from 10.1 to 12.3%, exhibiting an annual percentage shift of 6.8%. Conversely, the prevalence of gonorrhea dwindled from 2.0 to 1.3%, marking an annual percentage decline of 13.4% (P<0.001). After adjusting for covariates, chlamydia exhibited associations with having household registration in other provinces (adjusted odds ratio (aOR=0.55)), displaying symptoms of sexually transmitted infections (STIs) (aOR=1.65) and infected with gonorrhea (aOR=5.68). In parallel, gonorrhea demonstrated associations with providing oral sex to clients (aOR=3.74), manifesting STIs symptoms (aOR=4.27) and those infected with chlamydia (aOR=5.43). Our observations underscore the imperative to implement a comprehensive intervention strategy concentrating on chlamydia, while simultaneously fortifying endeavors to expand the scope of gonorrhea prevention services.

Fiscal policy and economic growth in Sub-Saharan Africa: Do governance indicators matter?

This study investigated the linkage between fiscal policy-governance indicators interaction and economic growth in 36 Sub-Saharan Africa (SSA) countries from the periods of 2011-2021 inclusive. The study employed two-step system Generalized Method of Moment (GMM) estimation technique due to its practical relevance in panel data analysis. The data obtained from World Bank and World governance indicator was checked for unit root through the help of Im Pesaran Shin and Levin-Lin-Chu unit-root tests, and the result revealed that data was stationary and safe for further analysis. The result of the study also presented that direct economic effect of fiscal policy is negative and significant in SSA countries. However, the interaction of fiscal policy with governance indicators has positive and significant effect on economic growth. Accordingly, before interacting with governance indicators, a percentage change in fiscal policy leads to a 0.20 percent decline in economic growth of SSA countries. Contrary to this, the interactive coefficient of fiscal policy and government effectiveness (0.019) and interactive coefficient of fiscal policy and corruption control (0.0046) are found to be positive and significant. Further, the finding of the study revealed that fiscal policy-voice and accountability interaction coefficient (0.011) and interactive coefficient of fiscal policy-regulatory qualities (0.014) are positively and significantly affecting economic growth of SSA countries. The policy implication is that policy makers in SSA countries should encourage economic policies that improve government effectiveness, strong corruption control, clean public services and better regulatory qualities.

What are the effects of monetary policy on productivity?

We assess the effects of monetary policy shocks on total factor productivity (TFP) using a cross-country panel of firm-level data. We find that monetary policy shocks have a significant effect on TFP: a 100 basis points contractionary monetary policy shock is associated with a 112 percent decline in TFP at a 6-year horizon. The effects of monetary policy shocks on TFP are stronger for financially constrained or vulnerable firms. Further, we find support for a credit channel transmission mechanism of monetary policy on TFP in that intangible investment reacts adversely to contractionary monetary policy shocks.

Abstract 430: Impact of the COVID-19 Pandemic on Out-of-Hospital Cardiac Arrest (OHCA) in Wayne County, Michigan

Background: The COVID-19 pandemic has affected the incidence, presentation, care, and survival of OHCA. Early in the pandemic, healthcare systems were challenged by work force reduction due to illness and supply chain disruptions. We hypothesize there was an increase in the number of OHCA and a decrease in patient survival during the COVID-19 pandemic. Methods: We analyzed data from the Michigan Cardiac Arrest Registry to Enhance Survival (CARES) from 2018-2022 in Wayne County from two systems of care, Health Emergency Medical Services (HEMS) and Detroit East Medical Control Authority (DEMCA). We compared patient arrests and response characteristics during time periods: 2018-2019 (pre COVID-19), 2020-2021 (COVID-19), and 2022. Descriptive statistics were utilized for this retrospective review. Results: 40 EMS agencies are included, and 12,695 OHCA cases were identified. HEMS and DEMCA recorded a total of 2,262 OHCA in 2018 and 2,401 in 2019. OHCA increased to 2,797 in 2020, 2,652 in 2021, and to 2,583 in 2022. There was a 6.1% increase in OHCA from 2018 to 2019, and a 16.5% increase in 2020, with a decrease of 6.4% in both 2021 and 2022. This trend is similarly observed in the rate of asystole as presenting rhythm. In 2018 and 2019, an average of 46.8% of patients were pronounced in the emergency department (ED) or on scene. This average rose to 56.8% in 2020 and 2021 and was 47.9% in 2022. There was also a decline in the average percentage of patients surviving until hospital admission, 23.3% in 2018 and 2019 and decreased to 18.4% in 2020 and 2021, and 22.5% in 2022. ( Figure 1. ) Conclusion: The COVID-19 pandemic may have impacted pre-hospital mortality and morbidity. There was an increase in OHCA and asystole as a presenting rhythm. The percentage of patients pronounced in the ED or on scene also increased. This data demonstrates that as a region, we have not returned to pre-pandemic levels and survivability for OHCA. Figure 1. Comparison of OHCA EMS Runs from 2018-2022 in Wayne County, MI

One-year lung function decline in sarcoidosis

BackgroundThe definition of progressive pulmonary fibrosis is based on a 1-year lung function decline. ObjectivesTo evaluate the epidemiology and clinical relevance of 1-year lung function decline in sarcoidosis. MethodsA retrospective observational study at a general sarcoidosis clinic. ResultsOf the 198 patients, 42 (18.4 %) had a 1-year lung function decline (absolute 12-month decline in percentage predicted forced vital capacity [%FVC] of ≥5 % or percentage predicted diffusion capacity for carbon monoxide [%DLCO] of ≥10 %). A 1-year lung function decline was associated with a 2-year lung function decline (a relative 24-month decline in %FVC of ≥10 % or %DLCO of ≥15 %), which occurred in 13 (7.4 %) of the 175 patients with 24-month follow-up results. A 1-year lung function decline was not associated with survival; a 2-year lung function decline predicted mortality. ConclusionsCompared with a 24-month decline, a 12-month decline in lung function did not predict worse survival in sarcoidosis.

The Impact of COVID-19 on the Utilization of Public Sector Radiological Services in the Western Cape Province of South Africa.

Background Coronavirus (COVID-19) was officially declared a pandemic in March 2020 and has had a major impact on global healthcare services, including radiology. However, little is known about the full impact of COVID-19 on the utilization of diagnostic imaging in Africa's public healthcare sector. Objectives The objective of this study was to compare public sector diagnostic imaging utilization by modality for the whole Western Cape Province (WCP) of South Africa (SA), as well as its metropolitan and rural areas, in 2019 and 2020 in terms of the absolute number of investigations and investigations per 1000 people. Method We performed a retrospective analysis of Western Cape Government Department of Health and Wellness and Stats SA District Council 2021 Mid-Year Population Estimates data. All diagnostic imaging investigations performed in 2019 and 2020 were collated and stratified by imaging modality, geographic region (metropolitan/rural), and calendar year. Data are presented as the total number of investigations and investigations per 1000people. We calculated mammography utilization for women aged 40-70 years and compared data for 2019 and 2020. Results Between 2019 and 2020, the provincial population increased by 1.9%, while total imaging investigations and investigations per 1000 people decreased by 19% (1,384,941 vs. 1,123,508, -261,433) and 20% (262/103 vs. 208/103), respectively. Total numerical decline was highest in plain radiographs (1,005,545 vs. 800,641, -204,904), accounting for more than three-quarters (78%) of the total reduction. Percentage decline was most pronounced for mammography, as utilization was almost halved (15.7/103vs.8.9/103, -43%), whereas computed tomography was the least impacted (17.9/103vs.16.7/103, -12%) with the remaining modalities decreasing between approximately one-quarter and one-fifth (magnetic resonance imaging = 26%, fluoroscopy = 25%, general radiographs = 23%, ultrasound = 16%, chest radiographs = 18%). Proportional metropolitan (-18.7%) and rural decreases (-19.3%) were similar. Conclusion COVID-19 had a substantial impact on WCP imaging services, decreasing overall radiological investigations by almost one-fifth. The greatest impact was on elective investigations, particularly mammography. Although the proportional impact was similar for the metropolitan and rural areas, COVID-19 nonetheless exacerbated existing discrepancies in imaging utilization between the geographical regions.The medium- and long-term clinical impacts of decreased imaging are still to be defined.

SCIENCE PRACTICUM ACTIVITIES THROUGH WATER AND AIR POLLUTION EXPERIMENTS ON ENVIRONMENTAL POLLUTION MATERIALS IN JUNIOR HIGH SCHOOLS

Learning that is carried out using the experimental practicum method gives students the ability to think critically, actively and collaboratively in solving a problem in science material, especially environmental pollution material. This study aims to provide an alternative way for educators to convey material related to environmental pollution, especially water and air pollution. The method used is the development of practicum learning methods on the material of water pollution and air pollution which is carried out in class 7th grade students at junior high school. The results of the water pollution practicum research stated that the average fish operculum movement experienced the highest decrease in Jar 3, from 95 to 69. The results of observations on the average movement of fish that experience slow changes and die the most are in Jar 2 with an average of 60% of fish moving slowly and 80% of fish dying in the second minute. The higher the dose of detergent, the less movement of the fish operculum and the slower the movement of fish and the death. In air pollution, the highest percentage decline in normal cricket activity was in Jar 2, from 50% in the 3rd minute to 30% in the 6th minute. The longer the crickets were exposed to the smoke of the mosquito coils, the lower the displacement of the places carried out by the crickets and the higher the activity move the antenna.

Associations between skeletal muscle energetics and accelerometry-based performance fatigability: Study of Muscle, Mobility and Aging.

Performance fatigability is typically experienced as insufficient energy to complete daily physical tasks, particularly with advancing age, often progressing toward dependency. Thus, understanding the etiology of performance fatigability, especially cellular-level biological mechanisms, may help to delay the onset of mobility disability. We hypothesized that skeletal muscle energetics may be important contributors to performance fatigability. Participants in the Study of Muscle, Mobility and Aging completed a usual-paced 400-m walk wearing a wrist-worn ActiGraph GT9X to derive the Pittsburgh Performance Fatigability Index (PPFI, higher scores = more severe fatigability) that quantifies percent decline in individual cadence-versus-time trajectory from their maximal cadence. Complex I&II-supported maximal oxidative phosphorylation (max OXPHOS) and complex I&II-supported electron transfer system (max ETS) were quantified exvivo using high-resolution respirometry in permeabilized fiber bundles from vastus lateralis muscle biopsies. Maximal adenosine triphosphate production (ATPmax) was assessed invivo by 31P magnetic resonance spectroscopy. We conducted tobit regressions to examine associations of max OXPHOS, max ETS, and ATPmax with PPFI, adjusting for technician/site, demographic characteristics, and total activity count over 7-day free-living among older adults (N = 795, 70-94 years, 58% women) with complete PPFI scores and ≥1 energetics measure. Median PPFI score was 1.4% [25th-75th percentile: 0%-2.9%]. After full adjustment, each 1 standard deviation lower max OXPHOS, max ETS, and ATPmax were associated with 0.55 (95% CI: 0.26-0.84), 0.39 (95% CI: 0.09-0.70), and 0.54 (95% CI: 0.27-0.81) higher PPFI score, respectively. Our findings suggested that therapeutics targeting muscle energetics may potentially mitigate fatigability and lessen susceptibility to disability among older adults.

Intraoperative Parathyroid Hormone Monitoring In Normohormonal Primary Hyperparathyroidism: How Low Do You Go?

The primary goal of this study was to determine in patients with normohormonal primary hyperparathyroidism (NHHPT) what percent reduction in post-excision intraoperative parathyroid hormone (IOPTH) from baseline would yield a rate of cure comparable to that in patients with classical primary hyperparathyroidism (PHPT). This is a retrospective cohort study of patients who underwent parathyroidectomy between July 2013 and February 2020. Demographic data, preoperative, intraoperative, and postoperative metrics were collected. Patients with NHHPT were compared to those with classical PHPT. Subgroup analyses were performed. Of the 496 patients included in the study, 66 (13.3%) were of the normohormonal variant based on preoperative intact parathyroid hormone (PTH) levels and 28 (5.6%) based on baseline IOPTH levels. The cure rates in the two normohormonal groups were not significantly different from their classical counterparts (98.4% and 100.0% vs. 97.1%, p = 1.000). The median percent decline in post-excision IOPTH from baseline that achieved cure in the normohormonal groups were 82.6% and 80.4% compared to their respective controls at 87.3%, p = 0.011 and p = 0.001. Although the rate of multiglandular disease was higher in one of the normohormonal variant groups, this difference was due to a higher rate of double adenomas, not four-gland hyperplasia. Patients with NHHPT undergoing parathyroidectomy can expect cure rates similar to that in patients with classical PHPT. The results of this study indicate that achieving an 80% drop or more in IOPTH levels predicts a high likelihood of cure. This is true irrespective of whether the patient is deemed normohormonal based on preoperative or intraoperative testing. 3 Laryngoscope, 134:2480-2484, 2024.

The Financial Impact of State Tax Regimes on Local Economies in the U.S.

We examine the complex relationship between taxes and local economies at the county level. Specifically, we explore the impacts of different types of state-level taxes, including income and payroll taxes, property and other taxes, as well as sales tax, on key economic performance indicators. Our study aims to comprehensively analyze how state-level taxation influences entrepreneurship, innovation, labor markets, and overall economic growth in local communities. The findings consistently demonstrate that taxes harm local economies, although the magnitude of the impact varies depending on the specific type of tax. Notably, a 10 percent increase in income and payroll taxes leads to a 3 percent drop in the nonfarm proprietors employment rate, 0.3 fewer patents per 1000 people, and a USD 3000 decrease in GDP per capita. A similar tax hike in sales taxes results in a 4.5 percent decline in the nonfarm employment rate and a 0.2 patent reduction per 1000 people. Property and other taxes also harm the economy: a 10 percent increase is linked to a 5.3 percent fall in the nonfarm proprietors employment rate, a 7.5 percent rise in local unemployment, and a USD 55,000 drop in regional GDP per capita.