Date Set Research Articles

86-LB: Real-World Effectiveness of Oral Semaglutide (OS) from a U.S. Commercially Insured and Medicare Advantage Population

Background: With OS’s FDA approval in September 2019, this study sought to provide real-world evidence on its effectiveness in a cohort of early users. Methods: Claims and lab result data were used to identify T2D patients who initiated OS between 09/20/19 - 10/31/20 (first claim date set as index). Selected patients had ≥1 HbA1c result within both ≤3 months pre- and ≥3 months post-index and ≥ 12 months pre-index health plan eligibility. Study groups included: all patients, patients persistent on OS (those with a OS prescription within 1.5 times of days supply dispensed overlapping/in proximity to most recent post-index HbA1c), GLP-1 naive patients, and patients with a pre-index HbA1c >9%. Results: Of the 323 individuals with T2D initiating OS, 42.4% were female with a mean age of 55 years and 77% were GLP-1 naive. Mean HbA1c was significantly reduced in all patients (-0.9%) and subgroups (all p Conclusions: OS initiation was associated with a significant reduction in HbA1c and increase in HbA1c goal attainment in real-world practice in this preliminary cohort. Disclosure N. Shivappa: Other Relationship; Self; Novo Nordisk. C. Swift: Employee; Self; Novo Nordisk Inc. J. Noone: Employee; Self; Novo Nordisk Inc. S. Du: None. M. Radin: Employee; Self; Novo Nordisk Inc. C. Gamble: Employee; Self; Novo Nordisk Inc. H. Tan: Other Relationship; Self; HealthCore. V. Willey: Employee; Self; HealthCore.

A Bayesian approach for fitting and comparing demographic growth models of radiocarbon dates: A case study on the Jomon-Yayoi transition in Kyushu (Japan).

Large sets of radiocarbon dates are increasingly used as proxies for inferring past population dynamics and the last few years, in particular, saw an increase in the development of new statistical techniques to overcome some of the key challenges imposed by this kind of data. These include: 1) null hypothesis significance testing approaches based on Monte-Carlo simulations or mark permutations; 2) non-parametric Bayesian modelling approaches, and 3) the use of more traditional techniques such as correlation, regression, and AIC-based model comparison directly on the summed probability distribution of radiocarbon dates (SPD). While the range of opportunities offered by these solutions is unquestionably appealing, they often do not consider the uncertainty and the biases arising from calibration effects or sampling error. Here we introduce a novel Bayesian approach and nimbleCarbon, an R package that offers model fitting and comparison for population growth models based on the temporal frequency data of radiocarbon dates. We evaluate the robustness of the proposed approach on a range of simulated scenarios and illustrate its application on a case study focused on the demographic impact of the introduction of wet-rice farming in prehistoric Japan during the 1st millennium BCE.

Internationalization pathways of Chinese private firms: A closer look at firm-specific advantages

Abstract Using a unique date set, we explore the internationalization processes of Chinese private sector firms. We show that variations in internationalization of private Chinese firms can be better explained by traditional internationalization theories than by the typical approach proposed in the recent literature that centers on state-created advantages. The firm-specific advantages of productivity, proprietary knowledge, and technology competence explain Chinese private foreign direct investment (FDI) in a similar way as they do typical FDI from western developed countries. Further, firm-specific advantages such as technology leadership, exporting experience, and ability to signal quality to partners abroad can explain differently motivated outward FDI by private Chinese firms. Our results fill an important gap in the literature, where the validity of the existing frameworks for explaining the internationalization of Chinese multinationals is hampered by the conflation of state-sponsored internationalization, knowledge-seeking FDI, and firm-specific advantages.

Detection of network attacks by deep learning method

In this paper, we discuss the possibility of using a neural network approach in solving the problem of detecting network attacks. The neural network is designed to solve the problem of classifying the transmitted traffic into not containing an attack and containing an attack. The difficulties of using a neural network in this problem are discussed. Difficulties are associated with the choice of significant information features for the formation of the date set and having as many training examples as possible for each type of attack. Solutions for the selection of significant information features are proposed. It consists in ranking the features in order of importance. A method and rules for ranking features are proposed. In the future, it is proposed to use only important features to train the neural network. The problem of uneven number of training examples for each type of attack is considered. It is proposed to preserve significant examples represented by small sample sizes by assigning weights to them. Experiments show the effectiveness of the proposals discussed in the paper.

A sequence-based multiple kernel model for identifying DNA-binding proteins

BackgroundDNA-Binding Proteins (DBP) plays a pivotal role in biological system. A mounting number of researchers are studying the mechanism and detection methods. To detect DBP, the tradition experimental method is time-consuming and resource-consuming. In recent years, Machine Learning methods have been used to detect DBP. However, it is difficult to adequately describe the information of proteins in predicting DNA-binding proteins. In this study, we extract six features from protein sequence and use Multiple Kernel Learning-based on Centered Kernel Alignment to integrate these features. The integrated feature is fed into Support Vector Machine to build predictive model and detect new DBP.ResultsIn our work, date sets of PDB1075 and PDB186 are employed to test our method. From the results, our model obtains better results (accuracy) than other existing methods on PDB1075 (84.19%) and PDB186 (83.7%), respectively.ConclusionMultiple kernel learning could fuse the complementary information between different features. Compared with existing methods, our method achieves comparable and best results on benchmark data sets.

Adhesion barriers and topical hemostatic agents are risk factors for post-cesarean section infections

BackgroundCesarean sections are the most common surgery worldwide, and post-cesarean section infections and hemorrhage are a major cause for morbidity and mortality. In recent years, many surgeons use adhesion barriers as well as hemostatic agents during primary and repeated cesarean section. The data regarding the safety of these agents is relatively limited. The objective of this study was to investigate whether the use of adhesion barriers and topical hemostatic agents pose a risk for post-cesarean section infections. MethodA case-control study composed of women who were admitted to the Soroka University Medical Center between the years 2012 and 2016 was conducted. The study group was composed of women admitted owing to post-cesarean section infections (cases) and those who underwent cesarean sections without post-cesarean section infection (control subjects). Matching was done according to date and surgery setting (elective versus emergency). A univariate analysis was followed by a multiple regression model in order to examine the association between adhesion barriers/hemostatic agents and post-cesarean section infections. ResultsDuring the study period, 113 patients developed postoperative infection (cases); 71.7% were diagnosed with surgical site infection, 7.1% with endometritis, and 21.2% with other infections. These were compared with 226 control subjects. In the univariate analysis, the use of adhesion barriers/hemostatic agents were found to be associated with post-cesarean section infection. Using a multivariable analysis controlling for previous cesarean section, skin closer technique, preterm delivery, and duration of surgery >60 minutes, the use of adhesion barriers as well as hemostatic agents was found to be independently associated with post-cesarean section infection (adjusted odds ratio = 2.11, 95% confidence interval = 1.17–3.84; adjusted odds ratio = 2.29, 95% confidence interval = 1.37–3.8, respectively) ConclusionAdhesion barriers and hemostatic agents were found to be independently associated with post-cesarean section infections. Further larger studies are needed to reinforce our findings. The use of these materials should be carefully considered, and their cost-effectiveness re-examined.

Recognition of abnormal body surface characteristics of oplegnathus punctatus

To identify the abnormal characteristics of the oplegnathus punctatus is great importance to the detection of iridovirus disease in the breeding environment. In this paper, an advanced neural network model to identify the characteristics of the oplegnathus punctatus and predict its different periods of suffering from iridovirus disease is proposed based on the establishment of a data set. First of all, a standard format data set of oplegnathus punctatus and an abnormal format date set are established in order to verify the effectiveness of the method in this paper. And then, the feature extraction fusion method is used for preprocessing in terms of the abnormal format data set, which combines the edge features extracted by the improved multi-template Sobel operator and the color features extracted by the HSV model. Finally, an improved VGG-GoogleNet network recognition model comes into being through the fusion and improvement of the VGG and GoogleNet neural network structure. The experiments results show that the prediction accuracy rate for oplegnathus punctatus suffering from iridovirus disease in the the abnormal format data set and the standard format data set are improved, which reach 98.55% and 69.18%.

Bayesian Revision of the Folsom Age Range Using IntCal20

ABSTRACT Folsom is an early Paleoindian archaeological tradition found in the North American West. Here we report new AMS radiocarbon dates for the Barger Gulch and Lindenmeier sites in Colorado along with unsuccessful dating attempts for Blackwater Draw, the Mitchell Locality, Shifting Sands, and Lipscomb on the Southern Plains. We applied Bayesian modeling using IntCal20 to our updated set of Folsom dates and estimate that the Folsom tradition lasted for a period spanning between 355–510 years at the 68 per cent credible interval or 325–650 years at the 95 per cent credible interval, starting sometime between 12,845–12,770 calendar years ago (cal yr BP) and ending sometime between 12,400–12,255 cal yr BP. Additionally, we model the spans of the start and end boundaries and find that both the adoption and abandonment of Folsom technology occurred over relatively short periods, less than 100 years and likely less than 50 years.

On the chronology of the Sabatynivka group of the Cucuteni-Trypillia cultural complex (Central Ukraine)

The paper treats the dating of the Sabatynivka group of Cucuteni-Trypillia. The authors compared the sets of radiocarbon dates, which were obtained for the sites of the aspect, analyzed the relative chronology of the Sabatynivka group, and checked their correspondence with the dating of the contemporaneous cultural aspects. This approach helped to establish the synchronism of the Sabatynivka group with the Skelia phase of Seredny Stog culture, Gumelniţa A2 and Cucuteni A3-A4. The sites of the group existed during 44-42 centuries BCE.

Revisiting the Safety of Prostaglandin Analog Eyelash Growth Products.

The FDA approved bimatoprost ophthalmic solution 0.03% for treatment of eyelash hypotrichosis in 2008. Consumer concern persists regarding potential side effects of this product. To identify gaps in the safety information associated with the use of prostaglandin eyelash growth products. Literature searches were performed using PubMed, Embase, and Nexis Uni databases without restriction to publication date, language, or study setting. The literature pertaining to bimatoprost for treatment of eyelash hypotrichosis is dominated by industry-sponsored clinical trials. Study design choices create gaps in our understanding of the clinical safety of these products. Because of study design choice, clinical trials of bimatoprost for eyelash growth may have systematically underreported the incidence of drug application discomfort and prostaglandin-associated periorbitopathy. The risk of increased iris pigmentation remains inadequately investigated. Consequently, there is an ongoing need to educate and monitor patients who choose to use these products.

Middle Holocene hunter–gatherers of Cis-Baikal, Eastern Siberia: Chronology and dietary trends

Analyses of radiocarbon dates (all corrected for the freshwater reservoir effect) and associated stable isotope values obtained from the skeletal remains of ~650 individuals provide many new insights about Middle Holocene hunter–gatherers (HGs) of the Cis-Baikal region, Eastern Siberia. The new radiocarbon evidence clarifies the culture history of the region by defining better the boundaries between the chronological (archaeological periods) and cultural (mortuary traditions) units, as well as our understanding of the transitions between them. Furthermore, differences between the four archaeological micro-regions with regard to the timing and duration of these culture historical units have come into focus for the first time. In terms of dietary patterns, the Early Neolithic foragers of the Angara and Southwest Baikal trended towards a greater reliance on aquatic foods. A similar trend was found in the Late Neolithic (LN) Isakovo group on the Angara, while the LN Serovo group in the Little Sea trended towards an increased dietary reliance on terrestrial game. In the Early Bronze Age HGs, a mosaic of dietary patterns was found: some groups experienced dietary shifts (frequently emphasizing different foods), while other groups displayed stability. Such differences were found even between close neighbours. All these results suggest significant variation in patterns of culture change within and between archaeological periods, mortuary traditions, and micro-regions. Some cultural patterns developed at a quick pace, others much more slowly; some appear to have collapsed rapidly, while others probably went through a more gradual transition to a different pattern. Additionally, this large set of radiocarbon dates allows novel insights into patterns of cemetery use: some seem to have been used continuously, others only sporadically, and some show long periods of disuse. Moreover, some cemeteries of the same mortuary tradition were apparently in use substantially earlier than others were even established. In sum, Cis-Baikal Middle Holocene HG strategies underwent a range of changes not only at the boundaries between relevant culture historical units but also within such units. New insights suggest considerable spatio-temporal variation in the nature, pace, and timing of these developments.

Training a thin and shallow lane detection network with self-knowledge distillation

With modern science and technology development, vehicles are equipped with intelligent driver assistant systems, of which lane detection is a key function. These complex detection structures (either wide or deep) are investigated to boost the accuracy and overcome the challenges in complicated scenarios. However, the computation and memory storage cost will increase sharply, and the response time will also increase. For resource-constrained devices, lane detection networks with a low cost and short inference time should be implemented. To get more accurate lane detection results, the large (deep and wide) detection structure is framed for high-dimensional and highly robust features, and deep supervision loss is applied on different resolutions and stages. Despite the high-precision advantage, the large detection network cannot be used for embedded devices directly because of the demand for memory and computation. To make the network thinner and lighter, a general training strategy, called self-knowledge distillation (SKD), is proposed. It is different from classical knowledge distillation; there are no independent teacher-student networks, and the knowledge is distilled itself. To evaluate more comprehensively and precisely, a new lane data set is collected. The Caltech Lane date set and TuSimple lane data set are also used for evaluation. Experiments further prove that a small student network and large teacher network have a similar detection accuracy via SKD, and the student network has a shorter inference time and lower memory usage. Thus it can be applied for resource-limited devices flexibly.

Tel Nami, Cyprus, and Egypt: Radiocarbon Dates and Early Middle Bronze Age Chronology

ABSTRACT This article reviews a set of radiocarbon dates for the Middle Bronze strata at Tel Nami, Israel. Employing a Bayesian analysis based on the stratigraphy of the site, I conclude that the results generally coincide with the high radiocarbon chronology for the Middle Bronze Age southern Levant. This result is supported by radiocarbon sequences from Tell el-Dabʿa (Egypt) and Tel Ifshar (Israel) and has significant historical implications for the dating of scarab seals previously attributed to the late Middle Kingdom, and for the earliest contacts between Egypt, the Levant and Cyprus during the Middle Bronze Age.

СТРАТИГРАФИЧЕСКИЕ НАБЛЮДЕНИЯ НА НЕОЛИТИЧЕСКОЙ СТОЯНКЕ ТАРТАС-1 (БАРАБИНСКАЯ ЛЕСОСТЕПЬ). ХАРАКТЕРИСТИКА ЗАХОРОНЕНИЙ, ПЕРЕРЕЗАЮЩИХ РАННИЙ КУЛЬТУРНЫЙ СЛОЙ ПАМЯТНИКА

Burial complexes dating back from the Neolithic era to the early-developed Bronze Age have been analyzed. The complexes were revealed at the Early Neolithic site of the Tartas-1 area in the Baraba forest-steppe. The site is represented by two housing buildings and a set of special pits intended for fish fermentation. The peculiar dishes, stone and bone tools, as well as the ritual burials of animals (treasure troves/offerings), made it possible to speak about a previously unknown culture of the Neolithic era called the Baraba Neolithic culture. The necropolises of various chronological periods were periodically constructed in the settlement area. The primary aim of the study was to compile the most complete summary of these burials showing the relative chronology of these objects. The Neolithic burial is the earliest. According to the radiocarbon dating, it dates back to the middle of the 5th millennium BC. This date is much later than the set of early dates received at the Neolithic site, the layer of which the burial cuts. The specificity of the burial practice does not allow making direct analogies with the famous Neolithic burial grounds. This may indicate the future identification of a special cultural and chronological layer, which may have occurred in the Neolithic era of this region. One burial is related to the early-developed Bronze Age (the Odinov culture), as evidenced by the specifics of the burial practice and the inventory. The relative chronology of this burial is clearly emphasized by the fact that the grave was cut by the burial of the Andronovo (Fedorovo) culture. The remaining 18 burials belong to the Andronovo (Fedorovo) culture. Two funeral complexes belong to the same period. Two rows of graves are traced; they are located along the edge of the terrace, parallel to each other. Two funeral complexes, in which the grave was surrounded by an intermittent ring-shaped ditch, are integrated in the upper row system. A distinctive feature of this area of the Andronovo cemetery is the presence of children’s and adults’ graves at the same time. Children’s burials are not planographically differentiated. There are both single and collective tombs. The accompanying inventory found in the graves is common to the Andronovo (Fedorovo) complexes; these are ceramic vessels, bronze cast biconical beads, temple rings, sewn plaques, as well as drilled astragali. The investigated funeral complexes include 20 burials and architectural structures (ditches) accompanying individual burials. To varying degrees, these complexes cut the cultural layer of the Neolithic site and have a later chronological position.

NEW RESULTS OF DIRECT RADIOCARBON AMS DATING OF THE POTTERY FROM THE BUH-DNISTER SUB-NEOLITHIC СULTURE

Traditional ideas about the origin of the Buh-Dnister Culture (BDC) and its synchronisation with the Neolithic cultures of the Danube-Carpathian region were questioned by series of radiocarbon dates measured on bones at the Kyiv laboratory in the 1998—2004. To start addressing this problem, 11 AMS dates on organic inclusions in the ceramic paste and charred residues on the surface of vessels were obtained at the Tokyo University laboratory. The set of new dates has given a wide scatter of their values within the entire period outlined by the previous BDC dates. Moreover, the two results of the second quarter of the 7th millennium BC for the Hlynske 1 and Bazkiv Ostriv site are beyond it and may potentially be the oldest dates of the culture. However, analysis of the samples in terms of carbon content, their susceptibility to the influence of the freshwater reservoir effect, correspondence to the stratigraphy of the sites and typology of materials detected only six more credible dates. Their order on the timeline coincides with generally accepted ideas about the sequence of existence of the different BDC pottery types. The youngest is the vessel of the Savran type from Shumyliv-Cherniatka has yielded two dates falling into the range of 4723—4491 cal BC, when the Trypillia culture bearers already populat the region. Two vessels of the Samchyntsi type from Bazkiv Ostriv yield three dates within the range of 5288—4847 cal BC, which corresponds to their finding next to fragments of fine «music-note» bowls of the Linear Band Pottery Culture. The Skybyntsi type vessel from Bazkiv Ostriv yield the oldest plausible date of 5621—5514 cal BC, which corresponds to the age of the Criş monuments in Moldova. Unfortunately, the new dates did not shed light on the issues of the time and direction of the first pottery spreading in the region. Thus, this needs further research including reliably direct radiocarbon dating on pottery.

The soft commodities multiple bubbles tests: evidence from the New York Futures Markets

ABSTRACT The soft commodity is a high-frequency trading market. We use the right-tailed unit root tests of Phillips et al. to investigate asset bubbles within and to detect explosive episodes on each soft commodity sample date set. Our empirical test uses weekly data from New York soft commodity market and finds bubbles existed in each of the soft commodities. The test model allows us to exam each bubble’s origination and termination dates using date-stamping in the recursive procedure. We found that the soft commodities bubble is more relevant to the man-made factor.

LIBYA: Election Date Set

Africa Research Bulletin: Political, Social and Cultural SeriesVolume 57, Issue 11 p. 22952A-22953A National Security LIBYA: Election Date Set First published: 20 December 2020 https://doi.org/10.1111/j.1467-825X.2020.09763.x Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume57, Issue11December 2020Pages 22952A-22953A RelatedInformation

Dielectric, elastic and piezoelectric properties of single domain Pb(Zn1/3Nb2/3)O3–6.5%PbTiO3 single crystal with 3m symmetry measured using one sample

In order to use finite element simulation to design electromechanical devices, self-consistent full tensor material properties are needed. The IEEE resonance technique usually requires more than 5 different geometry samples to complete the full tensor characterization, but the poling degree will depend on the sample geometry in relaxor-base ferroelectric single crystals. Hence, it is very difficult to obtain self-consistent full tensor properties using multiple samples. In this study, we used only one sample to determine the whole set of materials properties for single domain PZN–6.5%PT single crystals by combining the ultrasonic pulse-echo (UPE) method and the resonance ultrasonic spectroscopy (RUS) for the elastic and piezoelectric coefficients and the impedance analyzer for dielectric measurements. Comparison with other reported results show the advantage of our methodology and such self-consistent date set would facilitate fundamental studies on domain engineering technique as well as device design optimization using finite element software.

Direct dating reveals the early history of opium poppy in western Europe

This paper aims to define the first chrono-cultural framework on the domestication and early diffusion of the opium poppy using small-sized botanical remains from archaeological sites, opening the way to directly date minute short-lived botanical samples. We produced the initial set of radiocarbon dates directly from the opium poppy remains of eleven Neolithic sites (5900–3500 cal BCE) in the central and western Mediterranean, northwestern temperate Europe, and the western Alps. When possible, we also dated the macrobotanical remains originating from the same sediment sample. In total, 22 samples were taken into account, including 12 dates directly obtained from opium poppy remains. The radiocarbon chronology ranges from 5622 to 4050 cal BCE. The results show that opium poppy is present from at least the middle of the sixth millennium in the Mediterranean, where it possibly grew naturally and was cultivated by pioneer Neolithic communities. Its dispersal outside of its native area was early, being found west of the Rhine in 5300–5200 cal BCE. It was introduced to the western Alps around 5000–4800 cal BCE, becoming widespread from the second half of the fifth millennium. This research evidences different rhythms in the introduction of opium poppy in western Europe.

Effectiveness of Comprehensive Newborn Screening Program of Sickle Cell Disease on the Childhood Morbidity and Mortality of the Disease: A Systematic Review and Meta-Analysis

Sickle cell disease is a multisystem disorder associated with severe complications and premature death. To address the morbidity, disability, and mortality of inherited disorders, the implementation of newborn screening programmes are considered pivotal public health service intervention. Due to ethical consideration there are no RCTs that prove the benefits of comprehensive newborn screening (Lees, Davies and Dezateux, 2000). However, many evidences suggested early diagnosis and treatment can improve outcomes and survival of patients (Gaston et al., 1986; King et al., 2007). As such, an economic analysis reviewed many studies, cited that the pre-clinical diagnosis of SCD had twofold cost-effectiveness compared to symptomatic diagnosis (Grosse, Olney and Baily, 2005). The aim of this study was to assess the impact of the newborn screening program on the morbidity and mortality of disease among the children by assembling results from cohort studies. DESIGN AND METHODS The systematic review was performed in accordance with the PRISMA guidelines. Medline, EMBASE, and Cochrane Library were searched for cohort studies that addressed the sickle cell disease morbidity and mortality of the disease among children will consider eligible. The phenomena of interest were mortality, infection, stroke PICO have been translated to keywords and MeSH terms with search limit under 18 years old and date set until July 2020. Two reviewers assessed the quality of included cohort studies individually using Newcastle-Ottawa scale (NOS). Subsequently, the data were extracted in Microsoft Word. In case of disagreement, were settled by discussion. The incidence rates per 100 patient year and 95% confidence intervals were pooled to random-effects meta-analysis using RevMan5.4. Studies' heterogeneity identified by chi-squared test and the I2 statistic. RESULTS Eight studies included that met inclusion criteria two studies were from USA (Quinn et al., 2008 and Gill et al., 1995) , 1 from UK (Telfer et al., 2007), 1 from Belgium(Lê et al., 2010), 1 from Jamaica (King et al 2007), 1 from Africa (Rahimy et al, 2003), 1 from India (Upadhye et al., 2016) and 1 from Brazil (Rezende et al., 2018). The total number of participants in the 8 cohort studies were 2377 SCD patients (mean 297.1 and SE 73.9), that includes patients with the four common SCD genotypes: HbSS, HbSC, Hb Sβ+ and HbSβ0. The median age was 6.5 year (IQR: 4.95), with 9623 total years of follow up. The pooled incidence rate of SCD associated mortality per 100 patient year was 0.65 (95%CI 0.35-0.94; I2= 89%; p < 0.00001). While the infection incidence rate 17.74 (95%CI; 11.57-23.91; I2= 100%; p< 0.00001), Stroke 1.04(95% CI 0.60-1.47; I2= 78%; p< 0.0001), Acute chest syndrome 12.55(95% CI; 7.70-17.41; I2 =97%; p< 0.00001), Acute splenic sequestration crisis 1.95 (95% CI 1.31-2.59; I2= 69%; p=0.003) and Vaso-occlusive crisis 52.45(95% CI 45.67-59.14; I2= 92%; p< 0.00001). DISCUSSION In this systematic review and meta-analysis combining 8 cohort studies, pooled mortality rate was 0.65 per 100 patient-year, similar to (0.64) meta-analysis of 15 studies reported previously (Wastnedge, 2018). Furthermore, our study reported that the total infection rate was 17.7 per 100 patient-year. However, this result of infection cannot be considered a true gold standard and due to the variation in definitions used and other methodological heterogeneity. For example, Africa-based cohort study reported 23.2 per 100 patient-year attacks of malaria and fatal pneumococcal meningitis despite the use of antimalarial prophylaxis and anti-pneumococcal vaccine (Rahimy et al., 2003). Another notable result, Hemoglobin SC cohort study stated that the incidence of infections was, 62.2 episodes (59.8-64.6) per 100 patient-years. They assumed that might be due to higher impaired splenic function in HbSC patients compared to HbSS (Rezende et al., 2018). CONCLUSION This first systematic review and meta-analysis of cohort studies provided evidence supporting the sickle cell newborn screening program. However, still infection and pain episodes are the highest incidence symptoms. Despite children survival increasingly improved, disease burden remains at a peak in developing countries. One limitation of this study is high heterogeneity and this mainly due to countries disparity of included studies and variance in definition of events, particularly infection. Table Disclosures Inusa: Novartis: Honoraria, Other: Steering committee participation, Research Funding, Speakers Bureau; Global Blood Therapeutics: Honoraria, Other: Steering committee participation, Research Funding, Speakers Bureau; Bluebird bio: Research Funding; AstraZeneca: Honoraria, Other: Steering committee participation, Research Funding, Speakers Bureau; Vertex: Research Funding.