Measuring Spatial Distribution in the Banking System in Hungary

Over the past decade, due in part to the global economic crisis, a significant part of the bank branches have been closed in the European banking system, but in Hungary this proportion has been significantly higher than the European average. Therefore, the aim of the present study is to explore what aspects of commercial banks are taken into account when deciding where to be present within bank branches. This will also reveal the spatial dimension of public access to financial services. The present study seeks to answer the question of which socio-economic factors and in what form they affect the spatial structure of bank branches. The settlement-level examination can also provide additional indication of which settlements may be affected by further bank branch closures. Linear regression based on Ordinary Least Squares (OLS) parameter estimation was used to explore the factors influencing the location of bank branches. In addition, the possible clustering of bank branches was observed, i.e., whether spatial autocorrelation was present at certain stages of the analysis. Geographically Weighted Regression (GWR) was also estimated in the present study. Based on the results of the research, the resident population, the proportion of enterprises per capita, the average income, the number of neighbouring bank branches and the type of settlement all proved to be significant factors that may encourage decision-makers to establish a bank branch.

Anticoagulants after Discharge in Patients with COVID-19: What we Know at the End of 2021

This review discusses reasons for prolonged use of anticoagulants after discharge of patients with COVID-19 without additional indication for anticoagulation. Data regarding rate of thrombotic and thromboembolic complications in patients with COVID-19 after discharge from the hospital are presented. Large randomized controlled trials EXCLAIM, ADOPT, MAGELLAN, APEX and MARINER with prolonged use of anticoagulants in patients hospitalized with acute nonsurgical diseases before pandemia of COVID-19 are discussed. The first prospective randomized controlled trial MICHELLE with direct oral anticoagulant rivaroxaban in a dose 10 mg once daily after discharge of patients with COVID-19 with high risk at least venous thromboembolism are analyzed. It seems that the most relevant approach for the determination of indications for prolonged use of anticoagulants in doses dedicated for primary prevention of venous thromboembolism after discharge of patients with COVID-19 without apparent indication for anticoagulation is a modified IMPROVE VTE risk score with the addition of elevated in-hospital D-dimer level. And the most well-studied approach for anticoagulation in these patients is a direct peroral anticoagulant rivaroxaban 10 mg once daily for 35 (and possibly up to 45) days after discharge.

Comparison of Higher-Than-Standard to D-Dimer Driven Thromboprophylaxis in Hospitalized Patients With COVID-19

Introduction: Coronavirus disease 2019 is a global health threat often accompanied with coagulopathy. Despite use of thromboprophylaxis in this population, thrombotic event rates are high. Materials and methods: This was a multicenter, retrospective cohort study comparing the safety and effectiveness of thromboprophylaxis strategies at 2 institutions in hospitalized patients with coronavirus disease 2019. Regimen A utilized a higher-than-standard thromboprophylaxis dosage and Regimen B received full-dose anticoagulation for any D-dimer 3 mcg/mL or greater and prophylactic for less than 3 mcg/mL. The primary outcome compared the rate of thrombotic events between treatment groups. Secondary endpoints compared rates of major or clinically relevant non-major bleeding as well as the proportion of patients in each group experiencing thrombotic events within 30 days of discharge. Results: One-hundred fifty-three patients were included in the analysis, 64 receiving Regimen A and 89 receiving Regimen B. Seven (4.6%) thrombotic events occurred, 3 (4.7%) in patients receiving Regimen A, and 4 (4.5%) in Regimen B ( P = 1.0). Twelve patients (13.5%) receiving Regimen B had a bleeding event versus 2 (3.1%) in Regimen A ( P = .04), half of which were major in each group. All patients who bled in either treatment group were receiving mechanical ventilation, and 12 of 14 were receiving full-dose anticoagulation. One patient receiving Regimen A was readmitted with a pulmonary embolism. Conclusions: In this study, the thromboprophylactic regimen impacted bleeding, but no significant difference was seen with thrombotic outcomes. Almost all patients who experienced a bleed were mechanically ventilated and receiving full-dose anticoagulation. The use of full-dose anticoagulation should be cautioned in this population without an additional indication.

Relationships between developmental strategies for additional indications and price revisions for anticancer drugs in Japan

Background The relationships between developmental strategies for additional indications and drug price revisions have not been thoroughly studied. Here, we investigated the price revisions for anticancer drugs approved in Japan. Methods The study was based on published information on anticancer drugs approved between January 2009 and March 2020 in Japan. We investigated the relationships between the pharmacological and regulatory characteristics of anticancer drugs and occurrence/non-occurrence of the Japanese National Health Insurance (NHI) price revisions. Results Eighty-one new anticancer drugs were given NHI price listings during the survey. On April 1, 2020, the prices of 23 anticancer drugs had been revised from the initial pricing, the prices were reduced for 21 drugs (91.3%). Several parameters showed the relationships between drug characteristics and NHI price revisions. The achievement of additional indications and compound type were identified as explanatory factors for these relationships. Additional indication profiles were defined to assess the relationships between the methods for additional indication achievement and price revisions. When the type of additional indication was “Expansion”, the percentage of drugs received NHI price revisions was the highest (P<0.001). Conclusions NHI price revision was significantly related to the achievement of additional indications and compound type. The strategy for additional indications was found to affect the occurrence/non-occurrence of NHI price revisions.

Relationships between Developmental Strategies for Additional Indications and Price Revisions for Anticancer Drugs in Japan

Background The relationships between developmental strategies for additional indications and drug price revisions have not been thoroughly studied. Here, we investigated the price revisions for anticancer drugs approved in Japan. Methods The study was based on published information on anticancer drugs approved between January 2009 and March 2020 in Japan. We investigated the relationships between the pharmacological and regulatory characteristics of anticancer drugs and occurrence/non-occurrence of the Japanese National Health Insurance (NHI) price revisions. Results Eighty-one new anticancer drugs were given NHI price listings during the survey. On April 1, 2020, the prices of 23 anticancer drugs had been revised from the initial pricing, the prices were reduced for all, except for one drug. Several parameters showed the relationships between drug characteristics and NHI price revisions. The achievement of additional indications and compound type were identified as explanatory factors for these relationships. Additional indication profiles were defined to assess the relationships between the methods for additional indication achievement and price revisions. For the 32 drugs with additional indications, the relationships between the additional indication profiles and occurrence/non-occurrence of NHI price revision were investigated. The proportion of drugs with NHI price revisions was higher if the additional indication had more patients than if the additional indications had approximately the same numbers of patients or fewer patients. Conclusions NHI price revision was significantly related to the achievement of additional indications and compound type. The strategy for additional indications was found to affect the occurrence/non-occurrence of NHI price revisions.

Variability and trends of the surface solar spectral ultraviolet irradiance in Italy: a possible influence of lower and upper stratospheric ozone trends

In this study the short- and long-term variability of the surface spectral solar ultraviolet (UV) irradiance are investigated over Italy using high quality ground based measurements from three sites located at quite different environmental conditions, and covering the full latitudinal extent of the Italian territory: Aosta (45.7° N, 7.4° E, 570 m a.s.l.), Rome (41.9° N, 12.5° E, 75 m a.s.l.), and Lampedusa (35.5° N, 12.6° E, 50 m a.s.l.). The variability of the irradiances at 307.5 nm, 324 nm, and of the ratio between the 307.5 nm and the 324 nm irradiances were investigated with respect to the corresponding variability in total ozone and the geopotential height at 250 hPa (GPH). The study was performed for two periods: 2006–2020 for all stations, and 1996–2020 only for Rome. A statistically significant correlation between the GPH and total ozone monthly anomalies was found for all stations and all seasons of the year. A corresponding statistically significant correlation was also found in most cases between the GPH and the 307.5 nm irradiance monthly anomalies. The correlation between GPH anomalies at different sites was statistically significant, possibly explaining the strong and significant correlation between the total ozone monthly anomalies at the three sites. A statistically significant decrease of total ozone, of ~0.1 %/year was found for Rome for the period 1996–2020, which however did not induce increasing trends in irradiance at 307.5 nm (neither increasing trends in the ratio between the 307.5 nm and the 324 nm irradiances) at SZA = 67°. Further analyses revealed positive trends in the ratio and the 307.5 nm irradiance at smaller solar zenith angles (SZA), which can be attributed to the fact that total ozone decrease is driven by a decrease in the lower stratosphere while upper stratospheric ozone increases, and the effect of changes of upper stratospheric ozone becoming disproportionately larger for increasing SZA. It was also showed that long-term changes in total ozone follow changes in GPH, which is an additional indication that negative trends in total ozone are mainly driven by changes in lower stratospheric ozone. An anti-correlation between the GPH long-term changes and total ozone was also evident for all stations in 2006–2020. Positive trends in UV irradiance for this latter period which were possibly driven by changes in clouds and/or aerosols were found for Rome and Aosta. This study clearly points out the significance of dynamical processes which take place in the troposphere for the variability of total ozone and surface solar UV irradiance.

Relationships between Developmental Strategies for Additional Indications and Price Revisions for Anticancer Drugs in Japan

Background The relationships between developmental strategies for additional indications and drug price revisions have not been thoroughly studied. Here, we investigated the price revisions for anticancer drugs approved in Japan. Methods The study was based on published information on anticancer drugs approved between January 2009 and March 2020 in Japan. We investigated the relationships between the pharmacological and regulatory characteristics of anticancer drugs and occurrence/non-occurrence of the Japanese National Health Insurance (NHI) price revisions. Results Eighty-one new anticancer drugs were given NHI price listings during the survey. On April 1, 2020, the prices of 23 anticancer drugs had been revised from the initial pricing, the prices were reduced for all, except for one drug. Several parameters showed the relationships between drug characteristics and NHI price revisions. The achievement of additional indications and compound type were identified as explanatory factors for these relationships. Additional indication profiles were defined to assess the relationships between the methods for additional indication achievement and price revisions. For the 32 drugs with additional indications, the relationships between the additional indication profiles and occurrence/non-occurrence of NHI price revision were investigated. The proportion of drugs with NHI price revisions was higher if the additional indication had more patients than if the additional indications had approximately the same numbers of patients or fewer patients. Conclusions NHI price revision was significantly related to the achievement of additional indications and compound type. The strategy for additional indications was found to affect the occurrence/non-occurrence of NHI price revisions.

Determination of Duration of the Intensive Phase of Chemotherapy for Respiratory Tuberculosis in Children without Bacterial Excretion and at No Risk of Multiple and Extensive Drug Resistance

The objective of the study: to develop criteria to evaluate the duration of the intensive phase of chemotherapy for respiratory tuberculosis in children without bacterial excretion and at no risk of multiple and extensive drug resistance of tuberculous mycobacteria.Subjects and methods. Totally, 93 patients with newly diagnosed respiratory tuberculosis without bacterial excretion and at no risk of multiple and extensive drug resistance of tuberculous mycobacteria. Their age varied from 2 to 12 years old. Regimen III was used: the intensive phase – 4 drugs (isoniazid, rifampicin, pyrazinamide, ethambutol – HRZE).Results. The intensive phase lasted for 2 months in 39.8% of cases – the main criteria were achieved (relief of intoxication symptoms, normal blood rates, positive or stable CT changes) after 2 months and there was no indication to extend the duration of it. The intensive phase lasted for 3 months in 37.6% of cases – the main criteria were achieved after 2 months and there was at least one additional indication to extend it (17.2%); and the main criteria were achieved after 3 months and there was no indication to extend the duration of it (20.4%). The intensive phase lasted for more than 3 months (4 to 6 months) in 22.6% of cases – the main criteria were achieved after 3 months and there was at least one additional indication to extend it (12.9%), as well as in the case of failure to achieve the main criteria after 3 months regardless of the presence/absence of additional indications to extend its duration (9.7%).Conclusion. Various combinations of the main criteria and additional indications made the basis for differential approach to determining the duration of the intensive phase of chemotherapy in children with respiratory tuberculosis

Cyclists' Perception of Maintenance and Operation of Cycling Infrastructure—Results From a Norwegian Survey

The Norwegian authorities want to limit the extent of car use in city areas to existing levels. Such a limitation would help combat climate change, improve health of citizens, and alleviate congestion. This implies that any further increase in transport needs will have to be met by walking, cycling and use of public transport. Reaching this ambitious goal requires knowledge about cyclists' preferences concerning operation and maintenance (M&amp;O) of roads and foot/cycle paths. Previous research suggests that M&amp;O have great implications for travel mode choice, bicycle route/path choice, safety, security, and comfort. With the need to serve bicyclists of all ages and genders, this study additionally explores which M&amp;O of roads and foot/cycle the different demographic groups perceive positively or negatively. This article reports results from a nationwide survey in the summer of 2019. Two thousand three hundred seventy-six cyclists across Norway (55% male; 29% &lt;40; 17% &gt;60) participated to determine the cyclists' perceptions about year-round M&amp;O of roads and foot/cycle paths. Respondents, rather than being randomly selected, completed an internet-linked survey. The variables included maintenance of foot/cycle paths in terms of salt and snow plowing and operation and maintenance of roads in terms of glass, holes/bumps, and conditions. Our results suggest that female cyclists suffer more from adverse conditions than do males. We also find that males are more likely to cycle during winter, which is an additional indication that adverse conditions affect women and men differently. Surprisingly, older cyclists report to be less affected by poor conditions than younger cyclists. Self-selection to participate in the survey among older cyclists might be an important explanation for this result. Cycling conditions vary greatly between geographical areas, reflecting the large climatic variations across Norway. Most respondents have experienced a cycle accident where conditions contributed, and many sometimes forfeit cycling due to adverse conditions. Implications for future research and practice of M&amp;O are discussed.

Physcomitrium patens Mutants in Auxin Conjugating GH3 Proteins Show Salt Stress Tolerance but Auxin Homeostasis Is Not Involved in Regulation of Oxidative Stress Factors

Salt stress is among the most challenging abiotic stress situations that a plant can experience. High salt levels do not only occur in areas with obvious salty water, but also during drought periods where salt accumulates in the soil. The moss Physcomitrium patens became a model for studying abiotic stress in non-vascular plants. Here, we show that high salt concentrations can be tolerated in vitro, and that auxin homeostasis is connected to the performance of P. patens under these stress conditions. The auxin levels can be regulated by conjugating IAA to amino acids by two members of the family of GH3 protein auxin amino acid-synthetases that are present in P. patens. Double GH3 gene knock-out mutants were more tolerant to high salt concentrations. Furthermore, free IAA levels were differentially altered during the time points investigated. Since, among the mutant lines, an increase in IAA on at least one NaCl concentration tested was observed, we treated wild type (WT) plants concomitantly with NaCl and IAA. This experiment showed that the salt tolerance to 100 mM NaCl together with 1 and 10 µM IAA was enhanced during the earlier time points. This is an additional indication that the high IAA levels in the double GH3-KO lines could be responsible for survival in high salt conditions. While the high salt concentrations induced several selected stress metabolites including phenols, flavonoids, and enzymes such as peroxidase and superoxide dismutase, the GH3-KO genotype did not generally participate in this upregulation. While we showed that the GH3 double KO mutants were more tolerant of high (250 mM) NaCl concentrations, the altered auxin homeostasis was not directly involved in the upregulation of stress metabolites.