Exploring drug cost and disease outcome in rheumatoid arthritis patients treated with biologic and targeted synthetic DMARDs in Norway in 2010–2019 – a country with a national tender system for prescription of costly drugs

Background In Norway, an annual tender system for the prescription of biologic and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) has been used since 2007. This study aimed to explore annual b/tsDMARDs costs and disease outcomes in Norwegian rheumatoid arthritis (RA) patients between 2010 and 2019 under the influence of the tender system. Methods RA patients monitored in ordinary clinical practice were recruited from 10 Norwegian centers. Data files from each center for each year were collected to explore demographics, disease outcomes, and the prescribed treatment. The cost of b/tsDMARDs was calculated based on the drug price given in the annual tender process. Results The number of registered RA patients increased from 4909 in 2010 to 9335 in 2019. The percentage of patients receiving a b/tsDMARD was 39% in 2010 and 45% in 2019. The proportion of b/tsDMARDs treated patients achieving DAS28 remission increased from 42 to 67%. The estimated mean annual cost to treat a patient on b/tsDMARDs fell by 47%, from 13.1 thousand euros (EUR) in 2010 to 6.9 thousand EUR in 2019. The mean annual cost to treat b/tsDMARDs naïve patients was reduced by 75% (13.0 thousand EUR in 2010 and 3.2 thousand EUR in 2019). Conclusions In the period 2010–2019, b/tsDMARD treatment costs for Norwegian RA patients were significantly reduced, whereas DAS28 remission rates increased. Our data may indicate that the health authorities’ intention to reduce treatment costs by implementing a tender system has been successful.

Digital Immunity Module: Preventing Unwanted Encryption using Source Coding

Unwanted data encryption, such as ransomware attacks, continues to be a significant cybersecurity threat. Ransomware is a preferred weapon of cybercriminals who target small to large organizations' computer systems and data centres. It is malicious software that infects a victim's computer system and encrypts all its valuable data files. The victim needs to pay a ransom, often in cryptocurrency, in return for a decryption key. Many solutions use methods, including the inspection of file signatures, runtime process behaviors, API calls, and network traffic, to detect ransomware code. However, unwanted data encryption is still a top threat. This paper presents the first immunity solution, called the digital immunity module (DIM). DIM focuses on protecting valuable business-related data files from unwanted encryption rather than detecting malicious codes or processes. We show that methods such as file entropy and fuzzy hashing can be effectively used to sense unwanted encryption on a protected file, triggering our novel source coding method to paralyze the malicious manipulation of data such as ransomware encryption. Specifically, maliciously encrypted data blocks consume exponentially larger space and longer writing time on the DIM-protected file system. As a result, DIM creates enough time for system/human intervention and forensics analysis. Unlike the existing solutions, DIM protects the data regardless of ransomware families and variants. Additionally, DIM can defend against simultaneously active multiple ransomware, including the most recent hard to detect and stop fileless ones. We tested our solution on 39 ransomware families, including the most recent ransomware attacks. DIM successfully defended our sample file dataset (1335 pdf, jpg, and tiff files) against those ransomware attacks with zero file loss.

Digital Immunity Module: Preventing Unwanted Encryption using Source Coding

Unwanted data encryption, such as ransomware attacks, continues to be a significant cybersecurity threat. Ransomware is a preferred weapon of cybercriminals who target small to large organizations' computer systems and data centres. It is malicious software that infects a victim's computer system and encrypts all its valuable data files. The victim needs to pay a ransom, often in cryptocurrency, in return for a decryption key. Many solutions use methods, including the inspection of file signatures, runtime process behaviors, API calls, and network traffic, to detect ransomware code. However, unwanted data encryption is still a top threat. This paper presents the first immunity solution, called the digital immunity module (DIM). DIM focuses on protecting valuable business-related data files from unwanted encryption rather than detecting malicious codes or processes. We show that methods such as file entropy and fuzzy hashing can be effectively used to sense unwanted encryption on a protected file, triggering our novel source coding method to paralyze the malicious manipulation of data such as ransomware encryption. Specifically, maliciously encrypted data blocks consume exponentially larger space and longer writing time on the DIM-protected file system. As a result, DIM creates enough time for system/human intervention and forensics analysis. Unlike the existing solutions, DIM protects the data regardless of ransomware families and variants. Additionally, DIM can defend against simultaneously active multiple ransomware, including the most recent hard to detect and stop fileless ones. We tested our solution on 39 ransomware families, including the most recent ransomware attacks. DIM successfully defended our sample file dataset (1335 pdf, jpg, and tiff files) against those ransomware attacks with zero file loss.

New software package for archival of synoptic And upper air meteorological data

The functions of a software package of 6 programmes developed for retrieving, decoding quality control and formatting of surface and upper air coded data have been presented here in brief. Intelligent use has been made of Fortran- 77 fact1ltles to make these programmes extremely efficient. Global data for surface and upper air received on GTS for an entire day is sorted, decoded & formatted after quality control in about three and a half minutes (CPU time) on VAX 8810 system. The programmes do the management of files and can also be used for decoding the monthly data files of hard copy data. For coding of data, FGGE code has been used with very minor modifications. The results of quality control checks and number of reports received hour wise for each synoptic hour for each WMO block are monitored. Information from both is displayed on the terminal in tabular form and also recorded in disk for monthly archival.

Supplemental Material: Geologic map of Slate Range Crossing area, California, USA

Digital map data files in ArcGIS shapefile format for data collection points, geologic contacts, and geologic unit polygons.

Supplemental Material: Geologic map of Slate Range Crossing area, California, USA

Digital map data files in ArcGIS shapefile format for data collection points, geologic contacts, and geologic unit polygons.

Supplemental Material: Geologic map of central Panamint Range, California, USA

<div>Digital map data files in ArcGIS shapefile format for data collection points, geologic contacts, and geologic unit polygons.<br></div>

Supplemental Material: Geologic map of southern Panamint Valley, southern Panamint Range and central Slate Range, California, USA

<div>Digital map data files in ArcGIS shapefile format for data collection points, geologic contacts, and geologic unit polygons.<br></div>

Feasibility of using death certificates for studying place of death in Latin America

Objective. This paper assesses the availability and quality of death certificate data in Latin America and the feasibility of using these data to study place of death and associated factors. Methods. In this comparative study, we collected examples of current official death certificates and digital data files containing information about all deaths that occurred during 1 year in 19 Latin American countries. Data were collected from June 2019 to May 2020. The records for place of death and associated variables were studied. The criteria for data quality were completeness, number of ill-defined causes of death and timeliness. Results. All 19 countries provided copies of current official death certificates and 18 of these registered the place of death. Distinguishing among hospital or other health care institution, home and other was possible for all countries. Digital data files with death certificate data were available from 12 countries and 1 region. Three countries had data considered to be of high quality and seven had data considered to be of medium quality. Categories for place of death and most of the predetermined factors possibly associated with place of death were included in the data files. Conclusions. The quality of data sets was rated medium to high in 10 countries. Hence, death certificate data make it feasible to conduct an international comparative study on place of death and the associated factors in Latin America.