Short-term outcomes associated with temozolomide or PCV chemotherapy for 1p/19q-codeleted WHO grade 3 oligodendrogliomas: a national evaluation

Background The optimal chemotherapy regimen between temozolomide and procarbazine, lomustine, and vincristine (PCV) remains uncertain for W.H.O. grade 3 oligodendroglioma (Olig3) patients. We therefore investigated this question using national data. Methods Patients diagnosed with radiotherapy-treated 1p/19q-codeleted Olig3 between 2010-2018 were identified from the National Cancer Database. The OS associated with first-line single-agent temozolomide vs. multi-agent PCV was estimated by Kaplan-Meier techniques and evaluated by multivariable Cox regression. Results 1,596 radiotherapy-treated 1p/19q-codeleted Olig3 patients were identified: 88.6% (n=1,414) treated with temozolomide and 11.4% (n=182) with PCV (from 5.4% in 2010 to 12.0% in 2018) in the first-line setting. The median follow-up was 35.5 months (interquartile range [IQR] 20.7-60.6 months) with 63.3% of patients alive at time of analysis. There was a significant difference in unadjusted OS between temozolomide (5yr-OS 58.9%, 95%CI: 55.6-62.0) and PCV (5yr-OS 65.1%, 95%CI: 54.8-73.5; p=0.04). However, a significant OS difference between temozolomide and PCV was not observed in the Cox regression analysis adjusted by age and extent of resection (PCV vs. temozolomide HR 0.81, 95%CI: 0.59-1.11, p=0.18). PCV was more frequently used for younger Olig3s, but otherwise was not associated with patient’s insurance status or care setting. Conclusions In a national analysis of Olig3s, first-line PCV chemotherapy was associated with a slightly improved unadjusted short-term OS compared to temozolomide; but not following adjustment by patient age and extent of resection. There has been an increase in PCV utilization since 2010. These findings provide preliminary data while we await the definitive results from the CODEL trial.

Cross-national structure of economic competence: Insights from a German and Russian assessment

In this paper, we present a study, which models and measures the competencies of higher education students in business and economics—within and across countries. To measure student competencies in a valid and reliable way, the Test of Understanding in College Economics was used, which assesses microeconomic and macroeconomic competencies. The test was translated into several languages and adapted for different university contexts. In the presented study, the test contents were also compared with regard to the educational standards and the university curricula in Russia and Germany. Our findings from the cross-national analysis suggest one strong general factor of economic competence, which encompasses micro- and macroeconomic dimensions. This points to a stronger interconnection between learning and understanding economic contents than previous research suggests and indicates far-reaching curricular and instructional consequences for higher education economics as well as needs for further research, which are discussed in this paper.

A Bolder Conservation Future for Indonesia: Conserving Biodiversity, Carbon And Unique Ecosystem In Sulawesi

As more ambitious protected area (PA) targets for the post-2020 global biodiversity framework is set beyond Aichi Target 11, new spatial prioritisation thinking is required to expand protected areas to maximise different environmental values. Our study focuses on the biodiversity and forest-rich Indonesian island of Sulawesi, which has a terrestrial PA network that covers 10% of the island. We run scenarios to identified areas outside the current PA network and their representativeness of conservation features. We use Marxan to investigate trade-offs in the design of a larger PA network with varying coverage targets (17%, 30%, and 50%) that prioritises forest area, karst ecosystem, and carbon value as conservation features. Our first scenario required PAs to be selected at all times, and it required larger areas to meet these targets than our second scenario, which did not include existing PAs. The vast Mekongga, Banggai, and Popayato-Paguat landscapes were consistently identified as high priorities for protection in the various scenarios. The final section of our analysis used a spatially explicit three-phase approach to achieve this through PA expansion, the creation of new PAs, and the creation of corridors to connect existing PAs. Our findings identified 13,039 km2 of priority areas to be included in the current PA network, potentially assisting Indonesia in meeting the post-2020 GBF target if our approach is replicated elsewhere across Indonesia as a national or sub-national analysis like this study. We discuss various land management options through OECMs and the costs to deliver this strategy.

A National Analysis of Inpatient Pediatric Adenoidectomy

Objective: Hospital admission following pediatric adenoidectomy without tonsillectomy is not well characterized. The objective of our study is to better characterize risk factors for post-operative complications in younger children undergoing inpatient adenoidectomy. Methods: A cross-sectional analysis using data derived from the Kid’s Inpatient Database (KID) was performed. Study participants included children <3 years of age who underwent an adenoidectomy and were admitted to hospitals participating in the KID for years 1997, 2000, 2003, 2006, 2009, and 2012. Descriptive statistical analysis and a multivariate logistic regression analysis were performed to identify risk factors for post-operative complication. Results: A total of 3406 children (mean age 1.1 ± 0.7 years) were included. The overall post-operative bleeding and respiratory complication rates were 0.6% and 5.4%, respectively. Children less than 18 months of age demonstrated increased rates of post-operative respiratory complications ( P = .009), but not bleeding complications ( P = .857). Presence of cardiopulmonary congenital malformations (OR 1.54, 95% CI 1.07-2.20), chronic respiratory disease of the newborn (OR 5.03, 95% CI 2.86-8.85), and neuromuscular disorders (OR 1.97, 95% CI 1.09-3.57) were associated with post-operative respiratory distress. Conclusions: This analysis of a national dataset suggests that otherwise healthy children less than 18 months of age and children 18 months to 3 years of age with certain comorbidities may benefit from overnight observation following adenoidectomy.

Does Environmental Regulation Promote Industrial Green Technology Progress? Empirical Evidence from China with a Heterogeneity Analysis

The complex relationship between environmental regulation and green technology progress has always been a hot topic of research, especially in developing countries, where the impact of environmental regulation is important. Current research is mainly concerned with the impact of the single environmental regulation on technological progress and lacks study on the diversity of environmental regulations. The main purpose of this paper is to examine the heterogeneity of the effects of different types of environmental regulation on industrial green technology progress. As China’s scale of economy and pollution emissions are both large, and the government has also made great efforts in environmental regulation, this paper takes China as the example for analyses. We first use the EBM-GML method to measure the industrial green technology progress of 30 provinces in China from 2000 to 2018, and then apply the panel econometric model and threshold model to empirically investigate the influence of 3 types of environmental regulation. The results show that, first, the impacts of environmental regulation on industrial green technology progress are significantly different; specifically, command-based regulation has no direct significant impact, and autonomous regulation has played a positive role, and market-based regulation’s quadratic curve effect is significant, in which the cost-based and investment-based tool presents an inverted U-sharped and U-sharped, respectively. Second, there may be a weak alternative interaction among different types of environmental regulation. Third, a market-based regulatory tool has a threshold effect; with the upgrading of environmental regulation compliance, the effect of a cost-based tool is characterized by “promotion inhibition”, and that of an investment-based tool is “inhibition promotion”. Finally, the results of regional analysis are basically consistent with those of the national analysis. Based on the study, policy enlightenment is put forward to improve regional industrial green technology progress from the perspective of environmental regulation. This paper can provide a useful analytical framework for studying the relationship between environmental regulation and technological progress in a country, especially in developing countries.

Trends in HPV Testing for Patients With Sinonasal Squamous Cell Carcinoma: A National Analysis

Objective The objective of this study was to analyze national trends in human papillomavirus (HPV) testing for patients diagnosed with sinonasal squamous cell carcinoma (SNSCC). Study Design Retrospective database study. Setting National Cancer Database (2010-2016). Methods Cases from 2010 to 2016 with a primary SNSCC diagnosis and known HPV testing status were extracted from the National Cancer Database. Univariate and multivariate analyses were then performed to assess differences in socioeconomic, hospital, and tumor characteristics between tested and nontested patients. Results A total of 2308 SNSCC cases were collected, with 1210 (52.4%) HPV tested and 1098 (47.6%) not tested. On univariate analyses, patient age, insurance, income quartile, population density, treatment facility location, and tumor grade were significantly associated with HPV testing status. After multivariate logistic regression modeling, living in a suburban area had lower odds of HPV testing as compared with living in urban areas (odds ratio, 0.74 [95% CI, 0.55-0.99]; P = .041), while tumor grade III/IV had higher odds than grade I (odds ratio, 1.73 [95% CI, 1.29-2.33]; P < .001). HPV-tested patients had a similar 5-year overall survival to nontested patients (48.3% vs 45.3%, log-rank P = .405). A sharp increase in HPV testing rates was observed after 2010 ( P < .001). Conclusion Among patients with SNSCC, those with high-grade tumors were more likely to be tested for HPV, while patients with a suburban area of residence were less likely. Additionally, there was no significant survival benefit to HPV testing, with tested and nontested groups having similar overall survival. Level of evidence 4.

The World Bank and Healthcare Reforms: A Cross‐National Analysis of Policy Prescriptions in South America

Recent literature on comparative welfare states has recognised the central role international financial institutions (IFIs) play in shaping social policy. Particularly in low‐ and middle‐income countries (LMICs), where constraints often lead to reliance on foreign resources, IFIs can act as agenda‐setters, transferring their ideas to vulnerable governments. The neoliberal model promoted by IFIs at the end of the 20th century reveals their influence on domestic policy in South America. This study analyses the impact of World Bank (WB) prescriptions on healthcare reform legislation in five South American countries: Argentina, Bolivia, Colombia, Paraguay, and Peru. In doing so, it attempts to answer the following questions: Are LMICs receptive to IFIs’ healthcare system prescriptions? More precisely, have WB policy prescriptions been adopted in healthcare reform legislation in South American countries? If so, in what way? Through content analysis, this study examines domestic healthcare legislation vis‐à‐vis the WB’s prescriptions. The main findings show that countries are receptive to IFIs prescriptions, making them a legitimate source of policy recommendations. Further, the results suggest a correlation between economic development and reliance on foreign resources and the degree to which countries adhere to IFIs prescriptions.

Urbanization, the Youth, and Protest: A Cross-National Analysis

Demographic changes associated with the transformation from traditional to advanced economies are the basis for many of today’s theories of violent and non-violent protest formation. Both levels of urbanization and the size of the “youth bulge” have shown to be reliable measures for predicting protest events in a country. As these two processes result from modernization, it seems logical to hypothesize that the combined effect of the rise in urbanization and the increase in the youth population, urban youth bulge, would be a more relevant predictor for protests. Our tests on cross-national time-series data from 1950 to 2010 for 98 countries reveal that the combined effect of the two forces is an important predictor of anti-government protests. It may seem that the role of the urban youth bulge would appear to be an issue of the past as in more recent decades the proportion of the urban youth tends to decline in most countries of the world. However, this factor tends to be very relevant for many developing countries where both youth bulges have been growing for several decades and the general urban population is on the rise.