Larsontranberg4231

of the HIVST programme into CSO activities, this model shows large potential for substantial economies of scale. Further research will assess the overall cost-effectiveness of this model.Background The pneumococcal vaccine has been considered as the most effective measure to prevent pneumococcal diseases. In 2013, Shanghai launched a major public health program to vaccinate people aged 60 years or older with 23-Valent Pneumococcal Polysaccharide Vaccine (PPSV-23) free of charge. By the end of June 2020, a total of 1.56 million old people had been vaccinated free of charge. Objective To evaluate the cost-effectiveness of PPSV-23 vaccination program in Shanghai from the health system perspective. Methods According to the actual number of people aged 60 years or older with PPSV-23 vaccination in Shanghai from 2013 to 2018, a multi-cohort Markov model for life-time was developed to compare health and economic outcomes of vaccinated people vs. if they were not vaccinated for PPSV-23. Cost effectiveness was reported as incremental cost effectiveness ratio (ICER). A 5% discount rate was used for both costs and health outcomes. In addition, one-way sensitivity analysis was used to test the model's robustness. Results By the end of 2018, a total of 1,091,967 people aged 60 years or older were vaccinated with PPSV-23 in Shanghai, China. Comparing with the unvaccinated circumstances, PPSV-23 vaccination would cost US $19.62 million more and receive an additional 10,321.3 quality-adjusted life-year (QALY). PPSV-23 was associated with the ICER of $190.1 per QALY gained. The Results were sensitive to the variation of vaccine effectiveness against community-acquired pneumonia (CAP), and disease incidence, mortality, and costs of CAP. In all sensitivity analysis, the PPSV-23 was economical. Conclusion The PPSV-23 vaccination program in Shanghai was cost-effective. With the further development of the project, the administrative costs of the vaccine will be reduced, making it more cost-effective.Glyphosate is the most commonly used herbicide around the world, which led to its accumulation in the environment and consequent ubiquitous human exposure. Glyphosate is marketed in numerous glyphosate-based herbicide formulations (GBHs) that include co-formulants to enhance herbicidal effect of the active ingredient, but are declared as inert substances. However, these other ingredients can have biologic activity on their own and may interact with the glyphosate in synergistic toxicity. In this study, we focused to compare the cytogenetic effect of the active ingredient glyphosate and three marketed GBHs (Roundup Mega, Fozat 480, and Glyfos) by investigating cytotoxicity with fluorescent co-labeling and WST-1 cell viability assay as well as genotoxicity with cytokinesis block micronucleus assay in isolated human mononuclear white blood cells. Glyphosate had no notable cytotoxic activity over the tested concentration range (0-10,000 μM), whereas all the selected GBHs induced significant cell death from 1,000 e fact that GBHs are still currently in use, the toxicity of which rivals that of POEA-containing formulations (e.g., Glyfos) already banned in Europe. Hence, it is advisable to subject them to further comprehensive toxicological screening to assess the true health risks of exposed individuals, and to reconsider their free availability to any users.Introduction Social or physical distancing has been an effective measure for reducing the spread of COVID-19 infections. Investigating the determinants of adherence to social distancing can inform public health strategies to improve the behaviour. However, there is a lack of data in various populations. This study investigates the degree to which South Africans complied with social distancing during the country's COVID-19 lockdown and identifies the determinants associated with being in close contact with large numbers of people. Materials and Methods Data was collected from a South African national online survey on a data free platform, supplemented with telephone interviews. The survey was conducted from 8 to 29 April 2020. The primary outcome was the number of people that participants came into close contact with (within a 2-metre distance) the last time they were outside their home during the COVID-19 lockdown. Multivariate multinomial regression investigated the socio-demographic, psychosocial and househistancing regulations. Public health communication, interventions and policy can be tailored to address these determinants of social distancing.Although many studies have addressed the consequences of cyberbullying on mental health in secondary school, there is a lack of research in primary education. Moreover, most students who are cybervictims also suffer from traditional bullying, and studies on cyberbullying do not always control for the effects of the latter. The aim of our study is therefore to address the possible effects of cyberbullying on different aspects of the life and behavior of students in Years 3 to 6 of primary school. The sample consisted of 636 students attending 38 schools, as well as their parents. Children responded to a bullying and a cyberbullying questionnaire (the EBIPQ and ECIPQ, respectively), and their parents responded to three questionnaires the Strengths and Difficulties Questionnaire (SDQ), a sociodemographic questionnaire, and one on children's experiences related to bullying and cyberbullying. The results reveal that 14.4% of the children, mostly boys, had suffered at least one online aggression in the previous 2 months. Most of them were also victims of traditional bullying. In this latter group, no differences were found between the SDQ scores reported by cybervictims and those reported by non-cybervictims. In contrast, those cybervictims who were not victims of traditional bullying displayed more difficulties in relation to Conduct problems, Externalizing problems, Home-life impact, and Total difficulties on the SDQ scales. Our results show that cyberbullying affects children's lives as early as primary school, and especially boys, even in children who do not suffer from traditional bullying.Objective Fetus-in-fetu (FIF) is an extremely rare disease, and most prior publications are single case reports. Here, we describe the clinical characteristics, imaging manifestations, and the treatment and related complications of FIF from a large tertiary pediatric referral center. Materials After institutional review board approval, patients with a diagnosis of FIF between January 2010 and November 2019 were further selected and reexamined. We analyzed the general clinical characteristics, imaging manifestations, treatment, and prognosis of the patients. Results A total of seven (four male and three female) patients with FIF were included in the study. All patients were diagnosed with FIF during the antenatal ultrasound examination along with an abnormal increase in alpha fetoprotein, and it was confirmed by subsequent pathological examination. The median gestation period when FIF was first diagnosed was 25 (range 22-32) weeks. Ultrasound, computed tomography, and magnetic resonance imaging were the main pre-operative diagnostic techniques used. All patients underwent FIF resection within 1 month after birth four patients had open surgery and three had laparoscopic surgeries (one case was converted to open surgery); only one patient developed ascites after surgery. All patients are growing up healthy and without tumor recurrence at the last follow-up. The level of alpha fetoprotein decreased to normal within 1 year (range 3-10 months) after surgery performed. Conclusion As the size of the FIF increases, it can be found and diagnosed in antenatal ultrasound examination. Surgery is an important curative treatment for FIF and generally results in excellent long-term quality of life.Background Newborn screening for congenital adrenal hyperplasia (CAH-NBS) is not yet a worldwide consensus, in part due to inconclusive evidence regarding cost-effectiveness because the analysis requires an understanding of the short- and long-term costs of care associated with delayed diagnosis. Objective The present study aimed to conduct a cost-effectiveness analysis (CEA) to compare the costs associated with CAH-NBS and clinical diagnosis. Methods A decision model comparing the two strategies was tested by sensitivity analysis. The cost analysis perspective was the public health system. Unscreened patients' data were extracted from medical records of Hospital das Clinicas, Saõ Paulo, and screened data were extracted from the NBS Referral Center of São Paulo. The population comprised 195 classical patients with CAH, clinically diagnosed and confirmed by hormonal/CYP21A2 analysis, and 378,790 newborns screened during 2017. Adverse outcomes related to late diagnosis were measured in both cohorts, and the incremental cost-effectiveness ratio (ICER) was calculated. We hypothesized that CAH-NBS would be cost-effective. Results Twenty-five screened infants were confirmed with CAH (incidence 115,135). The mortality rate was estimated to be 11% in unscreened infants, and no deaths were reported in the screened cohort. Comparing the unscreened and screened cohorts, mean serum sodium levels were 121.2 mEq/L (118.3-124.1) and 131.8 mEq/L (129.3-134.5), mean ages at diagnosis were 38.8 and 17 days, and hospitalization occurred in 76% and 58% of the salt-wasting patients with the in the two cohorts, respectively. The NBS incremental cost was US$ 771,185.82 per death averted, which yielded an ICER of US$ 25,535.95 per discounted life-year saved. Conclusions CAH-NBS is important in preventing CAH mortality/morbidity, can reduce costs associated with adverse outcomes, and appears cost-effective.Maternal vaginal/rectal colonization of group B streptococcus (GBS) is a main risk for neonatal invasive infection. Efficient determination of GBS colonization in pregnant women is crucial. This study aimed to investigate the prevalence of GBS carriage and evaluate the diagnostic performance of six methodologies for GBS screening conducted in China, including blood agar plate, liquid chromogenic medium, and loop-mediated isothermal amplification (LAMP) without pre-enrichment, chromogenic agar plate with pre-enrichment, and GBS antigen detection without and with pre-enrichment in comparison with the standard reference method (Lim broth-enriched subculture with plating on 5% sheep blood agar). Vaginal/rectal swabs were collected from 1,281 pregnant women at 35-37 weeks of gestation. Of them, 309 were taken in triplicate, one for Lim broth-enriched subculture, one for blood agar plate, and the third for GBS antigen detection (Reagent W); 177 were acquired in duplicate, one for Lim broth-enriched subculture and t, results can be obtained within 0.5-1 h, while for blood agar plate, which needed 24-48 h, and further identification was required. Our data suggested that the performance of LAMP was highly comparable to the standard Lim broth-enriched subculture and LAMP is considered as an alternative for fast and accurate GBS screening.

MYCN amplification plays a critical role in defining high-risk subgroup of patients with neuroblastoma. We aimed to develop and validate the CT-based machine learning models for predicting MYCN amplification in pediatric abdominal neuroblastoma.

A total of 172 patients with MYCN amplified (n = 47) and non-amplified (n = 125) were enrolled. The cohort was randomly stratified sampling into training and testing groups. this website Clinicopathological parameters and radiographic features were selected to construct the clinical predictive model. The regions of interest (ROIs) were segmented on three-phrase CT images to extract first-, second- and higher-order radiomics features. The ICCs, mRMR and LASSO methods were used for dimensionality reduction. The selected features from the training group were used to establish radiomics models using Logistic regression, Support Vector Machine (SVM), Bayes and Random Forest methods. The performance of four different radiomics models was evaluated according to the area under the receiver operator characteristic (ROC) curve (AUC), and then compared by Delong test.