Endogenous rates of time preference in monetary growth models: stability and comparative dynamics

Two optimal monetary growth models are analyzed. In the first (Model C), the rate of time preference is assumed constant; and in the other (Model V) the rate of time preference is endogenous;In Model C, the constancy of the rate of time preference is found to drive the long-run super-neutrality of money in the model. Changes in (theta), the growth rate of money supply, have no long-run effects on the real sector. The long-run capital-labor ratio is such that its marginal product is the sum of the rate of time preference, the growth rate of the population, and the rate of capital depreciation. A change in (theta) does not affect these parameters, leaving the long-run capital-labor ratio unchanged;In Model V, changes in (theta) are not neutral in the long-run. The endogeneity of the rate of time preference allows changes in (theta) to affect the optimality condition for the long-run capital-labor ratio. An increase in (theta) increases the long-run (steady state) values of the capital-labor ratio and consumption;In both models, the increase in (theta) increases the long-run inflation rate, reducing the real rate of return on holding real money balances; this induces agents to hold less money at the new steady state. In Model C, the reduction in holdings of money is all that happens in the long-run. However, in Model V the rate of time preference provides a link between the monetary and real sectors of the economy; agents are induced, through adjustments in the rate of time preference, to shift from the asset with the relatively lower real rate of return (money) to that with the relatively higher real rate of return (capital);Also, in both models the increase in (theta) lowers the long-run achievable utility level. However, the reduction in utility is smaller in Model V. Stability analysis shows that both models display saddle point behavior

Disparities in Obstetric, Neonatal, and Birth Outcomes Among Syrian Women Refugees and Jordanian Women

Objectives: To compare obstetric and neonatal characteristics and birth outcomes between Syrian refugees and native women in Jordan.Methods: We used the Jordan Stillbirths and Neonatal Deaths Surveillance System to extract sociodemographic and obstetric characteristics of the mothers and birth characteristics of newborns. Multivariate analysis was used to compare the characteristics of 26,139 Jordanian women (27,468 births) and 3,453 Syrian women refugees (3,638 births) who gave birth in five referral hospitals (May 2019 and December 2020).Results: The proportions of low birthweight (14.1% vs. 11.8%, p < 0.001) and small for gestational age (12.0% vs. 10.0%, p < 0.001) newborns were significantly higher for those born to Syrian women compared to those born to Jordanian women. The stillbirth rate (15.1 vs. 9.9 per 1,000 births, p = 0.003), the neonatal death rate (21.2 vs. 13.2 per 1,000 live births, p < 0.001), and perinatal death rate (21.2 vs. 13.2 per 1,000 births, p < 0.001) were significantly higher for the Syrian births. After adjusting for sociodemographic and obstetric characteristics of women, only perinatal death was statistically significantly higher among Syrian babies compared to Jordanian babies (OR = 1.3, 95% CI: 1.1–1.7, p = 0.035).Conclusion: Syrian refugee mothers had a significantly higher risk of adverse obstetric and neonatal outcomes including higher rate of perinatal death compared to Jordanian women

The Incidence of Pulmonary Embolism and Associated FDG-PET Findings in IV Contrast-Enhanced PET/CT

Rationale and objectivesMost fluorine-18 fluorodeoxyglucose (FDG)-positron emission tomography with computed tomography (PET/CT) studies are performed on cancer patients. These patients are at increased risk of pulmonary embolism (PE). In this retrospective review, we determined the rate of PE, and the prevalence of associated FDG-PET findings on intravenous (IV) contrast-enhanced PET/CT.Materials and methodsWe identified all PET/CT studies performed at our institution with a reported finding of PE between January 2005 and October 2012. The medical record was reviewed for symptoms, which were identified after the diagnosis of PE, and whether the patients received treatment. The prevalence of associated FDG-PET findings was determined.ResultsA total of 65 total cases of PE (of 182,72 total PET/CT examinations) were identified of which 59 were previously unknown. This gives an incidental PE (IPE) rate of 0.32%. Of the patients where sufficient clinical information was available, 34 of 36 (94%) were treated either with therapeutic anticoagulation or inferior vena cava filter, and 30 of 36 (83%) were asymptomatic in retrospect. Of the patients with IPE, we found nine (15.2%) with associated focal pulmonary artery hypermetabolism, three (5.1%) with hypermetabolic pulmonary infarction, and one with increased isolated right ventricular FDG uptake (1.7%). One case of chronic PE demonstrated a focal hypometabolic filling defect in a pulmonary artery on PET.ConclusionsWe found IPE in 0.32% of PET/CT scans. Focal pulmonary artery hypermetabolism or hypometabolism, and hypermetabolic pulmonary artery infarction with the "rim sign" were uncommonly associated with PE. These findings could raise the possibility of IPE in non-IV contrast-enhanced PET/CT studies

Proteomics Mapping of Cord Blood Identifies Haptoglobin “Switch-On” Pattern as Biomarker of Early-Onset Neonatal Sepsis in Preterm Newborns

Intra-amniotic infection and/or inflammation (IAI) are important causes of preterm birth and early-onset neonatal sepsis (EONS). A prompt and accurate diagnosis of EONS is critical for improved neonatal outcomes. We sought to explore the cord blood proteome and identify biomarkers and functional protein networks characterizing EONS in preterm newborns.We studied a prospective cohort of 180 premature newborns delivered May 2004-September 2009. A proteomics discovery phase employing two-dimensional differential gel electrophoresis (2D-DIGE) and mass spectrometry identified 19 differentially-expressed proteins in cord blood of newborns with culture-confirmed EONS (n = 3) versus GA-matched controls (n = 3). Ontological classifications of the proteins included transfer/carrier, immunity/defense, protease/extracellular matrix. The 1(st)-level external validation conducted in the remaining 174 samples confirmed elevated haptoglobin and haptoglobin-related protein immunoreactivity (Hp&HpRP) in newborns with EONS (presumed and culture-confirmed) independent of GA at birth and birthweight (P<0.001). Western blot concurred in determining that EONS babies had conspicuous Hp&HpRP bands in cord blood ("switch-on pattern") as opposed to non-EONS newborns who had near-absent "switch-off pattern" (P<0.001). Fetal Hp phenotype independently impacted Hp&HpRP. A bayesian latent-class analysis (LCA) was further used for unbiased classification of all 180 cases based on probability of "antenatal IAI exposure" as latent variable. This was then subjected to 2(nd)-level validation against indicators of adverse short-term neonatal outcome. The optimal LCA algorithm combined Hp&HpRP switch pattern (most input), interleukin-6 and neonatal hematological indices yielding two non-overlapping newborn clusters with low (≤20%) versus high (≥70%) probability of IAI exposure. This approach reclassified ∼30% of clinical EONS diagnoses lowering the number needed to harm and increasing the odds ratios for several adverse outcomes including intra-ventricular hemorrhage.Antenatal exposure to IAI results in precocious switch-on of Hp&HpRP expression. As EONS biomarker, cord blood Hp&HpRP has potential to improve the selection of newborns for prompt and targeted treatment at birth

Lancet

BACKGROUND: In 2015, the second cycle of the CONCORD programme established global surveillance of cancer survival as a metric of the effectiveness of health systems and to inform global policy on cancer control. CONCORD-3 updates the worldwide surveillance of cancer survival to 2014. METHODS: CONCORD-3 includes individual records for 37.5 million patients diagnosed with cancer during the 15-year period 2000-14. Data were provided by 322 population-based cancer registries in 71 countries and territories, 47 of which provided data with 100% population coverage. The study includes 18 cancers or groups of cancers: oesophagus, stomach, colon, rectum, liver, pancreas, lung, breast (women), cervix, ovary, prostate, and melanoma of the skin in adults, and brain tumours, leukaemias, and lymphomas in both adults and children. Standardised quality control procedures were applied; errors were rectified by the registry concerned. We estimated 5-year net survival. Estimates were age-standardised with the International Cancer Survival Standard weights. FINDINGS: For most cancers, 5-year net survival remains among the highest in the world in the USA and Canada, in Australia and New Zealand, and in Finland, Iceland, Norway, and Sweden. For many cancers, Denmark is closing the survival gap with the other Nordic countries. Survival trends are generally increasing, even for some of the more lethal cancers: in some countries, survival has increased by up to 5% for cancers of the liver, pancreas, and lung. For women diagnosed during 2010-14, 5-year survival for breast cancer is now 89.5% in Australia and 90.2% in the USA, but international differences remain very wide, with levels as low as 66.1% in India. For gastrointestinal cancers, the highest levels of 5-year survival are seen in southeast Asia: in South Korea for cancers of the stomach (68.9%), colon (71.8%), and rectum (71.1%); in Japan for oesophageal cancer (36.0%); and in Taiwan for liver cancer (27.9%). By contrast, in the same world region, survival is generally lower than elsewhere for melanoma of the skin (59.9% in South Korea, 52.1% in Taiwan, and 49.6% in China), and for both lymphoid malignancies (52.5%, 50.5%, and 38.3%) and myeloid malignancies (45.9%, 33.4%, and 24.8%). For children diagnosed during 2010-14, 5-year survival for acute lymphoblastic leukaemia ranged from 49.8% in Ecuador to 95.2% in Finland. 5-year survival from brain tumours in children is higher than for adults but the global range is very wide (from 28.9% in Brazil to nearly 80% in Sweden and Denmark). INTERPRETATION: The CONCORD programme enables timely comparisons of the overall effectiveness of health systems in providing care for 18 cancers that collectively represent 75% of all cancers diagnosed worldwide every year. It contributes to the evidence base for global policy on cancer control. Since 2017, the Organisation for Economic Co-operation and Development has used findings from the CONCORD programme as the official benchmark of cancer survival, among their indicators of the quality of health care in 48 countries worldwide. Governments must recognise population-based cancer registries as key policy tools that can be used to evaluate both the impact of cancer prevention strategies and the effectiveness of health systems for all patients diagnosed with cancer. FUNDING: American Cancer Society; Centers for Disease Control and Prevention; Swiss Re; Swiss Cancer Research foundation; Swiss Cancer League; Institut National du Cancer; La Ligue Contre le Cancer; Rossy Family Foundation; US National Cancer Institute; and the Susan G Komen Foundation

Experience of Menarche Among Jordanian Adolescent Girls: An Interpretive Phenomenological Analysis

Study Objective: Menarche is a significant physical and emotional experience for adolescent girls, especially in certain cultures, where it is viewed as a rite of passage, affecting the meaning of lived experiences. The purpose of the study was to explore the menarche experience among Jordanian adolescent girls when they reach menarche. Design: Interpretive phenomenological analysis. Setting: Az-Zarqa City, Jordan. Participants, Interventions, and Main Outcome Measures: A homogenous sample of 7 Jordanian girls, ages 12-14 years, who had their first menstruation within the past 6 months. Participants were asked to narrate their experiences through journal writing; their reports to be used for interpretive phenomenological analyses by 2 independent researchers, to ensure the findings' trustworthiness. Results: Three major themes emerged as: (1) menstruation as a forbidden topic; (2) keeping the "topic" to oneself; and (3) no more secrets. Each theme was characterized according to distinct sets of emotions and knowledge-seeking patterns because Jordanian culture and Islamic teachings had greatly influenced the girls' experience of menarche. Menarche was considered a social taboo; not to be openly discussed. At the first signs of menarche, participants were shocked, scared, confused, and anxious. They had limited information and support from their family or school system. Therefore, they relied on self-perceptions about menarche, and viewed the experience of menstruation with profound negative emotions. Participants hesitated to share their experiences with their mothers and close friends. They felt alone and experienced their emotional turmoil in isolation and without support. Conclusion: Jordanian adolescent girls need formal health education to understand and manage the reproductive changes that occur in their bodies