Association of insurance disparities and survival in adults with multiple myeloma: A non-concurrent cohort study

Background: Multiple myeloma (MM) accounts for 10 % of all hematological malignancies. As recent advances in MM treatment continue to improve survival rates, socioeconomic barriers need to be identified to ensure equal treatment. This study evaluates the association between insurance status and survival in patients with MM. Methods: This study analyzed patients with MM from the 2007?2016 Surveillance, Epidemiology, and End Results (SEER) Program database. Insurance status was categorized as uninsured, Medicaid, private insurance, and other insurance. Cancer-specific survival was measured at one- and five-years post diagnosis. Results: From 2007?2016, there were 41,846 patients with MM extracted from the SEER database. Those with private insurance had a higher proportion of participants that identified as married (65.5 %), resided in metropolitan cities (90.1 %), and identified as white (76 %) and non-Hispanic (90.8 %). The uninsured group had the highest proportion of Black participants compared to other insurance groups (37.4 %). After adjustment for age, sex, race, ethnicity, marital status, and residence, the likelihood of five-year survival was significantly lower in those respondents with Medicaid (adjusted (adj) Hazard Ratio (HR): 1.44; 95 % Confidence Interval (CI): 1.36-1.53), when compared with private insurance holders. Those who were uninsured had a 26 % increased mortality hazard than those with private insurance (95 % CI 1.04-1.53). Conclusion: After adjustment, insurance status can influence the survival of adults with MM. As treatment modalities for MM continue to advance, the insurance status of a patient should not hinder their ability to receive the most effective and timely therapies.Peer reviewe

A publicidade na sociedade de consumo e os influenciadores digitais

A sociedade de consumo contemporânea, caracterizada por métodos de produção padronizada e em massa, em que a oferta excede a procura, vem levando os fornecedores a adotar estratégias de publicidade para estimular o aumento do consumo, com o intuito de permitir-lhes o escoamento permanente desses produtos e serviços. Com isso, investem em estudos acerca do comportamento dos consumidores e em publicidade com o intuito de moldar os hábitos de consumo das pessoas. O problema a ser enfrentado no artigo é identificar os limites éticos e legais para a publicidade feita pelos influenciadores digitais.  Pretende-se demonstrar o estímulo dos influenciadores no comportamento de compra dos consumidores, a importância da publicidade na sociedade de consumo e as normas legais que tratam das ações de publicidade no Código de Defesa do Consumidor (CDC) e no Conselho de Auto-regulamentação Publicitária (CONAR). O artigo utiliza o método hipotético-dedutivo para analisar as normas consumeristas, a fim de verificar os limites da publicidade frente ao CDC, tendo em vista o poder de persuasão da publicidade invisível realizada pelos influenciadores sobre os seus seguidores. O artigo está estruturado da seguinte forma: No capítulo 1 será tradado da importância da publicidade nas sociedades de consumo. No capítulo 2 será analisado como o CDC trata da publicidade, suas formas e vedações. No capítulo 3 será abordada a publicidade invisível realizada pelos influenciadores digitais. Conclui-se, ao final, que a publicidade feita pelos influenciadores digitais não pode ser invisível, devendo observar os princípios da identificação, da veracidade e não abusividade

A função normativa da Organização Mundial da Saúde– OMS e as recomendações para o enfrentamento da pandemia do Covid-19

A Carta da Organização das Nações Unidas determinou a criação de organismos internacionais especializados, com competências específicas, dentre os quais se destaca a Organização Mundial da Saúde (OMS). A organização da saúde surgiu em 1948 a partir de um consenso sobre a necessidade de cooperação mundial para reerguer a dignidade humana e combater a proliferação de doenças nos mais diversos países. A pandemia causada pela Covid-19 ampliou a necessidade de se buscar soluções globais para problemas de saúde. Assim, utilizando-se do método dedutivo de abordagem e, segundo os mo­delos descritivo e explicativo, o objetivo deste artigo é destacar como as organizações internacionais, notadamente a OMS, fazem parte do direito internacional contemporâneo e são o resultado do aumento das relações internacionais e da necessidade da cooperação entre os Estados. O que se pretende demonstrar é existência da função normativa da OMS (em sentido amplo), especialmente no tocante a obrigatoriedade de observância pelos países dela integrantes. Ao final, conclui-se que as organizações internacionais têm o papel de coordenar os sujeitos do direito internacional em torno de questões específicas, estimulando a cooperação internacional. Que a OMS pode emitir convenções e regulamentos com efeitos vinculantes (hard law) e recomendações não obrigatórias (soft law). Que as recomendações temporárias para o enfrentamento da Covid-19, apesar de não obrigatórias, devem ser observadas pela comunidade internacional, havendo uma expectativa de que os Estados as cumpram, pois baseadas na melhor evidência científica disponível

Child-OIDP index in Brazil: Cross-cultural adaptation and validation

Background: Oral health-related quality of life (OHRQoL) measures are being increasingly used to introduce dimensions excluded by normative measures. Consequently, there is a need for an index which evaluates children's OHRQoL validated for Brazilian population, useful for oral health needs assessments and for the evaluation of oral health programs, services and technologies. The aim of this study was to do a cross-cultural adaptation of the Child Oral Impacts on Daily Performances (Child-OIDP) index, and assess its reliability and validity for application among Brazilian children between the ages of eleven and fourteen. Methods: For cross-cultural adaptation, a translation/back-translation method integrated with expert panel reviews was applied. A total of 342 students from four public schools took part of the study. Results: Overall, 80.7% of the sample reported at least one oral impact in the last three months. Cronbach's alpha was 0.63, the weighted kappa 0.76, and the intraclass correlation coefficient (ICC) 0.79. The index had a significant association with self-reported health measurements (self-rated oral health, satisfaction with oral health, perceived dental treatment needs, self-rated general health; all p < 0.01). Conclusion: It was concluded that the Child-OIDP index is a measure of oral health-related quality of life that can be applied to Brazilian children

A de Sitter Hoedown

Rotating black holes in de Sitter space are known to have interesting limits where the temperatures of the black hole and cosmological horizon are equal. We give a complete description of the thermal phase structure of all allowed rotating black hole configurations. Only one configuration, the rotating Nariai limit, has the black hole and cosmological horizons both in thermal and rotational equilibrium, in that both the temperatures and angular velocities of the two horizons coincide. The thermal evolution of the spacetime is shown to lead to the pure de Sitter spacetime, which is the most entropic configuration. We then provide a comprehensive study of the wave equation for a massless scalar in the rotating Nariai geometry. The absorption cross section at the black hole horizon is computed and a condition is found for when the scattering becomes superradiant. The boundary-to-boundary correlators at finite temperature are computed at future infinity. The quasinormal modes are obtained in explicit form. Finally, we obtain an expression for the expectation value of the number of particles produced at future infinity starting from a vacuum state with no incoming particles at past infinity. Some of our results are used to provide further evidence for a recent holographic proposal between the rotating Nariai geometry and a two-dimensional conformal field theory.Comment: 35 + 1 pages, 9 figures; v3: typos correcte

Dirac Equation with Spin Symmetry for the Modified P\"oschl-Teller Potential in DD-dimensions

We present solutions of the Dirac equation with spin symmetry for vector and scalar modified P\"oschl-Teller potential within framework of an approximation of the centrifugal term. The relativistic energy spectrum is obtained using the Nikiforov-Uvarov method and the two-component spinor wavefunctions are obtain are in terms of the Jacobi polynomials. It is found that there exist only positive-energy states for bound states under spin symmetry, and the energy levels increase with the dimension and the potential range parameter $\alpha$.Comment: 9 pages and 1tabl

Aharonov-Bohm interferences from local deformations in graphene

One of the most interesting aspects of graphene is the tied relation between structural and electronic properties. The observation of ripples in the graphene samples both free standing and on a substrate has given rise to a very active investigation around the membrane-like properties of graphene and the origin of the ripples remains as one of the most interesting open problems in the system. The interplay of structural and electronic properties is successfully described by the modelling of curvature and elastic deformations by fictitious gauge fields that have become an ex- perimental reality after the suggestion that Landau levels can form associated to strain in graphene and the subsequent experimental confirmation. Here we propose a device to detect microstresses in graphene based on a scanning-tunneling-microscopy setup able to measure Aharonov-Bohm inter- ferences at the nanometer scale. The interferences to be observed in the local density of states are created by the fictitious magnetic field associated to elastic deformations of the sample.Comment: Some bugs fixe

Laser-induced etching of few-layer graphene synthesized by Rapid-Chemical Vapour Deposition on Cu thin films

The outstanding electrical and mechanical properties of graphene make it very attractive for several applications, Nanoelectronics above all. However a reproducible and non destructive way to produce high quality, large-scale area, single layer graphene sheets is still lacking. Chemical Vapour Deposition of graphene on Cu catalytic thin films represents a promising method to reach this goal, because of the low temperatures (T < 900 Celsius degrees) involved during the process and of the theoretically expected monolayer self-limiting growth. On the contrary such self-limiting growth is not commonly observed in experiments, thus making the development of techniques allowing for a better control of graphene growth highly desirable. Here we report about the local ablation effect, arising in Raman analysis, due to the heat transfer induced by the laser incident beam onto the graphene sample.Comment: v1:9 pages, 8 figures, submitted to SpringerPlus; v2: 11 pages, PDFLaTeX, 9 figures, revised peer-reviewed version resubmitted to SpringerPlus; 1 figure added, figure 1 and 4 replaced,typos corrected, "Results and discussion" section significantly extended to better explain etching mechanism and features of Raman spectra, references adde