Concentration indices of income related self-reported health: a meta-regression analysis

Proliferating evidence reporting on standardised cross-country concentration indexes of income related self-reported health is increasingly being used for policy evaluation. Nonetheless, limited efforts have been put forward to examine the extent to which such evidence is subject to any specific methodological and publication biases, given that studies rely upon survey data form different samples and both heterogeneous health system institutions and empirical strategies. We conduct the first study drawing upon appropriate statistical methods to examine the presence of publication bias in the health economics literature measuring health inequalities of self-reported health. We test for other biases including the effect of precision estimates based on meta-regression analysis (MRA). We account for a set of biases in estimates of income-related health inequalities that rely on concentration index-related methods and self-reported health measures. Our findings suggest evidence of publication bias that primarily depends on the cardinalisation of self-reported health and some evidence of study-specific precision

A new scenario for string unification

We present a new scenario for gauge coupling unification in flipped SU(5) string models, which identifies the $M_{32}$ scale of SU(3) and SU(2) unification with the empirical $M_{\rm LEP}\sim10^{15-16}$~GeV scale, and the $M_{51}$ scale of SU(5) and U(1) unification with the theoretical $M_{\rm string}\sim5\times10^{17}$~GeV string unification scale. The vacuum shift necessary for the cancellation of the anomalous $\rm U_A(1)$ and an SU(4) hidden sector with fractionally-charged particles, play a crucial role in the dynamical determination of all intermediate mass scales in this scenario.Comment: 8 pages, LaTeX, 2 figures (uuencoded

Experimental aspects of SU(5)xU(1) supergravity

We study various aspects of $SU(5)\times U(1)$ supergravity as they relate to the experimental verification or falsification of this model. We consider two string-inspired, universal, one-parameter, no-scale soft-supersymmetry-breaking scenarios, driven by the $F$-terms of the moduli and dilaton fields. The model is described in terms of the supersymmetry mass scale (\ie, the chargino mass $m_{\chi^\pm_1}$), $\tan\beta$, and the top-quark mass. We first determine the combined effect on the parameter space of all presently available direct and indirect experimental constraints, including the LEP lower bounds on sparticle and Higgs-boson masses, the $b\to s\gamma$ rate, the anomalous magnetic moment of the muon, the high-precision electroweak parameters $\epsilon_1,\epsilon_b$ (which imply m_t\lsim180\GeV), and the muon fluxes in underground detectors (neutrino telescopes). For the still-allowed points in $(m_{\chi^\pm_1},\tan\beta)$ parameter space, we re-evaluate the experimental situation at the Tevatron, LEPII, and HERA. In the 1994 run, the Tevatron could probe chargino masses as high as 100 GeV. At LEPII the parameter space could be explored with probes of different resolutions: Higgs boson searches, selectron searches, and chargino searches. Moreover, for m_t\lsim150\GeV, these Higgs-boson searches could explore all of the allowed parameter space with \sqrt{s}\lsim210\GeV.Comment: latex, 36 pages, 25 figures (not included). Figures are available via anonymous ftp from hplaa02.cern.ch (/pub/lopez) as either 33 ps files (Easpects*.ps, 8.1MB) or one uuencoded file (AllFigures.uu, 3.7MB

Use of generic medicines in Latvia : Awareness, opinions and experiences of the population

Funding Information: Funding was provided by EEA Financial Mechanism and Latvian state (award number 2012.EEZ/DAP/MIC/183). The project is financially supported by Iceland, Liechtenstein and Norway. Publisher Copyright: © 2019 The Author(s).Background: To stimulate use of generic medicines a combination of supply and demand side mechanisms are employed in the Latvian reimbursement system. It is reported that patients have high out-of-pocket pharmaceutical spending and that they overpay by not choosing generic medicines. Patient preferences may be an important obstacle in implementing generic policy. Objective of this study was to assess awareness, opinions and experience of the Latvian population regarding use of generic medicines. Methods: Survey of representative sample of the population of Latvia (n = 1005) aged 18-74 was conducted in March 2015. The survey was distributed in Latvian and Russian languages using Computer Assisted Web Interviews. Associations between experience with generic medicines, preference for medicines, and sociodemographic variables were tested with Pearson Chi-square statistics. Associations between the previous experience and information given by different sources versus choice between medicines were tested with Spearman's correlation test. Results: 72.3% of the population were informed about generic medicines. Men (66.9%) and respondents with primary or secondary education (58.3%; 69.3%) were less informed compared to total (72.3%). From those who recalled using generic medicines (n = 441), 94.4% evaluated their experience as positive or neutral. Despite this, only 21% of the population would opt for generic medicines. The strongest preference for brand-name medicines was in the age group > 55 (40.5%). Opinion of a physician was the most important factor when choosing between generic and brand-name medicines (88.7%). The more positive the information provided by general practitioners, physician specialists, pharmacists, family members, friends and internet is perceived, the more likely respondents are to choose generic medicines (p < 0.001). Conclusion: This study demonstrates that people in Latvia are aware of generic medicines but only a minority of the population would choose them when presented with a choice. It is therefore important that health care professionals provide objective and unbiased information about generic medicines to their patients. Interventions should aim to reach groups that are less informed and to improve providers' understanding and communication with patients about generics.publishersversionPeer reviewe

A structured review of long-term care demand modelling

Long-term care (LTC) represents a significant and substantial proportion of healthcare spends across the globe. Its main aim is to assist individuals suffering with more or more chronic illnesses, disabilities or cognitive impairments, to carry out activities associated with daily living. Shifts in several economic, demographic and social factors have raised concerns surrounding the sustainability of current systems of LTC. Substantial effort has been put into modelling the LTC demand process itself so as to increase understanding of the factors driving demand for LTC and its related services. Furthermore, such modeling efforts have also been used to plan the operation and future composition of the LTC system itself. The main aim of this paper is to provide a structured review of the literature surrounding LTC demand modeling and any such industrial application, whilst highlighting any potential direction for future researchers

Nucleophile-Catalyzed Additions to Activated Triple Bonds. Protection of Lactams, Imides, and Nucleosides with MocVinyl and Related Groups

Additions of lactams, imides, (S)-4-benzyl-1,3-oxazolidin-2-one, 2-pyridone, pyrimidine-2,4-diones (AZT derivatives), or inosines to the electron-deficient triple bonds of methyl propynoate, tert-butyl propynoate, 3-butyn-2-one, N-propynoylmorpholine, or N-methoxy-N-methylpropynamide in the presence of many potential catalysts were examined. DABCO and, second, DMAP appeared to be the best (highest reaction rates and E/Z ratios), while RuCl3, RuClCp*(PPh3)2, AuCl, AuCl(PPh3), CuI, and Cu2(OTf)2 were incapable of catalyzing such additions. The groups incorporated (for example, the 2-(methoxycarbonyl)ethenyl group that we name MocVinyl) serve as protecting groups for the above-mentioned heterocyclic CONH or CONHCO moieties. Deprotections were accomplished via exchange with good nucleophiles: the 1-dodecanethiolate anion turned out to be the most general and efficient reagent, but in some particular cases other nucleophiles also worked (e.g., MocVinyl-inosines can be cleaved with succinimide anion). Some structural and mechanistic details have been accounted for with the help of DFT and MP2 calculations

Publication and related biases in health services research: a systematic review of empirical evidence

Background: Publication and related biases (including publication bias, time-lag bias, outcome reporting bias and p-hacking) have been well documented in clinical research, but relatively little is known about their presence and extent in health services research (HSR). This paper aims to systematically review evidence concerning publication and related bias in quantitative HSR. Methods: Databases including MEDLINE, EMBASE, HMIC, CINAHL, Web of Science, Health Systems Evidence, Cochrane EPOC Review Group and several websites were searched to July 2018. Information was obtained from: (1) Methodological studies that set out to investigate publication and related biases in HSR; (2) Systematic reviews of HSR topics which examined such biases as part of the review process. Relevant information was extracted from included studies by one reviewer and checked by another. Studies were appraised according to commonly accepted scientific principles due to lack of suitable checklists. Data were synthesised narratively. Results: After screening 6155 citations, four methodological studies investigating publication bias in HSR and 184 systematic reviews of HSR topics (including three comparing published with unpublished evidence) were examined. Evidence suggestive of publication bias was reported in some of the methodological studies, but evidence presented was very weak, limited in both quality and scope. Reliable data on outcome reporting bias and p-hacking were scant. HSR systematic reviews in which published literature was compared with unpublished evidence found significant differences in the estimated intervention effects or association in some but not all cases. Conclusions: Methodological research on publication and related biases in HSR is sparse. Evidence from available literature suggests that such biases may exist in HSR but their scale and impact are difficult to estimate for various reasons discussed in this paper. Systematic review registration: PROSPERO 2016 CRD42016052333

First narrow-band search for continuous gravitational waves from known pulsars in advanced detector data

Spinning neutron stars asymmetric with respect to their rotation axis are potential sources of continuous gravitational waves for ground-based interferometric detectors. In the case of known pulsars a fully coherent search, based on matched filtering, which uses the position and rotational parameters obtained from electromagnetic observations, can be carried out. Matched filtering maximizes the signalto- noise (SNR) ratio, but a large sensitivity loss is expected in case of even a very small mismatch between the assumed and the true signal parameters. For this reason, narrow-band analysis methods have been developed, allowing a fully coherent search for gravitational waves from known pulsars over a fraction of a hertz and several spin-down values. In this paper we describe a narrow-band search of 11 pulsars using data from Advanced LIGO’s first observing run. Although we have found several initial outliers, further studies show no significant evidence for the presence of a gravitational wave signal. Finally, we have placed upper limits on the signal strain amplitude lower than the spin-down limit for 5 of the 11 targets over the bands searched; in the case of J1813-1749 the spin-down limit has been beaten for the first time. For an additional 3 targets, the median upper limit across the search bands is below the spin-down limit. This is the most sensitive narrow-band search for continuous gravitational waves carried out so far

Sex and gender differences in acute stroke care: metrics, access to treatment and outcome. A territorial analysis of the Stroke Code System of Catalonia

Introduction: Previous studies have reported differences in the management and outcome of women stroke patients in comparison with men. We aim to analyze sex and gender differences in the medical assistance, access to treatment and outcome of acute stroke patients in Catalonia. Patients and methods: Data were obtained from a prospective population-based registry of stroke code activations in Catalonia (CICAT) from January/2016 to December/2019. The registry includes demographic data, stroke severity, stroke subtype, reperfusion therapy, and time workflow. Centralized clinical outcome at 90 days was assessed in patients receiving reperfusion therapy. Results: A total of 23,371 stroke code activations were registered (54% men, 46% women). No differences in prehospital time metrics were observed. Women more frequently had a final diagnosis of stroke mimic, were older and had a previous worse functional situation. Among ischemic stroke patients, women had higher stroke severity and more frequently presented proximal large vessel occlusion. Women received more frequently reperfusion therapy (48.2% vs 43.1%, p < 0.001). Women tended to present a worse outcome at 90 days, especially for the group receiving only IVT (good outcome 56.7% vs 63.8%; p < 0.001), but not for the group of patients treated with IVT + MT or MT alone, although sex was not independently associated with clinical outcome in logistic regression analysis (OR 1.07; 95% CI, 0.94–1.23; p = 0.27) nor in the analysis after matching using the propensity score (OR 1.09; 95% CI, 0.97–1.22). Discussion and conclusion: We found some differences by sex in that acute stroke was more frequent in older women and the stroke severity was higher. We found no differences in medical assistance times, access to reperfusion treatment and early complications. Worse clinical outcome at 90 days in women was conditioned by stroke severity and older age, but not by sex itself