Kako je epidemija COVID-19 utjecala na upotrebu i tržište droga u Sloveniji?

The purpose of our study was to explore the effect of the COVID-19 epidemic on drug use, the drug market and the availability of help and support in Slovenia. Through an online questionnaire, we collected a non-representative sample of 680 people who used drugs before and during the epidemic in 2020. The results showed the use of illicit drugs and alcohol has reduced. A significant increase in the frequency of use has only been detected in marijuana. The most prominent changes in the drug market were the reduced number of drug dealers and lower availability of certain drugs. Accessibility to drug services has been reduced and respondents also had significant financial consequences due to loss of work. Due to decreased availability of sources of support at the time of the epidemic, adjustments to services for drug users are necessary before the end of the COVID-19 pandemic in terms of promoting online interventions and maintaining contact with users when the services are not physically accessible.Svrha našeg istraživanja bila je istražiti kako je epidemija COVID-19 utjecala na upotrebu droga i tržište droga u Sloveniji. Internetskim upitnikom obuhvatili smo nereprezentativni uzorak od 680 ljudi koji su konzumirali droge prije i tijekom epidemije 2020. Upotreba ilegalnih droga i alkohola smanjena je. Značajno povećanje učestalosti upotrebe zabilježeno je samo s marihuanom. Najistaknutije promjene na tržištu droga bile su pad dilera i manja dostupnost odre- đenih droga. Pristup uslugama za korisnike droga smanjen je, a ispitanici su imali i znatne financijske posljedice zbog gubitka posla. Zbog slabe dostupnosti izvora podrške u vrijeme epidemije, prilagodbe pružatelja usluga korisnicima droga potrebne su prije kraja pandemije, u smislu promicanja internetskih intervencija i održavanja kontakta s korisnicima kada usluge nisu fizički dostupne

Separating groups of uterine electromiographic records with term and pre-term delivery using coherence function

In this thesis we present automatic analysis of electromyogram of uterus (electrohysterogram) using coherence function which is one of non-linear signal processing techniques. We used records of international reference database TPEHG DB (Term-Preterm Electrohysterogram DataBase), which contains 300 electrohysterogram records. We preprocessed signals with nine different band-pass Butterworths filters with forward-backward filtering to avoid zero phase shift. Separation of groups took place in two variants, among early recorded and among late recorded records. We calculated coherence function between all pairs of records for each of variants. For calculation we used power spectrum of signals. Coherence estimation for whole frequency range, was made with two techniques - median amplitude and integral. Analysis of variance or ANOVA showed which frequency ranges and signals are useful for preterm - term records separation. For records classification we used frequency intervals and signals with p-value less than 0,05. Evaluation of classification was made on Bayes classifier, decision trees and our own built classifier. We developed it empirically, based on coherence decreasing among term records from frequency range 1-2,5 Hz to 2,5-3,5 Hz. Performance evaluation of classification is done in three ways - on training set, on the principle of training-testing set and with the approach "omitted one". Best results were shown with decision tree at frequency range 0,3-2,5 Hz, where sensitivity was 95 %, specificity and accuracy were 98 %. With our own developed classifier we reach sensitivity between 58 % and 63 % and specificity between 58 % and 63 %. Classification using Bayes classifier did not show good results, having sensitivity close to 0 %

COVID-19 vaccination intention at the beginning of COVID-19 pandemic in Slovenia

Background: With the successful development and introduction of vaccines to protect against COVID-19 disease, the pandemic is expected to end. The success of a vaccination programme depends on the uptake rates in the Slovenian population and especially among healthcare workers (HCWs), who are at higher risk of infection. Recently, several studies have examined the readiness of different population groups worldwide to be vaccinated. This study compares COVID-19 vaccination intentions between lay people and HCWs, and relationships between socio-demographic characteristics, attitudes and beliefs about COVID-19 vaccination, and vaccination intentions reported in the early stages of epidemics. Methods: A cross-sectional study based on an online survey was performed in Slovenia between 13 and 14 March 2020, when the epidemic was officially announced in the country. Data from 2,494 eligible respondents were analysed. Results: The study has shown that 33.2% of all respondents expressed the intention to get vaccinated against COVID-19 disease. This intention was expressed slightly more frequently among HCWs (38.9%) than among lay respondents (30.3%). Men compared to women, older and younger HCWs compared to middle-aged adults, and university graduates compared to HCWs with lower levels of education were more likely to get vaccinated against the disease. More HCWs than lay respondents believed that the COVID-19 vaccine would be safe and effective, and they were also more in favour to support vaccination of high-risk groups than mandatory vaccination of the general population. Conclusion: It is critical to communicate the importance of vaccination against COVID-19 appropriately and on a sound scientific basis through various health education programmes and the media, as only one-third of respondents and less than a half of HCWs indicated that they would be willing to get vaccinated once a vaccine is available

State-of-the-art three-dimensional analysis of soft tissue changes following Le Fort I maxillary advancement

We describe the comprehensive 3-dimensional analysis of facial changes after Le Fort I osteotomy and introduce a new tool for anthropometric analysis of the face. We studied the cone-beam computed tomograms of 33 patients taken one month before and 6-12 months after Le Fort I maxillary advancement with or without posterior vertical impaction. Use of a generic facial mesh for dense correspondence analysis of changes in the soft tissue showed a mean (SD) anteroposterior advancement of the maxilla of 5.9 (1.7) mm, and mean (SD) minimal anterior and posterior vertical maxillary impaction of 0.1 (1.7) mm and 0.6 (1.45) mm, respectively. It also showed distinctive forward and marked lateral expansion around the upper lip and nose, and pronounced upward movement of the alar curvature and columella. The nose was widened and the nostrils advanced. There was minimal forward change at the base of the nose (subnasale and alar base) but a noticeable upward movement at the nasal tip. Changes at the cheeks were minimal. Analysis showed widening of the midface and upper lip which, to our knowledge, has not been reported before. The nostrils were compressed and widened, and the lower lip shortened. Changes at the chin and lower lip were secondary to the limited maxillary impaction

Cross-Country Individual Participant Analysis of 4.1 Million Singleton Births in 5 Countries with Very High Human Development Index...

Background: Preterm birth is the most common single cause of perinatal and infant mortality, affecting 15 million infants worldwide each year with global rates increasing. Understanding of risk factors remains poor, and preventive interventions have only limited benefit. Large differences exist in preterm birth rates across high income countries. We hypothesized that understanding the basis for these wide variations could lead to interventions that reduce preterm birth incidence in countries with high rates. We thus sought to assess the contributions of known risk factors for both spontaneous and provider-initiated preterm birth in selected high income countries, estimating also the potential impact of successful interventions due to advances in research, policy and public health, or clinical practice. Methods: We analyzed individual patient-level data on 4.1 million singleton pregnancies from four countries with very high human development index (Czech Republic, New Zealand, Slovenia, Sweden) and one comparator U.S. state (California) to determine the specific contribution (adjusting for confounding effects) of 21 factors. Both individual and population-attributable preterm birth risks were determined, as were contributors to cross-country differences. We also assessed the ability to predict preterm birth given various sets of known risk factors. Findings: Previous preterm birth and preeclampsia were the strongest individual risk factors of preterm birth in all datasets, with odds ratios of 4.6–6.0 and 2.8–5.7, respectively, for individual women having those characteristics. In contrast, on a population basis, nulliparity and male sex were the two risk factors with the highest impact on preterm birth rates, accounting for 25–50% and 11–16% of excess population attributable risk, respectively (p < 0.001). The importance of nulliparity and male sex on population attributable risk was driven by high prevalence despite low odds ratios for individual women. More than 65% of the total aggregated risk of preterm birth within each country lacks a plausible biologic explanation, and 63% of difference between countries cannot be explained with known factors; thus, research is necessary to elucidate the underlying mechanisms of preterm birth and, hence, therapeutic intervention. Surprisingly, variation in prevalence of known risk factors accounted for less than 35% of the difference in preterm birth rates between countries. Known risk factors had an area under the curve of less than 0.7 in ROC analysis of preterm birth prediction within countries. These data suggest that other influences, as yet unidentified, are involved in preterm birth. Further research into biological mechanisms is warranted. Conclusions: We have quantified the causes of variation in preterm birth rates among countries with very high human development index. The paucity of explicit and currently identified factors amenable to intervention illustrates the limited impact of changes possible through current clinical practice and policy interventions. Our research highlights the urgent need for research into underlying biological causes of preterm birth, which alone are likely to lead to innovative and efficacious interventions

Variations in Multiple Birth Rates and Impact on Perinatal Outcomes in Europe

Objective Infants from multiple pregnancies have higher rates of preterm birth, stillbirth and neonatal death and differences in multiple birth rates (MBR) exist between countries. We aimed to describe differences in MBR in Europe and to investigate the impact of these differences on adverse perinatal outcomes at a population level. Methods We used national aggregate birth data on multiple pregnancies, maternal age, gestational age (GA), stillbirth and neonatal death collected in the Euro-Peristat project (29 countries in 2010, N = 5 074 643 births). We also used European Society of Human Reproduction and Embryology (ESHRE) data on assisted conception and single embryo transfer (SET). The impact of MBR on outcomes was studied using meta-analysis techniques with random-effects models to derive pooled risk ratios (pRR) overall and for four groups of country defined by their MBR. We computed population attributable risks (PAR) for these groups. Results In 2010, the average MBR was 16.8 per 1000 women giving birth, ranging from 9.1 (Romania) to 26.5 (Cyprus). Compared to singletons, multiples had a nine-fold increased risk (pRR 9.4, 95% Cl 9.1–9.8) of preterm birth (<37 weeks GA), an almost 12-fold increased risk (pRR 11.7, 95% CI 11.0–12.4) of very preterm birth (<32 weeks GA). Pooled RR were 2.4 (95% Cl 1.5–3.6) for fetal mortality at or after 28 weeks GA and 7.0 (95% Cl 6.1–8.0) for neonatal mortality. PAR of neonatal death and very preterm birth were higher in countries with high MBR compared to low MBR (17.1% (95% CI 13.8–20.2) versus 9.8% (95% Cl 9.6–11.0) for neonatal death and 29.6% (96% CI 28.5–30.6) versus 17.5% (95% CI 15.7–18.3) for very preterm births, respectively). Conclusions Wide variations in MBR and their impact on population outcomes imply that efforts by countries to reduce MBR could improve perinatal outcomes, enabling better long-term child health

Size Matters: Comparing the MDMA content and weight of ecstasy tablets submitted to European drug checking services in 2012-2021

Purpose The 3,4-methylenedioxymetamphetamine (MDMA) content in ecstasy tablets has increased enormously throughout Europe across the past decade. This study aims to determine whether this is caused by the production of “stronger” tablets (more mg MDMA per mg of tablet), or if tablets have simply been getting larger and heavier (more mg of tablet in total). Design/methodology/approach A data set of 31,716 ecstasy tablets obtained in 2012–2021 by 10 members of the Trans European Drug Information (TEDI) network was analysed. Findings The MDMA mass fraction in ecstasy tablets has remained virtually unchanged over the past 10 years, with increased MDMA contents being attributed almost exclusively to increased tablet weight. These trends seem to be uniform across Europe, despite varying sampling and analytical techniques being used by the TEDI participants. The study also shows that while tablet weight correlates perfectly with MDMA content on a yearly basis, wide variations in the MDMA mass fraction make such relations irrelevant for determining the MDMA content of individual tablets. Research limitations/implications These results provide new opportunities for harm reduction, given that size is a tangible and apparently accurate characteristic to emphasise that one tablet does not simply equate to one dose. This is particularly useful for harm reduction services without the resources for in-house quantification of large numbers of ecstasy tablets, although the results of this study also show that chemical analysis remains crucial for accurate personalised harm reduction. Originality/value The findings are both new and pertinent, providing a novel insight into the market dynamics of ecstasy tablet production at a transnational level

Using Robson's Ten‐Group Classification System for comparing caesarean section rates in Europe: an analysis of routine data from the Euro‐Peristat study

Objective Robson's Ten Group Classification System (TGCS) creates clinically relevant sub‐groups for monitoring caesarean birth rates. This study assesses whether this classification can be derived from routine data in Europe and uses it to analyse national caesarean rates. Design Observational study using routine data. Setting Twenty‐seven EU member states plus Iceland, Norway, Switzerland and the UK. Population All births at ≥22 weeks of gestational age in 2015. Methods National statistical offices and medical birth registers derived numbers of caesarean births in TGCS groups. Main outcome measures Overall caesarean rate, prevalence and caesarean rates in each of the TGCS groups. Results Of 31 countries, 18 were able to provide data on the TGCS groups, with UK data available only from Northern Ireland. Caesarean birth rates ranged from 16.1 to 56.9%. Countries providing TGCS data had lower caesarean rates than countries without data (25.8% versus 32.9%, P = 0.04). Countries with higher caesarean rates tended to have higher rates in all TGCS groups. Substantial heterogeneity was observed, however, especially for groups 5 (previous caesarean section), 6, 7 (nulliparous/multiparous breech) and 10 (singleton cephalic preterm). The differences in percentages of abnormal lies, group 9, illustrate potential misclassification arising from unstandardised definitions. Conclusions Although further validation of data quality is needed, using TGCS in Europe provides valuable comparator and baseline data for benchmarking and surveillance. Higher caesarean rates in countries unable to construct the TGCS suggest that effective routine information systems may be an indicator of a country's investment in implementing evidence‐based caesarean policies. Tweetable abstract Many European countries can provide Robson's Ten‐Group Classification to improve caesarean rate comparisons

Separating groups of uterine electromiographic records with term and pre-term delivery using coherence function

V diplomskem delu predstavimo avtomatično analizo elektromiograma maternice s koherenčno funkcijo, ki je ena izmed nelinearnih tehnik procesiranja signalov. Uporabili smo posnetke mednarodne referenčne baze TPEHG DB, ki vsebuje 300 posnetkov. Signale smo predprocesirali z devetimi različnimi Butterworthovimi pasovno-prepustnimi filtri in v izogib faznemu popačenju uporabili dvosmerno shemo filtriranja. Ločevanje skupin je potekalo v dveh variantah, ločevanje med zgodaj snemanimi in ločevanje med pozno snemanimi posnetki. Izračunali smo koherenčno funkcijo med vsemi pari posnetkov za vsako od variant. Računali smo jo med močnostnima spektroma signalov. Za oceno koherence za celotno frekvenčno območje smo izbrali dve cenilki - mediano amplitude in integral. Enosmerna analiza varianca ali ANOVA je pokazala, katere skupine posnetkov so primerne za ločevanje prezgodnjega in terminskega poroda. Frekvenčna območja in signale, katerih p-vrednosti so manjše od 0,05, smo uporabili za klasifikacijo posnetkov. Za klasifikacijo smo uporabili Bayesov klasifikator, odločitvena drevesa in klasifikator, ki smo ga empirično sestavili sami. Opazili smo, da se koherenca med terminskimi porodi med frekvenčnima območjema 1-2,5 Hz in 2,5-3,5 Hz znatno zmanjša, medtem ko se koherenca prezgodnjih porodov znatno ne spremeni. Ocenjevanje zmogljivosti klasifikacije je potekalo na tri načine - na učni množici, po principu učna-testna množica in s pristopom "izpusti enega". Najboljšo oceno klasifikacije smo dobili z uporabo odločitvenih dreves na učni množici, na frekvenčnem območju 0,3-2,5 Hz, kjer je bila občutljivost 95 %, specifičnost in natančnost pa 98 %. Malo slabše rezultate smo dobili z uporabo lastnega klasifikatorja. Občutljivost je bila med 58 % in 63 %, specifičnost pa med 61 % in 65 % za izbrane filtre in kanale. Klasifikacija z Baysovim klasifikatorjem pa ni pokazala vzpodbudnih rezulatov, z občutljivostjo blizu 0 %.In this thesis we present automatic analysis of electromyogram of uterus (electrohysterogram) using coherence function which is one of non-linear signal processing techniques. We used records of international reference database TPEHG DB (Term-Preterm Electrohysterogram DataBase), which contains 300 electrohysterogram records. We preprocessed signals with nine different band-pass Butterworths filters with forward-backward filtering to avoid zero phase shift. Separation of groups took place in two variants, among early recorded and among late recorded records. We calculated coherence function between all pairs of records for each of variants. For calculation we used power spectrum of signals. Coherence estimation for whole frequency range, was made with two techniques - median amplitude and integral. Analysis of variance or ANOVA showed which frequency ranges and signals are useful for preterm - term records separation. For records classification we used frequency intervals and signals with p-value less than 0,05. Evaluation of classification was made on Bayes classifier, decision trees and our own built classifier. We developed it empirically, based on coherence decreasing among term records from frequency range 1-2,5 Hz to 2,5-3,5 Hz. Performance evaluation of classification is done in three ways - on training set, on the principle of training-testing set and with the approach "omitted one". Best results were shown with decision tree at frequency range 0,3-2,5 Hz, where sensitivity was 95 %, specificity and accuracy were 98 %. With our own developed classifier we reach sensitivity between 58 % and 63 % and specificity between 58 % and 63 %. Classification using Bayes classifier did not show good results, having sensitivity close to 0 %