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Imprints in the cosmic background radiation: Franz Kafka and the multiverse
(German Quarterly, 2024-09-01) Gellen, K
Impact Evaluation of a Diarrhea Treatment Uptake Scale-up Program in Nigeria - a Difference-in-Difference Analysis
(2025-04-18) Xiang, Catherine
Diarrheal disease is the second leading cause of death in children under 5 years in Nigeria with an estimated 151,700 annual child deaths. Clinton Health Access Initiative (CHAI) worked with the Nigerian government to reduce child mortality by increasing treatment and coverage of ORS and zinc treatment for diarrheal disease. It is important to evaluate the reported increase in zinc and ORS coverage after the intervention was applied to assess whether the increased availability of diarrhea treatment led to an increase in treatment-seeking behavior among children under 5 years with diarrheal disease. Through a difference-in-difference analysis (DiD) in STATA/SE 18.0, the paper will evaluate whether there was a causal impact of the zinc and oral-rehydration salt (ORS) scale-up program on increasing diarrheal treatment-seeking. A logistic regression with robust standard errors was conducted on four treatment seeking outcomes (zinc, ORS, zinc and ORS, and zinc or ORS) while controlling for individual, household, and community level variables. After controlling for individual, household, and community variables, there were no statistically significant changes in zinc or ORS treatment uptake for children under 5 years that could be attributed to the intervention (Odds of OR: 0.87 95% CI=0.48, 1.59), zinc and ORS treatment (Odds of OR: 0.73 95% CI=0.12, 4.30), zinc treatment (Odds of OR: 0.85 95% CI=0.16, 4.57), or ORS treatment (Odds of OR: 0.90 95% CI=0.48, 1.67). We therefore did not find evidence that the program had an impact on uptake of zinc and ORS treatment. There is a need for more research that adopts rigorous causal methods to demonstrate the impact of policies targeted at reducing the burden of diarrheal diseases.
“German Erinnerungskultur and the Gaza War.“
(Interjekte) Engelstein, Stefani
Proximal Junctional Kyphosis and Failure Prophylaxis Improves Cost Efficacy, While Maintaining Optimal Alignment, in Adult Spinal Deformity Surgery.
(Neurosurgery, 2025-04) Passias, Peter G; Krol, Oscar; Williamson, Tyler K; Bennett-Caso, Claudia; Smith, Justin S; Diebo, Bassel; Lafage, Virginie; Lafage, Renaud; Line, Breton; Daniels, Alan H; Gum, Jeffrey L; Protopsaltis, Themistocles S; Hamilton, D Kojo; Soroceanu, Alex; Scheer, Justin K; Eastlack, Robert; Mundis, Gregory M; Kebaish, Khaled M; Hostin, Richard A; Gupta, Munish C; Kim, Han Jo; Klineberg, Eric O; Ames, Christopher P; Hart, Robert A; Burton, Douglas C; Schwab, Frank J; Shaffrey, Christopher I; Bess, Shay; International Spine Study Group
Background and objectives
To investigate the cost-effectiveness and impact of prophylactic techniques on the development of proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) in the context of postoperative alignment.Methods
Adult spinal deformity patients with fusion to pelvis and 2-year data were included. Patients receiving PJK prophylaxis (hook, tether, cement, minimally-invasive surgery approach) were compared to those who did not. These cohorts were further stratified into "Matched" and "Unmatched" groups based on achievement of age-adjusted alignment criteria. Costs were calculated using the Diagnosis-Related Group costs accounting for PJK prophylaxis, postoperative complications, outpatient health care encounters, revisions, and medical-related readmissions. Quality-adjusted life years were calculated using Short Form-36 converted to Short-Form Six-Dimension (SF-6D) and used an annual 3% discount rate. Multivariate analysis controlling for age, sex, levels fused, and baseline deformity severity assessed outcomes of developing PJK/PJF if matched and/or with use of PJK prophylaxis.Results
A total of 738 adult spinal deformity patients met inclusion criteria (age: 63.9 ± 9.9, body mass index: 28.5 ± 5.7, Charlson comorbidity index: 2.0 ± 1.7). Multivariate analysis revealed patients corrected to age-adjusted criteria postoperatively had lower rates of developing PJK or PJF (odds ratio [OR]: 0.4, [0.2-0.8]; P = .011) with the use of prophylaxis. Among those unmatched in T1 pelvic angle, pelvic incidence lumbar lordosis mismatch, and pelvic tilt, prophylaxis reduced the likelihood of developing PJK (OR: 0.5, [0.3-0.9]; P = .023) and PJF (OR: 0.1, [0.03-0.5]; P = .004). Analysis of covariance analysis revealed patients matched in age-adjusted alignment had better cost-utility at 2 years compared with those without prophylaxis ($361 539.25 vs $419 919.43; P < .001). Patients unmatched in age-adjusted criteria also generated better cost ($88 348.61 vs $101 318.07; P = .005) and cost-utility ($450 190.80 vs $564 108.86; P < .001) with use of prophylaxis.Conclusion
Despite additional surgical cost, the optimization of radiographic realignment in conjunction with prophylaxis of the proximal junction appeared to be a more cost-effective strategy, primarily because of the minimization of reoperations secondary to mechanical failure. Even among those not achieving optimal alignment, junctional prophylactic measures were shown to improve cost efficiency.Performance of Urinalysis Parameters in Predicting Urinary Tract Infection: Does One Size Fit All?
(Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2024-09) Advani, Sonali D; North, Rebecca; Turner, Nicholas A; Ahmadi, Sahra; Denniss, Julia; Francis, Adero; Johnson, Rachel; Hasan, Anum; Mirza, Faryal; Pardue, Sarah; Rao, Meghana; Rosshandler, Yasmin; Tang, Helen; Schmader, Kenneth E; Anderson, Deverick J
In a multihospital cohort study of 3392 patients, positive urinalysis parameters had poor positive predictive value for diagnosing urinary tract infection (UTI). Combined urinalysis parameters (pyuria or nitrite) performed better than pyuria alone for ruling out UTI. However, performance of all urinalysis parameters was poor in older women.