Gonadotropin-releasing hormone (GnRH) analogs are widely used in the treatment of hormone-dependent conditions such as prostate cancer, breast cancer, and central precocious puberty. These agents suppress sex hormone secretion by persistently downregulating the hypothalamic-pituitary-gonadal axis. To improve convenience and adherence, various long-acting injectable formulations, administered monthly, quarterly, or every 6 months, have been developed. However, there is ongoing debate regarding the relative advantages and optimal choice among these formulations. Evidence from clinical trials and real-world studies suggests that the efficacy and safety of multimonthly formulations are equivalent to or noninferior to those of monthly variants and produce similar clinical outcomes in hormone suppression and disease control. In addition, multimonthly injections are associated with fewer hospital visits, improved adherence to treatment, lower indirect costs, and improved quality of life for patients. Although differences in pharmacokinetics and initial hormonal responses have been observed, they do not translate into meaningful differences in clinical outcomes. Long-acting GnRH analogs are equally effective and offer a more efficient, patient-centered approach to managing hormone-dependent diseases.
This study evaluated the feasibility, reliability, and sensitivity of repeatedly administering brief PROMIS® computerized adaptive tests (CATs) monthly in a large, nationally representative internet panel. PROMIS CATs for anger, meaning in life, and positive affect were administered monthly for 13 consecutive months to the same 12,231 U.S. adults in the Understanding America Study (UAS). Each CAT was limited to three items per domain to minimize respondent burden. We assessed measurement precision, rank-order stability, and predictors of overall levels and month-to-month variability in each PROMIS measure. Time-series analyses also tested whether PROMIS scores were sensitive to acute health events reported each month. Three-item CATs achieved strong measurement precision (reliability ≥ 0.80) across wide score ranges and showed moderate rank-order stability (ICCs = 0.67-0.79). In between-subjects analyses, a greater number of chronic conditions was associated with both poorer average PROMIS scores and higher month-to-month variability. In within-subjects analyses, PROMIS scores were responsive to acute health events: anger and positive affect showed significant same-month changes in response to most health events, while meaning in life was less reactive. Event-related changes typically dissipated within 1-2 months. Brief PROMIS CATs can be administered monthly while maintaining psychometric rigor. This high-frequency approach enables the assessment of both average levels and temporal dynamics of health, revealing new insights into the effects of chronic disease and acute health events. These findings support the use of PROMIS measures in longitudinal population health research.
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Low-income elderly consumers, often overlooked in studies of public financial assistance programs, may face challenges in managing resources to maintain dietary health. This study examines how the payment frequency of an unconditional cash transfer program impacts dietary behaviors among low-income elderly populations in Colombia. Using nationally representative data from a federal financial assistance program, we implement a Multivalued Treatment Model with Propensity Score Matching and Augmented Inverse Probability Weighting to assess the effects of monthly versus bi-monthly payments on food expenditures, dietary diversity, and diet quality. Results show that monthly payments enhance dietary diversity and diet quality by supporting healthier food purchases compared to bi-monthly payments. Subgroup analyses revealed that older seniors and males benefit most from monthly payments. Mechanisms explored include consumption smoothing and subjective wealth perceptions, with findings suggesting that more frequent and predictable income flows may foster greater perceived financial stability. The study advances consumer behavior theory by linking payment frequency to dietary outcomes and offers practical implications for optimizing financial assistance programs. While bi-monthly payments reduce administrative costs, monthly payments are recommended to improve dietary health. These findings contribute to understanding income timing's role in fostering healthier consumer behavior.
Sacral chordoma is a rare and locally aggressive malignant tumor. Carbon ion radiotherapy (CIRT) has emerged as a promising therapeutic modality, but tumor size may not decrease immediately after treatment, presenting challenges in evaluating response. We aimed to evaluate tumor response after CIRT in sacral chordoma patients using quantitative parameters obtained from magnetic resonance imaging (MRI) multi-planar measurements and fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT). A retrospective analysis was conducted on 35 sacral chordoma patients who underwent CIRT. Baseline follow-up images for up to 60 months post-CIRT were assessed. Dynamic changes in tumor size, long-axis diameter (LAD), short-axis diameter (SAD), and cranio-caudal diameter (CCD) were measured. Additionally, FDG-PET/CT parameters consisting of maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were evaluated. A minor reduction in mean tumor size was first observed at six months post-CIRT (LAD: 1.2%; SAD: 3.1%; CCD: 3.4%). From 12 to 60 months post-CIRT, inter-measurement differences between LAD, SAD, and CCD were significant (p < 0.05), with the largest reduction in SAD (32.8%) and the smallest in LAD (11.0%) at 60 months. In a subgroup of 10 patients, who had FDG-PET/CT, the average monthly reduction was greater for metabolic parameters than for morphologic measurements (SUVmax: 2.0% monthly; LAD: 0.6% monthly). Sacral chordomas treated with CIRT exhibited an unequal shrinkage pattern. Among MRI-based plane-specific measurements, SAD demonstrated the greatest reduction. Furthermore, FDG-PET/CT may predict or confirm treatment response before morphological changes become apparent.
The United States is amid an unprecedented adolescent mental health crisis, and adolescents who experience socioeconomic disadvantage are at elevated risk for behavioral problems. Low socioeconomic status (SES) is related to parent distress and is one potential pathway through which disadvantage relates to adolescent internalizing and externalizing problems. Empirical support for this pathway is typically based on a single measure of objective SES considered in isolation. However, parents' subjective social status (SSS) also predicts their distress and may, in turn, shape adolescents' problem behaviors. We examine how multiple objective (annual income, monthly income volatility, and educational attainment) and subjective (SSS) markers of SES independently relate to adolescent internalizing and externalizing problems through parent distress using data from 104 parent-adolescent dyads. In mixed-effects models, we observed positive indirect effects of income volatility (within-dyad variation in monthly income) and parent SSS on adolescents' internalizing and externalizing symptoms through parent distress. Gains in monthly income and greater SSS predicted decreased parent distress, which in turn related to fewer adolescent internalizing and externalizing symptoms. Indirect effects were independent of annual income, educational attainment, and covariates (marital status, adolescent race, sex, SSS). These findings highlight that temporally (income volatility) and psychologically proximal (parent SSS) aspects of SES may serve as points for intervention to reduce parent distress and support adolescent mental health. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Subcutaneous (SC) ocrelizumab offers a streamlined alternative to intravenous (IV) infusion in the management of multiple sclerosis (MS). Building on time-and-motion (T&M) methodologies validated in oncology, we conducted a single-center operational study to quantify procedure-level time savings, estimate the resulting care-time dividend, and assess changes in patient flow following SC implementation. We employed a cross-sectional observational design in a five-chair day hospital treating ∼600 patients with MS treated with infusive therapies. T&M data were collected for 15 IV ocrelizumab administrations (April 2025) and 15 SC administrations (November 2025), capturing active clinical time across four phases: premedication, administration, observation, and checkout. Service-flow metrics (monthly visit volume, mean waiting time) were extracted from the electronic queue system for May 2025 (early SC implementation) and November 2025 (mature SC adoption). A deterministic operational model projected capacity gains under different SC adoption scenarios. SC ocrelizumab reduced total active clinical time from 320 to 60 min (-81%), driven by administration (210→10 min) and observation (60→15 min) reductions. At 15 SC administrations/month, this translated into 65 clinical hours and 50 chair-hours released-equivalent to 14 IV-equivalent infusion slots. Despite unchanged ocrelizumab volumes, monthly visits increased (+7.9%) and mean waiting time decreased (-30%) from May to November 2025. Scenario modeling projected 100-133 chair-hours released at 30-40 SC administrations/month. Transitioning from IV to SC ocrelizumab yields substantial procedural efficiencies and frees infusion-unit capacity. The care-time dividend enables expanded access to complex therapies without additional staff or infrastructure, positioning SC ocrelizumab as a structural efficiency tool in MS care.
Chronic migraine (CM) is a highly disabling neurological disorder characterized by ≥ 15 headache days per month, of which at least 8 exhibit migrainous features. Despite the availability of preventive therapies, conventional treatments are often limited by suboptimal efficacy and poor tolerability. Monoclonal antibodies targeting calcitonin gene-related peptide (CGRP) or its receptor have emerged as mechanism-based preventive options. This systematic review aims to evaluate the efficacy, safety, and clinical relevance of CGRP-targeted monoclonal antibodies in the prevention of chronic migraine. A comprehensive literature search of PubMed, Scopus, and Web of Science was conducted from database inception to July 2025. Randomized controlled trials and observational real-world studies evaluating CGRP-targeted monoclonal antibodies in adult patients with chronic migraine were included. The review followed PRISMA 2020 guidelines (Page et al. 2021), was registered in the PROSPERO database (CRD420261284751), and included 11 studies out of 1,688 identified records. Across included studies, CGRP-targeted monoclonal antibodies consistently demonstrated reductions in migraine frequency, improvements in ≥ 50% responder rates, and favorable safety profiles. Randomized controlled trials showed robust efficacy compared with placebo, while real-world studies confirmed effectiveness in more heterogeneous and treatment-resistant populations. However, variability in outcome definitions, particularly between monthly migraine days and monthly headache days, and differences in study design contributed to heterogeneity across findings. CGRP-targeted monoclonal antibodies represent an effective and well-tolerated preventive option for chronic migraine, with clinically meaningful benefits across both controlled and real-world settings. While current evidence is strong, further research is needed to evaluate long-term outcomes, optimize treatment strategies, and improve standardization of outcome measures. This systematic review was registered in the PROSPERO database (CRD420261284751).
Spinal osteoporosis is a prevalent skeletal disorder characterized by decreased bone mass and increased fracture risk. The combination of teriparatide and denosumab has shown promise in improving bone health by promoting bone formation and suppressing bone resorption. However, the effects of this combination treatment on trabecular bony strength in spinal osteoporosis remain unclear. The purpose of this study was to determine the effect of combination therapy of denosumab and teriparatide on volumetric bone mineral density as assessed by Quantitative Computed Tomography (QCT) in the lumbar spine. Fifty patients (average age: 67.5 years) who underwent treatment at our center for osteoporosis as diagnosed by QCT between Jan 2019 and March 2023 were included in this study. Retrospective analysis of a prospective database was performed. This database included information about patients' demographic details and pre-treatment QCT scores, adherence to treatment and post-treatment QCT scores. Only patients who completed a full 18 months of treatment with combination of daily teriparatide (20 µg) and 6-monthly denosumab (60 mg) and had 80% adherence to teriparatide were included in this study. Following the combination treatment for 18 months, the mean intra-treatment QCT T score (measured at an average of 6 months after completion of treatment with teriparatide) improved from - 3.81 to - 2.48 (p < 0.001), and the average trabecular bone density improved from 68.08 to 97.22 mg/cm3, a 54.9% increase (p < 0.001). The treatment was well-tolerated, with no serious adverse events reported. Combination therapy of teriparatide (20 µg) daily and 6 monthly denosumab (60 mg) demonstrates an improvement in the trabecular bone density in this small group of patients. The limitations of this study include a small sample size and an absence of analysis of bone turnover marker. Further research in the form of clinical trials should be conducted to affirm the efficacy of this treatment regimen and compare it to other treatment regimens.
Poverty is associated with depression and anxiety among adolescents, but evidence of interventions that prevent adolescent depression and anxiety among adolescents living in poverty is weak. Interventions either focus on reducing poverty or addressing depression and anxiety, but an approach that combines both may offer larger benefit. This multi-site parallel pilot cluster randomised controlled trial (cRCT) evaluates the feasibility and acceptability of a selective preventive intervention for depression and anxiety that simultaneously intervenes on both poverty and self-regulation among adolescents living in urban poverty. The study takes place in Bogotá (Colombia), Kathmandu (Nepal) and Cape Town (South Africa). The pilot cRCT has four arms: (i) self-regulation intervention, (ii) economic intervention, (iii) combined (self-regulation + economic) intervention, and (iv) control group (care as usual). Interventions consist of 20 weekly group sessions with adolescents, and 6 monthly group sessions with their caregivers. The self-regulation intervention for adolescents includes psychological activities (mindfulness breathing, problem solving, biofeedback and goal setting) and a physical activity. The economic intervention includes three dimensions (financial training, negotiation training, education information) and a monthly cash transfer. In each site, the aim was to recruit 240 adolescents and their caregivers across eight schools (clusters), with two schools randomised to each arm. Adolescents residing in areas at risk of multidimensional poverty and who had symptoms of depression or anxiety, but who did not meet thresholds indicating depression and anxiety disorders, were considered for enrolment. Recruitment into the study is complete: a total of 628 adolescents and 536 caregivers were enrolled. Participants will be assessed four times: at enrolment, post-intervention and at 12 and 18 months post-enrolment. Primary outcomes include feasibility and acceptability criteria for study and intervention delivery procedures (i.e. randomisation, masking, recruitment, retention, missingness, fidelity, attendance, adverse events) defined as traffic light criteria to assess progression to an adequately powered trial. Secondary outcomes include self-report instruments, physiological measures and neuropsychological tasks. The effectiveness of combining self-regulation and anti-poverty interventions remains untested. This study will establish the feasibility and acceptability of delivering such an intervention, as well as test the trial procedures to inform a future adequately powered trial. ISRCTN 14601588. Retrospectively registered. Date: 19 May 2024.
The Dobbs v. Jackson Women's Health Organization decision significantly altered abortion access in the U.S., increasing reliance on resources outside the formal healthcare system. This study examined utilization of a medical hotline supporting people managing their abortions and miscarriages, comparing trends before and after Dobbs. We conducted a retrospective cohort analysis of de-identified data of US-based English and Spanish-speaking individuals contacting the Miscarriage and Abortion (M + A) Hotline between June 24, 2021 (one year pre-Dobbs) and June 24, 2023 (one year post-Dobbs). We assessed changes in contact volume, characteristics, and reason for contact over time and by state abortion ban status using descriptive statistics. We applied comparative interrupted time series analyses to test the association of Dobbs with changes in Hotline contacts across state abortion policy environments. Among 16,429 unique Hotline contacts, 4009 (24%) occurred pre-Dobbs and 12,420 (76%) post-Dobbs, a 210% increase (p < 0.001). Pre-Dobbs, Hotline contacts increased 10% per month in no-ban states (p < 0.001). While baseline contact levels were comparable between ban and no-ban states, pre-Dobbs trends diverged significantly, with ban states experiencing 7% higher increases in monthly contacts (p < 0.001). Immediately post-Dobbs, monthly Hotline contact levels did not differ between ban and no-ban states; post-Dobbs trends diverged modestly between groups (p < 0.05). Hotline use was increasing rapidly prior to Dobbs-particularly in states that later enacted bans-indicating substantial unmet need preceding the policy change. Post-Dobbs, trends diverged modestly without an immediate surge, suggesting a more complex response than a simple policy-driven increase and underscoring persistent gaps in reproductive healthcare access. Society of Family Planning, the Center for Reproductive Health Research in the Southeast, and the US National Institutes of Health.
The Nutrition and Medicine program at Creighton University School of Medicine aimed to bridge the gap between medical education and the role of nutrition in patient care. Recognizing the limited nutrition education in the medical curriculum, the program offered monthly workshops led by medical students and physicians. These sessions covered evidence-based nutrition topics, current trends, and the impact of social media on nutritional knowledge. The Nutrition and Medicine program hosted monthly student-led workshops to discuss current, evidence-based nutrition topics. Workshops were conducted and followed by pre- and post-session surveys assessing students' self-reported confidence in their nutritional knowledge, as well as their information sources and perceptions of social media's influence. Nutrition knowledge was not directly tested. Medical students demonstrated a statistically significant increase in self-reported confidence in their own nutritional knowledge following session attendance (P < .0001). Baseline surveys reflected low to moderate confidence, with post-session responses showing movement toward the "confident" range on a 5-point Likert scale. Structured, student-led nutrition programming was associated with improved self-reported confidence in nutritional knowledge among medical students. These findings suggest that scalable, peer-led educational initiatives may help address gaps in nutrition-related self-efficacy within medical training.
Understanding long-term changes in weather variables and their impact on crop productivity is essential for climate resilient agriculture in semi-arid regions of India. This study assessed the district wise long-term trends in temperature and rainfall and examined their linkages with sesame (Sesamum indicum L.) yield across Bundelkhand region of India. Long-term monthly temperature and seasonal rainfall trends were analyzed using simple linear regression, Mann-Kendall, modified Mann-Kendall and Sen's slope methods. District-wise crop weather relations between sesame yield and weather variables were evaluated using correlation analysis and stepwise linear regression models. The long-term trends revealed a consistent warming across the region (0.9-2.2 °C/100 years), particularly during the late monsoon and post-monsoon months, whereas monsoon as well as annual rainfall showed a declining trend at the rate of -1.03 to -1.51 mm/year. Correlation results indicated that sesame yield was positively associated with temperature and heat accumulation indices (r = 0.28 to 0.48) especially during August-September, reflecting favourable thermal conditions for crop growth. In contrast, rainfall-related variables, including rainfall amount, number of rainy days, heavy rainfall events, and prolonged wet spells showed negative correlations with sesame yield (r = -0.26 to -0.47), with August rainfall exerting the strongest adverse influence. Regression models (R2 = 0.29 to 0.78) identified monthly temperature indices (Tmin, Tmax, Tavg, DTR, and GDD) and rainfall distribution and intensity indices (RainyDays, R10_days, R20_days, CWD, SDII, and CDD) as more important predictors than seasonal averages. The findings revealed that moderate warming may benefit sesame production, whereas excess and poorly distributed rainfall remains an important climatic constraint. Overall, this biometeorological assessment offers a strong scientific basis for formulating climate-resilient sesame production strategies that effectively address long-term climate trends as well as short-term weather variability.
Long-term (> 24 weeks) real-world evidence of eptinezumab's effectiveness is limited. We evaluated ≥ 50% and ≥ 75% response rates over 48 weeks in patients with high-frequency episodic migraine (HFEM) or chronic migraine (CM). EMBRACEIII (NCT05570149) is a prospective, multicenter, observational study. Adults with HFEM or CM who experienced ≥ 3 preventive treatment failures received eptinezumab 100 mg intravenously every 12 weeks, with optional 300 mg escalation after week 12 for inadequate response. Co-primary endpoints were ≥ 50% and ≥ 75% reductions in monthly migraine/headache days (MMD/MHD) at weeks 45-48 versus baseline. Secondary endpoints were changes in MMD/MHD, monthly analgesic intake (MAI), pain intensity (assessed using the numeric rating scale [NRS]), migraine-related disability and impact (assessed using the Headache Impact Test-6 [HIT-6], Migraine Disability Assessment [MIDAS], the Migraine Interictal Burden Scale-4 [MIBS-4]), patient-reported global treatment response (assessed using the Patient Global Impression of Change [PGI-C] questionnaire), and 100% response. Exploratory analyses assessed dose escalation, prior anti-calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs) treatment failures, responders without adverse events, ≥ 30% reduction in the NRS during residual attacks, and clinically complex subgroups. Among the 261 patients (safety population) included in the study, 124 completed ≥ 48 weeks of treatment with eptinezumab. At week 48, the response rates for ≥ 50%, ≥ 75%, and 100% were 82.3%, 51.6%, and 9.7%, respectively. All secondary endpoints improved significantly (p < 0.001), with significant reductions from baseline: MMD/MHD, - 15.5; MAI, - 14.9; NRS, - 3.3; HIT-6, -  20.6; MIDAS, - 74; and MIBS-4, - 4.3. Also, 94.8% of patients reported PGI-C improvement. Dose escalation occurred in 69.4% of patients. Patients receiving ≥ 3 doses of 300 mg eptinezumab achieved outcomes comparable to responders receiving 100 mg. Among patients with prior anti-CGRP mAb treatment failures (51.6%), ≥ 50% and 100% responders were similar to mAb-naïve patients, whereas ≥ 75% response was lower (37.5%; p = 0.002). Response rates of ≥ 50%,  ≥ 75% and 100% were achieved by 81.2%, 50.4%, and 8.5%, respectively, in patients without adverse events; 85.7%, 51.4%, and 8.6% in patients with psychiatric comorbidities; 87.8%, 54.9%, and 7.3% in patients with CM with medication overuse; and 89.2%, 50.0%, and 7.1% in patients with CM with both conditions. Eptinezumab demonstrated sustained 48-week effectiveness, with high response rates of ≥ 75% and 100% in a difficult-to-treat population. Effectiveness was preserved in patients with prior anti-CGRP mAb failures after 300 mg escalation and in clinically complex subgroups. Many patients achieved ≥ 30% reduction in NRS during residual migraine attacks. ClinicalTrials.gov: NCT05570149.
Pre-exposure prophylaxis (PrEP) is highly effective for preventing HIV, but out-of-pocket costs represent a critical barrier to uptake. We conducted an online survey from May 2020 to October 2021. Gay and bisexual men who have sex with men (GBMSM) in New England recruited through social networking apps were randomly assigned to view different monthly PrEP costs ($0-$105) and asked about their willingness to pay. Among 612 participants, each $10 increase in monthly costs was associated with a 6.0% point decrease in willingness to pay (p < 0.001). In logistic regression, each $1 increase reduced the odds of willingness to pay by 4% (odds ratio, 0.960; 95% CI, 0.952-0.968; p < 0.001). At $40 per month, 68% were willing to pay. Lower-income participants (<$75,000 annually) showed greater cost sensitivity (8.0% point decrease per $10 increase; p < 0.001). Participants at higher HIV acquisition risk (HIRI-MSM ≥ 10) were more willing to pay (β = 0.119; p = 0.001), as were those perceiving they definitely needed PrEP (β=-0.134 for those who may not or definitely did not need it; p = 0.005). These findings support policies that minimize or eliminate cost-sharing for PrEP to achieve HIV prevention goals. La profilaxis previa a la exposición (PrEP) es muy eficaz para prevenir el VIH, pero los costos de bolsillo representan una barrera crítica para su adopción. Realizamos una encuesta en línea desde mayo de 2020 hasta octubre de 2021. Hombres gay y bisexuales que tienen sexo con hombres (GBMSM) de Nueva Inglaterra reclutados a través de aplicaciones de redes sociales fueron asignados al azar para ver diferentes costos mensuales de PrEP (de $0 a $105) y se les preguntó sobre su disposición a pagar. Entre 612 participantes, cada incremento de $10 en los costos mensuales se asoció con una disminución de 6.0 puntos porcentuales en la disposición a pagar (p < 0.001). En la regresión logística, cada aumento de $1 redujo las probabilidades de disposición a pagar en un 4% (proporción de probabilidades: 0.960; IC del 95%: 0.952–0.968; p < 0.001). Con un costo de $40 al mes, el 68% estaba dispuesto a pagar. Los participantes de menores ingresos (menos de $75,000 anuales) mostraron una mayor sensibilidad al costo (disminución de 8.0 puntos porcentuales por cada aumento de $10; p < 0.001). Los participantes con mayor riesgo de adquirir VIH (HIRI-MSM ≥ 10) mostraron mayor disposición a pagar (β = 0.119; p = 0.001), al igual que quienes percibían que definitivamente necesitaban la PrEP (β=−0.134 para quienes creían que tal vez no o definitivamente no la necesitaban; p = 0.005). Estos hallazgos respaldan las políticas que minimizan o eliminan el reparto de costos para la PrEP a fin de lograr los objetivos de prevención del VIH.
This article presents a global database of salinity gradient energy (SGE) potential at river mouths. The dataset integrates satellite-derived sea surface salinity and temperature with river discharge data to estimate both theoretical and extractable SGE resources worldwide. Two complementary river discharge datasets are used: (i) a global multiannual dataset including 10,848 rivers (N20), and (ii) a curated dataset of 1,078 rivers with monthly discharge variability (ARA24). The database provides spatially distributed estimates of energy density, theoretical potential, and extractable potential, along with key design parameters, including environmental discharge, extraction factor, design flow, and capacity factor. Monthly variability is resolved for systems included in the ARA24 dataset, enabling analysis of seasonal dynamics. All data are provided in structured spreadsheet formats, including global summaries by country, region, and ocean basin. In addition, an interactive visualization tool is included to explore the sensitivity of extractable potential to environmental and operational parameters. This dataset supports global, regional, and site-specific analyses of SGE resources and provides a consistent basis for future techno-economic, environmental, and policy-oriented studies.
Surveillance for influenza A virus infections in vaccinated poultry flocks remains challenging due to animal welfare, logistical and financial constraints, particularly under current EU regulations governing high pathogenicity avian influenza (HPAI) vaccination. In this field study, we evaluated two environmental sampling (ES) methods - bedding boot swabs and drinker wipes - as alternatives to legally mandated individual bird testing, which involved monthly swabbing of 60 healthy birds (active surveillance, AS) and weekly swabbing of dead or sick birds (passive surveillance, PS). A total of 56 turkey flocks from 23 holdings in Lower Saxony, Germany, were monitored throughout the fattening period following single H9N2 vaccination at hatch. Semiquantitative reverse transcription polymerase chain reaction (RT-qPCR) revealed that, despite vaccination, H9N2 virus incursions occurred at least once in 76.8% (43/56) of flocks during the subsequent fattening period. Influenza A virus detection rate on the basis of individual samples was significantly higher by ES (24.1%) than through AS (10.65%; P<0.0001) or PS (15.6%, P=0.001). Overall, ES demonstrated superior performance in identifying 42/43 infected flocks (99.67%) compared with 30/43 (69.97%) by AS and 38/43 (88.37%) by PS. Heatmap and event-time analyses confirmed that ES reliably identified infection events very early and remained positive longer after initial detection. Non-invasive, animal-friendly ES was easy to implement and well accepted by farmers. Costs for ES surveillance were reduced by 73.5% compared to AS and PS. ES was found to be a sensitive, cost-effective and very practical alternative to conventional surveillance in influenza-vaccinated poultry, with direct relevance for future surveillance strategies in HPAI vaccination programmes.
This data article introduces a comprehensive real-time dataset (RTD) of Peru's Gross Domestic Product (GDP) growth rates from 1994 to 2025. The dataset was constructed by systematically collecting and processing three decades of the Peruvian Central Reserve Bank (BCRP) Weekly Reports and compiled into over 1000 structured data files organized across three processing tiers (raw, input, and output). For the 1994-2012 period, data were digitized from archival hardcover volumes using Optical Character Recognition (OCR) with rigorous manual verification. Post-2013 data were integrated via automated web-scraping and PDF extraction pipelines from digital publications. The resulting dataset includes monthly, quarterly, and annual growth rates for aggregate GDP and eight economic sectors, organized in two complementary formats: vintage (rows indexed by sector and publication month; columns correspond to target periods) and release (rows correspond to target periods; columns index the h th published estimate for that period, given each economic sector). The collection includes variants for base-year adjustments and identifies major benchmark revisions. All data are provided in CSV format with comprehensive documentation. An open-source Python pipeline enables full reproducibility and future updates. This RTD serves as an important resource for researching GDP revision patterns, real-time forecasting accuracy, nowcasting model evaluation, and cross-country comparisons of statistical practices in emerging economies.
Forensic DNA databases in the United States have expanded substantially over the past two decades. However, comprehensive, harmonised data describing database structure and composition remain limited. This dataset series documents forensic DNA infrastructure across national and state levels from 2001 to 2025. It includes a reconstructed time series of monthly National DNA Index System (NDIS) statistics from FBI archives, capturing counts of offender, arrestee, and forensic profiles, participating laboratory totals, and investigations aided. A complementary dataset compiles publicly available state-level statistics and policy metadata on arrestee collection laws, familial search practices, and DNA collection statutes across all 50 states. A third dataset provides standardised demographic and annual collection data obtained through previously published public records requests, including sex and racial composition where reported. Together, these resources provide a foundation for studying the historical development of forensic DNA systems in the U.S., enabling longitudinal and cross-sectional analyses of database growth, policy variation, and reporting practices across jurisdictions.
Background: Atopic dermatitis (AD) is a chronic and burdensome condition that causes intense itching and painful skin lesions and affects around 10% of adults and adolescents across the US. Potent systemic treatments, such as tralokinumab, are needed to treat patients with moderate-to-severe disease who have experienced inadequate symptom control using topical therapies. Novel systemic treatments can not only provide effective relief for these patients but can also be cost saving. Aim: To evaluate the budgetary implications of tralokinumab as a treatment for moderate-to-severe AD in a hypothetical US commercial healthcare plan with 1 million (M) members. Materials & methods: A budget impact model was developed to estimate the difference in total systemic treatment costs between two scenarios: one in which dupilumab, lebrikizumab, nemolizumab, abrocitinib and upadacitinib are assumed to be the only treatments available, and one in which tralokinumab is assumed to be an additional option. The analysis took the perspective of a US commercial payer and estimated total treatment costs over a 3-year time horizon. Patients were distributed to treatments based on forecasted market share data and could switch from dupilumab to other systemic treatments in the model at any time. Switching rates were also informed using forecasting data. Adult patients receiving tralokinumab and adults or adolescents receiving lebrikizumab and nemolizumab could switch to a lower frequency administration schedule if they achieved clear or almost clear skin, reducing the number of doses received and consequently the treatment costs. Treatment costs were informed by 2025 wholesale acquisition costs. Results: Total costs when tralokinumab was not available were estimated to be $21.0 M, $27.7 M and $35.9 M in years 1-3, respectively. When tralokinumab was available, estimates were $20.6 M (Δ-0.5 M) in year 1, $26.6 M (Δ-1.1 M) in year 2 and $34.1 M (Δ-1.8 M) in year 3. Therefore, availability of tralokinumab led to cumulative cost savings of $3.4 M across all 3 years ($2.3 M in adults and $1.1 M in adolescents). Cumulative treatment costs per plan member at year 3 also reduced from $84.68 to $81.26 (Δ-3.42) due to tralokinumab. Lastly, cumulative per patient treatment costs across the 653 patients estimated to receive systematic therapy over the 3 years reduced from $129,794 to $124,556 when tralokinumab was available. Conclusion: Tralokinumab is a cost-saving therapy when used for the treatment of moderate-to-severe AD in both adult and adolescent populations, with cost savings driven by competitive skin clearance rates, low monthly treatment costs and flexible dosing options in adults (i.e., Q2W → Q4W). What is this article about? This article reports the estimated cost implications of providing tralokinumab as a treatment option for patients with moderate-to-severe eczema; a debilitating condition that affects many adults and adolescents in the US. What were the results? Costs were estimated and compared for two scenarios: one where tralokinumab was available and one where it was not. The differences in total costs between these scenarios represented the cost implications associated with tralokinumab use. Results showed that tralokinumab had the potential to reduce total treatment costs for moderate-to-severe eczema for both adults and adolescents by a cumulative total of $3.4 million over a 3-year period. Why is this important? Eczema treatments that provide cost savings are important as they help to manage the ever-increasing healthcare costs associated with the disease, which put pressure on the budgets of commercial and public healthcare providers. The evidence provided by this research suggests that tralokinumab has cost-saving potential and our findings can be used to inform decisions around which treatments are offered to patients with moderate-to-severe eczema.