Evidence of Inflation Using Harmonized Consumer Price Indices in Some Euro Countries: France, Germany, Italy, and Spain, along with the Euro Zone

This paper deals with the analysis of the persistence in the Harmonized Indices of Consumer Prices in France, Germany, Italy, and Spain. The degree of persistence is measured through fractional integration or I (d) techniques, using monthly data from January 2010 to February 2023. We first conducted the analysis with data ending in December 2019, that is, with data prior to the COVID-19 pandemic. Then, we extended the sample, first up to December 2021 and finally to February 2023. Our results show that the findings of our series are highly persistent, with values of the differencing parameter about one or higher than one in the majority of cases. In fact, mean reversion is only observed in the case of Germany with pre-pandemic data. Generally, we observed an increase in the degree of persistence of the series as a consequence of both the COVID-19 pandemic and the Russia–Ukraine war, with the only exception being Spain, where we observe a reduction in the order of integration when including 2022–2023 data. © 2023 by the authors.

Environmental Noise Annoyance Trends in Selected Locations in Bratislava

The rapid development in traffic density and the economic transformation since 1989 has brought new problems concerning road traffic noise in Slovakia. The aim is to follow the time trends of noise annoyance in monitored localities in Bratislava at time intervals of 10, 20, and 30 years. We used the validated methodology for subjective assessment of noise annoyance in young and healthy individuals, as well as a method of objectification by direct measurement of sound levels. Respondents (n=3,675) were university students, living in the exposed and control dormitories representing a homogenous sample. The sharp increase in traffic noise burden in the exposed area was found at the first 10-year interval (1989-1999) (LAeq=67.5 dB). A slight decrease occurred in 2019 up to LAeq=63.9 dB and during lockdown due to COVID-19 pandemic it dropped to LAeq =62.5 dB. A sharp increase in road traffic noise annoyance was observed in the first 10-year interval (ORMH=2.56 (95 % CI=1.93-3.42) vs 6.01 (95% CI=4.97-7.95) with a slightly decreasing trend in 2020-2021. An increase in noise annoyance from entertainment facilities was observed as well. Despite a slightly declining trend, road traffic noise annoyance is still an important issue and there is a need for preventive measures to reduce such exposure in residential areas. © 2022 Internoise 2022 - 51st International Congress and Exposition on Noise Control Engineering. All rights reserved.

Time trends in mental health indicators in Germany's adult population before and during the COVID-19 pandemic.

Background: Times of crisis such as the COVID-19 pandemic are expected to compromise mental health. Despite a large number of studies, evidence on the development of mental health in general populations during the pandemic is inconclusive. One reason may be that representative data spanning the whole pandemic and allowing for comparisons to pre-pandemic data are scarce. Methods: We analyzed representative data from telephone surveys of Germany's adults. Three mental health indicators were observed in ~1,000 and later up to 3,000 randomly sampled participants monthly until June 2022: symptoms of depression (observed since April 2019, PHQ-2), symptoms of anxiety (GAD-2), and self-rated mental health (latter two observed since March 2021). We produced time series graphs including estimated three-month moving means and proportions of positive screens (PHQ/GAD-2 score ≥ 3) and reports of very good/excellent mental health, as well as smoothing curves. We also compared time periods between years. Analyses were stratified by sex, age, and level of education. Results: While mean depressive symptom scores declined from the first wave of the pandemic to summer 2020, they increased from October 2020 and remained consistently elevated throughout 2021 with another increase between 2021 and 2022. Correspondingly, the proportion of positive screens first decreased from 11.1% in spring/summer 2019 to 9.3% in the same period in 2020 and then rose to 13.1% in 2021 and to 16.9% in 2022. While depressive symptoms increased in all subgroups at different times, developments among women (earlier increase), the youngest (notable increase in 2021) and eldest adults, as well as the high level of education group (both latter groups: early, continuous increases) stand out. However, the social gradient in symptom levels between education groups remained unchanged. Symptoms of anxiety also increased while self-rated mental health decreased between 2021 and 2022. Conclusion: Elevated symptom levels and reduced self-rated mental health at the end of our observation period in June 2022 call for further continuous mental health surveillance. Mental healthcare needs of the population should be monitored closely. Findings should serve to inform policymakers and clinicians of ongoing dynamics to guide health promotion, prevention, and care.

Analysis and Prediction of COVID-19 Spread in Ernakulam District, Kerala

The world is witnessing a pandemic of SARS-CoV2 infection since the first quarter of the twenty-first century. Ever since the first case was reported in Wuhan city of China in December 2019, the virus has spread over 223 countries. Understanding and predicting the dynamics of COVID-19 spread through data analysis will empower our administrations with insights for better planning and response against the burden inflicted on our health care infrastructure and economy. The aim of the study was to analyze and predict COVID-19 spread in Ernakulam district of Kerala. Data was extracted from lab data management system (LDMS), a government portal to enter all the COVID-19 testing details. Using the EpiModel package of R-mathematical modeling of infectious disease dynamics, the predictive analysis for hospitalization rate, percentage of patients requiring oxygen and ICU admission, percentage of patients getting admitted, duration of hospital stay, case fatality rate, age group and gender-wise fatality rate, and hospitalization rate were computed. While calculating the above-said variables, the percentage of vaccinated population, breakthrough infections, and percentage of hospitalization among the vaccinated was also taken into consideration. The time trend of patients in ICU showed men outnumbered women. Positive cases were more among 20–30 years, while 61–70 years age group had more risk for ICU admission. An increase in CFR with advancing age and also a higher CFR among males were seen. Conclusions: Analyzing and predicting the trend of COVID-19 would help the governments to better utilize their limited healthcare resources and adopt timely measures to contain the virus. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Time trends in cardiac stress testing and imaging in Slovakia during the years 2011-2021. Part I

Objectives: To analyze time trends in ordering cardiac stress testing and imaging in Slovakia, based on reported charges to health insurance companies. Method(s): We evaluated the number of procedures and payments for exercise ECG, stress echocardi-ography (SE), stress myocardial perfusion scintigraphy, CT angiography, and cardiac CT in Slovakia during the years 2011-2021. The data were provided by all health insurance companies in Slovakia. The number of procedures was evaluated according to the medical codes in the current "List of medical procedures and their point values". Result(s): During the years 2011-2021, all health insurance companies reported that the number of CT angiographies and cardiac CT scans increased every year. The total number of heart CT increased by 510 % and payments for them increased by 296 %. The ratio of payments of health insurance companies for CT and all other analyzed tests increased from a value of 1.1 in 2011 to a value of 5.2 in 2021. Since 2017, there has been a continuous decrease in the number of exercise ECG, with a reduction of 56 % (the year 2021 vs the maximal number in the year 2012). Since 2014, the number of myocardial perfusion scintigraphies has continuously increased, while the relative frequency compared to exercise ECG also increased. The frequency of SE has permanently been very low. During the pandemic period of COVID-19 in 2020-2021, the number of performed exercise ECG and SE tests was significantly reduced, but the number of heart CT scans and myocardial perfusion scintigraphies increased significantly. Conclusion(s): We present analysis of time trends in cardiac testing (exercise stress ECG, stress echocar-diography, stress myocardial perfusion scintigraphy, CT coronary angiography, and coronary calcium CT) and insurance reimbursements for them in the Slovak Republic during the years 2011-2021. Fig. 5, Ref. 10, on-line full text (Free, PDF) www.cardiologyletters.sk. Copyright © 2022, SYMEKARD s.r.o.. All rights reserved.

Temporal Trends in Patients with Peripheral Artery Disease Influenced by COVID-19 Pandemic.

Background: The COVID-19 pandemic influences the health care management of acute and chronic diseases. Data concerning the influence of the pandemic on hospitalizations of patients with peripheral artery disease (PAD) are sparse. Methods: We analysed all patients hospitalized due to PAD between 1 January 2019 and 31 December 2020 in Germany. Hospitalizations of PAD patients during the pre-pandemic year 2019 were compared to the pandemic year 2020. Results: Overall, 361,029 hospitalizations of PAD patients in the years 2019 and 2020 (55.4% aged ≥70 years; 36.6% females) were included in this study. In the pre-pandemic year of 2019, a total of 25,501 (13.2%) more hospitalizations due to PAD were detected compared to the COVID-19 pandemic year of 2020 (2019: 192,765 [53.4%] vs. 2020: 168,264 [46.6%], p = 0.065). Overall, in 610 (0.4%) of the hospitalization cases, a COVID-19 infection was diagnosed. Regarding interventional/surgical treatments, total numbers of peripheral endovascular intervention of the lower extremity decreased by 9.9% (83,845 vs. 75,519, p < 0.001), surgical peripheral artery revascularization of the lower extremity by 11.4% (32,447 vs. 28,754, p = 0.041) and amputations by 4.0% (20,612 vs. 19,784, p < 0.001) in 2020 compared to 2019. The case fatality rate (2.6% vs. 2.4%, p < 0.001), as well as MACCE rate (3.4% vs. 3.2%, p < 0.001), were slightly higher during the pandemic year 2020 compared to the pre-pandemic year 2019. Conclusions: The COVID-19 pandemic influenced the number of hospitalizations of PAD patients with a 13.2% reduction in hospital admissions and decreased total numbers of revascularization and amputation treatments.

Multiple imputation to minimise bias from missing stage information in estimates of early cancer diagnosis in England: a population-based study.

INTRODUCTION: Monitoring early diagnosis is a priority of cancer policy in England. Information on stage has not always been available for a large proportion of patients, however, which may bias temporal comparisons. We previously estimated that early-stage diagnosis of colorectal cancer rose from 32% to 44% during 2008-2013, using multiple imputation. Here we examine the underlying assumptions of multiple imputation for missing stage using the same dataset. METHODS: Individually-linked cancer registration, Hospital Episode Statistics (HES), and audit data were examined. Six imputation models including different interaction terms, post-diagnosis treatment, and survival information were assessed, and comparisons drawn with the a priori optimal model. Models were further tested by setting stage values to missing for some patients under one plausible mechanism, then comparing actual and imputed stage distributions for these patients. Finally, a pattern-mixture sensitivity analysis was conducted. RESULTS: Data from 196,511 colorectal patients were analysed, with 39.2% missing stage. Inclusion of survival time increased the accuracy of imputation: the odds ratio for change in early-stage diagnosis during 2008-2013 was 1.7 (95% CI: 1.6, 1.7) with survival to 1 year included, compared to 1.9 (95% CI 1.9-2.0) with no survival information. Imputation estimates of stage were accurate in one plausible simulation. Pattern-mixture analyses indicated our previous analysis conclusions would only change materially if stage were misclassified for 20% of the patients who had it categorised as late. INTERPRETATION: Multiple imputation models can substantially reduce bias from missing stage, but data on patient's one-year survival should be included for highest accuracy.

Mental distress among young adults in Great Britain: long-term trends and early changes during the COVID-19 pandemic.

PURPOSE: In Great Britain, few studies documented mental health trends in young adults in the years preceding 2020, the mental health dimensions affected, and how these compare with changes observed during the COVID-19 pandemic. METHODS: Long-term trends in mental health among 16-34 year old men and women between 1991 and 2018, and changes between 2018-19 and July-September 2020 were examined using all waves from the British Household Panel Study (1991-2008), the UK Household Longitudinal Study (2009-20), and the first five UKHLS COVID-19 waves administered in April, May, June, July, and September 2020. Findings are based on the GHQ-12 continuous score (0-36), clinically significant cases (4 + /12) and severe cases (7 + /12) for mental distress, and item endorsements. RESULTS: Between 1991 and 2018, the prevalence of cases (4 + /12) increased from 14-22% to 19-32% across groups. Increases were largest in women aged 16-24. In April 2020, the risk of caseness (4 + /12) increased across groups by 55% to 80% compared to the 2018-19 baseline. This increase, however, rapidly diminished over time: in July-September 2020, there was only a higher risk of caseness (4 + /12) in men aged 25-34 (prevalence ratio = 1.29, 95% CI 1.01-1.65) compared to the 2018-19 baseline. CONCLUSION: Whereas distress surged in April 2020, its return to pre-pandemic levels by September 2020 highlights the nuanced impact that the pandemic may have over time. Given the magnitude of the decline in mental health over the past decade, attention must be given to young adults once the pandemic ends.

In-patient Expenditure Between 2012 and 2020 Concerning Patients With Liver Cirrhosis in Chongqing: A Hospital-Based Multicenter Retrospective Study.

Background: Liver cirrhosis is a major global health and economic challenge, placing a heavy economic burden on patients, families, and society. This study aimed to investigate medical expenditure trends in patients with liver cirrhosis and assess the drivers for such medical expenditure among patients with liver cirrhosis. Methods: Medical expenditure data concerning patients with liver cirrhosis was collected in six tertiary hospitals in Chongqing, China, from 2012 to 2020. Trends in medical expenses over time and trends according to subgroups were described, and medical expenditure compositions were analyzed. A multiple linear regression model was constructed to evaluate the factors influencing medical expenditure. All expenditure data were reported in Chinese Yuan (CNY), based on the 2020 value, and adjusted using the year-specific health care consumer price index for Chongqing. Results: Medical expenditure for 7,095 patients was assessed. The average medical expenditure per patient was 16,177 CNY. An upward trend in medical expenditure was observed in almost all patient subgroups. Drug expenses were the largest contributor to medical expenditure in 2020. A multiple linear regression model showed that insurance type, sex, age at diagnosis, marital status, length of stay, smoking status, drinking status, number of complications, autoimmune liver disease, and the age-adjusted Charlson comorbidity index score were significantly related to medical expenditure. Conclusion: Conservative estimates suggest that the medical expenditure of patients with liver cirrhosis increased significantly from 2012 to 2020. Therefore, it is necessary to formulate targeted measures to reduce the personal burden on patients with liver cirrhosis.

Mortality Associated with Idiopathic Pulmonary Fibrosis in Northeastern Italy, 2008-2020: A Multiple Cause of Death Analysis.

Mortality from idiopathic pulmonary fibrosis (IPF) is increasing in most European countries, but there are no data for Italy. We analysed the registry data from a region in northeastern Italy to assess the trends in IPF-related mortality during 2008-2019, to compare results of underlying vs. multiple cause of death analyses, and to describe the impact of the COVID-19 epidemic in 2020. We identified IPF (ICD-10 code J84.1) among the causes of death registered in 557,932 certificates in the Veneto region. We assessed time trends in annual age-standardized mortality rates by gender and age (40-74, 75-84, and ≥85 years). IPF was the underlying cause of 1310 deaths in the 2251 certificates mentioning IPF. For all age groups combined, the age-standardized mortality rate from IPF identified as the underlying cause of death was close to the European median (males and females: 3.1 and 1.3 per 100,000/year, respectively). During 2008-2019, mortality rates increased in men aged ≥85 years (annual percent change of 6.5%, 95% CI: 2.0, 11.2%), but not among women or for the younger age groups. A 72% excess of IPF-related deaths was registered in March-April 2020 (mortality ratio 1.72, 95% CI: 1.29, 2.24). IPF mortality was increasing among older men in northeastern Italy. The burden of IPF was heavier than assessed by routine statistics, since less than two out of three IPF-related deaths were directly attributed to this condition. COVID-19 was accompanied by a remarkable increase in IPF-related mortality.

A Dynamic Bayesian Model for Identifying High-Mortality Risk in Hospitalized COVID-19 Patients.

As Coronavirus Disease 2019 (COVID-19) hospitalization rates remain high, there is an urgent need to identify prognostic factors to improve patient outcomes. Existing prognostic models mostly consider the impact of biomarkers at presentation on the risk of a single patient outcome at a single follow up time. We collected data for 553 Polymerase Chain Reaction (PCR)-positive COVID-19 patients admitted to hospital whose eventual outcomes were known. The data collected for the patients included demographics, comorbidities and laboratory values taken at admission and throughout the course of hospitalization. We trained multivariate Markov prognostic models to identify high-risk patients at admission along with a dynamic measure of risk incorporating time-dependent changes in patients' laboratory values. From the set of factors available upon admission, the Markov model determined that age >80 years, history of coronary artery disease and chronic obstructive pulmonary disease increased mortality risk. The lab values upon admission most associated with mortality included neutrophil percentage, red blood cells (RBC), red cell distribution width (RDW), protein levels, platelets count, albumin levels and mean corpuscular hemoglobin concentration (MCHC). Incorporating dynamic changes in lab values throughout hospitalization lead to dramatic gains in the predictive accuracy of the model and indicated a catalogue of variables for determining high-risk patients including eosinophil percentage, white blood cells (WBC), platelets, pCO2, RDW, large unstained cells (LUC) count, alkaline phosphatase and albumin. Our prognostic model highlights the nuance of determining risk for COVID-19 patients and indicates that, rather than a single variable, a range of factors (at different points in hospitalization) are needed for effective risk stratification.