Outcome ratio – ATRX http://atrx.net/ Wed, 25 May 2022 17:01:30 +0000 en-US hourly 1 https://wordpress.org/?v=5.9.3 https://atrx.net/wp-content/uploads/2021/10/icon-3-120x120.png Outcome ratio – ATRX http://atrx.net/ 32 32 FORTEC Elektronik: 3rd Quarter Report FY 2021/2022 https://atrx.net/fortec-elektronik-3rd-quarter-report-fy-2021-2022/ Wed, 25 May 2022 16:57:09 +0000 https://atrx.net/fortec-elektronik-3rd-quarter-report-fy-2021-2022/ BIG ENOUGH COMPETE – PRETTY SMALL TAKE CARE OF. Report 3rd QUARTER 2021/2022 Report 3rd Fiscal quarter 2021/2022 Content Preface Group management report Consolidated balance sheet Consolidated statement of comprehensive income Explanatory remarks FORTEC Report 3. Quarter 2021/2022 2 Preface Dear shareholders, Despite exceptionally difficult market conditions, we continued to grow during the first nine […]]]>

BIG ENOUGH

COMPETE –

PRETTY SMALL

TAKE CARE OF.

Report 3rd QUARTER 2021/2022

Report 3rd Fiscal quarter 2021/2022

Content

Preface Group management report Consolidated balance sheet

Consolidated statement of comprehensive income Explanatory remarks

FORTEC Report 3. Quarter 2021/2022 2

Preface

Dear shareholders,

Despite exceptionally difficult market conditions, we continued to grow during the first nine months of the year.

After coping well with the changing challenges of the COVID-19 pandemic over the past two years, the war in Ukraine has once again exacerbated the disruption to our global supply chains. Additionally, new regional lockdowns have been implemented in China over the past few weeks, resulting in additional efforts from our customers.

Despite taking significant steps to protect our employees, we were increasingly impacted by staff absences due to Covid-19 related illnesses at all sites in the third quarter. However, the latest Covid-19 case numbers give us reason to be optimistic that the situation will return to normal.

In the context of these difficult circumstances, the consolidated turnover of 66.0 million euros (previous year: 57.7 million euros) generated in the first nine months of 2021/2022 and the significant increase profit with an EBIT of EUR 6.3 million (previous year: EUR 3.6 million) is a remarkable achievement by all employees. It is a gratifying result that encourages us to continue on the path we have chosen.

The order backlog, which reached €85.3 million as of March 31, 2022 (previous year: €55.0 million), provides a solid basis for the coming months, but also indicates that chain problems of supply impede the fulfillment of orders on time.

Despite the ongoing challenges, we continue to develop the group in a sustainable and successful way with a view to taking FORTEC forward into the future as an attractive, innovative and financially sound group of companies.

Thank you for your trust and support along the way.

Germering, May 2022

Sandra Maille

CEO

FORTEC Report 3. Quarter 2021/2022 3

Group management report: 3rd quarter of the 2021/2022 financial year 01.07.2021-31.03.2022

Profit situation

In the first nine months of the 2021/2022 financial year, consolidated sales increased by around 14.4% to 66.0 million euros (previous year: 57.7 million euros).

Other operating income fell from 900 thousand euros to 1.5 million euros. The increase is due to the first consolidation of the second-tier Czech subsidiary ALLTRONIC and to the increase in income from exchange differences.

The cost of materials increased by €39.2 million to €44.4 million, in line with the increase in turnover despite tight supply chains. The cost of sales ratio decreased slightly from 67.8% to 67.3%. Gross margin, taking into account work in progress, increased in the nine-month period of fiscal year 2021/2022 to 33.1%, compared to 31.7% the previous year.

Personnel costs increased by around 10.5% to 10.9 million euros due to salary adjustments and more expensive new appointments due to the tight labor market situation. However, the personnel expense ratio decreased from 17.1% to 16.5% due to the increase in turnover.

Depreciations of EUR 1.2 million (previous year: EUR 1.3 million) remained almost constant compared to the previous year.

Other operating expenses increased from EUR 4.4 million in the previous year to EUR 4.7 million and amounted to 7.1% of sales (prior year: 7, 6%). This increase is explained by the increase in advertising and travel costs as well as the costs of external service providers for the recruitment of staff.

Due to the factors mentioned, operating profit (EBIT) as a key financial performance indicator of EUR

6.2 million is significantly higher than the previous year’s value of 3.6 million euros. The EBIT margin, based on sales, increased from 6.2% the previous year to 9.6% during the reference period.

The net result for the nine-month period of the 2021/2022 financial year amounted to 4.6 million euros, significantly higher than that of the same period of the previous year (2.6 million euros ). The return on sales after tax thus rose from 4.5% to 7.0%.

Earnings per share improved significantly during the reporting period to EUR 1.43 (previous year: EUR 0.79).

Asset position

Assets, with total assets of EUR 66.6 million (30/06/2021: EUR 64.0 million), non-current assets

amounted to 17.9 million euros (30/06/2021: 18.3 million euros).

Of this amount, the goodwill of the acquired subsidiaries is the largest item with 6.9 million EUR (30/06/2021: 6.7 million EUR),

monitoring of rights of use recognized in accordance with IFRS 16 for 5.6 million EUR (30/06/2021: 5.9 million EUR).

Among current assets, inventories are the largest single item with a value of EUR 22.9 million (30/06/2021: EUR 19.7 million), representing 34.4% of the balance sheet total (30/06/2021: /2021: 30.8%). The accumulation of inventory serves to smooth out any further fluctuations in supply chains. The trade receivables item increased

FORTEC Report 3. Quarter 2021/2022 4

from €8.7 million as of June 30, 2021 to €9.8 million as of March 31, 2022 due to revenue. Cash and cash equivalents increased from €14.7 million to €13.5 million due to dividend payments and loan repayments.

Financial and liquidity position

The financial situation of the company remains excellent and, with an above-average equity ratio of 72.0% (30/06/2021: 69.6%), is also impressive compared to companies with a business model similar. With shareholders’ equity of EUR 47.9 million (30/06/2021: EUR 44.5 million), the company is sufficiently equipped to make forward-looking decisions.

Non-current debts to banks, the second largest item of non-current debts, were reduced from €2.4 million as of June 30, 2021 to €1.7 million in accordance with the repayment plan. The largest item remained the long-term lease debts of EUR 4.7 million (30/06/2021: EUR 5.1 million).

In current liabilities, liabilities related to deliveries and services went from €4.9 million at June 30, 2021 to €5.0 million at March 31, 2022. Other liabilities went from €1.3 million euros to 1.5 million euros.

Provide

In a context of good activity over the nine-month period, the Management Board confirms its forecasts for the 2021/2022 financial year and anticipates growth of up to 15% in Group sales and an increase of up to 20% of the BAII Group’s turnover.

FORTEC’s business performance will continue to be affected by the impact of the global pandemic, the critical supply situation due to tight supply chains and the war in Ukraine. Especially given the war in Ukraine and its geopolitical and economic consequences, it is extremely difficult to make reliable predictions about future developments at this time. The 2021/2022 forecast is therefore subject to the condition that the underlying circumstances do not worsen further.

FORTEC Report 3. Quarter 2021/2022 5

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BreakPoint: The War in Ukraine and the Myth of Overpopulation https://atrx.net/breakpoint-the-war-in-ukraine-and-the-myth-of-overpopulation/ Sat, 21 May 2022 16:02:31 +0000 https://atrx.net/breakpoint-the-war-in-ukraine-and-the-myth-of-overpopulation/ Russia’s invasion of Ukraine was extremely expensive, and not just because of global sanctions and the loss of military equipment. In fact, the highest price Russia is paying in this war is for an increasingly scarce resource: lives. Estimates of Russian casualties in the first week of the war ranged from 2,000 to 6,000, with […]]]>

Russia’s invasion of Ukraine was extremely expensive, and not just because of global sanctions and the loss of military equipment. In fact, the highest price Russia is paying in this war is for an increasingly scarce resource: lives. Estimates of Russian casualties in the first week of the war ranged from 2,000 to 6,000, with thousands more lost since then. Every life lost is tragic, but as British journalist Ed West points out, it’s a loss that modern Russia simply cannot afford.

Russians, like in so many other European countries, just don’t have enough babies. The country’s population is shrinking by more than 100,000 people a year, with no clear end in sight. Some parts of the country are simply being emptied of their population. According to West, around 20,000 Russian villages have been abandoned in recent years, followed closely by tens of thousands.

This is a factor that could ultimately affect the outcome of the war, West thinks: “If the Russians turn out not to want this fight, it will probably be for the simple fact that the country does not have enough of men to spare. The majority of these poor young men killed for Russia’s honor will be their mother’s only child, in many cases their only child.”

It turns out that Russia’s problem is not unique. This country, so rich in land but poor in youth, is just one of dozens of nations across an “infertile crescent” from Spain to Singapore, made up of populations aging so rapidly that their long-term existence is put in jeopardy. questioned.

West cites a few examples that put the statistics into perspective: “In 2000, Thailand had 7 workers for every retiree; by 2050, that number will be just 1.7. In Greece, 1,700 schools closed between 2009 and 2014. .” In Stoke-on-Trent, England, “40% of bars and clubs have closed in the past 20 years, with the ratio of infants to pensioners falling from 4:1 to 1:2 in a century”. And in Paris, “15 schools merged or closed between 2015-2018”.

According to the United Nations World Fertility Map, all continents except Africa are below or approaching the replacement birth rate. This widespread population collapse is so abrupt that West likens it to PD James’ novel “Children of Men,” a tale of a world devoid of babies.

One of the reasons it is hard to imagine a world threatened by aging and depopulation is that for decades now we have been fed a constant diet of alarm about overpopulation. Ever since Paul Ehrlich published his book “The Population Bomb” in 1968, the idea that the Earth is overpopulated has become the myth of the zombie that doesn’t die. “The battle to feed humanity is over,” Ehrich said. “In the 1970s, the world will experience famines – hundreds of millions of people will starve to death.”

He was wrong, of course, largely because human beings are not mere eating machines. We have the ability to innovate and improve methods of food production and living, and that is exactly what has happened. To the extent that famines still occur, they are usually the result of political corruption and war. In fact, we now produce enough food to feed 3 billion more people than actually exist!

So why does the idea of ​​overpopulation and the solution of having fewer children persist? How can this belief still prevail over millions of people in the developed world despite mounting evidence to the contrary?

The partial answer is that influential people in government, academia, and the press have engaged in an antinatal mentality and find it difficult to admit that the real problem is too few new humans. The myth of an overpopulated planet persists despite all the evidence because it has long been accepted as dogma, and hardly anyone has bothered to question it since.

The demographic trends at work in Russia and around the world, including the United States, will not be easily reversed. One author has compared the increase in a nation’s fertility to the pushing of water upwards. And in many ways, the gray, shrunken world of our not-so-distant future is an experience never before attempted. The most important strategies to address this—beyond creating cultures where children and families are valued again—probably haven’t been thought of yet.

What we can say at this point is that the dwindling supply of young men in Russia is just another example of the gap between popular wisdom and facts. With regard to overpopulation, these facts are known. We see the results before our eyes. And the dreaded future of too many mouths to feed has not materialized. Instead, we have a banquet for billions. But some countries may not join us.

From BreakPoint, May 11, 2022; reproduced with permission from the Colson Center, breakpoint.org.

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Canadian inflation hits highest level since MC Hammer released 2 Legit 2 Quit https://atrx.net/canadian-inflation-hits-highest-level-since-mc-hammer-released-2-legit-2-quit/ Wed, 18 May 2022 20:34:03 +0000 https://atrx.net/canadian-inflation-hits-highest-level-since-mc-hammer-released-2-legit-2-quit/ Canadian households are facing the highest inflation in a generation. Statistics Canada (Statistics Canada) has released Consumer Price Index (CPI) data for April. The agency attributes the recent acceleration to food and shelter, which propelled growth to the highest level since the early 1990s. Some may call it a peak for growth, but that’s not […]]]>

Canadian households are facing the highest inflation in a generation. Statistics Canada (Statistics Canada) has released Consumer Price Index (CPI) data for April. The agency attributes the recent acceleration to food and shelter, which propelled growth to the highest level since the early 1990s. Some may call it a peak for growth, but that’s not what top Bay Street analysts see for the next report.

Canadian inflation hits 6.8%, the highest rate since 1991

Canadian inflation rose again, although the acceleration was slower than in recent months. Annual CPI growth was 6.8% in April, up just 0.1 points from the previous month. It was the highest reading since September 1991. In other words, if you’re under 30, you’ve never seen your cost of living rise so quickly.

Food and shelter fueled inflation in Canada last month

Stat Can attributes most of the latest rise to food and housing prices. The cost of food rose 9.7% in April, rising faster than any period since September 1981. The agency notes that this was the fifth month that the food component was above 5 points. With supply chain disruptions including export restrictions, it is unlikely to drop soon.

Most Canadians know that housing costs are rising, but the CPI isn’t rising for whatever reason you might think. According to the agency, house prices rose 7.4% in April, the fastest rate since 1983. The increases were mainly attributed to fuel costs like heating and air conditioning. Homeowners’ replacement costs also show a strong increase of 13.0%, an approximation for new homes.

“The earlier house price boom is now feeding into the CPI aggressively, with new home prices and ‘other owned accommodation spending’ (mainly property charges) being the two main drivers last month,” said Douglas Porter, chief economist at BMO. .

Bay Street sees next inflation report accelerating

Annual growth accelerated by only 0.1 point in April, one tenth of the 1.0 point increase in the CPI seen in March. While this may indicate growth is slowing, that is not the case on Bay Street this morning.

BMO Capital Markets warned clients that the slow month was only temporary. “…it’s relative calm ahead of another downpour in next month’s report, as gasoline prices track a double-digit increase in May alone,” Porter explained.

The National Bank of Canada (NBF) also warned that the tight labor market is an inflation risk. “In an extremely tight labor market environment with record high unemployment, workers are well placed to seek compensation, which should translate into relatively high inflation in services,” said Matthieu. Arseneau, Deputy Chief Economist of the FBN.

Adding: “For these reasons, the Central Bank must continue its accelerated process of normalizing interest rates, which are still far too accommodative for the economic situation.”

High inflation becomes a larger and more difficult problem to solve the longer it persists. Once wages begin to adjust to inflation levels, the “transient” potential is eliminated. Higher wages also tend to raise consumer prices, which can lead to more inflation. Breaking out of an inflationary spiral is very difficult, and it’s a problem that even the top brass at RBC have warned about.

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Jervois begins expansion of BFS refinery at Kokkola https://atrx.net/jervois-begins-expansion-of-bfs-refinery-at-kokkola/ Mon, 16 May 2022 13:04:07 +0000 https://atrx.net/jervois-begins-expansion-of-bfs-refinery-at-kokkola/ Strong points Jervois Initiates Bankable Feasibility Study (“BFS”) to Expand Cobalt Refining Capacity at Kokkola Jervois Finland, a 100% subsidiary of Jervois, has been operating for more than 50 years in the production of cobalt chemicals and powders The BFS scope will expand access to the annual capacity of the Jervois refinery from 6,250 […]]]>

Strong points

  • Jervois Initiates Bankable Feasibility Study (“BFS”) to Expand Cobalt Refining Capacity at Kokkola

  • Jervois Finland, a 100% subsidiary of Jervois, has been operating for more than 50 years in the production of cobalt chemicals and powders

  • The BFS scope will expand access to the annual capacity of the Jervois refinery from 6,250 metric tons to at least 12,250 metric tons of refined cobalt, to meet growing global demand

  • Kokkola expansion expected to increase Jervois’ participation in cobalt reclamation, with 10-15% of cobalt inputs to be received as recycled units

  • Advances Jervois’ strategy to become a significant global supplier of cobalt products for batteries and other industries

May 16, 2022 – TheNewswire – Australia – Jervois Global Limited (“Jervois“or the”Company”) (ASX:JRV) (TSXV:JRV) (OTC:JRVMF) announces the start of a bankable feasibility study (“BFS”) to expand refined cobalt production in the Kokkola Industrial Park, Finland.

Jervois’ wholly-owned subsidiary, Jervois Finland, is a leading supplier of high quality cobalt products, with advanced technological capabilities, product quality and reliability, and a strong commitment to high environmental and sustainability standards. Jervois Finland has over 50 years of cobalt production experience in Kokkola, with a global customer base in rechargeable batteries, chemicals, catalysts, ceramics and powder metallurgy applications.

The BFS will assess the potential expansion of Jervois Finland’s production via the construction of a new refinery close to the location of its current facilities in the Kokkola Industrial Park. The expansion is expected to consist of the addition of at least 6,000 metric tons of annual cobalt refining capacity and would be separate from Jervois’ existing business relationships. An expansion of refining capacity should be available alongside the expected expansion of cobalt demand for the second half of this decade.

The expansion of Jervois Finland’s production capacity advances the company’s strategy to become a leading global supplier of specialty chemicals and advanced cobalt manufactured products for the battery and other industries, alongside the development of its cobalt operations in Idaho (“ICO”) in the United States, which is expected to begin production of cobalt concentrate in the third quarter of 2022. Jervois also recently announced the BFS result for the restart of stage 1 of the São Miguel Paulista (“SMP”) Nickel and Cobalt refinery in Brazil, which Jervois is in the process of acquiring.

Jervois Finland’s flexible downstream platform in advanced cobalt materials production capability represents a unique advantage. The refinery will be physically connected to Jervois Finland’s existing state-of-the-art manufacturing plants, to enable further optimization of the capacity of the existing product line at the powder and chemical plants. Jervois Finland has a finished product production capacity of 11,000 metric tons per year of contained cobalt. More refined production will lead to greater flexibility to adapt to end-user demands and to continuously optimize the product range.

Jervois Finland’s existing ESG framework, including responsible sourcing, will cover expanded refining operations and input requirements.

Kokkola’s proposed expansion will lead to Jervois’ increased participation in ‘closed-loop’ circular recycling, where cobalt is used by customers and returned to Jervois Finland for regeneration. Approximately 10-15% of cobalt inputs are expected to be received as recycled units, which is similar to the ratio currently processed at Jervois Finland’s existing operations.

The expansion schedule will be determined as part of the BFS, but will not require any significant short-term financial investment for Jervois. The selection processes for technical partners in Finland are ongoing, covering key areas of work such as flowsheet piloting, process engineering, and environmental and other permits.

Initial commercial discussions with end product customers and refinery feed suppliers (including recyclers) are also underway.

On behalf of Jervois Global Limited,

Bryce Crocker, General Manager

For more information, please contact:

Forward-looking statements

This press release may contain certain “forward-looking statements” within the meaning of the United States Private Securities Litigation Reform Act of 1995 and applicable Canadian securities laws. When used in this press release, the words “anticipate”, “believe”, “estimate”, “expect”, “target”, “plan”, “anticipate”, “may”, “schedule “, “expect” and similar words or phrases identify forward-looking statements or information. Such forward-looking statements or information may relate to Jervois Finland’s production mix, proposed refinery size, timing of study completion, timing of future operations, potential levels of recycling inputs and certain other factors. or information. These statements represent the current views of Jervois regarding future events and are necessarily based on a number of assumptions and estimates which, while considered reasonable by Jervois, are inherently subject to significant business risks, contingencies and uncertainties. , economic, competitive, political and social. . Many factors, known and unknown, could cause actual results, performance or achievements to differ materially from the results, performance or achievements that are or may be expressed or implied by such forward-looking statements. Jervois does not intend, and undertakes no obligation, to update such forward-looking statements or information to reflect changes in assumptions or changes in circumstances or any other event affecting such statements and information other than as required. by applicable laws, rules and regulations. .

Neither the TSX Venture Exchange nor its Regulation Services Provider (as that term is defined in the policies of the TSX Venture Exchange) accepts responsibility for the adequacy or accuracy of this release.

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JP Morgan downgrades PH citing ‘myriad challenges’ https://atrx.net/jp-morgan-downgrades-ph-citing-myriad-challenges/ Wed, 11 May 2022 04:09:00 +0000 https://atrx.net/jp-morgan-downgrades-ph-citing-myriad-challenges/ Philippine flags fly in front of the Philippine Stock Exchange at Bonifacio Global City in Taguig on June 18, 2021. Jonathan Cellona, ​​ABS-CBN News/File MANILA — JP Morgan downgraded the Philippines to “underweight” on Tuesday citing “challenges that could cause the stock market to underperform,” in a report following the May 9 election. “We are […]]]>
Philippine flags fly in front of the Philippine Stock Exchange at Bonifacio Global City in Taguig on June 18, 2021. Jonathan Cellona, ​​ABS-CBN News/File

MANILA — JP Morgan downgraded the Philippines to “underweight” on Tuesday citing “challenges that could cause the stock market to underperform,” in a report following the May 9 election.

“We are downgrading the Philippines to underweight and the Philippine real estate sector to neutral,” JP Morgan said in its Philippines equity strategy report made available to clients.

An underweight means he expects Philippine equities to not perform as well as their counterparts in the near term.

“We recommend selling for a possible post-election rally in hopes, consistent with advice from the Philippines equity strategy team,” JP Morgan said.

“Philippine stocks face myriad challenges including twin deficits, higher inflation, slower government spending in post-election quarters (transition pain), high government debt, risk of depreciation valuation and potential earnings growth disappointment,” he added.

The report was released a day after national elections in the Philippines where former Senator Ferdinand “Bongbong” Marcos Jr.; the namesake son of dictator Ferdinand Marcos, jumped in the partial unofficial result.

Marcos is set to become the country’s 17th president with 31,073,556 votes compared to Vice President Leni Robredo with 14,807,254 votes as of 8:37 a.m. on May 11 out of a total of 98.23% of the election results transmitted .

Screenshot caption: Presidential race results as of May 11.  Screenshot
Results of the presidential race as of May 11. Screenshot

INVESTOR CONCERNS

In its Philippine Strategy Flash report, which was released ahead of the May 9 polls, JP Morgan also listed the concerns of investors funding a Marcos presidency based on feedback from the past 3 months.

Investor concerns include:

  • potential for reassessment of the administration’s position on large private sector corporate families based on past alignments or historical group positions on issues related to the former Marcos regime
  • political issues “given the candidate’s lack of a substantial articulated economic platform” and his seemingly limited access to mainstream media such as debates and pre-election interviews
  • lack of a significant background as a government official
  • perception based on legacy of Marcos Sr regime

Philippine stocks opened lower on Tuesday at the 6,632 level, down 1.89% before rallying and closing at the 6,720.93 level.

Financial analyst and head of research at COL Financial, April Lee Tan, said earlier that the stock market moves were likely driven by global issues such as the US Federal Reserve’s aggressive interest rate hikes and war. in Ukraine.

Tan said it would be too early to tell if the poll results influenced the market.

JP Morgan clarified that the report has nothing to do with the poll results.

“We believe the Philippines faces a challenging macroeconomic outlook after 2022, regardless of the outcome of the May 2022 presidential elections,” he said.

WHAT A MARCOS ADMIN WOULD INHERITATE

The financial services company pointed out that the next administration would be under pressure to alleviate current economic challenges such as weaker gross domestic product growth due to the pandemic and rising debt.

National public debt hit a record 12.68 trillion pesos in March, fueled largely by pandemic borrowing and the country’s ambitious infrastructure program.

The country’s debt-to-GDP ratio has risen to 60.5% in 2021, from less than 40% before the pandemic.

Bangko Sentral ng Pilipinas Governor Benjamin Diokno said earlier that the debt ratio remains manageable as long as the government ensures robust economic growth in the future.

The Philippine economy had grown by an average of 6% before the pandemic.
But it contracted 9.6% in 2020, its worst performance since the end of World War II due to the pandemic, before rebounding to 5.6% in 2021 as quarantine restrictions were eased in the last part of the year.

JP Morgan said the recent growth trajectory could “weaken” in 2023.

“We expect the benefits of reopening to the GDP growth trajectory to diminish next year and put strong pressure on the government to ramp up capital spending,” JP Morgan said.

He said it would be crucial for the next administration to “explore and consider” tax reforms such as the carbon tax or increasing sin taxes to get public debt under control.

There are also upside risks to inflation from rising prices for oil and other global commodities as the conflict between Russia and Ukraine persists.

Inflation could settle above the 2-4% target this year at 4.3% and should remain elevated for the rest of the year, according to the central bank’s outlook.

Although the BSP has kept the interest rate at 2% since November 2020, it could start “normalizing” policies in June, Diokno said, to dampen inflation.

However, interest rate hikes could also dampen economic growth. Balancing growth and mitigating inflation is the challenge, the BSP said.

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BNT162b2 vaccination after SARS-CoV-2 infection decreases risk of recurrent infection https://atrx.net/bnt162b2-vaccination-after-sars-cov-2-infection-decreases-risk-of-recurrent-infection/ Mon, 09 May 2022 12:53:40 +0000 https://atrx.net/bnt162b2-vaccination-after-sars-cov-2-infection-decreases-risk-of-recurrent-infection/ 1. In a retrospective cohort study of individuals who recovered from SARS-CoV-2, BNT162b2 vaccination decreased the risk of recurrent infection. Evidence rating level: 2 (good) Summary of the study: The long-term efficacy and durability of immune protection provided after SARS-CoV-2 (Covid-19) infection is unclear. The aim of this retrospective cohort study was to assess whether […]]]>

1. In a retrospective cohort study of individuals who recovered from SARS-CoV-2, BNT162b2 vaccination decreased the risk of recurrent infection.

Evidence rating level: 2 (good)

Summary of the study: The long-term efficacy and durability of immune protection provided after SARS-CoV-2 (Covid-19) infection is unclear. The aim of this retrospective cohort study was to assess whether vaccination with the BNT162b2 Covid-19 vaccine (Pfizer-BioNTech) would protect against reinfection in individuals previously infected with Covid-19. In this retrospective cohort study, the electronic medical records of patients who had previously recovered from Covid-19 in Israel were reviewed for the incidence of reinfection. Reinfection rates between individuals vaccinated with the BNT162b2 vaccine and unvaccinated individuals were compared to determine vaccine efficacy. The study found that reinfection occurred in 2.46 cases per 100,000 people per day in vaccinated people, which was significantly lower than 10.21 cases per 100,000 people per day in unvaccinated people, which gives a vaccine efficacy of 82%. Rates were similar between individuals vaccinated with one dose and those receiving two doses. Taken together, this study supports that previously infected people who also receive subsequent vaccination against Covid-19 have a lower risk of reinfection compared to those who are not vaccinated. The results of this study are limited by the retrospective design of the study, the use of irregular PCR tests and the analysis of only patients receiving the BNT162b2 vaccine.

Click to read the study in the NEJM

Relevant Reading: mRNA Vaccination Stimulates Cross-Variant Neutralizing Antibodies Caused by SARS-CoV-2 Infection

In depth [retrospective cohort]: In this retrospective cohort study, 149,032 electronic medical records of people previously infected with SARS-CoV-2 (Covid-19) at a single health center in Israel were reviewed. Patients were eligible if they had recovered from a documented Covid-19 infection 100 days prior to receiving any vaccination and had not previously experienced Covid-19 reinfection. The study cohort was divided into individuals receiving at least one dose of BNT162b2 Covid-19 vaccine and unvaccinated, with the primary outcome being the incidence of reinfection with Covid-19 as determined by the chain reaction test. by polymerase (PCR). The Cox proportional hazards regression model was used to analyze the statistical differences between the two groups. Reinfections were significantly lower in the vaccinated group where 354 of 83,356 people were reinfected (2.46 cases per 100,000 people per day), compared to the unvaccinated group where 2,120 of 60,877 patients were reinfected (10 79 cases per 100,000 people per day). The adjusted hazard ratio for protection against reinfection by vaccination was 0.18 (95% confidence interval [CI], 0.16-0.20) in patients aged 16-64 years and 0.40 (95% CI, 0.24-0.64) in those older than 65 years. Vaccine efficacy was estimated at 82% (95% CI, 80-84). Reinfection rates were similar among individuals with a hazard ratio of 0.98 (95% CI, 0.64-1.5) for individuals receiving two doses versus one dose. Overall, the study supports that vaccination with the BNT162b2 vaccine confers significant protection against reinfection with Covid-19 in people already infected with Covid-19.

Picture: PD

©2022 2 Minute Medicine, Inc. All rights reserved. No work may be reproduced without the express written consent of 2 Minute Medicine, Inc. Learn about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

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Investigation of the association between the sex of the surgeon and the ergonomic constraint of the laparoscopic device in gynecological surgery https://atrx.net/investigation-of-the-association-between-the-sex-of-the-surgeon-and-the-ergonomic-constraint-of-the-laparoscopic-device-in-gynecological-surgery/ Mon, 02 May 2022 06:45:43 +0000 https://atrx.net/investigation-of-the-association-between-the-sex-of-the-surgeon-and-the-ergonomic-constraint-of-the-laparoscopic-device-in-gynecological-surgery/ Goal of the study To assess whether female versus male gender is associated with greater ergonomic strain with the use of 4 advanced energy laparoscopic devices (LigaSure, HALO PKS, ENSEAL, and Harmonic Scalpel). Design Online survey distributed by e-mail via the REDCap platform. All responses were anonymous. Setting United States National Survey. Speakers Gynecological surgeons […]]]>

Goal of the study

To assess whether female versus male gender is associated with greater ergonomic strain with the use of 4 advanced energy laparoscopic devices (LigaSure, HALO PKS, ENSEAL, and Harmonic Scalpel).

Design

Online survey distributed by e-mail via the REDCap platform. All responses were anonymous.

Setting

United States National Survey.

Speakers

Gynecological surgeons were interviewed through the Society of Gynecologic Surgeons mailing list and 4 departmental obstetrics and gynecology mailing lists.

Speeches

The survey was distributed between 5/01/2020 and 11/01/2020.

The primary endpoint was the presence of physical complaints due to laparoscopic devices. Descriptive statistics compared surgeon characteristics and ergonomic symptoms. A logistic regression was performed, adjusted for the characteristics of the surgeon.

Measures and main results

The response rate was 39%, including 149 women (78%) and 41 men (22%). Women compared to men had a significantly younger age (mean 34 vs 44, p<0.01), smaller glove size (mean 6.5 vs 7.5, p<0.01), shorter waist (median 66 vs. 71 inches, p<. 01), et étaient moins fréquemment en pratique depuis > 10 years (19% versus 49%, p < 0.01). Women significantly more often reported physical complaints related to the use of laparoscopic appliances (79% vs. 41%, p<0.01). Women reported that all devices had too large a fit for proper use (p < 0.01). Women had a 5.37 times greater risk of physical disorders attributed to the use of laparoscopic instruments (ORC 5.37, 95% CI 2.56-11.25); with adjustment for glove size, age, and laparoscopic case volume and duration, this was no longer significant (aOR 2.02, 95% 0.59-6.93).

Conclusion

Women significantly more often report physical complaints and improper fit of the LigaSure, HALO PKS, ENSEAL and Harmonic scalpel. Female sex is associated with a five times greater risk of physical problems when using a laparoscopic device. Further investigation of the surgeon factors underlying device stress is an essential next step in understanding and reducing surgeon ergonomic injuries.

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No photography is useless if it is part of the growing process https://atrx.net/no-photography-is-useless-if-it-is-part-of-the-growing-process/ Sat, 30 Apr 2022 14:40:41 +0000 https://atrx.net/no-photography-is-useless-if-it-is-part-of-the-growing-process/ Not succeeding does not mean not progressing. I think for many of us, the last few years of the pandemic have brought this feeling to light, especially since when it comes to photography, “success” is already such a broad and nebulous concept. My own interpretation of the criteria I would need to consider myself successful […]]]>

Not succeeding does not mean not progressing. I think for many of us, the last few years of the pandemic have brought this feeling to light, especially since when it comes to photography, “success” is already such a broad and nebulous concept.

My own interpretation of the criteria I would need to consider myself successful has changed many times since I first picked up a camera in 2015. It’s only very recently that I feel to have been able to establish some objectives to achieve. and constantly work in these directions.

This means that I sometimes regret the five years or so of my first work: I have completely changed since that work to the point that I hardly consider it “my” photography anymore. Not only the look, feel and method behind the work, but these images lack the real purpose that my current work contains. If only I had started earlier along the path that I walk now, how much farther would I be; how much closer I would be to my goals.

Considering that time wasted is a real burden, a stress on how I apply my time in the present, anxious to look back now as I look back then, with regret. It magnifies every frame of misused film, every page of darkroom paper, every hour of waiting in place for elements that didn’t come together in the way I would have preferred. I am very aware of these events: because a success is well defined for these on a smaller scale, a failure is all the more tangible.

I can dwell on these because the successes I seek overall will take years to manifest as a long-term narrative expressed through printed results, so through this lens I I can identify a lot more waste than I can validate, a lot more disappointment than satisfaction.

The longer I work on my projects, the less I shoot, down to about half of what I used to do in a month, reaching about the same pass/fail ratio as when I was working digitally. . It’s actually a great accomplishment, but it doesn’t always look like it because of the way I’ve framed the waste. I have to remember to avoid thinking of waste in this way, but to reframe the whole process into a series of positive and negative outcomes that wouldn’t exist without the other.

There’s no realistic way to look back at my early years and not see that even though I’ve changed since then, that change wouldn’t have been possible without that original process. Those original hits, which I now consider waste, got me to where I am today. The time spent preparing each photo that I have been happy or satisfied with cannot be considered a waste, whether it was a long-term failure or a short-term failure.

Even if I never achieve any of my future goals, the process of working towards them is absolutely something that I can consider a success, a good and worthwhile use of my time. It’s not always necessary to have a short-term reward or even a long-term reward – and in the type of work I apply myself to, there is rarely anything other than this satisfaction in the moment, being present. to apply my craft to a story I want to tell.

There’s magic in not getting shot, but only if you decide to structure things that way for yourself. To see goals outside of acclaim and popularity, awards and reach. This is partly why I reframed the way I view and value my audience towards intimacy rather than a huge but loosely defined crowd.

A real waste would mean a situation where my time goes to something useless. Discovering a use for these failures in the process of success, or finding them as valuable lessons, removes that weight from my perception. I have to be free to fail otherwise I will end up locking myself into one way of doing things. If I stop experimenting because of the pain of feeling like I’ve wasted my time, then it’s just as much a waste of time, because I’ll lose the joy of discovering, of changing as a person. and as a documentary filmmaker.

I used to automatically frame sitting quietly in a white cube as a waste of time, but now I can see that there are always aspects to take away, even from a private sensory experience. I have traveled overseas, photographed many images over the hours and spent thousands of pounds, only to have a few keepers in the end, and no use for them in those quantities. Only the experience stays with me, which means I can decide that time has been wasted, or I can find value in the experience and recognize that where I am now is built on the foundations of then, a place where I can and have learned from these experiences, and where I am open to continuing to fail to learn from them too.

All of the photographs accompanying this article are individual successes, but all have the potential to be a waste of time if I don’t go the rest of the way to incorporate them into the projects where they should belong. The individual photographs are less of a point of pride for me than they used to be, now I have to know they are living their best life on the page before I am satisfied. It means constant dedication to work, constant exploration and interrogation in order to produce the most fulfilling final pieces possible.

Using this mindset to shape the use of my future time, to plan and account for failures and waste as part of the process automatically leaves me in a position where even if I waste time, I spend less time to stress about this lost time, to refuse to continue this cycle. I always feel like my time is ticking and I always try to avoid excessive downtime even though I know it’s probably healthier to take a break. Wasting time not shooting is one thing, but I still feel it very deeply when I’m shooting, developing, printing, sequencing, putting in hours and still feeling like it’s a waste of time – it’s something I still need to work on.

I’ve found that perspective has been really positive for the kind of long-term thinking my documentary projects require, and allows me to align long-term gains by planting metaphorical seeds today that I know will be of no use to me until many years down the line. Things like connecting with publishers and galleries when I know I don’t yet need to showcase my work in this way means connections I may never use, but I can still take advantage of these relationships while I have them, even if they end up useless in the way I originally intended.


About the Author: Simon King is a London-based photographer and photojournalist, currently working on a number of long-term documentary and street photography projects. The opinions expressed in this article are the sole responsibility of the author. You can follow his work through his documentary collective, The New Exit Photography Group, and on Instagram.

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PR seems more effective against high-risk prostate cancer https://atrx.net/pr-seems-more-effective-against-high-risk-prostate-cancer/ Thu, 28 Apr 2022 16:34:24 +0000 https://atrx.net/pr-seems-more-effective-against-high-risk-prostate-cancer/ Traditionally, radical prostatectomy (RP) in patients with high-risk prostate cancer has been considered less effective than external radiation therapy (EBRT) combined with androgen deprivation therapy. Emerging data over the past decade has demonstrated that PR with adjuvant or salvage therapy can be as effective as EBRT combined with androgen deprivation therapy. In a study by […]]]>

Traditionally, radical prostatectomy (RP) in patients with high-risk prostate cancer has been considered less effective than external radiation therapy (EBRT) combined with androgen deprivation therapy. Emerging data over the past decade has demonstrated that PR with adjuvant or salvage therapy can be as effective as EBRT combined with androgen deprivation therapy.

In a study by Chierigo et al,1 the authors assessed the roles of RA and EBRT in cancer-specific mortality (CSM) difference in men with high-risk prostate cancer in the Surveillance, Epidemiology, and End Results (SEER). The authors hypothesized that there is no difference in CSM between RP and EBRT.

It is important to understand the different definitions of high-risk prostate cancer. The National Comprehensive Cancer Network (NCCN) definition includes either Gleason (GS) scores of 8-10 (level group 4-5) or prostate-specific antigen (PSA) levels greater than 20 ng/mL or clinical stage of at least T3. They then subdivided the high-risk prostate cancer cohort based on the Johns Hopkins classification into Johns Hopkins High-Risk (JH-HR) groups (cT3a or Level 4 group or PSA>20 ng/mL) and very high risk (JH-VHR) groups (cT3b-cT4 and or primary Gleason pattern 5 and or 2-3 HR features and or≥5 positive biopsy cores with grade 4 group).

In the SEER database, CSM was defined as deaths attributable to prostate cancer, as recorded on death certificates. Conversely, mortality from other causes was defined as deaths attributable to causes other than prostate cancer. In the SEER database (2010-2016), the authors identified all patients treated with RP or EBRT. The primary endpoint of this analysis was whether there were differences in CSM between PR and EBRT across the entire NCCN HR patient cohort, and whether differences in survival, based on treatment, existed within the JH-HR and JH-VHR subgroups. .

Of the 24,407 NCCN patients with high-risk prostate cancer, 9,823 (40%) underwent RA and 14,584 (60%) received EBRT. When divided into subgroups, 10,300 (42%) were classified as JH-HR and 14,107 (58%) were JH-VHR.

Among JH-HR patients, 4863 (47%) were treated with RP and 5437 (53%) with EBRT. Among JH-VHR patients, 4960 (35%) were treated with RP and 9147 (65%) with EBRT. Patients receiving brachytherapy, alone or in combination, were excluded.

Among the core cohort, EBRT patients were older (median age, 71 vs. 64 years), had higher PSA values ​​(median, 13 vs. 8 ng/mL), and had higher clinical T and N stages. In addition, 5-year mortality rates from other causes were higher in the EBRT group than in the PR group (12% versus 3.4%).

The authors used propensity score matching (PSM) for the entire NCCN high-risk patient cohort to account for variation in baseline characteristics. PSM resulted in 2 equal groups of 7363 PR patients and 7363 EBRT patients, with no significant residual differences in age, PSA, GS biopsy, and clinical stages T and N. Median follow-up times for event-free patients were 41 months and 35 months for PR and EBRT, respectively. The rates of MSC at 5 years follow-up were 2.3% (95% CI, 1.9-2.9) for PsA and 4.1% (95% CI, 3.4-4, 8) for EBRT (P<.01). This resulted in a multivariate hazard ratio of competing risks of 0.68 (95% CI, 0.54-0.86; P<.001) in favor of RP. Additionally, the JH-VHR group was an independent predictor of higher CSM (HR, 4.2; P<.001) compared to the JH-HR group.

After applying the PSM to the JH-VHR cohort, 2 equally sized groups of 4020 RP and 4020 EBRT were identified, with no statistically significant residual differences in age, PSA, GS biopsy, or clinical stages T and N The 5-year MSC rates were 3.5% for RP and 6.0% for EBRT (P<0.001), for a multivariate risk to competing risk ratio of 0.58 (P<.01) in favor of RP.

Similarly, for the JH-HR cohort, matched groups of 3207 RP and 3207 EBRT were identified, with no statistically significant residual differences in age, PSA, GS biopsy, and clinical stages T and N. The rates of CSM at 5 years of follow-up were 0.7% for PR and 1.2% for EBRT, with a statistically non-significant multivariate multivariate hazard ratio of 0.7 (P=0.2).

High-risk prostate cancer requires multimodal treatment discussion and planning, regardless of the primary treatment used initially. In clinical practice, androgen deprivation therapy is used for virtually all patients receiving EBRT for high-risk prostate cancer. However, this information (i.e. percentage treated and dose and duration of androgen suppression therapy) is not available in this dataset. Similarly, 50% or more of post-RP high-risk patients will require adjuvant or salvage therapy (EBRT or androgen deprivation), but this information is also not available in the dataset. used for this analysis. Additionally, this population-based dataset does not provide information on comorbidities and other factors that lead to the selection of one treatment over another. PSM was used to account for the fact that the EBRT cohort was older and had a higher PSA level and higher stage; however, it cannot account for all unmeasured confounders. Despite several limitations, this type of analysis may be our best source of data regarding the comparative effectiveness of various treatment modalities for high-risk prostate cancer until ongoing randomized controlled trials are completed.

Several important points can be drawn from this analysis of a large population-based dataset of high-risk prostate cancer patients, which is then analyzed as the JH-HR and JH-VHR cohorts. JH subclassification into HR and VHR appears to be a robust prognostic variable for CSM. CSM was lower for PR-treated patients, compared to EBRT, in the entire NCCN cohort and in the JH-VHR prostate cancer patient subgroup, but not in the JH-HR subgroup. This may be because the event rate (i.e. death) was quite low in the JH-HR prostate cancer group. Interestingly, in the JH-HR group, the 5-year MSC rate was only 0.7% for RP and 1.2% for EBRT. It is very possible that high-risk prostate cancer detected by PSA portends a more favorable outlook compared to the pre-PSA era, regardless of the type of primary treatment used. These data may be useful in counseling patients about primary RP or EBRT and the risk of death after definitive treatment for high-risk prostate cancer.

Reference

1. Chierigo F, Wenzel M, Würnschimmel C, et al. Survival after radical prostatectomy versus radiotherapy in high-risk and very high-risk prostate cancer. J Urol. 2022;207(2):375-384. doi:10.1097/JU.0000000000002250

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Euro retreats as Emmanuel Macron beats Le Pen in France https://atrx.net/euro-retreats-as-emmanuel-macron-beats-le-pen-in-france/ Mon, 25 Apr 2022 08:45:42 +0000 https://atrx.net/euro-retreats-as-emmanuel-macron-beats-le-pen-in-france/ US stocks fell sharply on Friday as concerns over the Federal Reserve intensified. The Dow Jones and S&P 500 indexes had one of the worst days this year after Jerome Powell warned the bank would continue its aggressive rate hike policy. This will imply more rate hikes and even quantitative tightening. Investors are also worried […]]]>

US stocks fell sharply on Friday as concerns over the Federal Reserve intensified. The Dow Jones and S&P 500 indexes had one of the worst days this year after Jerome Powell warned the bank would continue its aggressive rate hike policy. This will imply more rate hikes and even quantitative tightening. Investors are also worried about margin pressure as the earnings season continues. Data compiled by FactSet showed that 20% of all companies published. Of these companies, 79% reported a positive EPS surprise while 69% reported a positive revenue surprise. The S&P 500 forward 12-month PE ratio rose to 18.6.

The pound fell to the lowest level since 2020 on concerns over the next actions of the Bank of England. Investors believe the BOE will pause its rate hikes and adopt a more dovish tone as the economy slows. Evidenced by the fact that consumer confidence slumped to its lowest level since 2008. According to Gfk, confidence slumped minus 7 points to -38 in April as inflation concerns grew. Other data showed retail sales fell sharply in March.

The euro fell on Monday morning as investors focused on the outcome of the French election. The results between Marine Le Pen and Emmanuel Macron showed the incumbent taking a solid lead. He won 58% of the total vote even as voter turnout remained low. He also becomes the first French president to be re-elected in 20 years. Therefore, it means fearing that France is led by a far-right leader. As a result, analysts expect the status quo in Europe to continue. The key data to watch will be the latest current German assessment and business climate data. Their impact on the euro will be relatively minimal.

NAS100

The Nasdaq 100 index fell sharply on concerns about rising interest rates. It fell to a low of $13,318, the lowest level since March 21. It moved down the Bollinger bands and below the 23.6% Fibonacci retracement level. It also broke below the 23.6% Fibonacci retracement level and while the Relative Strength Index (RSI) pointed down. Therefore, the index will likely continue to decline in the short term.

GBPUSD

GBPUSD continued its bearish trend after weak economic data from the UK. The pair is trading at 1.2831, which is significantly below the key resistance at 1.300. On the four-hour chart, it moved below the descending triangle pattern. It also broke below the 25-day and 50-day moving averages, while the stochastic oscillator and momentum pointed lower. The pair will likely have a relief rally today.

EURUSD

The EURUSD pair remained under pressure as investors reflected on the French elections. It is trading at 1.0796, which sits between the middle and lower lines of the Bollinger Bands as the Stochastic Oscillator moved above the oversold level. The pair is also below the 25-day moving average. The pair will likely stay within this range today.

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