bluuebunny/crossref_metadata_2025 huggingface dataset:
What Matters to Patients? A Mixed Method Study of the Importance and Consideration of Oncology Patient Demands
Authors: waelli mathias , Minvielle Etienne , Acero Maria Ximena , Aribi Khouloud Ben , Lalloue Benoit
Published: January 2021

BackgroundA patient-centred approach is increasingly the mandate for healthcare delivery, especially with the growing emergence of chronic conditions. A relevant but often overlooked obstacle to delivering person-centred care is the identification and consideration of all demands based on individual experience, not only disease-based requirements. Mindful of this approach, there is a need to explore how patient demands are expressed and considered in healthcare delivery systems. This study aims to: (i) understand how different types of demands expressed by patients are taken into account in the current delivery systems operated by Health Care Organisations (HCOs); (ii) explore the often overlooked content of specific non-clinical demands (i.e. demands related to interactions between disease treatments and everyday life). MethodWe adopted a mixed method in two cancer centres, representing exemplary cases of organisational transformation: (i) circulation of a questionnaire to assess the importance that breast cancer patients attach to every clinical (C) and non-clinical (NC) demand identified in an exploratory inquiry, and the extent to which each demand has been taken into account based on individual experiences; (ii) a qualitative analysis based on semi-structured interviews exploring the content of specific NC demands.ResultsFurther to the way in which the questionnaires were answered (573 answers/680 questionnaires printed) and the semi-structured interviews (36) with cancer patients, results show that NC demands are deemed by patients to be almost as important as C demands (C = 6.53/7 VS. NC = 6.13), but are perceived to be considered to a lesser extent in terms of pathway management (NC = 4.02 VS C = 5.65), with a significant variation depending on the type of non-clinical demands expressed. Five types of NC demands can be identified: demands relating to daily life, alternative medicine, structure of the treatment pathway, administrative and logistic assistance and demands relating to new technologies.ConclusionsThis study shows that HCOs should be able to consider non-clinical demands in addition to those referring to clinical needs. These demands require revision of the healthcare professionals’ mandate and transition from a supply-orientated system towards a demand-driven approach throughout the care pathway. Other sectors have developed hospitality management, mass customisation and personalisation to scale up approaches that could serve as inspiring examples.
Do breastfeeding practices correlate with childhood diarrhoea? Multiple data analyses using national surveys in Ghana
Authors: Tampah-Naah Anthony Mwinilanaa
Published: January 2021

Background: Breastfeeding is a natural intervention that tends to have a protective effect on the occurrence of diarrhoea in children. In environments where breastfeeding is suboptimal coupled with the early introduction of complementary foods, children are at a higher risk of experiencing diarrhoea. This study examined whether breastfeeding practices are associated with childhood diarrhoea in Ghana using multiple secondary datasets. Methods: The study used Ghana Demographic and Health Survey (GDHS) 2003, 2008 and 2014 datasets. These datasets contain data on women and issues related to children who were two years of age (0-23 months). An appended weighted sample of 4,675 mother-child pairs was used for the analyses. Logistic regression analyses were performed to assess the association between breastfeeding practices (including other explanatory variables) and childhood diarrhoea.Results: Children who were not exclusively breastfed had higher odds of experiencing diarrhoea. These categories of children most likely to be exposed to diarrhoea included those who were not breastfeeding (OR = 3.382, 95% CI = 2.019, 4.820), predominantly breastfeeding (OR = 1.824, 95% CI = 1.198, 2.777), and partially breastfeeding (OR = 2.795, 95% CI = 1.931, 4.047).Conclusions: Findings for this study further affirms to the protective effect breastfeeding has against childhood diarrhoea. Exclusive breastfeeding and at times predominant breastfeeding could prevent or minimize diarrhoea compare to non-practice of breastfeeding or partial breastfeeding.
Prevalence of excess weight gain and associated risk factors among postmenopausal women: a population-based study in Ghana.
Authors: Bonsu Isaac Mensah , Myezwa Hellen , Brandt Corlia , Omoniyi Moses M. , Ajidahun Tunde A.
Published: January 2021

Background: Excess weight (obesity and overweight) is a pervasive condition that is considered a global epidemic and a threat to public health. Furthermore, numerous changes in fat deposits occur with the advent of menopause, leading to a change in the distribution of body fat. Therefore this study determined the prevalence of excess weight gain and associated risk factors among postmenopausal women (PW) in Ghana.Methods: This is a descriptive cross-sectional study conducted over five months at Bono-East regional capital, Techiman in Ghana. A total of 378 postmenopausal women were recruited for this study. Structured questionnaires were administered to obtain the socio-demographic data from each study participant. Anthropometrics such as body mass index (BMI), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) among participants were also determined. Data were inputted into excel, and analysis was done using IBM SPSS 25.Results: BMI, WHtR and WHR recorded participants with the excess weight of 73.2%, 91.8%, and 91.0% respectively out of the total study participants and there was no significant difference among the stratified study participants. Participants age ≤50 years were at a high risk of been obese even though it was not significant. Study participants with > 15 years of the postmenopausal stage have a high chance of been obese for BMI and WHtR but not WHR. The mean age of study participants was 60.09±6.24 years with the 51-60 years age group having the highest frequency (48.8%). Out of the total study participants, 26.8%, 8.2% and 9.0% with desirable weight were recorded using BMI, WHtR, and WHR respectively. And there was no significant difference (P=0.999) between the proportions for WHtR and WHR. However, the distribution of study participants with desirable weight by BMI was significantly higher than that of WHtR (P=0.0031) and WHR (P=0.0063). Conclusions: The prevalence rates of obesity and overweight were higher among postmenopausal women using the WHR than BMI and WHtR. Participants age ≤ 50 years, parity and those from the Ga tribe were also at a higher risk of having abdominal obesity.
The correlation of duration of cervical flexion per day with neck disability index scores in office workers: a cross sectional study
Authors: Jinlong Zhang , Yunyun Fang , Lijie Gao , Jian Chen , Cheng Wang , Hongchen He , Qinglu Luo
Published: January 2021

Background: An increasing number of office workers complain of neck pain after extended smart phone use. We conducted this study to examine the correlation between the duration of cervical flexion per day (DCF) during smart phone use and neck disability index scores (NDI) scores of office workers in China.Methods: In this cross-sectional study, 1791 individuals responded to an on line questionnaire. For our study, we included responses of 498 [27.8%] office workers. Excluded from the study were 1293 [72.9%] individuals including building workers, students, non-office workers, and those who did not complete the questionnaire. Participants completed an online questionnaire survey from May 29, 2019 to April 10, 2020. The NDI scores were used to evaluate cervical symptoms. Linear regression, threshold saturation effect analysis, t-test, and Pearson’s chi-square tests were used to analyze the data.Results: We analyzed questionnaire results of the 498 office workers. The t-test showed no significant differences among the gender groups for age, working age, and NDI scores (P>0.05). While low back pain had a strong correlation with NDI scores [β (95%CI):2.40 (1.49, 3.31), P <0.0001]. When adjusting for age, working age, and low back pain covariates, DCF had a positive correlation with NDI scores. In addition, DCF had a curve line correlation with NDI scores-a monotone increasing relationship; the fold point was 6 (P<0.05).Conclusions: DCF had a positive curve line correlation with the NDI scores suggesting that office workers should limit DCF to a maximum of 6 hours to decrease NDI scores.
Associated factors of early initiation of breastfeeding among mothers in Rajshahi district, Bangladesh: A cross-sectional study
Authors: Ayesha Ummay , M Abu Sayed Md. Al , Islam Md. Nurul , Hossain Md. Ripter , Tasmia Samme Amena , Hossain Md. Golam
Published: January 2021

Background: Early initiation of breastfeeding (EIBF) provides the first immunization for the newborns, fortify their immune defense system and eventually reduce the mortality rate. This study aimed to identify the factors associated with EIBF among mothers in Rajshahi district, Bangladesh. Methods: A total number of 421 mothers living in Rajshahi district who had at least one child aged 6-24 months were considered as sample. Mothers were selected using multistage random sampling. This study was conducted from January to March, 2019. The EIBF was measured by a principal question, “Did you provide your breast milk to your newborn within one hour after delivery?” Frequency distribution, Chi-square test and multivariable binary logistic regression model were utilized in this study for getting prevalence and associated factors of EIBF respectively. Results: This study revealed that the prevalence of EIBF among mothers in Rajshahi district was 88.4%. Multivariable logistic model provided eight factors associated with EIBF: (i) husbands’ education level, (ii) husbands’ occupation, (iii) family monthly income, (iv) mothers’ age, (v) mothers’ BMI, (vi) place of delivery, (vii) planned pregnancy and (viii) mothers taking advice regarding the benefit of breastfeeding during their pregnancy. Conclusions: This study identified several modifiable factors associated with EIBF. The customs, culture and other characteristics are almost same across the country. These factors could be considered to increase the rate of EIBF among mothers in Bangladesh.
Deficient macrophage autophagy protects mice from Cerium Oxide nanoparticle-induced lung fibrosis
Authors: Annangi Balasubramanyam , Lu Zhuyi , Bruniaux Jonathan , Ridoux Audrey , Silva Vanessa Marques da , Vantelon Delphine , Boczkowski Jorge , Lanone Sophie
Published: January 2021

Background: Cerium (Ce) is a rare earth element, rapidly oxidizing to form CeO2, and currently used in numerous commercial applications, especially as nanoparticles (NP). The potential health effects of Ce remain uncertain, but literature indicates the development of rare earth pneumoconiosis accompanied with granuloma formation, interstitial fibrosis and inflammation. The exact underlying mechanisms are not yet completely understood, and we propose that autophagy could be an interesting target to study, particularly in macrophages. Therefore, the objective of our study was to investigate the role of macrophagic autophagy after pulmonary exposure to CeO2 NP in mice. Mice lacking the early autophagy gene Atg5 in their myeloid lineage and their wildtype counterparts were exposed to CeO2 NP by single oropharyngeal administration and sacrificed up to one month after. At that time, lung remodeling was thoroughly characterized (inflammatory cells infiltration, expression of fibrotic markers such as αSMA, TGFβ1, total and type I and III collagen deposition), as well as macrophage infiltration (quantification and M1/M2 phenotype). Results: Such pulmonary exposure to CeO2 NP induces a progressive and dose-dependent lung fibrosis in the bronchiolar and alveolar walls, together with the activation of autophagy. Blockage of macrophagic autophagy protects from alveolar but not bronchiolar fibrosis, via the modulation of macrophage polarization towards M2 phenotype. Conclusion: In conclusion, our findings bring novel insight on the role of macrophagic autophagy in lung fibrogenesis, and add to the current awareness of pulmonary macrophages as important players in the disease.
Refraining from seeking mental healthcare and poorer mental well-being: A longitudinal population-based study on men in Sweden
Authors: Olsson Sara , Burström Bo , Hensing Gunnel , Löve Jesper
Published: January 2021

Background: Depression and anxiety disorder contribute to a significant part of the disease burden among men, yet many men refrain from seeking care or receive insufficient care when they do seek it. This is plausibly detrimental to men’s mental well-being, but there is a lack of population-based research to confirm this. This study investigated 1) if men who had refrained from seeking mental healthcare had poorer mental well-being than those who sought care, 2) if those who sought care but perceived it as insufficient had poorer mental well-being than those who perceived care as sufficient, and 3) if these differences persisted after one year. Methods: This longitudinal study used questionnaire data from a population-based sample of 1240 men, aged 19-64 years, in Sweden. Having refrained from seeking mental healthcare, or perceiving the care as insufficient, at any time in life, was assessed in a questionnaire, 2008. Current mental well-being was assessed in 2008 and 2009 using mean scores on the WHO (Ten) Well-being Index, with a lower score indicating poorer mental well-being. Group differences were calculated using t-tests and multivariable linear regression analysis.Results: Of the men who had perceived a need for mental healthcare, 37% refrained from seeking such care. They had lower mental well-being scores in 2008, compared to those who sought care. Of those seeking care, 29 % perceived it as insufficient. They had lower mental well-being scores in 2008, compared to those who perceived the care as sufficient, but this was not statistically significant when controlling for potential confounders. There were no differences in mental well-being scores based on care-seeking or perceived care-sufficiency in 2009. Conclusions: This population-based study provides some support for the hypothesis that refraining from seeking mental healthcare, or perceiving the care as insufficient, is detrimental to men’s mental well-being. However, the lack of differences over time contradicts this hypothesis. The results highlight the need for larger longitudinal studies, measuring care-seeking within a more specified time frame, and using longer follow-up periods. This should be combined with efforts to increase men’s mental healthcare-seeking and to provide mental healthcare that is perceived as sufficient.
Characteristics of relief and residual low back pain after discectomy in patients with lumbar disc herniation: analysis using a detailed visual analogue scale
Authors: Takahashi Hiroshi , Aoki Yasuchika , Inoue Masahiro , Saito Junya , Nakajima Arata , Sonobe Masato , Akatsu Yorikazu , Koyama Keita , Shiga Yasuhiro , Inage Kazuhide , Eguchi Yawara , Orita Sumihisa , Maki Satoshi , Furuya Takeo , Akazawa Tsutomu , Abe Tetsuya , Funayama Toru , Noguchi Hiroshi , Miura Kousei , Mataki Kentaro , Shibao Yosuke , Eto Fumihiko , Kono Mamoru , Koda Masao , Yamazaki Masashi , Ohtori Seiji , Nakagawa Koichi
Published: January 2021

Background: Several authors have reported favorable results in low back pain (LBP) for patients with lumbar disc herniation (LDH) treated with discectomy. However, detailed changes over time in the characteristics and location of LBP before and after discectomy for LDH remain unclear. To clarify these points, we conducted an observational study to determine the detailed characteristics and location of LBP before and after discectomy for LDH, using a detailed visual analog scale (VAS) bilaterally.Methods: We included 65 patients with LDH treated by discectomy in this study. A detailed VAS for LBP was administered with the patient under 3 different conditions: in motion, standing, and sitting. Bilateral VAS was also administered (affected versus opposite side) for LBP, lower extremity pain (LEP), and lower extremity numbness (LEN). The Oswestry Disability Index (ODI) was used to quantify clinical status. Changes over time in these VAS and ODI were investigated. Pfirrmann grading and Modic change as seen by magnetic resonance imaging (MRI) were reviewed before and 1 year after discectomy to determine disc and endplate condition.Results: Before surgery, LBP on the affected side while the patients were in motion was significantly higher than LBP while they were sitting. This increased LBP on the affected side in motion was improved significantly after discectomy. By contrast, the residual LBP while sitting at 1 year after surgery was significantly higher than the LBP while they were in motion or standing. At 1 year following discectomy, residual LBP while sitting was significantly greater in cases showing changes in Pfirrmann grade or Modic type.Conclusions: Improvement of LBP on the affected side while the patient is in motion suggests that radicular LBP is improved following discectomy by nerve root decompression. Furthermore, that residual LBP is found while the patient is sitting is reflective of the load and pressure put on the disc and endplate.
COPD patients prescribed inhaled corticosteroid in primary care – Time for re-assessment based on exacerbation rate and blood eosinophils?
Authors: Savran Osman , Godtfredsen Nina Skavlan , Sørensen Torben , Jensen Christian , Ulrik Charlotte
Published: January 2021

Background and objective: Inhaled corticosteroid (ICS) therapy for COPD should be guided by exacerbations and blood-eosinophils according to the GOLD 2020 strategy document. In the present study, we applied these recent recommendations in a large cohort of COPD patients recruited from general practice. Methods: The participating general practitioners (n = 144) recruited patients with a diagnosis of COPD currently prescribed ICS and reported data on exacerbation history and blood-eosinophils. Clinical variables were compared using two-sample t-tests. Results: The study cohort comprised 1,567 COPD patients (44% males and mean age 72 years). In the past 12 months, 849 (54%) of the COPD patients currently prescribed ICS had no exacerbation, whereas 383 (24%) and 328 (21%) patients, respectively, had a history of one exacerbation and two or more exacerbations. Compared to patients with one or no exacerbation, patients with ≥2 exacerbations (21%) per year reported more dyspnea (p<0.001) and had higher degree of airflow obstruction (p<0.001). Among patients with no and at least one exacerbation within the preceding 12 months, 30% and 26%, respectively, had a blood-eosinophil count ≥ 0.3 x 109/L. In patients with two or more exacerbations within the last 12 months, 77% had a blood-eosinophil count of ≥ 0.1 x 109/L. Furthermore, 166 patients (11%) had at least one hospital admission due to COPD exacerbation, and a blood-eosinophil count of ≥ 0.1 x 109/L.Conclusion: This study of a large cohort of COPD patients currently prescribed inhaled corticosteroids suggests the need for re-evaluating the management strategy to increase benefit and reduce adverse effects of ICS treatment in COPD patients managed in primary care.
Understanding patient outcomes to develop a multimorbidity adapted patient-reported outcomes measure: a qualitative description of patient and provider perspectives.
Authors: Sasseville Maxime , Chouinard Maud-Christine , Fortin Martin
Published: January 2021

Background: Multimorbidity is a complex health situation that requires interventions tailored to patient needs; the outcomes of such interventions are difficult to evaluate. The purpose of this study was to describe the outcomes of patient-centred interventions for people with multimorbidity from the patients’ and healthcare providers’ perspectives.Methods: This study followed a qualitative descriptive design. Nine patients with multimorbidity and 18 healthcare professionals (nurses, general practitioners, nutritionists, and physical and respiratory therapists), participating in a multimorbidity-adapted intervention in primary care were recruited. Data were collected using semi-structured interviews with 12 open-ended questions. Triangulation of disciplines among interviewers, research team debriefing, data saturation assessment and iterative data collection and analysis ensured a rigorous research process.Results: Outcome constructs described by participants covered a wide range of themes and were grouped into seven outcome domains: Health Management, Physical Health, Functional Status, Psychosocial Health, Health-related Behaviours, General Health and Health Services. The description of constructs by stakeholders provides valuable insight on how outcomes are experienced and worded by patients.Conclusion: Participants described a wide range of outcome constructs, which were relevant to and observable by patients and were in line with the clinical reality. The description provides a portrait of multimorbidity-adapted intervention outcomes that are significant for the selection and development of clinical research outcome measures.
Assessing a national policy on strengthening chronic care in primary care settings of a middle-income country using patients’ perspectives.
Authors: Aekplakorn Wichai , Suriyawongpaisal Paibul , Srithamrongsaw Samrit , kaewkamjonchai Phanuwich
Published: January 2021

Background To improve care for patients with chronic diseases, a recent policy initiative in Thailand focused on strengthening primary care based on the concept of Chronic Care Model (CCM). This study aimed to assess the perception of patients about the health care services after the implementation. Methods We conducted a cross-sectional survey of 4,071 patients with hypertension and/or diabetes registered with 27 primary care units and 11 hospital non-communicable diseases (NCDs) clinics in 11 provinces.The patients were interviewed using a validated questionnaire of the Patient Assessment of Chronic Illness Care. Upgraded primary care units (PCUs) were ordinary PCUs with the multi-professional team including a physician. Trained upgraded PCUs were upgraded PCUs with the training input. Structural equation modeling was used to create subscale scores for CCM and 5 A model characteristics. Mixed effect logistic models were employed to examine the association of subscales (high vs low score) of patient perception of the care quality with type of PCUs.Results Compared to hospital NCD clinics, ordinary PCUs were the best in the odds of receiving high score for every CCM subscale (ORs: 1.46-1.85; p<0.05), whereas the trained upgraded PCUs were better in terms of follow-up (ORs:1.37; p <0.05), and the upgraded PCU did not differ in all domains. According to the 5 A model subscales, patient assessment also revealed better performance of ordinary PCUs in all domains compared to hospital NCD clinics whereas upgraded PCUs and trained upgraded PCUs did so in some domains. Seeing the same doctor on repeated visits (ORs: 1.82-2.17; p<0.05) or having phone contacts with the providers (ORs:1.53-1.99; p<0.05) were found beneficial using CCM subscales and the 5A model subscales. However, patient assessment by both subscales did not demonstrate a statistically significant association across health insurance status.Conclusions The policy implementation might not satisfy the patients’ perception on quality of chronic care according to the CCM and the 5A model subscale. However, the arrangement of chronic care with patients seeing the same doctors or patients having telephone contact with healthcare providers may satisfy the patients’ perceived needs.
Lifestyle Changes and Weight-gain in Youth during a 4-Month COVID-19 Lockdown: A Retrospective Observational Study
Authors: Liu Suixin , Dun Yaoshan , Jeffrey Ripley-Gonzalez , Zhou Nanjiang , You Baiyang , Li Qiuxia , Li Hui , Zhang Wenliang , Thomas Randal , Olson Thomas , Liu Jie , Dong Yuchen
Published: January 2021

Background: The coronavirus disease-2019 (COVID-19) has resulted in nationwide lockdowns, cessation of school and work, and social distancing. Reducing the negative impacts, such as weight-gain, has garnered global attention.Methods: In this dual-center retrospective observational study of 12,889 students (aged 18-20), who performed a national student physical fitness battery between December 1, 2019, to January 20, 2020, and completed a follow-up online questionnaire beginning on May 1, 2020, and ending on May 23, 2020, and examined the associations between weight-gain and COVID-19 induced stress, depression and self-reported physical activity, dietary habits and sedentary time. Results: Participants gained an average of 2.6 kg (95% CI: 2.0 to 3.2 kg) for males and 2.1 kg (1.9 to 2.4 kg) for females. An increase in overweight and obese individuals according to Asian cut-off points as a demographic percentage by 4.5% and 2.7% and 4.8% and 3.4% in males and females respectively (P<0.001). Weight change was associated with sedentary time, COVID-19 induced stress, and depression score. Conclusion: These findings suggest that limiting sedentary time during lockdowns and strategies aimed t improve lifestyle habits and psychological health may be warranted to mitigate weight-gain during the pandemic.Registration: Registered with ChiCTR, registration no.: ChiCTR2000033514
Carbon financial markets underlying climate risk management, pricing and forecasting: Fundamental analysis
Authors: Amri Adil El , Boutti Rachid , Oulfarsi Salah , Rodhain Florence , Bouzahir Brahim
Published: January 2021

Climate Change (CC) is a major issue of our century. Controlling the constraints of Greenhouse Gas (GHG) emissions through transformation into opportunities, in an organization to increase industrial production, has become a necessity. The main reason for this adoption was the effectiveness of energy management and responsible linkages that are being developed to determine the issues and opportunities of carbon finance for organizations. Through analysis of the European Union Emissions Trading Scheme (EU ETS) and the Clean Development Mechanism (CDM), this article presents and demonstrates a variety of determinants of CO2 prices (EUA) to be used in econometric techniques. This paper details the main carbon price drivers related to institutional decisions, energy prices, and weather events. Our study focuses on price changes in the EUA, being the most liquid carbon asset. In this regard, we highlighted the daily spot price of the EUA to highlight the daily changes affecting this price, given the high volatility in this Carbon financial market. The treatments of the determinants of CO2 prices (EUA) can be used to analyze the evolving and expanding Carbon financial markets sphere. It features stylized facts about Carbon financial markets from an economics and management perspective, as well as covering key aspects of pricing strategies (institutional decisions, energy prices, and extreme weather events), risk, and portfolio management. Aimed at those with fundamental analysis, the CO2 prices within the framework of the EU ETS depend on several determinants. This paper constitutes an introduction to emission trading and an overview of the regulations governing Carbon financial markets. First, we detail the price changes in the EUA and primary energy prices. Second, we introduce the main characteristics of emissions trading, be it in terms of spatial and temporal limits, Clean Dark Spread, Clean Spark Spread, and Switch Price. Third, we provide a descriptive analysis of atmospheric variables, structural variations, and the Subprime crisis and their impacts on the price development of EU CO2 allowances.

Keywords: Fundamental analysis, European Union Emissions Trading Scheme, Clean Development Mechanism (CDM), Determinants of CO2 prices (EUA), Climate risk management.
Macroprudential policy and financial stability, role and tools
Authors: Bouchetara Mehdi , Nassour Abdelkader , Eyih Sidi
Published: January 2021

The aim of macroprudential policy is to ensure financial stability by avoiding the outbreak of banking crises, which have a dangerous effect on the economy. Is macroprudential policy effective in the face of banking crises and systemic risks? The macroprudential policy has received significant interest from policy-makers and researchers. A few developing countries were using macroprudential policy tools well before the 2008 financial crisis, but significant progress has been made thereafter in both emerging and industrialized economies to put in place specific institutional settings for macroprudential policy. The fundamental objective of macroprudential policy is to maintain the stability of the financial system by making it more resistant and preventing the risk build-up. The objective of this paper is to analyze the important role of macroprudential policy in ensuring overall financial stability. Since the financial crisis of 2008, macroprudential policy has been increasingly used across economies. These measures aim at smoothing financial cycles and thereby mitigating the impact on the real economy, thereby allowing monetary policy to focus on price stability and promote growth and full employment. Macroprudential policy instruments fall into two categories, depending on their purpose, namely, to prevent procyclicality or to enhance the resilience and soundness of the financial system against shocks. The first category of instruments is used to stop bubbles from forming and smooth cycles, i.e. to force the debt-equity of economic operators on an income basis to prevent unsustainable credit bubbles, or to require dynamic loss provisioning rules. The second category of macro-prudential policy is to improve the resilience to shocks, such as capital surcharges for systemic institutions or the requirement to hold liquid assets to cope with market panics, and to make the financial system less complex.

Keywords: macroprudential policy, financial stability, tools and measures, systemic risks.
Development of a special purpose LED ultraviolet lamp in a T8 flask
Authors: Zhuravleva J. A. , Nesterkina N. P. , Kuznetsov E. A.
Published: January 2021

Fluorescent tubular ultraviolet lamps are used in medicine, industry, cosmetology, forensic science, and banking. During the development of the LED ultraviolet lamp in a T8 flask, a comparison of its lighting characteristics (power, energy flux, spectral distribution of radiation) with the parameters of special-purpose fluorescent lamps produced at industrial enterprises has been carried out. The design of the LED lamp includes a glass uviole tube with a diameter of 26 mm and a length of 322 mm (wall thickness is 1 mm, glass grade - SL97-3). For precise installation of the lamp in the irradiation facility and supplying electric power to it, plastic caps of the G13 pin type (the distance between the electrical contacts is 12.7 mm) are used. Measurements of electrical parameters, energy flux and spectral distribution of radiation have been carried out at nominal mains voltage on a Gooch &Housegophotocolorimetric measuring device. The developed LED lamp consumes seven times less electricity, has significantly longer (five times) expected service life and is a safer source of ultraviolet radiation, since it does not contain harmful vapors of mercury and its compounds. The LED ultraviolet lamp in a T8 flask can be used instead of the manufactured LUFT-10 lamps for special purposes, namely, in irradiators for carrying out technological processes (photochemical reactions, drying, curing), for attracting and disinsecting insects in traps, in photocopiers.
Algorithms and models of power losses in circuit breakers installed in networks
Authors: Gracheva E. I. , Gorlov A. N. , Alimova A. N.
Published: January 2021

Determination of the main characteristics of the topology and technical condition of equipment underoperating conditions is necessary for analyzing and assessing power and electricity losses in intrashoplow-voltage industrial power supply networks. A comparative analysis of the technical characteristicsof automatic circuit breakers VA57-31 (KEAZ), NSX100 TM-D (Schneider Electric), DPX3 160 (Legrand), Tmax XT1 TMD (ABB) has shown that the main technical parameters of the machines are close in their values. At that it has been found out that automatic switches of the BA57-31 series have the lowest value of power losses per pole (7.5 W), whereas the automatic switches of the Tmax XT1 TMD series have the highest value (10 W). Thus, under the operating conditions of the equipment, the lowest value of power and electricity losses is characteristic of low-voltage electrical networks with installed circuit breakers of the BA57-31 series, and the highest value of losses is noted in in-shop systems with installed circuit breakers Tmax XT1 TMD. Using catalog data, the dependences of active power losses in circuit breakers on rated currents have been established; the algorithms have been developed and the obtained dependences have been modeled using approximating functions. The standard deviation of the compiled approximating functions has been calculated. Analytical expressions of the dynamics of power losses per pole have been determined as a function of the rated current. The graphical dependences of the investigated parameters of low-voltage equipment have been presented. The developed models are recommended to be used to increase the reliability of the assessment and refinement of the amount of active power and electricity losses in low-voltage electrical networks of industrial power supply systems, agrotechnical complexes, and enterprises of the public utility sector.
The Proposed Elements of Intercultural Communicative Competence (ICC) For Indonesian EFL English Teachers
Authors: Idris Mas Muhammad
Published: January 2021

The development of intercultural communicative competence (henceforth ICC) has inevitably made one be able to mingle and communicate effectively and appropriately using the target language with other people who have different backgrounds of culture, language, and nation. It is due to the ICC is seen as a complex competence in this twenty-first-century life. However, in the educational context, this competence is rarely noticed seriously by the Indonesian EFL or English teachers. Therefore, this paper is set out to present a comprehensive understanding of ICC and recommend a number of competencies related to ICC that should be possessed by the Indonesian EFL or English teachers in Indonesia. The competencies are linguistic, sociolinguistic, discourse, intercultural competence, and intercultural awareness which are all considered able to assist the Indonesian EFL or English teachers in developing their intercultural competence and their student’s ICC too.
Investigating Preposition Usage Problems of English Language Education Study Program Students
Authors: Sanjaya Albertus Agung , Bram Barli
Published: January 2021

As one of the English grammar elements, prepositions might be considered difficult for students of English as a foreign language (EFL). Many studies on this topic have been conducted but it remains problematic and unresolved. Accordingly, the researchers aimed to explore the prepositions in this paper. Gathering the data from fifty acknowledgments of undergraduate theses of the English Language Education Study Program (ELESPA) of a private university in Yogyakarta, the researchers analyzed preposition usage problems that occurred in the acknowledgments. Results showed that three main problems involving the use of prepositions, namely the misselection of prepositions for, in, and to, insertion of prepositions about and to, and omission of prepositions about. Factors causing the problems were investigated and it was found that students’ first language (L1) influenced the incorrect usage of English prepositions.
Principales cambios en los Incoterms® 2020
Authors: Huamán Sialer Marco Antonio
Published: January 2021

En el presente artículo se analizan y comentan los principales cambios de carácter general y cambios de carácter específicos contenidos en el Incoterms® 2020, publicación 723 de la Cámara de Comercio Internacional de Paris (ICC), en comparación con los Incoterms® 2010, publicación 715 de la ICC.
Problemas (y paradojas) actuales de la regulación publicitaria en el ámbito sanitario
Authors: Álvarez Rubio Julio
Published: January 2021

El trabajo trata sobre la existencia de diferentes tensiones en el ámbito de la regulación de la actividad publicitaria en España. Se analiza cómo, en ocasiones, la vinculación de esa actividad promocional con la protección de la salud sirve para proponer reformas innecesarias en determinados ámbitos que suelen resultar sensibles para determinados intereses económicos corporativos mientras que, en otras, se obvian problemas acuciantes necesitados de regulación urgente precisamente por la existencia de tales intereses y por la escasa capacidad que, para influir políticamente, tienen consumidores y usuarios. Fundamentalmente se analizan los ámbitos de la publicidad de las clínicas dentales, las pseudociencias y el juego.
Defensa extrajudicial del consumidor en la Argentina
Authors: Tambussi Carlos Eduardo
Published: January 2021

Existen en la República Argentina sistemas extrajudiciales de protección al consumidor dentro de la propia estructura del proveedor como posibilitados por el sector social o a través de organismos del estado, que es necesario poner en valor por su significado de funcionamiento y aplicación de la responsabilidad social empresaria, su impronta de propuesta de medios alternativos y sus posibilidades de arribo a conciliación o acuerdo ante las quejas planteadas. El ejercicio por parte de los consumidores de sus necesidades de reclamos por estos sistemas debe ser conocido y fomentado, ya que fortalece el concepto de ciudadanía y no impide el reclamo judicial.
La subjetividad en el régimen nazi: deconstrucción y construcción
Authors: Bucetto María Sol
Published: January 2021

En su afán por defender la superioridad de la raza aria, el genocidio perpetuado por el régimen nazi se apoyó sobre la idea de crear la figura de un sujeto de raza inferior, cuya extirpación de la sociedad resultaba indispensable para garantizar la supremacía germana. Este “otro” fue creado desde las esferas del poder, para poder ser cosificado, disciplinado y deshumanizado. En este artículo se analizará la influencia de las instituciones de la Modernidad en el proceso de destrucciónde la subjetividad del pueblo judío y las consecuencias emocionales que han sufrido las víctimas durante el Holocausto y a la hora de tener que enfrentarse nuevamente al mundo libre.
Morphological characteristics of uterine tubes ampullae in elderly females
Authors: Balandina Irina A. , Nekrasova Anna M.
Published: January 2021

The aim of the study is to determine the size and to identify the features of histoarchitectonics of the uterine tube ampulla of an old-aged female. Materials and methods. The ampulla of both uterine tubes was examined in 26 nulliparous and 78 giving birth elderly women using morphometric, histological, immunohistochemical, and micrometric research methods. Results. The length and outer diameter of uterine tubes at the points of transition of isthmus into the ampulla and ampulla into the infundibulum as well as in the central part of ampulla are characterized by the absence of a statistically significant difference in parameters in nulliparous and giving birth women. The histoarchitectonic features of the ampullae of the uterine tubes in nulliparous and giving birth women in old age consist in the flattening of the epithelium of the mucous membrane, which forms many closely spaced thickened folds that create an uneven narrowing of the ampulla lumen, and the proliferation of connective tissue between the bundles of muscle fibers of the muscular membrane. The presence of Ki-67 expression in single cells of less than 1%, as well as a thin layer of epithelial membrane antigen in the epithelium of the ampulla along with the complete absence of its expression in the stroma reflect normal tissue regeneration and act as an equivalent to the anatomical norm in elderly females. When comparing lumen areas of ampulla and its wall at mid-section as well as the circumference of epithelial lining, a predominance of parameters in the right uterine tube was revealed (p<0.01). Conclusion. The study showed the similar qualitative and quantitative morphological characteristics of the uterine tube ampullae both in nulliparous and giving birth females in old age.
Basic Biology of Trypanosoma brucei with Reference to the Development of Chemotherapies
Authors: Dean Samuel
Published: January 2021

Trypanosoma brucei are protozoan parasites that cause the lethal human disease African sleeping
sickness and the economically devastating disease of cattle, Nagana. African sleeping sickness, also known as
Human African Trypanosomiasis (HAT), threatens 65 million people and animal trypanosomiasis makes large
areas of farmland unusable. There is no vaccine and licensed therapies against the most severe, late-stage disease
are toxic, impractical and ineffective. Trypanosomes are transmitted by tsetse flies, and HAT is therefore
predominantly confined to the tsetse fly belt in sub-Saharan Africa. They are exclusively extracellular and they
differentiate between at least seven developmental forms that are highly adapted to host and vector niches. In
the mammalian (human) host they inhabit the blood, cerebrospinal fluid (late-stage disease), skin, and adipose
fat. In the tsetse fly vector they travel from the tsetse midgut to the salivary glands via the ectoperitrophic space
and proventriculus. Trypanosomes are evolutionarily divergent compared with most branches of eukaryotic life.
Perhaps most famous for their extraordinary mechanisms of monoallelic gene expression and antigenic variation,
they have also been investigated because much of their biology is either highly unconventional or extreme.
Moreover, in addition to their importance as pathogens, many researchers have been attracted to the field because
trypanosomes have some of the most advanced molecular genetic tools and database resources of any
model system. The following will cover just some aspects of trypanosome biology and how its divergent biochemistry
has been leveraged to develop drugs to treat African sleeping sickness. This is by no means intended
to be a comprehensive survey of trypanosome features. Rather, I hope to present trypanosomes as one of the
most fascinating and tractable systems to do discovery biology.
In vitro Evaluation and Molecular Dynamics, DFT Guided Investigation
of Antimalarial Activity of Ethnomedicinally used Coptis teeta Wall
Authors: Goswami Ashis Kumar , Sharma Hemanta Kumar , Gogoi Neelutpal , Kashyap Ankita , Gogoi Bhaskarjyoti
Published: January 2021

Background:

Malaria is caused by different species of Plasmodium; among which P. falciparum is the most severe. Coptis teeta is an ethnomedicinal plant of enormous importance for tribes of north east India.

Objective:

In this study, the anti malarial activity of the methanol extracts of Coptis teeta was evaluated in vitro and lead identification via in silico study.

Method:

On the basis of the in vitro results, in silico analysis by application of different modules of Discovery Studio 2018 was performed on multiple targets of P. falciparum taking into consideration some of the compounds reported from C. teeta.

Results:

The IC50 of the methanol extract of Coptis teeta 0.08 µg/ml in 3D7 strain and 0.7 µg/ml in Dd2 strain of P. falciparum. From the docking study, noroxyhydrastatine was observed to have better binding affinity in comparison to chloroquine. The binding of noroxyhydrastinine with dihydroorotate dehydrogenase was further validated by molecular dynamics simulation and was observed to be significantly stable in comparison to the co-crystal inhibitor. During simulations it was observed that noroxyhydrastinine retained the interactions, giving strong indications of its effectiveness against the P. falciparum proteins and stability in the binding pocket. From the Density-functional theory analysis, the band gap energy of noroxyhydrastinine was found to be 0.186 Ha indicating a favourable interaction.

Conclusion:

The in silico analysis as an addition to the in vitro results provide strong evidence of noroxyhydrastinine as an anti malarial agent.
The Fate of Nanoparticles In Vivo and the Strategy of Designing Stealth Nanoparticle for Drug Delivery
Authors: Bao Jianwei , Zhang Qianqian , Duan Tijie , Hu Rongfeng , Tang Jihui
Published: January 2021

Nano-drug delivery systems (Nano-DDS) offer powerful advantages in drug delivery
and targeted therapy for diseases. Compared to the traditional drug formulations, Nano-DDS can increase
solubility, biocompatibility, and reduce off-targeted side effects of free drugs. However,
they still have some disadvantages that pose a limitation in reaching their full potential in clinical
use. Protein adsorption in blood, activation of the complement system, and subsequent sequestration
by the mononuclear phagocyte system (MPS) consequently result in nanoparticles (NPs) to be
rapidly cleared from circulation. Therefore, NPs have low drug delivery efficiency. So, it is important
to develop stealth NPs for reducing bio–nano interaction. In this review, we first conclude the
interaction between NPs and biological environments, such as blood proteins and MPS, and factors
influencing each other. Next, we will summarize the new strategies to reduce NPs protein adsorption
and uptake by the MPS based on current knowledge of the bio–nano interaction. Further directions
will also be highlighted for the development of biomimetic stealth nano-delivery systems by
combining targeted strategies for a better therapeutic effect.
Cytotoxic Activity of Tropane Alkaloides of Species of Erythroxylum
Authors: Araújo Neto José F. , de O. Ribeiro Erika M. , do Vale Ademir E. , David Jorge M. , David Juceni P.
Published: January 2021

Erythroxylaceae is a family composed of four genera, with Erythroxylum being the only
one represented in the Neotropical region. Chemical studies indicate the presence of alkaloids, terpenes,
flavonoids, and phenolic compounds as main compounds. The incorporation of cytotoxic activity
assays of natural products using cell cultures assists in the selection of potential chemotherapeutic
agents. In this work, we describe a revision of the cytotoxicity evaluation studies performed with extracts
or pure substances obtained from Erythroxylum species through an integrative review. We
found studies that evaluated the cytotoxic activity of 21 species of Erythroxylum against 45 different
cell lines. The analysis of the chemical composition of these species shows that the metabolites present
in each species influence their cytotoxic potential, especially the presence of disubstituted tropane
alkaloid species with the highest cytotoxic potential. MTT and Sulforrodamine B assays were the
main in vitro tests used for the evaluation of the cytotoxic activities. From the total species, less than
10% of the Erythroxylum species have already been evaluated for cytotoxic activity. Four of them
showed high cytotoxic activity according to the criteria of the NCI plant screening program. Thus, this
genus represents a potential source of natural products with antitumor activity.