bluuebunny/crossref_metadata_2025 huggingface dataset:
Static and group-based trajectory analyses of factors associated with non-adherence in patients with multiple sclerosis newly-initiating once- or twice-daily oral disease-modifying therapy
Authors: Nicholas Jacqueline A , Edwards Natalie C , Edwards Roger A , Dellarole Anna , Manca Luigi , Harlow Danielle E , Phillips Amy L
Published: June 2022

Background

Increased understanding of adherence may facilitate optimal targeting of interventions.

Objective

To utilize group-based trajectory modeling (GBTM) to understand longitudinal patterns of adherence and factors associated with non-adherence in patients with multiple sclerosis (MS) newly-initiating once-/twice-daily oral disease-modifying therapy (DMT) (fingolimod, dimethyl fumarate, or teriflunomide).

Methods

Commercial plan data were analyzed using proportion of days covered (PDC) to evaluate factors associated with non-adherence. GBTM clustered patient subgroups with similar longitudinal patterns of adherence measured by monthly PDC (≥80%) and multinomial logistic regression identified factors associated with adherence trajectory subgroups.

Results

Among 7689 patients, 39.5% were non-adherent to once-/twice-daily oral DMTs. Characteristics associated with non-adherence (PDC<80%) included younger age, female, depression or migraine, switching during follow-up, more frequent dosing, relapse, and absence of magnetic resonance imaging. GBTM elucidated three adherence subgroups: Immediately Non-Adherent (14.9%); Gradually Non-Adherent (19.5%), and Adherent (65.6%). Additional factors associated with adherence (i.e. region, chronic lung disease) were identified and factors differed among trajectory subgroups.

Conclusion

These analyses confirmed that a significant proportion of patients with MS are non-adherent to once-/twice-daily oral DMTs. Unique patterns of non-adherence and factors associated with patterns of adherence emerged. The approach demonstrated how quantitative trajectories can help clinicians develop tailored interventions.
Prevention of hip fractures in older adults residing in long-term care facilities with a hip airbag: a retrospective pilot study
Authors: Nemeth Banne , van der Kaaij Marleen , Nelissen Rob , van Wijnen Jan-Kees , Drost Katja , Blauw Gerard Jan
Published: June 2022

Background

Hip and pelvic fractures do commonly occur among older adults. This pilot study aimed to evaluate the effect of introduction of the WOLK hip airbag on the incidence of hip fractures.

Methods

A retrospective study was performed among 969 participants residing within 11 long-term care facilities for older patients, belonging to one large healthcare organization in The Netherlands. The intervention concerned application of 45 WOLK hip-airbags, distributed among selected residents of the long-term care facilities. Inclusion criteria; physically active participants with a pelvic circumference between 90-125 cm able to wear the hip airbag. Exclusion criteria; participants who continuously removed the hip airbag themselves or participants who depended on a wheelchair for mobility. Main outcome measures were the occurrence of falls and hip, pelvic and other fractures.

Results

The incidence of hip and pelvic fractures declined from 3.3/100 person years to 1.8/100 person years during the study for an Incidence Rate Ratio (IRR) of 0.55 (95% confidence interval (95%CI) 0.34–0.87) in the entire study population. The incidence of other fractures did not decline during the study period (IRR 0.72;95%CI 0.37–1.40). The incidence of falls declined to some extent during the study (IRR 0.88; 95%CI 0.83–0.93).

Conclusions

After introduction of the WOLK hip airbag a reduction of the incidence of hip and pelvic fractures by almost half was observed in older patients residing in long-term care facilities, even though only 45 hip airbags were distributed among the 969 residents. As selection bias cannot be ruled out in this study, the results of this pilot study warrant replication by a future clinical trial to determine true effectiveness of this intervention.
Clinical and microbiological characteristics and challenges in diagnosing infected aneurysm: a retrospective observational study from a single center in Japan
Authors: Matsui Kohsuke , Takahashi Kensuke , Tashiro Masato , Tanaka Takeshi , Izumikawa Koichi , Miura Takashi , Eishi Kiyoyuki , Furumoto Akitsugu , Ariyoshi Koya
Published: June 2022

Background

It is challenging to diagnose infected aneurysm in the early phase. This study aimed to describe the clinical and microbiological characteristics of infected aneurysm, and to elucidate the difficulties in diagnosing the disease.

Methods

Forty-one cases of infected aneurysm were diagnosed in Nagasaki University Hospital from 2005 to 2019. Information on clinical and microbiological characteristics, radiological findings, duration of onset, and type of initial computed tomography (CT) imaging conditions were collected. Factors related to diagnostic delay were analyzed by Fisher’s exact test for categorical variables or by the Wilcoxon rank-sum test for continuous variables.

Results

Pathogens were identified in 34 of 41 cases; the pathogens were Gram-positive cocci in 16 cases, Gram-negative rods in 13 cases, and others in five cases. Clinical characteristics did not differ in accordance with the identified bacteria. At the time of admission, 16 patients were given different initial diagnoses, of which acute pyelonephritis (n = 5) was the most frequent. Compared with the 22 patients with an accurate initial diagnosis, the 19 initially misdiagnosed patients were more likely to have been examined by plain CT. The sensitivities of plain CT and contrast-enhanced CT were 38.1% and 80.0%, respectively.

Conclusions

In cases of infected aneurysm, diagnostic delay is attributed to non-specific symptoms and the low sensitivity of plain CT. Clinical characteristics of infected aneurysm mimic various diseases. Contrast-enhanced CT should be considered if infected aneurysm is suspected.
Encouraging early outcomes with image guided pencil beam proton therapy for cranio-spinal irradiation: first report from India
Authors: Gaikwad Utpal , Noufal M. P. , Sylvia Jacinthlyn , Reddy Ashok K. , Panda Pankaj Kumar , Chilukuri Srinivas , Sharma Dayananda , Jalali Rakesh
Published: June 2022

Background

To report our experience with image guided pencil beam proton beam therapy (PBT) for craniospinal irradiation (CSI).

Materials and Methods

Between January 2019 and December 2021, we carried out a detailed audit of the first forty patients treated with PBT. We had recorded acute toxicities, reporting early outcomes and discuss limitations of current contouring guidelines during CSI PBT planning.

Results

Median age of the patient cohort was 8 years, and histologies include 20 medulloblastoma, 7 recurrent ependymoma, 3 pineoblastoma, 3 were germ cell tumors and remaining 7 constituted other diagnoses. Forty percent patients received concurrent chemotherapy. Median CSI dose was 23.4 Gy (Gray; range 21.6–35 Gy). Thirty-five patients (87.5%) completed their CSI without interruption, 5 required hospital admission. No patient had grade 2/ > weight loss during the treatment. Forty-five percent (18) developed grade 1 haematological toxicities and 20% (8) developed grade 2 or 3 toxicities; none had grade 4 toxicities. At median follow up of 12 months, 90% patients are alive of whom 88.9% are having local control. Special consideration with modification in standard contouring used at our institute helped in limiting acute toxicities in paediatric CSI patients.

Conclusion

Our preliminary experience with modern contemporary PBT using pencil beam technology and daily image guidance in a range of tumours suitable for CSI is encouraging. Patients tolerated the treatment well with acceptable acute toxicity and expected short-term survival outcome. In paediatric CSI patients, modification in standard contouring guidelines required to achieve better results with PBT.
Migrant Sexualities, Queer Travelers: Iranian Bears and the Asylum of Translation in Turkey
Authors: Yildiz Emrah
Published: June 2022

Since the early 2000s, an increasing number of lgbt+ and queer Iranians have sought asylum through the office of the United Nations High Commissioner for Refugees in Turkey. As recent queer and feminist scholarship has demonstrated, a “gay enough” litmus test often determines whether asylum seekers will be recognized as having a credible fear of persecution. To unhcr officers conducting asylum interviews, a claimant’s gender nonconformity functions as a proxy for credibility. Self-identified bears, with their masculine gender expression, cannot pass this litmus test and thus are expected to confess an indifference to religion, or areligiosity. Arguing that expectations of gender nonconformity and areligiosity make the application process an asylum of translation for self-identified bear claimants from Iran, this article examines the discursive labyrinth asylum seekers must navigate to become legible and advances a novel conception of the twinned process of confession and translocation that asylum-seeking has become in countries of transit like Turkey.
Clinicopathological Characteristics Predicting Further Recurrence and Survival Following Resection of In-Transit Melanoma Metastases
Authors: Lawless Anna K. , Coker David J. , Lo Serigne N. , Ahmed Tasnia , Scolyer Richard A. , Ch’ng Sydney , Nieweg Omgo E. , Shannon Kerwin , Spillane Andrew , Stretch Jonathan R. , Thompson John F. , Saw Robyn P. M.
Published: June 2022

Background

In-transit metastases (ITMs) affect approximately 4% of patients with cutaneous melanoma. This study sought to identify clinical and pathological characteristics that predict further recurrence and survival following resection of ITMs.

Patients and Methods

Patients (n = 573) who underwent surgical resection of their first presentation of ITM following previous surgical treatment of an American Joint Committee on Cancer (AJCC) stage I–II melanoma between 1969 and 2017 were identified from an institutional database. Clinicopathological predictors of patterns of recurrence and survival following ITM resection were sought.

Results

The median time of ITM development was 2.4 years after primary melanoma resection. ITMs were most frequently located on the lower limb (51.0%). The most common melanoma subtype associated with ITM development was nodular melanoma (44.1%). After surgical resection of a first ITM, 65.4% of patients experienced recurrent disease. Most recurrences were locoregional (44.7%), with distant metastasis occurring in 23.9% of patients. Lower limb ITMs were more frequently associated with subsequent ITMs [odds ratio (OR) 2.41, p = 0.0002], and the lowest risk of distant metastasis (p < 0.0001) compared with other primary sites. Primary melanomas and ITM on head and neck, as well as the presence of ulceration, were associated with worse survival.

Conclusions

Recurrence after surgical resection of a first ITM was common. Patterns of recurrence differed according to anatomical site; further ITM recurrences were more likely for lower limb ITMs, which were also associated with longer distant recurrence-free survival. Distant metastasis was more common for ITM on the head and neck, with worse survival.
The Propagation of Demand Shocks through Housing Markets
Authors: Anenberg Elliot , Ringo Daniel
Published: June 2022

Housing demand stimulus produces a multiplier effect by freeing up owners attempting to sell their current home, allowing them to reenter the market as buyers. Exploiting a shock to first-time home buyer demand caused by a cut in mortgage insurance premiums, we find that homeowners buy their next home sooner when the probability of their current home selling increases. We build and calibrate a search model that explains these findings as a result of homeowners avoiding the cost of owning two homes simultaneously. Simulations demonstrate that stimulus to home buying generates a substantial multiplier effect, particularly in cold markets. (JEL R21, R31, R38)
The Neo-Fisher Effect: Econometric Evidence from Empirical and Optimizing Models
Authors: Uribe Martín
Published: June 2022

This paper assesses the presence and importance of the neo-Fisher effect in postwar data. It formulates and estimates an empirical and a New Keynesian model driven by stationary and nonstationary monetary and real shocks. In accordance with conventional wisdom, temporary increases in the nominal interest rate are estimated to cause decreases in inflation and output. The main finding of the paper is that permanent monetary shocks that increase the nominal interest rate and inflation in the long run cause increases in interest rates, inflation, and output in the short run and explain about 45 percent of inflation changes. (JEL E12, E23, E31, E43, E52)
REPUTAÇÃO E CAPITAL SOCIAL COMO FATORES INFLUENCIADORES NO FUNCIONAMENTO DE UMA REDE DE SUPERMERCADOS
Authors: Ferreira Cassiano De Andrade , Antonialli Luiz Marcelo , Giglio Ernesto Michelangelo
Published: June 2022

O objetivo do trabalho foi caracterizar a influência da reputação e do capital social dos associados/gestores no funcionamento de uma rede de supermercados. O tema é relevante, considerando o incremento do formato de redes nos negócios e da necessidade de se aprofundar o conhecimento dos fatores presentes na operacionalidade dos grupos. A pesquisa se caracteriza por ser qualitativa e descritiva. Investigou-se o caso da Rede Delta de Supermercados (nome fictício), e os sujeitos foram os associados/gestores. Os dados foram coletados por meio de entrevistas semiestruturadas, analisadas com a técnica de análise de conteúdo, considerando a narrativa como unidade de investigação. Os resultados mostraram que a variável de reputação é importante para o relacionamento entre os associados e que os participantes do grupo não querem se relacionar com associados/gestores, ou mesmo empresas que são percebidas como uma reputação ruim. O capital social construído pelos atores também se apresentou como variável importante na funcionalidade da rede, uma vez que aproxima os atores nos valores e nas ações. Um limite do trabalho é que não foi possível estabelecer uma clara associação entre a reputação e o capital social, deixando em aberto se essa associação teria um efeito multiplicador na ótima funcionalidade da rede. O artigo contribui para o aprofundamento do conhecimento dos fatores relevantes de funcionalidade das redes.
DIFICULDADES QUE AS MULHERES ENFRENTAM AO EMPREENDER: O PAPEL DAS COMPETÊNCIAS EMPREENDEDORAS E DA RESILIÊNCIA HUMANA NA SUPERAÇÃO DESSAS BARREIRAS
Authors: Cardoso Marttina Sara Guimarães , Souza Igor Guevara Loyola de
Published: June 2022

As mulheres estão, cada vez mais, conquistando seu espaço no campo do empreendedorismo. No entanto, essas empresárias ainda enfrentam diversas barreiras durante o desenvolvimento do seu empreendimento. Nesse sentido, este estudo teve como objetivo avaliar as competências empreendedoras de mulheres empresárias do Distrito Federal. A pesquisa, de abordagem quantitativa, foi realizada com 108 mulheres, mensurando as suas competências empreendedoras e a resiliência humana. Os resultados revelaram que as principais dificuldades que as mulheres enfrentam são a falta de reconhecimento de suas habilidades como empreendedora e a percepção de tratamento diferenciado por ser mulheres. As principais competências desenvolvidas foram exigência de qualidade e eficiência, persistência e comprometimento. Quanto à resiliência, os fatores autossuficiência e perseverança apresentaram as maiores médias. O estudo constatou que as mulheres que possuem filhos não têm competências distintas das mulheres que não são mães. Por fim, foi possível inferir que a resiliência explica o desenvolvimento de competências empreendedoras.
Physicians' Role in Helping to Die
Authors: Guerrero Quiñones Jose Luis
Published: June 2022

Euthanasia and the duty to die have both been thoroughly discussed in the field of bioethics as morally justifiable practices within medical healthcare contexts. The existence of a narrow connection between both could also be established, for people having a duty to die should be allowed to actively hasten their death by the active means offered by euthanasia. Choosing the right time to end one’s own life is a decisive factor to retain autonomy at the end of our lives. However, there is no definitive consensus on why physicians should be the ones performing the medical procedure to end a person’s life. The moral problems arising from such assertion are not to be taken lightly, for medical tradition has long regarded the duty not to kill, not to actively end a patient’s life, as the core moral obligation that gives meaning to the medical profession. Our concern is to question the moral justifiability of the arguments offered by physicians not to actively help patients die.
Η συμμετοχή των πολιτών στη νομοθετική διαδικασία
Authors: Βαρειά Μαρίκα
Published: June 2022

Το θέμα της διδακτορικής διατριβής είναι η συμμετοχή των πολιτών στη νομοθετική διαδικασία και το πως αυτή αναπτύχθηκε και εξελίχθηκε μεταπολεμικά στα ευρωπαϊκά κράτη και στην Ευρωπαϊκή Ένωση στο πλαίσιο της αντιπροσωπευτικής δημοκρατίας. Ως εκ τούτου, οι σχετικοί θεσμοί συμμετοχής δεν εξετάζονται σαν μέτρο σύγκρισης μεταξύ αντιπροσωπευτικής και άμεσης δημοκρατίας αλλά ως μορφές εμπλουτισμού και αναζωογόνησης της δημοκρατικής βάσης της αντιπροσωπευτικής δημοκρατίας, λαμβάνοντας δε υπόψη την κρίση την οποία αυτή διέρχεται. Αξιοποιώντας το θεωρητικό μοντέλο της συμμετοχικής δημοκρατίας, πραγματοποιήθηκε μια ιστορικοσυγκριτική μελέτη κυρίως μέσω των ευρωπαϊκών και ελληνικών συνταγματικών κειμένων αλλά και των συνθηκών της Ευρωπαϊκής Ένωσης. Σε πρώτη φάση, μελετήθηκε η μεταπολεμική περίοδος, βάσει της οποίας διαμορφώθηκαν δύο νομοθετικά μοντέλα, το παραδοσιακό και των αποκλίσεων, ανάλογα με την συνταγματική αξιοποίηση των θεσμών άμεσης συμμετοχής στο νομοθετείν και στην αναθεωρητική διαδικασία. Σε δεύτερη φάση, ερευνήθηκε η σύγχρονη περίοδος και πραγματοποιήθηκε η ένταξη των θεσμών συμμετοχής στα επιμέρους νομοθετικά στάδια (προνομοθετικό, νομοθετικό, μετανομοθετικό). Ακολούθως, ελέγχθηκε η περίπτωση της Ευρωπαϊκής Ένωσης ενώ τέλος, εξετάστηκε η ελληνική περίπτωση υπό το πρίσμα των ευρωπαϊκών συγκριτικών δεδομένων και η πιθανή αξιοποίησή τους, στο ελληνικό νομοθετικό γίγνεσθαι.
New Knowledge from Research – Can Global Congenital Cardiac Surgery Play a Part? A Call for International Collaboration
Authors: Jeevan Francis Jeevan , George Joseph , Stoica Serban
Published: June 2022

Over 1.3 million babies are born each year with congenital heart defects (CHD), with the highest incidence in low-income countries (LIC) and low-middle income countries (LMICs) (Fanaroff., 2012). The Lancet Commission on Global Surgery found that surgically treatable conditions make up 28-32% of the total global burden of diseases, of which most are cardiovascular diseases (Meara et al., 2015). Currently, high-income countries (HICs) undertake mission trips to LICs and LMICs to provide surgical care for those who otherwise would not have access. These trips also provide an opportunity to train the local surgical teams. It has been proposed that there should be a shift in thinking from ‘humanitarian surgery’ to ‘global surgery’, as this benefits both the provider and the receiver. With this change, we should address several limitations in our current infrastructure, including but not limited to, the lack of international research collaboration, the need for globalising and scaling up the paediatric cardiac surgical workforce, offsetting greenhouse gas emissions from mission trips, and opportunities for mentorship and training in LICs.
Second-order perturbations in Alfvén waves in finite pressure plasma
Authors: Dmitrienko Irina
Published: June 2022

It is shown first that in finite pressure plasma, just as in cold plasma, Alfvén waves created by an initial perturbation generate plasma flows and decreases in the magnetic field, which propagate along with these waves. Second, at the stage of their interaction, Alfvén waves generate slow magnetosonic (SMS) waves propagating along the magnetic field. These results suggest that at least some of the fast plasma flows observed in the magnetotail can be one of the manifestations of propagating Alfvén waves both in the magnetosphere regions with cold plasma and in the magnetosphere regions with finite pressure plasma. They also provide potential possibility for determining the position of a source of Alfvén disturbance from observations of Alfvén waves and their induced SMS waves.
Comparative analysis of variability in the mid-latitude stratosphere and ionosphere in winter periods
Authors: Yasyukevich Anna , Vesnin Artem
Published: June 2022

In this work, we perform a joint analysis of the spatial-temporal dynamics of ionospheric and stratospheric variability (with scales characteristic of internal gravity waves) at different longitudes of midlatitudes of the Northern Hemisphere. We analyze the winter periods of 2012–2013 and 2018–2019 when strong midwinter sudden stratospheric warmings (SSWs) occurred. An increase in the variability in the stratosphere is shown to occur in a limited latitude interval 40°–60° N in the region of existence of a winter circumpolar vortex. Under SSW conditions, the generation of wave disturbances in the stratosphere ceases manifesting itself in a significant decrease in the stratospheric variability index. Similar behavior is noted in the spatial-temporal dynamics of the index of the total electron content variability. The level of ionospheric variability at midlatitudes decreases significantly after SSW peaks. The decrease in the ionospheric variability can be explained by a reduction in wave generation in the stratosphere, associated with the destruction of the circumpolar vortex during SSWs
Shape of spectrum of galactic cosmic ray intensity fluctuations
Authors: Starodubtsev Sergei
Published: June 2022

The impact of solar wind plasma on fluxes of galactic cosmic rays (CR) penetrating from the outside into the heliosphere with energies above ~1 GeV leads to temporal variations in the CR intensity in a wide frequency range. Cosmic rays being charged particles, their modulation occurs mainly under impacts of the interplanetary magnetic field.

It is well known that the observed spectrum of interplanetary magnetic field (IMF) fluctuations in a wide frequency range ν from ~10–7 to ~10 Hz has a pronounced falling character and consists of three sections: energy, inertial, and dissipative. Each of them is described by the power law PIMF(ν)~ν–α, while the IMF spectrum index α increases with increasing frequency. The IMF fluctuations in each of these sections are also characterized by properties that depend on their nature.

Also known are established links between fluctuation spectra of the interplanetary magnetic field and galactic cosmic rays in the case of modulation of the latter by Alfvén or fast magnetosonic waves. The theory predicts that fluctuation spectra of cosmic rays should also be described by the power law PCR(ν)~ν–γ. However, the results of many years of SHICRA SB RAS research into the nature and properties of cosmic ray intensity fluctuations based on data from neutron monitors at stations with different geomagnetic cut-offs RC from 0.5 to 6.3 GV show that the observed spectrum of fluctuations in galactic cosmic ray intensity in the frequency range above 10–4 Hz becomes flat, i.e. it is similar to white noise. This fact needs to be realized and explained.

This paper reports the results of research into the shape of the spectrum of galactic cosmic ray intensity fluctuations within a frequency range ν from ~10–6 to ~1 Hz and compares them with model calculations of white noise spectra, using measurement data from the neutron monitor of the Apatity station. A possible physical explanation has been given for the observed shape of the cosmic ray fluctuation spectrum on the basis of the known mechanisms of their modulation in the heliosphere.
Flat location and size as a determinant of homeownership duration
Authors: Foryś Iwona
Published: June 2022

Motivation: Both the research on the residential market focuses primarily on analyses of the size and quality of the housing stock, or seeking dependencies with socio-economic factors. The second research area is the analysis of prices and construction of residential price indices. As an equally important issue is assessing the intensity of trade in particular types of flat and location. A standard view is that those small flats are more frequently traded on the market than large ones.

Aim: The study concerns analysis of ownership duration of a flat by the same owner (from the day of purchase to the sale day). It depends on the characteristics of the dwelling, including the location and size. The research will verify the hypothesis of a shorter duration for small units and its location. The study relies on the example of one local housing market. The study use regression analysis to examine the property value on the city’s districts and duration analysis to explore ownership duration time, and nonparametric models of a proportional model Cox gambling with explanatory variables dependent on time.

Results: This research is significant in socio-spatial connection to the housing market. It shows that the current practice of buying a small flat as an investment in the housing market is appropriate. Due to the rapid price increase of small flats and high turnover, the chances for a good investment are increasing. With the help of the Cox model, the study shows that on the local market poor location in the old city housing estate and a larger floor area decreased the odds of a property to be sold quickly. The study results are valuable due to the unique role of housing on investing in the local market.
Legal and economic determinants of restructuring processes in health care entities in Poland
Authors: Głód Grzegorz , Langer Maciej
Published: June 2022

Motivation: The majority of problems in the health care system originate in the limited financial resources, but the efficiency of the system is also — indirectly — affected by the management of these resources, which is sometimes not as effective as it might be. These problems become particularly apparent in the Polish public health care, undergoing constant reforms. This brings into focus the issue relating to restructuring processes, which are determined by relevant legal regulations and the competences of people in charge, who need to maintain the consistency of implementation.

Aim: The article aims to analyse legal and economic determinants in the restructuring of health care entities in Poland, with particular emphasis on the possible application of restructuring proceedings to these entities. Further, it identifies key success factors for restructuring processes from the perspective of management. The following legal acts were included in the analysis: the Act of 15 May 2015 the Restructuring Law, the Act of 15 April 2011 on medical activity, the Act of 23 April 1964 the Civil Code, the Act of 28 February 2003 the Bankruptcy Law. The review of good management practices in the research area was presented.

Results: Based on the analysis, recommendations concerning the implementation of restructuring processes in health care entities were formulated. The benefits stemming from the application of restructuring proceedings to health care entities were discussed. The key elements of the restructuring plan, accompanied with practical guidelines, were presented.
Central ICT system SL2014: the way to reduce the transaction costs of European projects
Authors: Kępa Marcin
Published: June 2022

Motivation: European funds are these kinds of goods for which effective demand exceeds supply. The market value of European projects in Poland is estimated at approximately PLN 1125,44 bn, of which the EU co-financing is PLN 664,29 bn. Their effective use depends on the quality of the institutions responsible for their aggregation, allocation and proper expenditure (in accordance with the EU policies).

Aim: The analysis of mechanisms determining the market game on the European project market in Poland in the light of the new institutional economics. Particular attention will be paid to the administrative tools that facilitate efficient long-distance communication between the parties to a project co-financing contract (central ICT system SL2014).

Results: ICT systems constitute a part of a wider phenomenon commonly referred to as e-administration. It may be regarded as an institution in the meaning of the new institutional economics. This institution reduces the transaction costs related to handling European projects as well as the transaction costs in other areas connected with public governance. Wherever the e-administration can be applied (e-administration may be found useful in the case of public health emergencies that were triggered by the SARS-CoV-2 pandemic). Central ICT system SL2014 (as an element of e-administration) significantly reduced transaction costs in the field of handling European projects in the 2014–2020 financial perspective.
Pregnant women and their partners' views and experiences of reduced fetal movements: a narrative literature review
Authors: Dube Kushupika , Smyth Rebecca , Heazell Alexander , Lavender Tina
Published: June 2022

Background/Aims

Globally, 2 million stillbirths occur annually, 98% of which occur in low-income settings. In low-income settings, stillbirth may be associated with maternal perception of reduced fetal movements. However, little is known about maternal experiences of reduced fetal movements and subsequent engagement with health services in low-income settings. This narrative literature review initially aimed to improve understanding of views and experiences of reduced fetal movements in pregnant women in low-income settings using information synthesised from international studies. However, only a small number of articles from low-resource settings were found.

Methods

The literature reviewed qualitative, quantitative and mixed-method studies guided by a systematic approach. The findings were discussed narratively.

Results

A total of 40 studies were identified, only four of which were from low-income settings. The four main themes identified were: maternal perception of fetal movements, facilitators and barriers to seeking healthcare, reduced fetal movements as a predictor of fetal outcomes and knowledge of fetal movements and management strategies.

Conclusions

A variety of factors may influence maternal perception of reduced fetal movements and experience of care. As most studies were conducted in high-income settings, it is imperative to describe women's experiences of reduced fetal movements in low-income settings.
Male partners' involvement during antenatal care in Ekiti State, southwest Nigeria
Authors: Ade-Ojo Idowu Pius , Olofinbiyi Olusanya Rufus , Adeyanju Benedict Tolulope , Olajuyin Adebola Ayotomiwa , Yusuf Tajudeen Oluwaseun
Published: June 2022

Background/Aims

Male partners' involvement in the use of antenatal care services has been evaluated as a crucial determinant in the uptake of these services. This study investigated the opinion of antenatal care attendees on male partners' role in the use of antenatal care services in Ekiti State.

Methods

A cross-sectional study was conducted and data obtained through semi-structured questionnaires administered to 600 antenatal clinic attendees at the Ekiti State University Teaching Hospital, Ado Ekiti.

Results

Half (51.1%) of respondents attended antenatal care clinics to promote the development and growth of their unborn babies. Over a third (40.6%) of the respondents reported that the decision to attend an antenatal care clinic was made by ‘male partners’, while 82.8% of respondents had their male partners participate in activities that facilitated their use of antenatal care services.

Conclusions

Male partners play an important role in the uptake of antenatal care services. The authors advocate for policies to be created to increase male partner participation in the use of antenatal care services.
The effect of anticoagulants on clinical outcomes for patients with heart failure in sinus rhythm
Authors: Hamer Oliver , Mansoor Mohamed , Tailor Karishma , Hill James
Published: June 2022

In this commentary, Hamer, Mansoor, Taylor and Hill critically appraise a Cochrane systematic review of the risks and benefits of oral anticoagulation in patients with heart failure in sinus rhythm.
Ethics are central to nursing care
Authors: Eftekhari Helen
Published: June 2022

In this month's BANCC column, Helen Eftekhari takes a look at the ethics that guide cardiac nurses in clinical practice and research.
Riding a ‘sea of uncertainty’ in the drug treatment of cardiac conditions in care home residents
Authors: Cowan Helen
Published: June 2022

In this new quarterly column, Helen Cowan sheds some light on the lesser known area of cardiac nursing in care homes, looking at nurse-led diagnosis and management of cardiac conditions.
When a patient says ‘no’
Authors: Greenaway Beth
Published: June 2022

In this month's patient story, Beth Greenaway reflects on the importance of patient choice and empowerment.
Bruegger's exercises vs deep cervical flexor training in asymptomatic participants with forward head posture: a randomised controlled trial
Authors: Chodankar Ashma , Gurudut Peeyoosha , Welling Aarti
Published: June 2022

Background/Aims Forward head posture is the most frequent postural deviation in typically healthy individuals and is associated with rounding of the shoulders. Prevention should be considered when it is at the asymptomatic stage by screening and early exercise intervention. The aim of the study was to examine the effects of Bruegger's exercises compared to deep cervical flexor training in asymptomatic participants with forward head posture.

Methods This randomised controlled trial included 51 participants with asymptomatic forward head posture, who were allocated to one of three groups. One group undertook Bruegger's exercises with an elastic resistance band, another group performed deep cervical flexor training with a pressure biofeedback unit and the control group performed isometric neck exercises. Outcomes measured were the craniovertebral angle, the craniocervical flexion endurance test and the Pectoralis Minor Index, which were assessed at baseline on day 1 and at the end of the 3-week intervention. Follow-up assessment was undertaken for craniovertebral angle at 6 and 9 weeks from day 1 of the intervention. Statistical analysis included paired t-tests, the Wilcoxon signed-rank test, analysis of variance and the Kruskal–Wallis test.

Results All three groups showed improvements in craniovertebral angle and the craniocervical flexion endurance test when compared between pre- and post-intervention. Only those in the Bruegger's exercises group showed an increase in the length of the pectoralis minor according to the Pectoralis Minor Index. Deep cervical flexor muscle endurance increased significantly (P<0.0002) for those in the Bruegger's exercises group and deep cervical flexor training group. At the end of the intervention (week 3) (P<0.0205) and follow up at week 9 (P<0.0029), individuals in the Bruegger's exercises group had maintained the craniovertebral angle correction for longer than those in the deep cervical flexor training and control group.

Conclusions Bruegger's exercises with an elastic resistance band was found to be an effective intervention exercise to correct posture from head to scapula and can be included in the treatment of patients with postural head and neck issues.
Promoting cross-sectoral cooperation in the early intervention model
Authors: Matijaš Tena , Bulić Dajana
Published: June 2022

Cross-sectoral cooperation is a complex process involving different systems with their complexities and separate protocols through partnership, sharing responsibilities and benefits. In the developmental system model of early intervention, cross-sectoral coopera- tion implies the connection between the health care system, social welfare and the educational system. In the Republic of Croatia, this type of cooperation has not come to life at the level that would be necessary for the entire system to function adequately. This is why families of children with neurodevelopmental risk and developmental difficulties are often left to fend for themselves and seek support and therapy. Objective: The aim of this paper is to present a model of connecting the health institution, the paediatrician of the health center and the experts of the social care institution that provides early intervention services (EI), and to examine whether this cooperation ac- celerates family involvement in EI support and services. Methods: The collaboration was conducted through secure virtual communication, with paediatricians directing families of chil- dren with a certain deviation from typical development to a social institution, the EI provider, where experts conducted triage by team development assessment. Results: 27 children and their families were included and it was shown that the mentioned cooperation led to the acceleration of obtaining support for the family in an average of 72 days. It also turned out that there was an indirect acceleration of administrative procedures in exercising the right to EI service in 13 days. Conclusion: The results show a positive effect of cross-sectoral cooperation and networking through a system of information ex- change through secured technologies.
The Effect of Play Activities for COVID-19 Positive and MIS-C Pediatric Patients on the Anxiety and Fear of Children and Their Parents
Authors: Tural Buyuk Esra , Hafize Erdeniz Emine , Uzsen Hatice , Odabasoglu Emel , Koyun Merve
Published: June 2022

Aim: This study aims to determine the effects of play activities for COVID-19 positive and MIS-C pediatric patients on the anxiety and fear of children and their parents. Methods: This is an experimental study that was prepared through STROBE. The study population consisted of 38 children treated in a university hospital COVID-19 unit. The Children’s Anxiety Meter-State and the Children’s Fear Scale were administered before and after the play activities. The parents’ fear and anxiety were assessed using the COVID-19 Phobia Scale and the Beck Anxiety Inven- tory. The book and coloring set was prepared in advance and delivered to the experimental group in a package. After the sets were given to the parents, the parents read the book to their children the same day. Afterward, they were asked to color pictures of coro- navirus precautions together with the children. SPSS 22.00 package program was used to analyze the study data. The Mann-Whit- ney U test was used to compare independent groups, and Wilcoxon analysis was used to analyze dependent variables before and after the play activities. Results: Based on the children’s anxiety and fear scores in the experimental group, significant differences were found before and after the play activities and significant differences between the anxiety scores (<0.05) of parents and children. However, no significant difference was found between post-play anxiety and fear scores of children in the experimental group and the scores of the control group. Discussion: The experimental group had low mean anxiety and fear scores after the play activities. Play activities should be used to reduce the anxiety and fear of children who are treated in isolation in hospitals during the COVID-19 pandemic. Even if children are restricted to isolation rooms, their daily routines should be maintained, and their parents should be supported.
A Case of Pediatric Multisystem Inflammatory Syndrome Temporally Associated with SARS-CoV-2
Authors: Pavlyshyn Halyna , Horishna Ivanna , Slyva Viktoriia , Dyvonyak Olga , Panchenko Olga
Published: June 2022

Introducion. COVID-19 in children is a relatively mild disease. Though a more serious condition characterized by systemic inflamma- tion does occur in children in a Kawasaki disease-like form named multisystem inflammatory syndrome (MIS-C). MIS-C in children is a less common pathology. Case Report. A clinical case of multisystem inflammatory syndrome in children (MIS-C) temporally associated with SARS-CoV-2 in- fection in a previously healthy preschool-age girl is presented. The disease had an incomplete Kawasaki disease-like form corre- sponding to this syndrome in children and adolescents as defined by WHO and CDC criteria. Conclusion. This clinical case draws the attention of general practitioners and pediatricians to the peculiarities of this type of syn- drome diagnosis and management.
Intelligent Sampling of Anterior Human Nasal Swabs using a Collaborative Robotic Arm
Authors: Parak Roman , Juricek Martin
Published: June 2022

Advanced robotics does not always have to be associated with Industry 4.0, but can also be applied, for example, in the Smart Hospital concept. Developments in this field have been driven by the coronavirus disease (COVID-19), and any improvement in the work of medical staff is welcome. In this paper, an experimental robotic platform was designed and implemented whose main function is the swabbing samples from the nasal vestibule. The robotic platform represents a complete integration of software and hardware, where the operator has access to a web-based application and can control a number of functions. The increased safety and collaborative approach cannot be overlooked. The result of this work is a functional prototype of the robotic platform that can be further extended, for example, by using alternative technologies, extending patient safety, or clinical tests and studies. Code is available at https://github.com/Steigner/Robo_Medicinae_I
Integrative design and processing of a conformal optical window pair in a cylindrical isolator
Authors: Ou Yang , Dai Yifan , Chen Shanyong , Fan Xiaoqiang , Hu Hao , Xiong Yupeng , Xiong Bing , Du Chunyang , Guan Chaoliang
Published: June 2022

In order to perform the flow visualization of a shock train structure by the schlieren imaging method in the cylindrical isolator, to the best of our knowledge, a novel integrative design and processing scheme of an aluminum alloy pipe with an acrylic conformal optical window pair are proposed. The optical ray tracing and wavefront correction methods were applied to design the inner cylindrical surfaces and outer aspherical cylindrical surfaces of the optical window pair for parallel light correction based on the conjoint analysis with the processing capability. Under the tolerance analysis and the optimization of the machining path, the integrative model was fabricated on a three-axis computer numerical control machine using two-axis turning and fast tool servo machining. The wavefront aberration (peak-to-valley value) and wavefront aberration (RMS) of the optical window pair were corrected within 12.189 and

2.658

λ

(

λ
=

632.8

n
m

) in the observation area which met the requirements of high-precision schlieren observation.
The association between vaginal hygiene practices and spontaneous preterm birth: A case-control study
Authors: Janssen Laura E. , Verduin Rubin J. T. , de Groot Christianne J. M. , Oudijk Martijn A. , de Boer Marjon A.
Published: June 2022

Background

Spontaneous preterm birth (SPTB) is a major cause of neonatal morbidity and mortality worldwide and defining its risk factors is necessary to reduce its prevalence. Recent studies have pointed out that bacterial vaginosis, a disturbance in the vaginal microbiome, is associated with SPTB. It is hypothesized that vaginal hygiene practices can alter the vaginal microbiome and are therefore associated with SPTB, but there are no studies investigating this matter.

Methods and findings

A case-control study was conducted between August 2018 and July 2021 in two affiliated university medical centers in Amsterdam, the Netherlands. We included a total of 79 women with a SPTB and compared them with 156 women with a term birth. Women with uterine anomalies, a history of cervical surgery or major congenital anomalies of the fetus were excluded. All participants filled in a questionnaire about vaginal washing with water, soap or gel, the use of intravaginal douches and vaginal steaming, both before and during pregnancy. Most women washed vaginally with water, 144 (61.3%) women before pregnancy and 135 (57.4%) women during pregnancy. A total of 43 (18.3%) washed with soap before and 36 (15.3%) during pregnancy. Before pregnancy, 40 (17.0%) women washed with vaginal gel and 27 (11.5%) during pregnancy. We found that the use of vaginal gel before pregnancy (aOR 2.29, 95% CI: 1.08–4.84) and even more during pregnancy, was associated with SPTB (aOR 3.45, 95% CI: 1.37–8.67). No association was found between washing with water or soap, intravaginal douching, or vaginal steaming and SPTB.

Conclusions

Our findings suggest that the use of vaginal gel is associated with SPTB. Women should be informed that vaginal use of gels might not be safe.
Estimating genetic variability among diverse lentil collections through novel multivariate techniques
Authors: Hussain Syed Atiq , Iqbal Muhammad Sajjad , Akbar Muhammad , Arshad Noshia , Munir Saba , Ali Muhammad Azhar , Masood Hajra , Ahmad Tahira , Shaheen Nazra , Tahir Ayesha , Khan Muhammad Ahson , Ilyas Muhammad Kashif , Ghafoor Abdul
Published: June 2022

Lentil is an important food legume throughout the world and Pakistan stands at 18th position with 8,610 tons production from 17,457 hectares. It is rich in protein, carbohydrates, fat, fiber, and minerals that can potentially meet food security and malnutrition issues, particularly in South Asia. Two hundred and twenty lentil genotypes representing Pakistan (178), Syria (14), and the USA (22) including 6 from unknown origins were studied for yield, yield contributing traits, and cooking time (CT). Genotype 6122 (Pakistan) performed the best during both years with seed yield per plant (SY) 68±1.7 g, biological yield per plant (BY) 264±2.8 g, pod size (PS) 0.61±0.01 cm, number of seeds per pod (NSP) 2, cooking time (CT) 11 minutes, with no hard seed (HS). The genotypes 6122 (Pakistan) and 6042 (Syria) produced the highest BY, hence these have the potential to be an efficient source of fodder, particularly during extreme winter months. The genotypes 5698 (Pakistan) and 6015 (USA) were late in maturity during 2018–19 while 24783 and 5561 matured early in 2019. A minimum CT of 10 minutes was taken by the genotypes 6074 and 5745 of Pakistani origin. The lowest CT saves energy, time, and resources, keeps flavor, texture, and improves protein digestibility, hence the genotypes with minimum CT are recommended for developing better lentil cultivars. Pearson correlation matrix revealed significant association among several traits, especially SY with BY, PS, and NSP which suggests their use for the future crop improvement program. The PCA revealed a considerable reduction in components for the selection of suitable genotypes with desired traits that could be utilized for future lentil breeding. Structural Equational Model (SEM) for SY based on covariance studies indicated the perfect relationship among variables. Further, hierarchical cluster analysis establishes four clusters for 2017–18, whereas seven clusters for 2018–19. Cluster 4 of 2017–18 and cluster 5 of 2018–19 exhibited the genotypes with the best performance for most of the traits (SY, BY, PS, NSP, CT, and HS). Based on heritability; HSW, SY, BY, NSP were highly heritable, hence these traits are expected for selecting genotypes with genes of interest and for future lentil cultivars. In conclusion, 10 genotypes (5664, 5687, 6084, 6062, 6122, 6058, 6087, 5689, 6042 and 6074) have been suggested to evaluate under multi-location environments for selection of the best one/s or could be utilized in hybridization in future lentil breeding programs.