bluuebunny/crossref_metadata_2025 huggingface dataset:
Financial Constraints of the Pro-environmentally Oriented Firms in the Covid-19 Crisis
Authors: Botrić Valerija
Published: February 2023

Environmentally oriented firms are more pressed for resources in general, especially during periods of economic downturn. Since their business plans are frequently more innovative, they are perceived as riskier by financial institutions. Furthermore, the recent global COVID-19 crisis was not primarily related to financial disruptions, and most governments provided generous and widespread support to different segments of their economies. However, the evidence on the degree to which firms were faced with access to finance problems during this crisis is still scarce. This paper aims to explore the extent to which environmentally-oriented firms in post-transition economies are disproportionally affected by the financial constraints related to the market disruptions caused by COVID-19 pandemics compared to non-environmentally oriented firms. The World Bank Enterprise Survey 2019 has been used to investigate this issue. Based on this data source, an indicator of firm environmental proactivity is developed. The firms’ financial constraints in the pandemic period are evaluated based on the responses from the three survey rounds of the World Bank COVID-19 follow-up enterprise survey, covering different stages of the pandemic. The post-transition countries in the analysis are heterogeneous, consisting of both EU members (Bulgaria, Croatia, Slovakia, and Slovenia) and EU accession countries (Bosnia and Herzegovina and Serbia). The lowest percentage of firms having an environmental strategy was found in Croatia, while the highest percentage is in Slovenia. Based on the results, it can be concluded that firms adopting environmental strategies in analyzed countries mostly follow regulations and/or chose low-cost measures.
Keywords: financial constraints, pro-environmental orientation, post-transition, COVID- 19
Greek Accounting Standards and Debt Covenants. Changes in Contracting
Authors: Kalantzopoulos Nikolaos , Mandilas Athanasios , Valsamidis Stavros , Kourtidis Dimitrios
Published: February 2023

Businesses, organizations, and even more governments are strongly related with information provided by accounting in order for CEO’s or managers and even more members of parliament to make decisions. Financial statements which contain multiple criteria, and how managers or shareholders treat them influence the decisionmaking of organizations and all types of businesses, public and private. Auditing financial statements ensures their reliability and validity. Both lenders and borrowers must choose the right set of debt covenants to minimize risk from their respective perspectives. It is critical to use and select debt covenants in relation to the side of interest. For instance, in past decades, financial covenants based on balance sheet variables are more likely in debt contracting. Nowadays, the trend of choosing a batch of covenants in contracting changed. In this paper, we investigate the relationship between changing the Greek direction and accounting standard setting. Greek accounting standards are moving away from “old-fashioned” book- and record-keeping standards. This was a great change that took place in 2015, and since then, new notions of accounting practice have been introduced. Fair value, net realizable value, present value, cash equivalents, and useful economic life are some concepts that were first used in accounting the process in Greek economy. Changes were massive and everyone involved with accounting, financial statements, and the way they were introduced should change the way they are analyzed. We hypothesized that this significant shift in accounting standard setting reduces the value of analyzing balance sheets in debt contracting. Since 2015, balance sheet-based covenants started to vanish, especially from private debt contracting. We tried to correlate borrowers and their likelihood in using balance sheet-based covenants. The correlation between the change in accounting standard setting and the concurrent change in trend of choosing accounting-based covenants in debt contracting is being investigated. The results are consistent with our hypothesis. A mechanism that separates multiple covenants and correlates them with significant debt characteristics will be an innovative tool for managers and credit institutions, as well as a more definite way of auditing, for instance, by digitalizing it, which will be a great tool for everyone involved in businesses.
Keywords: accounting-based covenants, debt contracting, Greek accounting standards
The Protection of Public Health As A Reason For Restricting Trade And Screening Foreign Investments Within The EU Legal Order
Authors: Spiliopoulos Odysseas , Triantafyllopoulou Athanasia
Published: February 2023

One of the fundamental principles underpinning the functioning of the European Union economic system is the principle of an open market economy with free competition. This is a principle of constitutional order, from which derive the freedom of trade and the freedom of investment. The EU legal order, however, allows the authorities of the Member States to adopt and implement national measures restricting the free exercise of the above economic activities. A key condition for restrictive measures to be taken is that there are reasons for general non-economic interest, such as the need to protect public health. The present study aims to examine the context of exercising this capability at two levels and in two areas. Regarding the intra-EU level, a Member State may impose restrictions on the free movement of goods within the internal market provided that it seeks to ensure the protection of consumer health. As far as the level of economic relations with third countries is concerned, especially the investment sector, the possibility of screening foreign investment and mainly the FDI is provided to achieve objectives related to the safeguarding of fundamental interests of society such as public health. The value of the study is that it contributes a particular legal perspective on important issues raised mainly by the pandemic outbreak in the field of economic relations, and especially in the field of trade and investment.
Keywords: European Union, freedom of trade, freedom of investment, exceptions
Role of Artificial Intelligence in Human Resource Management in the Middle East Countries
Authors: Hmoud Bilal , Varallyai Laszlo
Published: February 2023

The primary goal of this article is to contribute to the field of technology adoption research by providing researchers, organizations, HR leaders, service providers, and decision-makers with advanced understanding and valid inputs on the development of AI-based HR solutions and the determinants of adoption. The overall objective of this research is to determine the general attitude of HR managers toward the adoption of AI in HRM and to assess the factors that determine the adoption of AI from the perspective of HR managers. The proposed adoption factors were grouped into four constructs, innovation characteristics, trust, technology-organizational-environment (TOE) factors, and emphasized HR roles within the organization. The research was conducted among HR managers in Middle Eastern countries, specifically Jordan, Kuwait, Saudi Arabia, and Qatar. An online questionnaire was used to collect data from a total of 389 respondents. The results showed that respondents were largely positive toward AI applications in HRM. This positive attitude can be inferred from the mean values of two variables, relative advantage and attitude toward the application of AI in HRM. The research results showed that HR managers have a positive attitude and confidence that emerging AI applications can contribute to supporting the efficiency, effectiveness, and quality of HRM. In addition, the results showed a constructive perception of the relative benefits of AI. Researchers, policymakers, and service providers are also recommended to investigate the phenomenon from two perspectives, first, the impact of attitudes on actual adoption decisions and second, the factors that influence this impact.
Keywords: artificial intelligence, HRM, technology adoption, HR leaders, technologicalorganizational- environmental
Reforms in primary health care in Bulgaria - past, present, future
Authors: G. IVANOVA Nevena
Published: February 2023

The health of any nation, and the Bulgarian one in particular, is extremely important for the economy, security and development of the country. Unlike other European countries, due to defects in the structure and functioning, the Bulgarian health system could not achieve satisfactory final results in a number of important aspects of public health. One part of the essential problems includes high rates of morbidity, mortality, wide spread of health risk factors, and on the other - insufficient satisfaction of medical professionals (doctors, nurses, support staff) and patients. This, combined with the changes in the political administration of Bulgaria, led to a decision for a radical reform in the health care system. Conditionally, the changes can be divided, according to their nature, into 6 large groups: 1) Reforms leading to democratization of the system; 2) Reforms related to liberalization; 3) Reforms in the status of primary care practices; 4) Reforms in the organization, construction and structure of the system; 5) Reforms in financing and payment methods; 6) Reforms in the management of the primary care system and practices. The purpose of this review article is to present the theoretical framework, grounds and goals for the reform of the health care system in Bulgaria carried out in the past, with a focus on primary care and the current state. The health of any nation, and the Bulgarian one in particular, is extremely important for the economy, security and development of the country. Unlike other European countries, due to defects in the structure and functioning, the Bulgarian health system could not achieve satisfactory final results in a number of important aspects of public health. One part of the essential problems includes high rates of morbidity, mortality, wide spread of health risk factors, and on the other - insufficient satisfaction of medical professionals (doctors, nurses, support staff) and patients. This, combined with the changes in the political administration of Bulgaria, led to a decision for a radical reform in the health care system. Conditionally, the changes can be divided, according to their nature, into 6 large groups: 1) Reforms leading to democratization of the system; 2) Reforms related to liberalization; 3) Reforms in the status of primary care practices; 4) Reforms in the organization, construction and structure of the system; 5) Reforms in financing and payment methods; 6) Reforms in the management of the primary care system and practices. The purpose of this review article is to present the theoretical framework, grounds and goals for the reform of the health care system in Bulgaria carried out in the past, with a focus on primary care and the current state.
OPTIMIZATION OF THE NUTRIENT MEDIUM FOR THE PRIMARY STAGES OF COMMON WALNUT MICROCLONAL PROPAGATION IN VITRO
Authors: Tesliuk N. I. , Lytvyn M. L. , Hudzenko T. V.
Published: February 2023

SummaryAim. To optimize the processes of microclonal propagation of Juglans regia in vitro by selecting the composition and consistency of the nutrient medium. Methods. The methods of in vitro culture establishment of initial explants and microclonal propagation were used. Parts of the stem and buds of young sprouts, germinated by the mini-greenhouse method from the seeds of Juglans regia, were used as initial explants. Murashige&Skoog (MS) and Driver&Kuniyuki (DKW) nutrient media were used to establish Juglans regia explants in vitro. Agar was used as a gelling agent. The solid, semi-liquid, and liquid media were prepared with addition of 7 g/l, 3.5 g/l and 0 g/l of agar, respectively. All experimental variants of the media were modified by adding the phytohormone of the cytokinin group 6-BAP. The pH of the medium was controlled at the level of 7.1–7.2. The established explants in vitro were cultivated at a temperature of + 25°C, a light intensity of 2500 lux, a relative humidity of 56–70% and a photoperiod 16/8 h light/dark. On the 3rd, 7th and 14th day, the survival rate, growth and development parameters of the initial explants were estimated. Results. It was found that the optimal nutrient medium for in vitro establishment and cultivation of Juglans regia is the DKW medium, on which the high survival rate of explants was observed (80%), as well as accelerated swelling of buds and their proliferation. It is proposed to use semi-liquid nutrient media for in vitro establishment of initial Juglans regia explants. The use of semi-liquid nutrient medium DKW for the initial stages of common walnut micropropagation in vitro contributed to the acceleration of the processes of reproduction of this culture by 2 days and improved the survival rate by 20% compared to solid medium. Conclusion. The use of semi-liquid nutrient medium DKW for introduction into the culture and cultivation of walnut (Juglans regia) in vitro is recommended to increase the survival rate of explants by 20%, as well as the accelerated activation of buds (2 days) and their further proliferation.
Thickness of Leaf Anatomical Tissue Dicot Ornamental Plants at Different Light Intensities
Authors: Daningsih Entin , Fransiska Nadia , Mardiyyaningsih Asriah Nurdini
Published: February 2023

Different light intensities affect the leaf anatomy. This study aims to measure the thickness of the anatomical tissue of the leaves of six types of dicot ornamental plants at different light intensities. This study used a quantitative experimental method with a completely randomized factorial design (CRD-Factorial). This design consisted of two factors, namely the main factors were six types of plants, namely Codiaeum variegatum (L.) A. Juss., Bougainvillea glabra Choisy, Tabernaemontana divaricata (L.) R, Br. Ex Roem. & Schult., Syzygium paniculatum Gaertn, Excoecaria cochinchinensis Lour., and Aerva sanguinolenta BI. The second factor is the different light conditions (open and shading) with three replications. Parameters measured were total leaf anatomical tissue thickness, upper and lower epidermis, palisade, and spongy using a modified paraffin method from Johansen. Data were analyzed using the CRD-Factorial ANOVA model followed by the LSD test. Correlation  done between palisade, spongy, and lower epidermis thickness with total tissue thickness. The results showed that the leaf anatomy of six types of dicot ornamental plants varied. All plants have one layer of upper and lower epidermis tissue. In Codiaeum variegatum (L.) A. Juss., Syzygium paniculatum Gaertn, and Excoecaria cochinchinensis Lour. has two layers of palisade tissue while the Bougainvillea glabra Choisy, Tabernaemontana divaricata (L.) R,Br. Ex Roem. & Schult. and Aerva sanguinolenta BI has one layer of palisade tissue. Meanwhile, the spongy tissue in all plants has one layer of tissue. The thickness of the leaf tissue decreased in the shading area along with the depletion of the palisade, spongy, and lower epidermis tissue as indicated by a correlation from moderately strong to very strong. Shrinkage of palisade tissue, sponges, and lower epidermis is a plant's attempt to get optimal light in shading areas. The more lower epidermis srink, the thickness of leaf become thin while the thickness of palisade and sponge varied so the thickness of total leaf from each species also varied.
The Influence of Service Quality and Company Image on Customer Satisfaction and Word of Mouth
Authors: Sugiharto Didik Priyo Sugiharto , Almanik Yustino Islami Almanik , Wiyarni Wiyarni
Published: February 2023

The purpose of this research is to investigate the relationship among service quality, company image, customer satisfaction, and word of mouth. The population of this study is the parents of students in Avesiena Nature School Malang, East Java, Indonesia, which is 193 people. This study used saturated sample, it means the sample is the same number with the population. In order to examine the relationship both direct and indirect between service quality and company image on word of mouth, this study used path analysis. According to validity and reliability tests, the data that used in this study can be said valid and reliable. Results of this study show that service quality, company image, and customer satisfaction have a significant impact on word of mouth. Indirectly or through customer satisfaction, service quality and company image also have a significant effect.

 

Key words: Service Quality, Company Image, Customer Satisfaction, Word of Mouth
Clinical Experience of the Application of Intravenous Therapy with VIT. C, Ozonotherapy and Biomagnetic Therapy
Authors: Damyanov Dr. Chr. , Pavlov Dr. Vl. , Todorov Dr. Al. , Pashina Iv.
Published: February 2023

On the background of the announced COVID-19 pandemic, the treatment of seasonal viral infections demonstrates a serious irrational approach by ignoring numerous scientific publications about methods from the arsenal of integrative medicine. Among these methods stand out: intravenous vitamin C application in high doses, Ozone therapy and Scalar Biomagnetic therapy (SBT) with magnetic pairs. After a thorough review of a number of scientific publications and based on our clinical experience of the application of these methods in oncological diseases, we have prepared our own protocol for the treatment of viral diseases including these three methods. The protocol was prepared in January 2021. In this publication, we present the first results using this method for the treatment of oncological and viral diseases,
OSWALDO FIDALGO, PIONEIRO DA ETNOMICOLOGIA NO BRASIL
Authors: Trierveiler-Pereira Larissa , Prado-Elias Amanda
Published: February 2023

Oswaldo Fidalgo é um micólogo brasileiro que iniciou seus estudos com fungos de forma autônoma nos anos 1950. Fidalgo contribuiu de forma significativa para a história da micologia no país, realizando estudos em herbários nacionais e estrangeiros, além de participar ativamente da formação de uma nova geração de micólogos. Em 1965, Fidalgo publicou um estudo compilando informações etnomicológicas sobre diferentes grupos indígenas brasileiros, sendo que este trabalho representa um divisor de águas na história da etnomicologia no país. Na década de 1970, Fidalgo trabalhou com o botânico britânico Ghillean Prance, e juntos investigaram os fungos utilizados na dieta dos Yanomami. Com o intuito de resgatar informações sobre a carreira acadêmica de Fidalgo e os primórdios dos estudos etnomicológicos no país, realizamos entrevistas com Fidalgo e Prance. Os dados apresentados neste artigo são resultados dessas entrevistas e demais investigações em literatura.
Martial Arts Studies, issue 13, Editorial
Authors: Bowman Paul , Griffith Lauren , Judkins Benjamin N. , Wong Wayne
Published: February 2023

Editorial for Martial Arts Studies issue 13.
Comparação Entre Controladores por Realimentação Parcial e Total de Estados Otimizados para Conversores Conectados à Rede Sujeitos a Incertezas Paramétricas
Authors: Mattos Everson , Borin Lucas C. , Evald Paulo J. D. de O. , Hollweg Guilherme V. , Montagner Vinícius F.
Published: February 2023

Este artigo propõe uma comparação de técnicas de realimentação de estados, utilizando duas malhas de controle para a regulação das correntes de conversores conectados à rede por meio de filtro LCL. A malha interna visa ao amortecimento do pico de ressonância do filtro LCL e é implementada de duas formas diferentes: ou por uma realimentação total de estados, ou por uma realimentação parcial de estados, reduzindo o número de sensores. A malha externa utiliza a realimentação dos estados de controladores ressonantes para garantir rastreamento de referências senoidais para correntes e rejeição de distúrbios harmônicos provenientes das tensões da rede. Os ganhos das duas malhas de controle são sintonizados off-line por meio de um algoritmo de otimização por enxame de partículas, que se mostra eficaz para fornecer controladores que garantam estabilidade e desempenho otimizado frente a incertezas na impedância da rede e harmônicas na tensão de rede, garantindo correntes experimentais em conformidade com a norma IEEE 1547. A análise de desempenho dos controladores indica a superioridade do controlador com realimentação total de estados. Entretanto, os resultados da realimentação parcial também são satisfatórios para faixas estreitas de incerteza na impedância de rede.
Paliwa opałowe przyszłości – badania kotła centralnego ogrzewania zasilanego alkoholem etylowym
Authors:   Instytut Nafty i Gazu – Państwowy Instytut Badawczy, Basiura Maciej , Rataj Mateusz ,   Instytut Nafty i Gazu – Państwowy Instytut Badawczy
Published: February 2023

W pierwszej części opisano prace badawcze podejmowane w Instytucie Nafty i Gazu – Państwowym Instytucie Badawczym w związku ze stopniowym odchodzeniem rozwiniętych gospodarek światowych od paliw kopalnych. Przedstawiono prace dotyczące zagospodarowania biogazu rolniczego oraz jego mieszanek z wysokometanowym gazem ziemnym i LPG na potrzeby zasilania urządzeń gazowych do użytku domowego oraz przemysłowych urządzeń gazowych. Opisano również trwające badania nad wykorzystaniem wodoru jako medium umożliwiającego zagospodarowanie i magazynowanie nadwyżek energii elektrycznej z odnawialnych źródeł energii (ang. power to gas, P2G). Prace te skupiają się na bezpieczeństwie użytkowania mieszanin wodoru z wysokometanowym gazem ziemnym, a także na wpływie domieszek wodoru na wszystkie elementy systemu przesyłowego. Przedstawiono także prace dla sektora transportu opisujące wykorzystanie bioetanolu jako dodatku do benzyn lub oleju napędowego. Pozwala to na zmniejszenie zużycia stosowanych paliw konwencjonalnych również w transporcie. Zaprezentowano też analizy, na podstawie których stwierdzono możliwość wykorzystania alkoholu etylowego jako paliwa opałowego do urządzeń grzewczych. W celu potwierdzenia wyników tych analiz przeprowadzono badania kotła centralnego ogrzewania wyposażonego w olejowy palnik nadmuchowy. Kocioł c.o. przebadano w cyklu badawczym, podczas którego temperatura wody zasilającej instalację c.o. wynosi 80°C, a temperatura wody wracającej do kotła – 60°C. W takich warunkach pracy urządzenia zmierzono parametry energetyczne kotła, tj. sprawność i obciążenie cieplne, oraz zmierzono ilość produkowanego kondensatu. Badania przeprowadzono, używając do zasilania kotła lekkiego oleju opałowego oraz alkoholu etylowego technicznego 96-procentowego. Na tej podstawie wyciągnięto następujące wnioski: obciążenie cieplne osiągane przez układ grzewczy uległo zmniejszeniu pomimo regulacji dostępnych parametrów urządzenia (ciśnienie na palniku oraz ilość powietrza do spalania); sprawność urządzenia nie uległa pogorszeniu; zawartość substancji niepożądanych w spalinach uległa obniżeniu; ilość produkowanego kondensatu w palniku zasilanym alkoholem etylowym uległa zwiększeniu względem tego samego palnika pracującego na oleju opałowym. W końcowej części usystematyzowano i przedstawiono wnioski z przeprowadzonych badań.
Rzecz o edukacyjnym kłamstwie
Authors: Śliwerski Bogusław , Kobierski Konrad
Published: February 2023

The subject of the analysis is within the category of an educational lie. According to Maria
Ossowska, this might be understood as either a justified or permitted misleading of someone,
or the maintaining an illusion for either one’s own or another’s sake.
Looking at different categories of these distortions of truth, we find that they are used not only for
a child’s upbringing or the benefit of the topic, but for withholding or modifying the information about
the reality or educational concept. Cheating is an example of an educational lie and it combines
someone’s opinion with truth, but would be falsely incompatible with factual knowledge and truthful
understanding. Pupils who cheat mislead the teacher and, in the instructor’s ignorance, are led to believe
that those pupils have, in fact, knowledge reflected in the exam. Likely the teacher is being cheated as
well the student for different reasons. The educational lie has another dimension (when we take into
account the sham activity) the quasi teaching or the pseudo-education. This occurs when
educators/teachers offer their pupils/clients something different from what should be. The pretence
takes place along with the authentic process of learning or completing educational tasks.
Comparative Study on the Anaesthetic Effect of Tiletamine-zolazepam and Propofol as an Induction Agent for Conventional and Endoscopic Abdominal Surgeries in Domestic Cats
Authors: Chauhan S.A. , Pant Shubham , Khandekar G.S. , Tripathi S.D. , Aher V.D. , Attar T.I. , Nimbalkar V.G.
Published: February 2023

Background: Felines have higher metabolic and heart rates than canines and therefore are considered to be the delicate subjects for anaesthesia and pain management. Major surgeries in felines require balanced anaesthesia with smooth and fast induction, longer duration of action and faster and excitement free recovery. Methods: The study was conducted on 24 clinical cases of cats, subjected to conventional and endoscopic surgeries for abdominal affections, premedicated with atropine and dexamethasone at the rate of 0.04 and 0.2 mg/kg body weight to assess the anaesthetic effect of tiletamine-zolazepam combination at the rate of 8mg/kg body weight IM in group A (n=12) and propofol @ 8 mg/kg body weight IV in group B (n=12) respectively as inducing agent to isoflurane maintained anaesthesia. Result: The mean induction time were 421.9±69.47 seconds (7.03±1.16 minutes) in group A and 56.2±0.43 seconds (0.94±0.01 minute) in group B. In both the groups quality of induction was smooth with rapid loss of all reflexes allowing easy intubation. A significant drop in rectal temperature at 15 min post induction with minimal alterations in heart rate, respiration rate and saturated oxygen level were observed. The mean time of recovery recorded were 75.91±8.1 minutes in group A and 88.2±10.2 minutes in group B. Smooth, rapid and good quality recovery was observed in both the anaesthetic groups; however, propofol-induced transitory hypothermia and shivering, lowered the quality of recovery in group B. All the physiological and hematological parameters were in normal limits.
Variation on growth unit morphology in Khaya senegalensis (Desr.) A. Juss., 1830 (Meliaceae) and Pterocarpus erinaceus Poir., 1804 (Fabaceae) according to habitat and climate
Authors: ADJI Beda Innocent , AKAFFOU Doffou Sélastique , SABATIER Sylvie
Published: February 2023

Retrospective analysis provides access to long-term growth series to understand and interpret the structural functioning of tree crowns required for their sustainable management. The aim of this study was to assess the development and adaptation of crown shoots in Khaya senegalensis and Pterocarpus erinaceus to a changing environment in preparation for establishing permanent plots. The growth units (GUs) morphology of the axes of 420 young, adult, and old individuals was analyzed in full sunlight or shade during the rainy and dry season in seven locations in Côte d'Ivoire. The results showed that growth unit morphology is an indicator of the choice of growth conditions. Heterogeneous habitat had no significant effect on growth unit morphology (P > 0.05) in either species. The morphology of the growth units varied from one location (climate) to another due to distinct environmental characteristics (P < 0.05). The southern part of the gradient (Toumodi and Bouaké in the central region of the country) offers favourable and hence priority areas for reforestation programmes based on the two species. The age of the individuals influenced the number of phytomers per growth unit (P < 0.05). Young individuals (cuttings) are good ideotypes for the selection of suitable resistant genotypes. Whatever the species, the rainy season increased the success rate of plot establishment. The growth units of the two species are practically the same size (P > 0.05). Our results could be a decision guide for the selection of suitable environments for the implementation of reforestation or agroforestry programs based on Khaya senegalensis and Pterocarpus erinaceus, in order to conserve and sustainably manage these species in the current climate change context.

Keywords: Khaya senegalensis, Pterocarpus erinaceus, Environment, Morphology, Growth Units (GUs)
OPERATING COSTS OF TRADE IN SERBIA
Authors:   Faculty of Economics, University of Belgrade, Serbia, Lukic Radojko
Published: February 2023

In order to achieve the target profit, it is necessary to manage costs and sales revenues as efficiently as possible. With this in mind, this paper focuses on the specifics of operating cost management in trade with special reference to Serbia. Among other things, the analysis of the efficiency of operating cost management in Serbian trade is based on the Super Radial DEA model. Consequently, according to Super Radial CCR-I and Super Radial CCR-O, efficient management of trade operating costs in Serbia was only in 2014, and inefficient in other years. According to Super Radial BCC-I, efficient management of trade operating costs in Serbia was in 2013, 2014 and 2020, and inefficient in other years. According to Super Radial BCC-O, efficient management of trade operating costs in Serbia was efficient in 2013, 2014 and 2015, and inefficient in other years. In order to improve the efficiency of operational cost management, as well as the overall business, in Serbian trade it is necessary, by applying modern concepts of cost management (for example, costing by activities) and new business models. organic products, etc.), more efficiently manage input elements (real growth rate of gross domestic product, number of employees, assets, capital, employees' salaries, purchase value of sold goods and operating costs), as well as output (sales, margin and net profit) .
Substance Use and the Paramedic Role: A Scoping Review
Authors: Bolster Jennifer , Armour Richard , O'Toole Michelle , Lysko Meghan , Batt Alan
Published: February 2023

Introduction: As the paramedic profession continues to grow and evolve, a shift from reactive to holistic patient care models is required. As the first and often the only point of medical contact for many patients from marginalized and under-served populations, the paramedic role, and its potential future implications in caring for these patients needs to be explored. Aim: The objective of this scoping review was to explore the paramedic's role in caring for people who use illicit drugs. Methods: A scoping review of English language literature published since 2002 was conducted using CINAHL, MEDLINE, EMBASE, and Google Scholar. We used a previously published paramedic search term filter for sensitivity combined with search terms related to drug-related substance use and addiction. Studies were selected based on relevance to the research question. Results: A total of 104 peer-reviewed and 14 grey literature articles were selected for inclusion. The main finding of this scoping review is the notable lack of evidence base surrounding the contemporary paramedic role in the care provision of people who use drugs (PWUD). The results highlight high rates of mortality following a paramedic-attended drug poisoning event, presenting a unique opportunity for paramedics to intervene in meaningful ways that extend past traditional drug poisoning response. Conclusions: The interface between the community of PWUD and the paramedic may be a highly influential encounter during a patient's journey through the healthcare system. The evolving role of the paramedic in this encounter requires focused study and should be viewed as a research priority in response to the ongoing drug poisoning crisis.
Qualitative Evaluation of Intracranial Pressure Slopes in Patients Undergoing Brain Death Protocol
Authors: Ideta Mylena Miki , Oliveira Louise Makarem , Gonçalves Daniel Buzaglo , Paschoalino Mylla Christie , Carvalho Nise Alessandra , Della Coletta Marcus Vinicius , Paiva Wellingson , Brasil Sérgio , Amorim Robson L. O.
Published: February 2023

Background: Due to the importance of brain death (BD) diagnostic do not mistake, reliable confirmatory exams should be performed to enhance its security. This study aims to evaluate the intracranial pressure (ICP) pulse morphology behavior in brain-dead patients through a noninvasive monitoring system. Methods: A pilot case-control study was conducted in adults that met the BD national protocol criteria. Quantitative data from the ICP waveforms were extracted and analyzed comparing BD patients and health subjects. Results: Fifteen patients were included. ICP waveforms presented substantial differences amidst BD patients when compared to the control group. Moreover, pulse amplitude and time to peak variables values in the case group were also statistically significant. Conclusions: In this exploratory study, noninvasive ICP waveforms have shown potential as a screening method in patients with suspected brain death. Future studies should be carried out in a larger population.
Allograft Versus Bioactive Glass (BG-S53P4) in Pediatric Benign Bone Lesions
Authors: Syvänen Johanna , Serlo Willy , Jalkanen Jenni , Kohonen Ia , Raitio Arimatias , Nietosvaara Yrjänä , Helenius Ilkka
Published: February 2023

Background:

Benign bone cysts in children have a high risk of recurrence after bone grafting. The optimal treatment and filling material for these lesions are currently unknown.

Methods:

We compared cyst recurrence after intralesional curettage and filling with allograft versus bioactive glass (BG-S53P4; Bonalive) in a randomized clinical trial. The volume of recurrent cyst at 2-year follow-up was the primary outcome.

Results:

Of 64 eligible children, 51 (mean age, 11.1 years) were randomized to undergo filling of the cyst using morselized allograft (26) or bioactive glass (25). Twelve (46%) of the children in the allograft group and 10 (40%) in the bioactive glass group developed a recurrence (odds ratio [OR] for bioactive glass = 0.79, 95% confidence interval [CI] = 0.25 to 2.56, p = 0.77). The size of the recurrent cyst did not differ between the allograft group (mean, 3.3 mL; range, 0 to 13.2 mL) and the bioactive glass group (mean, 2.2 mL; range, 0 to 16.6 mL, p = 0.43). After adjusting for the type of lesion (aneurysmal bone cyst versus other), bioactive glass also did not prevent larger (>1 mL) recurrent cysts (adjusted OR = 0.42, 95% CI = 0.13 to 1.40, p = 0.16). The Musculoskeletal Tumor Society score improved significantly (p ≤ 0.013) from preoperatively to the 2-year follow-up in both groups (to 28.7 for bioactive glass and 29.1 for bone graft). Four (15%) of the children in the allograft group and 6 (24%) in the bioactive glass group required a reoperation during the follow-up (OR for bioactive glass = 1.74, 95% CI = 0.43 to 7.09, p = 0.50).

Conclusions:

Filling with bioactive glass and with allograft in the treatment of benign bone lesions provided comparable results in terms of recurrence and complications.

Level of Evidence:

Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Nationwide Results of Microorganism Antigen Testing as a Component of Preoperative Synovial Fluid Analysis
Authors: Toler Krista O’Shaughnessey , Paranjape Pearl Ravindra , McLaren Alex , Levine Brett , Ong Alvin , Deirmengian Carl
Published: February 2023

Background:

Antigen immunoassays to detect synovial fluid (SF) microorganisms have recently been made available for clinical use. The purpose of this study was to determine the sensitivity and specificity of an SF microorganism antigen immunoassay detection (MID) panel, evaluate the panel’s capability to detect microorganisms in the setting of culture-negative periprosthetic joint infection (PJI), and determine diagnostic predictive values of the MID panel for PJI.

Methods:

This study included 67,441 SF samples obtained from a hip or knee arthroplasty, from 2,365 institutions across the United States, submitted to 1 laboratory for diagnostic testing. All data were prospectively compiled and then were analyzed retrospectively. Preoperative SF data were used to classify each specimen by the International Consensus Meeting (2018 ICM) definition of PJI: 49,991 were not infected, 5,071 were inconclusive, and 12,379 were infected. The MID panel, including immunoassay tests to detect Staphylococcus, Candida, and Enterococcus, was evaluated to determine its diagnostic performance.

Results:

The MID panel demonstrated a sensitivity of 94.2% for infected samples that yielded positive cultures for target microorganisms (Staphylococcus, Candida, or Enterococcus). Among infected samples yielding positive cultures for their respective microorganism, individual immunoassay test sensitivity was 93.0% for Staphylococcus, 92.3% for Candida, and 97.2% for Enterococcus. The specificity of the MID panel for samples that were not infected was 98.4%, yielding a false-positive rate of 1.6%. The MID panel detected microorganisms among 49.3% of SF culture-negative infected samples. For PJI as a diagnosis, the positive predictive value of the MID panel was 91.7% and the negative predictive value was 93.8%. Among MID-positive PJIs, 16.2% yielded a discordant cultured organism instead of that detected by the antigen test.

Conclusions:

SF microorganism antigen testing provides a timely adjunct method to detect microorganisms in the preoperative SF aspirate, yielding a low false-positive rate and enabling the detection of a microorganism in nearly one-half of SF culture-negative PJIs.

Level of Evidence:

Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
Equity-Driven Implementation of Patient-Reported Outcome Measures in Musculoskeletal Care
Authors: Stern Brocha Z. , Franklin Patricia D. , Shapiro Lauren M. , Chaudhary Saad B. , Kamal Robin N. , Poeran Jashvant
Published: February 2023

The clinical use of patient-reported outcome measures (PROMs) in musculoskeletal care is expanding, encompassing both individual patient management and population-level applications. However, without thoughtful implementation, we risk introducing or exacerbating disparities in care processes or outcomes. We outline examples of opportunities, challenges, and priorities throughout PROM implementation to equitably advance value-based care at both the patient and population level. Balancing standardization with tailored strategies can enable the large-scale implementation of PROMs while optimizing care processes and outcomes for all patients.
Acute Lower Extremity Fracture Management in Chronic Spinal Cord Injury
Authors: Carbone L.D. , Ahn J. , Adler R.A. , Cervinka T. , Craven C. , Geerts W. , Hsu J.R. , Huang D. , Karunakar M.A. , Kiratli B.J. , Krause P.C. , Morse L.R. , Mirick Mueller G.E. , Nana A. , Rogers E. , Rivera J.C. , Spitler C. , Weaver F.M. , Obremskey W.
Published: February 2023

Background:

Our objective was to develop a clinical practice guideline (CPG) for the treatment of acute lower extremity fractures in persons with a chronic spinal cord injury (SCI).

Methods:

Information from a previous systematic review that addressed lower extremity fracture care in persons with an SCI as well as information from interviews of physical and occupational therapists, searches of the literature, and expert opinion were used to develop this CPG. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) system was used to determine the quality of evidence and the strength of the recommendations. An overall GRADE quality rating was applied to the evidence.

Conclusions:

Individuals with a chronic SCI who sustain an acute lower extremity fracture should be provided with education regarding the risks and benefits of operative and nonoperative management, and shared decision-making for acute fracture management should be used. Nonoperative management historically has been the default preference; however, with the advent of greater patient independence, improved surgical techniques, and advanced therapeutics and rehabilitation, increased use of surgical management should be considered. Physical therapists, kinesiotherapists, and/or occupational therapists should assess equipment needs, skills training, and caregiver assistance due to changes in mobility resulting from a lower extremity fracture. Therapists should be involved in fracture management as soon as possible following fracture identification. Pressure injuries, compartment syndrome, heterotopic ossification, nonunion, malunion, thromboembolism, pain, and autonomic dysreflexia are fracture-related complications that clinicians caring for patients who have an SCI and a lower extremity fracture may encounter. Strategies for their treatment are discussed. The underlying goal is to return the patient as closely as possible to their pre-fracture functional level with operative or nonoperative management.
Predeposited Autologous Blood Transfusion in Single-Anesthetic Bilateral Total Knee Arthroplasty with Modern Blood Conservation Strategy
Authors: Tsukada Sachiyuki , Wakui Motohiro , Kurosaka Kenji , Saito Masayoshi , Nishino Masahiro , Hirasawa Naoyuki
Published: February 2023

Background:

This study was performed to examine the hypothesis that the rate of allogeneic blood transfusion in patients who did not predeposit an autologous blood transfusion before single-anesthetic bilateral total knee arthroplasty (TKA) would be noninferior to that in patients who did predeposit blood.

Methods:

We assessed the number of allogeneic transfusions required in 338 patients undergoing single-anesthetic bilateral TKA with a preoperative hemoglobin level of ≥11.0 g/dL. All TKAs were performed by a single surgeon according to the same operative and postoperative protocol. All patients received a combination of intravenous and intra-articular tranexamic acid. Neither a pneumonic tourniquet nor a drain was used. The difference in the risk of allogeneic transfusion between patients without and with autologous blood predeposit was compared with a noninferiority margin of 10 percentage points.

Results:

Allogeneic transfusion was required in 1 (0.5%) of 194 patients who predeposited autologous blood and 3 (2.1%) of 144 patients who did not predeposit blood. The difference in risk was −1.6 percentage points (95% confidence interval, −4.1 to 1.0 percentage points); the confidence interval did not include the noninferiority margin and included zero.

Conclusions:

In single-anesthetic bilateral TKA, allogeneic transfusion requirements in patients who did not predeposit autologous blood were noninferior to those in patients who predeposited blood.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Observing the character of public accountant through the spirit of Fastabiqul Khairat
Authors: Aripratiwi Ratna Anggraini , Jannah Binti Shofiatul , Lating Ade irma Suryani , Hanun Nur Ravita
Published: February 2023

This study aims to examine the character of public accountant in spirit fastabiqul khairat through a religius approach. The method used in this research is qualitative with a religiosity pradigm strategy. This study found that the spirit of fastabiqul khairat appears in every audit process, carried out by public accountant, starting from the engagement process to the issuance of an audit opinion. In the ethical crisis faced by public accountant, it takes a character building with integrity “amal shalih“ and not unjust. Public accountant prioritize aspects of conviction in every decision, adhere to the applicable rules. Through the spirit of fastabiqul khairat, it’s expected to be able to produce ethical behaviour for public accountant, which will lead to the concept of a code of ethics of public accountant profession.
Expropriating Privacy
Authors: Maxwell Ferg , Fleming Victoria
Published: February 2023

During the winter of 2020, Toronto resident Khaleel Seivwright, began to construct small mobile shelters to provide insulation and privacy to unhoused residents living outdoors. Conditions produced by the COVID-19 pandemic increased demand on the city’s already underfunded and strained shelter system, subsequently accelerating development of encampments in parks throughout the city. From the outset, these “tiny shelters” served as a flashpoint in public discourse on the question of the relative health, safety, and beauty of unhoused privacy. Drawing on media coverage of Seivwright’s case, we address the question of the private persona as it emerges in relation to the unhoused, and to the practices of violent expropriation which daily police their existence. By examining the news discourses produced about Sievwrights tiny shelters, we interrogate how Sievwright’s public persona came to represent encampment residents as well as himself subsequently emerging as a boundary subject mediating the contradictory relations immanent to domesticity: between public and private space and public and private identity. Our analysis asks how the limits of privacy are actively imposed and managed under capitalism: who is allowed to have domestic space, where is that domestic space allowed to exist, and crucially what public personas emerge in relation to practices departing from the normative bounds of capitalism’s public/private distinction? Using critical discourse analysis (CDA), we examine the ways in which public personas are mediated by individuals and media institutions at the same time as addressing how personas themselves intervene in this process. CDA directs us to ask how personas are constituted through language. This emphasis on persona as both outcome of relations of power and as mediator in its own right permits us to address figures who are conventionally denied personas while simultaneously complicating and challenging the meanings behind domesticity within capitalist cities.
The First Tropical Kingbird Nest in New Mexico
Authors: Baumann Matthew J.
Published: February 2023

A nest of the Tropical Kingbird (Tyrannus melancholicus) at Sumner Lake State Park, De Baca County, 17 June 2022, was the first found in New Mexico. It followed summer sightings elsewhere in southern New Mexico since 2010 and is part of a pattern of northward spread of the species’ breeding range in Arizona and Texas.
A perfect couple: A visual opsin from the box jellyfish binds Gαs to form a stable protein complex with unparalleled temporal control of Gβγ signalling
Authors: Wyk Michiel van , Kleinlogel Sonja
Published: February 2023

Phototransduction is mediated by distinct types of G-protein cascades in different animal taxa: bilateral invertebrates typically utilize the Gαq pathway whereas vertebrates typically utilize the Gαt(i/o) pathway. By contrast, photoreceptors in jellyfish (Cnidaria) utilize the Gαs intracellular pathway, similar to olfactory transduction in mammals1. How this habitually slow pathway has adapted to support dynamic vision in jellyfish remains unknown. Here we study a light-sensing protein (rhodopsin) from the box jellyfish Carybdea rastonii and uncover a novel mechanism that dramatically speeds up phototransduction. Unlike other G-protein coupled receptors (GPCRs), this rhodopsin constitutively binds a single downstream Gαs partner to enable G-protein activation and inactivation within tens of milliseconds. This is the first time an uninterrupted G-protein coupled receptor/G-protein complex is described. We use this unique GPCR in a viral gene therapy to restore light responses in blind mice using the previously unforeseen Gαs signalling pathway.