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KASPEROVYCH, Yuliia. "FUNCTIONAL CAPACITY OF THE TAX SYSTEM OF UKRAINE". Economy of Ukraine 2020, n. 12 (11 dicembre 2020): 36–55. http://dx.doi.org/10.15407/economyukr.2020.12.036.
Testo completoAbstract (sommario):
The vast majority of scholars have reached a common vision on the fiscal function performance by taxes, in the predominant – on the regulatory (with a division into incentive and deterrent) and to a large extent – on the controlling function. With the change of political cadence and the beginning of COVID-19 quarantine in Ukraine, a number of important tax reforms were launched to de-shadow the economy and establish fairer taxation, which affected all three tax functions. At the same time, systemic problems regarding the functional capacity of the tax system of Ukraine remain on the agenda. First, the failure of the fiscal function of taxes, which is associated with common schemes of tax avoidance and evasion, namely smuggling and “gray” imports, abuse of the simplified taxation system, wages “in envelopes”, unaccounted cash income without the use of cash registers, the erosion of the tax base in low-tax jurisdictions. Second, the limited potential of the regulatory function of taxes due to the weak effectiveness of existing tax incentives. New tax incentives carry the risks of significant revenue losses in the absence of reliable compensators in the future. Third, low confidence in the control function of taxes due to the weak institutional capacity of tax and customs authorities. Complex tax and customs administration provides ample opportunities for corruption risks. There is no effective system of anticipation and prevention of violations. Given the significant number of problems in the implementation of all major tax functions in Ukraine, relevant strategic goals and objectives are proposed to strengthen the functional capacity of the domestic tax system, which should be the basis for strategizing its development.
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Ahuja, Gautam, Laurence Capron, Michael Lenox e Dennis A. Yao. "Strategy and the Institutional Envelope". Strategy Science 3, n. 2 (giugno 2018): ii—x. http://dx.doi.org/10.1287/stsc.2018.0062.
Testo completo
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Ruangsomboon, Onlak, Nattakarn Praphruetkit e Apichaya Monsomboon. "Parallel-group, randomised, controlled, non-inferiority trial of high-flow nasal cannula versus non-invasive ventilation for emergency patients with acute cardiogenic pulmonary oedema: study protocol". BMJ Open 12, n. 7 (luglio 2022): e052761. http://dx.doi.org/10.1136/bmjopen-2021-052761.
Testo completoAbstract (sommario):
IntroductionHigh-flow nasal cannula (HFNC) is an innovative oxygen-delivering technique, which has been shown to effectively decrease the intubation risk in patients with hypoxaemic respiratory failure of various aetiologies compared with conventional oxygen therapy. Also, it has proved to be non-inferior to non-invasive positive pressure ventilation (NIPPV) in patients with hypoxaemic respiratory failure primarily due to pneumonia. Evidence on its benefits compared with NIPPV, which is the standard of care for patients with acute cardiogenic pulmonary oedema (ACPE) with hypoxaemic respiratory distress, is limited. Therefore, we planned this study to investigate the effects of HFNC compared with NIPPV for emergency patients with ACPE.Methods and analysisIn this single-centred, non-blinded, parallel-group, randomised, controlled, non-inferiority trial, we will randomly allocate 240 patients visiting the emergency department with ACPE in a 1:1 ratio to receive either HFNC or NIPPV for at least 4 hours using computer-generated mixed-block randomisation concealed by sealed opaque envelopes. The primary outcome is the intubation rate in 72 hours after randomisation. The main secondary outcomes are intolerance rate, mortality rate and treatment failure rate (a composite of intolerance, intubation and mortality). The outcome assessors and data analysts will be blinded to the intervention. These categorical outcomes will be analysed by calculating the risk ratio. Interim analyses evaluating the primary outcome will be performed after half of the expected sample size are recruited.Ethics and disseminationThis study protocol has been approved by the Siriraj Institutional Review Board (study ID: Si 271/2021). It has been granted the Siriraj Research and Development Fund. All participants or their authorised third parties will provide written informed consent prior to trial inclusion. The study results will be published in a peer-reviewed international journal and presented at national and international scientific conferences.Trial registration numberTCTR20210413001.
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Lin, Shanshan, Bo Zhu, Yiyi Zheng, Shufeng Liu e Chuhuai Wang. "Effect of RUSI-based core stability exercise on chronic non-specific low back pain patients: study protocol for a randomised controlled trial". BMJ Open 11, n. 12 (dicembre 2021): e047317. http://dx.doi.org/10.1136/bmjopen-2020-047317.
Testo completoAbstract (sommario):
IntroductionLow back pain (LBP) is one of the most highly prevalent pain both in developed countries and low-income and middle-income countries. Despite increasing healthcare resources and numerous treatment methods for LBP, the efficacy of these therapeutic strategies is still uncertain. Recently, core stability exercise (CSE) is popularly applied as a preventive or rehabilitative method in the treatment of LBP. However, the adequate activation of the local muscle systems of CSE needs further optimisation and quantification. This trial aims to investigate the feasibility and efficacy of CSE monitored by real-time ultrasound image (RUSI) on LBP individuals.Methods and analysisForty subjects with chronic non-specific LBP (CNLBP), aged from 20 to 50 years, will be randomly allocated into two groups using sealed, consecutively numbered opaque envelopes: (1) study group (SG): CSE monitored by RUSI and (2) control group (CG): identical CSE without monitoring. Interventions will last 30 mins, two times a week for 8 weeks. The primary outcomes include pain intensity, disability and quality of life, and the secondary outcomes will be the postural control static stability, onset timing of trunk muscles activation, ultrasound images of muscle thickness and surface electromyography (sEMG) signal of muscle activities. Outcome measures will be collected at baseline, 4 and 8 weeks during training, and at 6 months follow-up. Data will be collected and analysed by an assessor blinded to group allocation. Effect sizes and mixed-model repeated measures analysis of variance (2 groups×4 time points) will be calculated.Ethics and disseminationThis protocol and informed consent has been approved by the Institutional Research Ethics Committee of the First Affiliated Hospital, Sun Yat-sen University (Approval number: [2020] 254-1). The findings of this study will be disseminated to participants through social networks and will be submitted to peer-reviewed journals and scientific conferences.Trial registration numberChinese Clinical Trial Registry (ChiCTR2000034498).
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Santamaria, Victor, Xupeng Ai, Karen Chin, Joseph P. Dutkowsky, Andrew M. Gordon e Sunil K. Agrawal. "Study protocol for a randomised controlled trial to determine the efficacy of an intensive seated postural intervention delivered with robotic and rigid trunk support systems". BMJ Open 13, n. 8 (agosto 2023): e073166. http://dx.doi.org/10.1136/bmjopen-2023-073166.
Testo completoAbstract (sommario):
IntroductionChildren with cerebral palsy (CP) classified as gross motor function classification system (GMFCS) levels III–IV demonstrate impaired sitting and reaching control abilities that hamper their overall functional performance. Yet, efficacious interventions for improving sitting-related activities are scarce. We recently designed a motor learning-based intervention delivered with a robotic Trunk-Support-Trainer (TruST-intervention), in which we apply force field technology to individualise sitting balance support. We propose a randomised controlled trial to test the efficacy of the motor intervention delivered with robotic TruST compared with a static trunk support system.Methods and analysisWe will recruit 82 participants with CP, GMFCS III–IV, and aged 6–17 years. Randomisation using concealed allocation to either the TruST-support or static trunk-support intervention will be conducted using opaque-sealed envelopes prepared by someone unrelated to the study. We will apply an intention-to-treat protocol. The interventions will consist of 2 hours/sessions, 3/week, for 4 weeks. Participants will start both interventions with pelvic strapping. In the TruST-intervention, postural task progression will be implemented by a progressive increase of the force field boundaries and then by removing the pelvic straps. In the static trunk support-intervention, we will progressively lower the trunk support and remove pelvic strapping. Outcomes will be assessed at baseline, training midpoint, 1-week postintervention, and 3-month follow-up. Primary outcomes will include the modified functional reach test, a kinematic evaluation of sitting workspace, and the Box and Block test. Secondary outcomes will include The Segmental Assessment of Trunk Control test, Seated Postural & Reaching Control test, Gross Motor Function Measure-Item Set, Canadian Occupational Performance Outcome, The Participation and Environment Measure and Youth, and postural and reaching kinematics.Ethics and disseminationThe study was approved by the Columbia University Institutional Review Board (AAAS7804). This study is funded by the National Institutes of Health (1R01HD101903-01) and is registered at clinicaltrials.gov.Trial registration numberNCT04897347; clinicaltrials.gov.
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Santiago, Rene. "Silver Linings on Metro Manila's Traffic Miseries". Transactions of the National Academy of Science and Technology 36, n. 2014 (luglio 2014): 1–20. http://dx.doi.org/10.57043/transnastphl.2014.2987.
Testo completoAbstract (sommario):
Traffic congestion is often associated with megacities, of which the Greater Metro Manila is 5th largest in the world. Its traffic problem, however, is bruited about as "world class". This distinction is the by-product_ of an inability to address infrastructure gaps, a disregard of well-studied plans over the last (three) decades, and piece-meal efforts at adopting scientific solutions. This paper re-visits the root causes of the problem and redefines the changing objective function - from maximizing vehicular to people flows. Lessons from other cities have demonstrated a multitude of congestion antidotes that have gained the status of best practices. Some of these have been called Transportation Systems Management (TSM) and Transportation Demand Management (TDM). More roadways and more rail transit lines have been the traditional response to traffic congestion. TSM/TDM has expanded the menu of solutions - to include actions to reduce the use of single-occupant vehicles, regulate travel demand in time and space, designation of exclusive lanes for higher occupancy vehicles. In Metro Manila, this strand has taken the form of vehicle number coding, flirtations with staggered working hours, one-way schemes, reversible lanes, computer-coordinated traffic signaling system, and widespread adoption ofretrograde U-Tum schemes. The limits to road building dictate that more people should share rides by taking public transport and minimizing car use. That would necessitate a radical re-invention of the public transport system that has been caught - with consent - on a low performance equilibrium trap in the last 40 years. It is a low-cost measure with high pay-offs, but one that is most difficult to execute. No one would dare confront the elephant on the roads: the jeepneys (>60,000) and the metro buses (>5,300) with their atomized operating structure. Very little is being done on land use controls which has long-term impacts, while road pricing is talked about but avoided like a plague. There is no silver bullet in solving traffic congestion; it requires a comprehensive set of measures implemented over several years. In terms of master plans, Metro Manila has not been lacking. There was the MMETROPLAN of 1975 which brought about the LRT 1 and the now-forgotten bus ways on Magsaysay Boulevard. This was followed by MMUTSTRAPP in 1984 and the MMUTIS in 1998. Some components of these plans were implemented - but they were Sisyphean in character. All of the three plans from 1975 to 2011 were constrained by small budget envelopes ofrecent vintage is the Transport Roadmap for the Greater Capital Region, which included a bold 'dream plan' to vanish traffic congestion by year 2030. It requires massive investments in infrastructure: 137 km of new roads, 78 km of urban expressway, and more than 200 km rail transit lines - elevated and underground. It also calls for a radical restructuring of the current surface public transport system comprising the jeepney and bus modes. The dream plan is estimated to require Php2,600 billion to fix traffic congestion that is costing the economy Php2.4 billion a day. Unlike the previous three plans, this one can fit into the projected budget envelope to year 2030. The prospect of relief, however, is clouded by institutional arthritis - an inability to execute projects of the transport kind. It is hard to imagine 200 km ofrail lines being built in 15 years, when 4 km could not even break ground in 5 years. A black swan event - such as a massive earthquake - could finesse institutional rigidities. Rapid diffusion of new technologies, like autonomous cars and smart roads, as well as increasing global pressure towards green transport offer more sanguine prospects to end traffic woes. Growing discontents with traffic jams may just be the deus ex machina that would shake up lethargic public sector agencies and put an end to the jeepney mentality.
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Byndoor, Yatish, e Tamilisetti Vidya Sagar. "Levobupivacaine versus ropivacaine in patients undergoing lower abdominal surgeries". Indian Journal of Pharmacy and Pharmacology 10, n. 2 (15 luglio 2023): 111–15. http://dx.doi.org/10.18231/j.ijpp.2023.023.
Testo completoAbstract (sommario):
Regional anesthesia, like Peripheral nerve block, is commonly used for peripheral surgeries to reduce severe intraoperative and postoperative pain relief. .Some studies with levobupivacaine have shown that duration of analgesia of levobupivacaine are longer compared to that of an equivalent dose of bupivacaine or ropivacaine.This study is done to compare efficacy and safety of levobupivacaine with ropivacaine. In this study we tried to compare efficacy and clinical characteristics of isobaric forms of intrathecal levobupivacaine 0.5% and ropivacaine 0.75% in lower abdominal surgeries.This prospective, observational and open labeled, comparative study done for a period of one year in a tertiary care health centre, in South India, prior approval from Institutional ethics committee was taken. 60 patients were included and each of 60 patients was randomized (sealed, numbered and opaque envelopes) to one of two groups of 30 patients. Each of the patients enrolled in the study received one of two solutions: levobupivacaine or Ropivacaine, patient was turned supine immediately after injection, time of which was defined as ‘zero’. Thereafter, investigator, assessed upper and lower limits of sensory block (analgesia to pinprick), degree of motor block and recorded heart rate and arterial pressure. The patients were then transferred into the operating theatre and assessments were continued at 30 min intervals thereafter until complete motor and sensory blocks regression. Data were analysed using a standard computer-based statistics package.Mean time of onset of sensory blockade for levobupivacaine was 3.85±0.5 min and in Ropivacaine was 3.90 ± 0.6 min. Mean time of onset of motor blockade in levobupivacaine group was 3.65 ± 0.72 min and in Ropivacaine group was 3.82 ± 0.88 min, mean duration of motor blockade in Levobupivacaine group was 201.15±22.06 min and in Ropivacaine group was 204 ± 21.20 min. Mean time for regression for levobupivacaine was 98.27±10.18 min and for ropivacaine was 96.33 ±8.21min. There is no significant difference, Mean time for first request of analgesic for Levobupivacaine was 262.22 ±36.60 and for Ropivacaine was 261.20 ± 32.71 min. There is no statistically significant difference; there was no statistically significant difference in the incidence of adverse events in both the groups. So both the drugs are considered to be safe in spinal anesthesia.In conclusion, Ropivacaine and Levobupivacaine has similar onset of sensory and motor blockade with comparable hemodynamic parameters and time for rescue analgesic administration was comparable between two groups and incidence of post- operative complications is not significant with both drugs.
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Elhassan, Yahya, e Ray Monkhouse. "The Outcome of Extended Tarso-Metatarsal and Mid-Tarsal Midfoot Arthrodesis". Foot & Ankle Orthopaedics 7, n. 1 (gennaio 2022): 2473011421S0001. http://dx.doi.org/10.1177/2473011421s00018.
Testo completoAbstract (sommario):
Category: Midfoot/Forefoot Introduction/Purpose: Arthrodesis of extended midfoot arthritis (more than four joints) remains surgically challenging and technically demanding due to bone loss and deformity with a goal to achieve fusion between multiple joints. Yet the outcome and fusion rate of this particular group was sparsely reported and with a lot of heterogeneity. The aim of this study is to assess the outcome of extended midfoot arthrodesis, which included a combined fusion of Tarsometatarsals, Naviculocuneiform, and/or the Talonavicular joints. Methods: Patients who underwent extended midfoot fusion (> four joints) over ten year period (2009-2019) were identified. Only non-neuropathic patients where multiple joints midfoot fusion were performed were included, more specifically the group of patients who required combined fusion of the second and third Tarsometatarsal joints with extension to the Naviculocuneiform, the Talonavicular, and/or the first Tarsometatarsal joints. All operations were performed by the senior author through a single incision using non-locking compression lag screws and 2.7mm locking plates. Institutional review board approval was obtained to review electronic patient records and imaging. Etiology of midfoot arthritis, fusion rate, reoperation, postoperative complications, and patient satisfaction were independently evaluated. Pre-paid addressed envelopes were posted and Patient Report Outcome Measures (PROMs), including patient satisfaction, MOxFQ (Manchester Oxford Foot ) were collected, and statistical analysis was performed. Results: Fifty-one patients (59 feet) out of 162 patients were included. The questionnaire response rate was 82.3%. Female: male ratio was 2.9:1 with a mean age 56.9. The most prevalent diagnosis was primary osteoarthritis in 54.2%, rheumatoid arthritis in 10.2 %, post-traumatic arthritis 17%. AVN of the navicular was the indication for surgery in 18.6%. Extension to naviculocuneiform and talonavicular joint was performed in 100% and 40.6% respectively. 73.8 % were satisfied, with a higher satisfaction rate in older age (P < 0.005) and talonavicular group (P <0.05).Total number of joints fused was 292, with a fusion rate of 95.6%. A lower fusion of the talonavicular and naviculocuneiform joints was observed at 89.8% and 79.2% respectively (Table).Other minor complications included removal of metal, metatarsals stress fracture, metatarsalgia, talonavicular arthrosis, delayed wound healing, SPN neuroma, and CRPS. Deep infection was not reported. Conclusion: In this series, we highlighted that extended multiple joint midfoot arthrodesis which included fusion of the naviculocuneiform or/and the talonavicular joints produced a high fusion rate when compared to the total number of joints fused, although a lower fusion rate was observed across the naviculocuneiform and talonavicular joints. Extended midfoot arthrodesis is complex; patients should be well informed and counseled about the outcome and the consequences, with a careful approach when quoting satisfaction.
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Tzempelikos, Athanassios, Andreas K. Athienitis e Panagiota Karava. "Simulation of façade and envelope design options for a new institutional building". Solar Energy 81, n. 9 (settembre 2007): 1088–103. http://dx.doi.org/10.1016/j.solener.2007.02.006.
Testo completo
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Poonai, N., A. Butter, D. Ashok, M. Rieder e S. Ali. "GD03: Hyoscine butylbromide (Buscopan) versus acetaminophen for non-surgical abdominal pain in children: a randomized controlled superiority trial". CJEM 19, S1 (maggio 2017): S63. http://dx.doi.org/10.1017/cem.2017.163.
Testo completoAbstract (sommario):
Background: Children with abdominal pain in the emergency department (ED) are at particular risk of suboptimal analgesia due to fears of missing appendicitis and absent guidelines. Many still experience pain at discharge. Acetaminophen is the most commonly used analgesic and efficacy of hyoscine butylbromide (HBB) is supported by adult evidence. However, no evidence exists for either agent in children with abdominal pain. Objective: To determine if HBB is superior to acetaminophen for abdominal pain in children. Methods: We will consecutively recruit children 8-17 years presenting to the ED with presumed non-surgical abdominal pain rated >4/10 on the Faces Pain Scale – Revised (FPS-R) and described as colicky, excluding:-Suspected appendicitis or bowel obstruction-Anticholinergic, analgesic, or antispasmodic <12 hours-Peritoneal inflammation-Unable to swallow pills-Hypersensitivity to either intervention-Medically unstable-Previous bowel obstruction, abdominal surgery, myasthenia gravis, liver disease, glaucoma, or recent abdominal trauma (<48 hours)-Toxin ingestion (<24 hours)-Vomiting-Pregnancy Randomization and allocation concealment will be pharmacy-controlled and performed using a computerized random number generator and sequentially numbered, opaque, sealed envelopes, respectively. The physician, research assistant, nurse, and participant will be blinded. Due to perceptible differences, participants will be randomized in a double-dummy approach to:-HBB 10 mg tablet + acetaminophen placebo OR-Acetaminophen 15 mg/kg liquid (maximum 975 mg) + HBB placebo. The primary outcome will be the difference from baseline on the FPS-R at 120 minutes, reflecting HBB’s time to peak plasma concentration. The FPS-R has been validated in children >five years. Secondary outcomes include:-Pain scores at 15, 30, 45, 60, 80, 100, and 120 minutes post-intervention (FPS-R and 100 mm visual analog scale)-Discharge pain score-Rescue analgesia-Time to achieve a 20% reduction in pain-Adverse effects-Recidivism <48 hours-Missed surgical diagnoses (National Ambulatory Care Reporting System (NACRS) database)-Caregiver satisfaction (five-item Likert scale). Using the intention to treat principle, ordinal, ratio, and categorical data will be analyzed using the Mann-Whitney, paired t-test, and Pearson’s chi-square, respectively and summarized using 95% confidence intervals. Assuming a standard deviation of 2 faces, 83 children per group will be required to detect a 1-face difference at 5% significance with 90% power. Increasing by 20% equals 100 participants per group. P values <0.05 will be considered significant. An institutional audit revealed 380 eligible patients per year during research assistant availability. Given a 30% refusal rate, we expect five participants enrolled per week for 40 weeks. Importance: Our findings will guide evidence-based analgesic choices for children with non-surgical abdominal pain in the ED.
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Mohamed, Rabab Mohamed, Islam Morsy e Jehan Mohammad Darwish Hamed. "Bilateral ultrasound guided erector spinae plane block vs. preoperative pregabalin for postoperative pain management in lumbar spine surgery". Anaesthesia, Pain & Intensive Care 27, n. 5 (7 ottobre 2023): 513–20. http://dx.doi.org/10.35975/apic.v27i5.2306.
Testo completoAbstract (sommario):
Background & Objective: Injecting local anesthetics into the erector spinae plane and obstructing the dorsal and ventral rami could reduce the pain. Pregabalin and gabapentin are used to reduce neuropathic pain; however, pregabalin has demonstrated greater analgesic potency than gabapentin. This work aimed to compare the analgesic effects and complications between preoperative pregabalin and erector spinae plane block (ESPB) for lumbar spine surgery under general anesthesia.
Methodology: Sixty patients were allocated to the 2 groups using a computer-generated random number that was hidden in sealed, opaque envelopes. In Group 1, the patients received pregabalin 150 mg twice daily for 3 days before surgery. After preoxygenation and before induction of anesthesia, dexmedetomidine 1 µg/kg was given in both of the groups. In Group 2, after the patient was placed in the prone position for the operation and after the induction of general anesthesia, ESPB was carried out bilaterally under ultrasound guidance. Ropivacaine hydrochloride was administered at a quantity of 20 mL upon confirmation of the needle's proper insertion. Numerical Rating Scale (NRS) was used to assess the pain intensity.
Results: There was a longer-lasting analgesia in the ESPB group with significantly lower NRS only at 12 h and 18 h (P = 0.001) compared to the pregabalin group, but they were comparable at 24 h (P = 0.407). The time to request first rescue analgesic and the total morphine consumption were significantly different; a significantly longer time for the first rescue analgesic (17.10 vs. 11.73 h) and a significantly reduced amount of morphine consumption (6.30 vs. 10.33 mg) in ESPB group.
Conclusion: Both bilateral erector spinae plane block and preoperative pregabalin seem to be helpful for providing adequate pain management postoperatively for lumbar spine surgery; however, bilateral erector spinae plane block was superior in pain management during the first 24 h postoperatively with fewer side effects.
Abbreviations: ESPB - Erector Spinae Plane Block; α2-AR - Alpha 2 Adrenoreceptors; NRS - Numerical Rating Scale; ACE - Angiotensin Converting Enzyme; NaCl - Normal Saline; MAP - Mean Arterial Blood Pressure; IV - Intravenous; PACU - Post-Anesthesia Care Unit; X2 - Chi-square; IQR - Interquartile Range; MAC - Minimum Alveolar Concentration;
Preregistration: The study had approval from the Ethical Committee and Institutional Review Board of the Faculty of Medicine, Tanta University with approval code (35692/9/22).
Key words: US-ESPB; Ultrasound Guided; Erector Spinae Plane Block; Pregabalin; Lumbar Spine Surgery
Citation: Mohamed RM, Morsy I, Hamed JMD. Bilateral ultrasound guided erector spinae plane block vs. pregabalin for postoperative pain management in lumbar spine surgery. Anaesth. pain intensive care 2023;27(5):513−520; DOI: 10.35975/apic.v27i5.2306
Received: April 07, 2023; Reviewed & Accepted: July 01, 2023
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Williams, Colin C., e Ioana Alexandra Horodnic. "Explaining and tackling envelope wages in the Baltic Sea region". Baltic Journal of Management 10, n. 3 (6 luglio 2015): 295–312. http://dx.doi.org/10.1108/bjm-10-2014-0153.
Testo completoAbstract (sommario):
Purpose – The purpose of this paper is to advance a new way of explaining and tackling the illegitimate wage practice where employers pay their employees an undeclared (envelope) wage in addition to their formal salary. Drawing upon institutional theory, it is here proposed that envelope wages result from the lack of alignment of a society’s formal institutions (i.e. the codified laws and regulations) with its informal institutions (i.e. the socially shared unwritten understandings which reflect citizens’ norms, values and beliefs). Design/methodology/approach – To evaluate this, data are reported from a 2013 Eurobarometer survey involving 1,738 face-to-face interviews with formal employees in four Baltic countries, namely, Estonia, Latvia, Lithuania and Poland. Findings – The finding is that the greater is the asymmetry between the formal and informal institutions (i.e. the level of disagreement of citizens with the codified laws and regulations of formal institutions), the higher is the propensity to pay envelope wages. This is the case at both the individual- and country levels. Practical implications – To reduce the prevalence of envelope wages, the resultant argument is that the values of employers and employees need to be aligned with the formal institutions. This requires alterations not only in the informal institutions, using measures such as tax education, awareness raising campaigns and normative appeals, but also changes in formal institutions so as to improve trust in government by fostering greater procedural justice, procedural fairness and redistributive justice. Originality/value – This is the first paper to apply institutional theory to explaining and tackling envelope wages in the Baltic Sea region.
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Romano, Angela. "Bribes, Gifts and Graft in Indonesian Journalism". Media International Australia 94, n. 1 (febbraio 2000): 157–71. http://dx.doi.org/10.1177/1329878x0009400115.
Testo completoAbstract (sommario):
This study of the ‘envelope culture’ — in which sources offer money or other gifts to journalists — explores the complex web of social, economic and institutional conditions that perpetuate the cultures of gift-giving, bribery and graft in Indonesian journalism. The study finds that the envelope relationship may lead to exploitation of either sources or journalists and, at its extreme, has generated a nefarious criminal subculture. This paper also explores the policy responses of the Indonesian journalists' professional association and various newsrooms. Attempts to control the envelope culture often fail because anti-envelope policies are often too ambiguous, policies are rarely accompanied by pay increases sufficiently substantial to encourage behavioural change, senior journalistic role models fail to set appropriate examples and newsrooms lack systems for detecting and prosecuting offenders.
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Saaly, Maryam, Kiril Bobko, Pooneh Maghoul, Miroslava Kavgic e Hartmut Holländer. "Energy performance of below-grade envelope of an institutional building in cold regions". Journal of Building Engineering 27 (gennaio 2020): 100911. http://dx.doi.org/10.1016/j.jobe.2019.100911.
Testo completo
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Ram, Ron, Odelia Amit, Amos Adler, Yael Bar-On, Ofrat Beyar-Katz, Irit Avivi, David Shasha e Ronen Ben-Ami. "Antibiotic Stewardship in Patients after Cellular Therapy with Febrile Neutropenia- a Single Center Prospective Unblinded Randomized Trial". Blood 138, Supplement 1 (5 novembre 2021): 747. http://dx.doi.org/10.1182/blood-2021-152559.
Testo completoAbstract (sommario):
Abstract Background: Neutropenic fever is a life-threatening condition which is common in patients undergoing allogeneic/autologous hematopoietic cell transplantation (HCT) or chimeric antigen receptor - T cell (CAR-T) therapy. Empirical treatment includes monotherapy with a beta-lactam containing anti-pseudomonal activity. Nevertheless, stewardship of antibiotic in this vulnerable population is controversial. Methods: This was a single center, prospective, unblinded randomized study, of patients after HCT or CAR-T therapy that were enrolled between January 2020 and March 2021. Allocation was concealed in sequentially numbered sealed opaque envelopes. All patients signed informed consent and the study was approved by the Tel Aviv Medical Center Institutional Review Board. Patients were randomly assigned to receive either standard empiric antibiotic ( piperacillin/tazobactam or ceftazidime) that was continued until recovery of counts (control group), or standard empiric antibiotic that was discontinued after 48-72 hours providing there was no evidence of clinical or microbiology documented infection (intervention group). Rapid identification of bloodstream infections was performed with BioFire filmarray multiplex PCR assay (bioMerieux), and results were used to adjust antibiotic treatment early. The primary outcome was the percentage of days without empiric antibiotic (antibiotic-free-neutropenia days). Secondary outcome included successful response to treatment, defined as the combination of- continuation of clinical improvement on day 5 after initiation of antibiotic, no reoccurrence of bacetermia/fever/clinical infection signs on day 5, and no need for additional therapy on day 4-5 after starting antibiotic. Breakthrough fever, death within 30 days of episode onset, duration of hospitalization, duration of neutropenia, graft vs. host disease (GVHD) and characteristics of cytokine release syndrome (CRS) were also evaluated, as appropriate. Results: 110 patients were randomized to standard therapy (control group, n=51) and antibiotic stewardship strategy (intervention group, n=59), Figure 1. The patients' baseline characteristics were well-balanced between the 2 groups, Table 1. Febrile neutropenia occurred in 91 of the patients, and these patients were eligible for the per-protocol analysis. In the intention-to-treat population, the fraction of antibiotic-free neutropenia days was significantly higher for patients allocated to the stewardship arm, compared to those allocated to the standard arm (median [IQR], 0.8 [0.62-0.86] versus 0.51 [0.17-0.86], respectively, p=.0016). This was also true for the subgroups of patients treated per-protocol (median [IQR], 0.75 [0.61-0.83] versus 0.42 [0.12-0.72], respectively, p<.001) and in the subgroups of patients after allogeneic HCT, autologous HCT and CAR-T therapy (0.75 [0.57-0.86] vs. 0.5 [0.40-0.51], p=.0046; 0.66 [0.62-0.83] vs. 0.59 [0.19-0.81], p=.077; and 0.7 [0.45-0.82] vs 0.06 [0-0.28], p=.025, respectively), Figure 2. There was no difference in the success rate between the 2 groups (84.7% vs. 78%, P =0.45). Thirty-day death rate was similarly low in both groups. Other outcome are depicted in Table 2. Linear regression was used to assess the interaction of patient and treatment variables with the fraction of antibiotic-free days. Assignment to the stewardship arm was significantly associated with a higher fraction of antibiotic-free days (p=.003), whereas CART treatment was associated with a lower fraction of antibiotic-free days (p=.004). Conclusions: This is the first randomized study showing in a homogenous population of patients after cellular therapy, the safety of antibiotic stewardship. Optimization of antibiotic schedule is a widely available and cost-effective strategy to improve treatment outcomes in patients with high risk febrile neutropenia after cellular therapy. Figure 1 Figure 1. Disclosures Ram: Gilead: Honoraria; Novartis: Honoraria. Avivi: Kite, a Gilead Company: Speakers Bureau; Novartis: Speakers Bureau.
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Giama, Effrosyni, Elli Kyriaki, Panagiota Antoniadou, Maria Symeonidou e Agis M. Papadopoulos. "Energy and Environmental Evaluation of Retrofitting Facades for Zero Energy Buildings: The Case of an Office Building in Greece". Journal of Physics: Conference Series 2069, n. 1 (1 novembre 2021): 012108. http://dx.doi.org/10.1088/1742-6596/2069/1/012108.
Testo completoAbstract (sommario):
Abstract Energy and environmental targets are expressed clearly by the EU policies setting ambitious goals for 2030 and 2050 considering energy intensive sectors such as buildings. Pursuing high energy performance with the least environmental impact of a building, along with ensuring the well-being of the occupants, is the ultimate goal of an institutional framework that addresses energy efficiency and environmental sustainability. Part of this effort is the improvement of the building envelope’s thermal performance, along with the respective one of HVAC systems, as those determine thee energy performance of buildings in their use phase. Main scope of the paper is to evaluate and analyse different scenarios considering the retrofitting of facades as part of the refurbishment towards Zero and Positive Energy Buildings, but also in connection with the strive for Net Zero Energy, Net Zero Cost Energy and Net Zero Emissions goals. The paper also discusses energy and environmental evaluation of refurbishing an office building in Greece, examining the performance of different envelope construction typologies and alternative insulation scenarios. These scenarios include state of the art insulation techniques, but also innovative design elements such as the use of different final coating materials for ventilated façades like the use of phase-changing materials (PCMs). The results of the assessment undertaken are used to rate the construction solutions by means of energy and environmental parameters proving the environmental impact of concrete and insulation materials in construction phase but also the reduced primary energy consumption and thus the CO2 emissions in the life cycle of the building. Considering the environmental evaluation, the carbon footprint analysis was used according to Greenhouse Gas Protocol focusing mainly on CO2 emissions, which is the main emission target of EU policies. The impact assessment followed demonstrated that the most significant impact categories are global warming, acidification and eutrophication.
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de Koning, Anouk. "‘Handled with care’: Diffuse policing and the production of inequality in Amsterdam". Ethnography 18, n. 4 (28 febbraio 2017): 535–55. http://dx.doi.org/10.1177/1466138117696107.
Testo completoAbstract (sommario):
The intersection of race and the criminal justice system has been a longstanding topic of activism, public debate and research in the US context. In recent years, European countries have also seen a growing social and academic debate about the way racialized minorities are policed. Based on ethnographic research in Amsterdam, this article argues that in order to understand such racialized policing, we have to go beyond a narrow focus on the police itself, and instead examine the broader institutional landscape tasked with security. This institutional landscape is made up of penal and welfare actors who together enact what I call diffuse policing. Such diffuse policing envelops targeted persons and spaces in a dense web of surveillance, and disciplinary and reform interventions that are hard to escape or challenge. This article explores the cumulative effects of this dense security landscape, and argues that it produces significant inequalities among youths in Amsterdam.
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Gantt, Soren, Caroline Quach, David E. Anderson, Francisco Diaz-Mitoma e Joanne Langley. "LB18. An Enveloped Virus-like Particle (eVLP) Cytomegalovirus (CMV) Vaccine Is Immunogenic and Safe: Results of a First-in-Humans Study". Open Forum Infectious Diseases 5, suppl_1 (novembre 2018): S765. http://dx.doi.org/10.1093/ofid/ofy229.2192.
Testo completoAbstract (sommario):
Abstract Background CMV is the most common cause of congenital infection and may result in permanent neurodevelopmental injury including vision and hearing loss. A vaccine to prevent transmission of CMV during pregnancy or to immunocompromised persons is a public health priority. Neutralizing antibodies (nAb) to the CMV envelope glycoprotein B (gB) in natural infection are thought to confer protection, but some vaccine candidates based on this protein alone have been insufficiently immunogenic. In this FiH dose-ranging, controlled, observer-blinded study the safety and immunogenicity of an eVLP expressing the ectodomain of gB fused to transmembrane and cytoplasmic domains of the vesicular stomatitis virus G protein (gB-G) was evaluated. Method Healthy CMV-seronegative 18–40 year olds at three sites in Canada (Vancouver, Montreal, Halifax) were randomized to one of four dose formulations (0.5 µg, 1 µg, or 2 µg gB content with Alum) or 1 µg gB without Alum, or placebo given on days 0, 56, and 168. Outcome measures were solicited and unsolicited adverse events (AE), severe AE, gB binding antibody titers and avidity assessment, and nAb to CMV infection of fibroblast and epithelial cells. A Data Safety Monitoring Board was in place. Result Among 128 participants, the most common solicited local and general AEs were pain and headache, respectively. No SAEs or withdrawals occurred. A dose-dependent boosting of nAb titers was observed after doses 2 and 3, with the highest titers in the Alum-adjuvanted 2.0 µg dose recipients. Fibroblast cell nAb were seen in 100% of 2.0 µg dose recipients, and epithelial cell nAb in 31%. Epithelial cell nAb was correlated with higher geometric mean gB binding titers, and there was a correlation between fibroblast and epithelial cell nAb titers. Conclusion An eVLP CMV vaccine was immunogenic at very low doses in healthy seronegative adults and no safety signals were seen. Alum adjuvantation increased immunogenicity as did higher antigen content and multiple doses. This phase 1 trial supports further development of this eVLP CMV vaccine candidate. ClinicalTrials.gov NCT02826798 Disclosures S. Gantt, VBI Vaccines: Investigator, No direct financial benefit—company provided institutional support for clinical trial. C. Quach, VBI Vaccines: Investigator, No direct financial benefit—company provided institutional support for clinical trial. D. E. Anderson, VBI Vaccines: Employee and Shareholder, Salary. F. Diaz-Mitoma, VBI Vaccines: Consultant and Shareholder, Salary. J. Langley, VBI Vaccines: Investigator, No direct financial benefit—company provided institutional support for clinical trial.
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E. Ndujiuba, Friday, Dr Adebakin E. Taiwo, Edward O. Oladigbolu e Edikan M. Okon. "Optimization Strategy for Energy-Efficiency in Institutional Building: A Case Study of Bells University, Ota". International Research Journal of Innovations in Engineering and Technology 06, n. 08 (2022): 79–91. http://dx.doi.org/10.47001/irjiet/2022.608011.
Testo completoAbstract (sommario):
Enhancement of human and environmental wellbeing due to gas emissions has prioritised national development towards decreasing energy consumption in buildings. Unfortunately, building design and methods in developing nations are not sufficient to achieve reduced no energy consumption. Therefore, this study aimed to assess strategies for energy-efficient buildings in the institution. To know the different design strategies available to build and maintain an energy-efficient building in an institution; literature analysis, structured questionnaire, observation and simulation analysis was performed using Insight 360 software to analyse the building within the Bells University of Technology, Ota. The questionnaire showed that different energy efficiency indicators and strategies analysed from the literature were adequately utilized (41.14%) in the institution. Also, built professionals (students and staff in construction, architecture and designing section) have a background to moderate knowledge of energy efficiency. The simulation result showed a reduction in energy consumption of the building in response to building orientation, window shade, wall-towall ratio, wall construction and roof construction. This shows a great ability to reduce energy consumption and improve human health and well-being. The study concludes and recommends that one of the factors to put into consideration when designing is the nature of the building envelope because it determines the energy required to heat and cool. The government should increase awareness on Energy efficient buildings and appropriate laws should guide the implementation of Energy efficiency in building design policy.
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Anarene, Bengold. "Revolutionizing Energy Efficiency in Commercial and Institutional Buildings: A Complete Analysis". International Journal of Scientific Research and Management (IJSRM) 12, n. 09 (19 settembre 2024): 7444–68. http://dx.doi.org/10.18535/ijsrm/v12i09.em12.
Testo completoAbstract (sommario):
Heating, ventilation, and air conditioning (HVAC) systems of commercial and institutional buildings consume a large proportion of the energy used worldwide and, as a result, are a major contributor to greenhouse gas emissions and operational expenses. According to Wang et al. (2021), HVAC systems in commercial buildings account for approximately 40% of total energy consumption, making them a key focus in efforts to reduce energy use and emissions. As climate change and energy resource depletion intensify, increasing the energy efficiency of these buildings is viewed as a sustainable development solution. Improving building energy efficiency is considered one of the most effective strategies to mitigate global energy consumption and carbon footprints (Pérez-Lombard et al., 2008). This critical review re-anchors the current research, strategies, and case studies toward improving energy efficiency in existing commercial and institutional buildings, providing insights on which approaches work best, the challenges of implementation, and ways forward to guide future research and practice. The paper starts by outlining an overall view of the use of energy in commercial and institutional buildings and identifies the key energy-using systems, which include HVAC, lighting, and the building envelope (Mendell et al., 2017). Technological enhancements scientifically proven to reduce energy consumption include efficient HVAC systems, lighting systems, and advancements in insulation and window technologies (Kim et al., 2019). In addition, the utilization of renewable energy within existing building structures—such as solar and wind energy—is explored as a complementary option for reducing reliance on non-renewable energy sources (Hossain et al., 2020). Beyond technological improvements, behavioral change and policy measures play a critical role in improving energy efficiency. Studies have shown that occupant behavior significantly affects energy consumption, and energy management practices, coupled with incentives, can lead to measurable efficiency gains (Delzendeh et al., 2017). Energy performance standards and governmental incentives are essential in fostering greater efficiency in building systems (Ürge-Vorsatz et al., 2012). The review also addresses the challenges of retrofitting, particularly the high initial costs, operational disruptions, and legal constraints involved in upgrading existing buildings. These barriers, particularly in terms of cost and logistics, are critical to overcome if retrofitting is to be widely adopted (Ma et al., 2012). Case studies such as the Empire State Building's retrofitting project, which resulted in a projected 38% energy savings, and Harvard University's energy efficiency initiatives, demonstrate the real-world feasibility of significant energy reductions (Guldmann et al., 2020). It is particularly relevant to stress here that more innovation is required in the sphere of energy-efficient technologies, backed by stronger policy support, education, and collaboration among stakeholders. As noted by Sartori et al. (2012), the collaboration between governments, industry, and academia is essential to address the global challenge of increasing the energy efficiency of buildings and reducing energy consumption in response to climate change.
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Huysmans, Jef. "Democratic curiosity in times of surveillance". European Journal of International Security 1, n. 1 (27 gennaio 2016): 73–93. http://dx.doi.org/10.1017/eis.2015.2.
Testo completoAbstract (sommario):
AbstractTaking my cue from feminist curiosity and literature on the everyday in surveillance studies, I am proposing ‘democratic curiosity’ as a tool for revisiting the question of democracy in times of extitutional surveillance. Democratic curiosity seeks to bring into analytical play the social and political power of little nothings – the power of subjects, things, practices, and relations that are rendered trivial – and the uncoordinated disputes they enact. Revisiting democracy from this angle is particularly pertinent in extitutional situations in which the organisation and practices of surveillance are spilling beyond their panoptic configurations. Extitutional surveillance is strongly embedded in diffusing arrangements of power and ever more extensively enveloped in everyday life and banal devices. To a considerable degree these modes of surveillance escape democratic institutional repertoires that seek to bring broader societal concerns to bear upon surveillance. Extitutional enactments of democracy then become an important question for both security and surveillance studies.
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Sidhu, Anureet Virk, Rebecca Abraham, Venkata Mrudula Bhimavarapu, Jagjeevan Kanoujiya e Shailesh Rastogi. "Impact of Liquidity on the Efficiency of Banks in India Using Panel Data Analysis". Journal of Risk and Financial Management 16, n. 9 (31 agosto 2023): 390. http://dx.doi.org/10.3390/jrfm16090390.
Testo completoAbstract (sommario):
The current study investigates the impact of the liquidity coverage ratio (LCR) on the efficiency of Indian banks for the period 2010 to 2019. The study examines the effect of internal bank elements like ownership structure, transparency and disclosure, and technological advancement on the relationship between the LCR and efficiency. Bank efficiency proxied as technical efficiency is evaluated by applying the data envelope analysis approach. Applying the panel data regression technique, the authors discover that the LCR has a positive impact on the technical efficiency at a constant return to scale of banks. The relationship between the LCR and the technical efficiency at a variable return to scale is non-linear. Initially, as liquidity increases, the efficiency of banks improves, after reaching its optimum level, efficiency starts to decline. Furthermore, liquidity tends to improve efficiency of banks with higher promoter stakes, whereas opposing results are evidenced for institutional investors and technological advancement.
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Sengupta, Soumish, Supriya Basu, Kadambari Ghosh e Subhrajyoti Sengupta. "Our experience with the management of penile fracture: a single institutional prospective observational study in eighteen patients over a two-year period". International Surgery Journal 8, n. 7 (28 giugno 2021): 2089. http://dx.doi.org/10.18203/2349-2902.isj20212712.
Testo completoAbstract (sommario):
Background: Penile fracture is a not an unusual encounter in urological emergency. The condition results from disruption of the tunica albuginea which envelops the corpora cavernosa as a result of any condition which leads to the sudden rise of intra-cavernosal pressure. The study was designed to analyse the clinical spectrum and complication of penile fracture.Methods: This is a prospective observational study undertaken from April, 2019 to March, 2021on 18 patients. The demographic profile of all the patients, aetiology of penile fracture, management strategies and pre-operative sexual functions were documented. Erectile function was evaluated using international index of erectile function (IIEF).Results: Seventeen out of 18 patients (94.44%) gave a history of injury during sexual intercourse. Out of the seventeen patients with history of injury following sexual intercourse, only 9 (52.94%) were married. 15 (93.75%) had disruption of the tunica albuginea in the ventrolateral position with 10 patients (66.66%) on the right side. Patients were followed up in the OPD after 2 weeks and then at 6 month and 1-year intervals. At 12 months postop, none of the patients complained of sexual inactivity. Average time to return to sexual activity was 3.2 months. Two patients complained of penile curvature >20 degree. Six patients complained of penile nodule at the site of repair.Conclusions: Penile fracture is a urological emergency which is primarily diagnosed clinically. Prompt diagnosis and surgical exploration gives good outcome in terms of preservation of sexual function.
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Krause, Paweł, Artur Nowoświat e Krzysztof Pawłowski. "The Impact of Internal Insulation on Heat Transport through the Wall: Case Study". Applied Sciences 10, n. 21 (24 ottobre 2020): 7484. http://dx.doi.org/10.3390/app10217484.
Testo completoAbstract (sommario):
This paper presents a case study on how to improve the energy efficiency of an institutional building of significant heritage value through retrofitting the external wall system. This building is located in Upper Silesia, Poland. Due to the architectural value of the facade, thermal insulation had to be applied from the inside. As part of this publication, basing on the measurements and simulations, the authors present the results involving the improvement of energy efficiency of the insulated wall. On this basis, they also demonstrate the impact of insulation from the inside on the change of humidity inside the room. The tests were carried out both quantitatively by means of heat flux measurement and qualitatively by means of infrared temperature measurement. The research was supported by numerical modeling. The obtained results indicate that the thermal insulation used in the form of mineral insulation boards applied from the inside improves thermal insulation of the wall. Thus, heat losses through the examined envelope were limited. Computer simulations indicated that no condensation may occur under the condition considered.
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Fořt, Jan, Pavel Beran, Petr Konvalinka, Zbyšek Pavlík e Robert Černý. "EVALUATION OF THE APPLICATION OF A THERMAL INSULATION SYSTEM: IN-SITU COMPARISSON OF SEASONAL AND DAILY CLIMATIC FLUCTUATIONS". Acta Polytechnica 57, n. 3 (30 giugno 2017): 159–66. http://dx.doi.org/10.14311/ap.2017.57.0159.
Testo completoAbstract (sommario):
The current outdated state of many institutional and administrative buildings in the EU region poses a significant burden from the energy sustainability point of view. According to the contemporary EU requirements on the energy efficiency of buildings maintenance, an evaluation of performed improvements is essential for the assessment of expended investments. This paper describes the effect of building envelope reconstruction works consisting in the installation of a thermal insulation system. Here, a long-term continuous monitoring is used for the extensive assessment of the seasonal and daily temperature and relative humidity fluctuations. The obtained results include temperature and relative humidity profiles in the wall cross-section as a response to the changing exterior climatic conditions. The analysis of measured data reveals substantial improvements in thermal stability of the analyzed wall during temperature peaks. While the indoor temperatures exceeding 28 °C are recorded during summer before application of the thermal insulation layer, the thermal stability of the indoor environment is distinctly upgraded after performed improvements. Based on the complex long-term monitoring, a relevant experience is gained for the future work on energy sustainability and fulfilment of the EU directives.
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Williams, Colin, e Besnik Krasniqi. "Beyond the formal/informal employment dualism: evaluating individual- and country-level variations in the commonality of quasi-formal employment". International Journal of Social Economics 48, n. 9 (31 maggio 2021): 1290–308. http://dx.doi.org/10.1108/ijse-01-2021-0059.
Testo completoAbstract (sommario):
PurposeTo transcend the view of employment as either formal or informal, this paper evaluates the prevalence of quasi-formal employment where formal employers pay formal employees an unreported (“envelope”) wage in addition to their formal reported salary. To explain the individual-level variations in quasi-formal employment, the “marginalisation” thesis is evaluated that this practice is more prevalent among vulnerable groups and to explain the country-level variations, and a neo-institutionalist theory is evaluated that it is more prevalent where formal institutional failures lead to an asymmetry between the formal laws and regulations and the unwritten socially shared rules of informal institutions.Design/methodology/approachTo evaluate the individual- and country-level variations in the prevalence of quasi-formal employment, a multi-level logistic regression is provided of data from special 2019 Eurobarometer survey 92.1 involving 11,793 interviews with employees across 28 European countries (the 27 member states of the European Union and the United Kingdom).FindingsOf the 3.5% of employees (1 in 28) who receive under-reported salaries, the marginalisation thesis is supported that it is largely vulnerable population groups. So too is the neo-institutionalist explanation that quasi-formal employment is more common in countries where the non-alignment of formal and informal institutions is greater, with the formal institutional failings producing this identified as lower levels of economic development, less modernised state bureaucracies and lower levels of taxation and social protection.Practical implicationsThe policy implication is that tackling quasi-formal employment requires not only enforcement authorities to improve the risk of detection of this illegal wage practice but also governments to change wider macro-level structural conditions. These are outlined.Originality/valueContemporary new evidence is provided of the prevalence of quasi-formal employment along with how this illegal wage practice can be explained and tackled.
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Saaly, Maryam, Pooneh Maghoul e Hartmut Holländer. "Investigation of the effects of heat loss through below-grade envelope of buildings in urban areas on thermo-mechanical behaviour of geothermal piles". E3S Web of Conferences 205 (2020): 05010. http://dx.doi.org/10.1051/e3sconf/202020505010.
Testo completoAbstract (sommario):
Harvesting geothermal energy through the use of thermo-active pile systems is an eco-friendly technique to provide HVAC energy demand of buildings. Mechanical behaviour of thermo-active piles is impacted by thermal cycles. Moreover, in urban areas, the temperature of the ground is higher than non-constructed areas due to the heat loss through the below-grade enclosure of buildings. This heat dissipation increases the thermal capacity of the soil and affects the mechanical response of the geothermal pile foundation subjected to thermo-mechanical loading. To investigate the effect of buildings heat loss on thermo-active piles, a numerical thermo-mechanical (TM) analysis was carried out on a proposed energy foundation system for an institutional building, the Stanley Pauley Engineering Building (SPEB) in the campus of the University of Manitoba, Winnipeg, Canada. The mechanical response of the geothermal piles to the thermal cycles with and without considering heat leakage through the basement of the SPEB is compared. Results showed that the cooling loads induced a maximum vertical pile head displacement of -1.18 mm. After 5 years operation of the system, the maximum vertical pile head displacement decreased to -1.05 mm for the case in which heat loss through the basement in considered in the models. In addition, the maximum axial load effective along the pile axis was 6% higher for the case that considers heat loss through the basement compared to the case without considering heat leakage through the building’s below-grade envelope.
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Harbin, Laura M., Nan Lin, Frederick R. Ueland e Jill M. Kolesar. "SYNE1 Mutation Is Associated with Increased Tumor Mutation Burden and Immune Cell Infiltration in Ovarian Cancer". International Journal of Molecular Sciences 24, n. 18 (18 settembre 2023): 14212. http://dx.doi.org/10.3390/ijms241814212.
Testo completoAbstract (sommario):
SYNE1, a nuclear envelope protein critical for cellular structure and signaling, is downregulated in numerous malignancies. SYNE1 alterations are found in 10% of gynecologic malignancies and 5% of epithelial ovarian cancers. Previous studies demonstrated an association between SYNE1 mutation, increased tumor mutation burden (TMB), and immunotherapy response. This study evaluates the SYNE1 mutation frequency, association with TMB, and downstream effects of SYNE1 mutation in ovarian cancer. Genetic information, including whole-exome sequencing, RNA analysis, and somatic tumor testing, was obtained for consenting ovarian cancer patients at an academic medical center. Mutation frequencies were compared between the institutional cohort and The Cancer Genome Atlas (TCGA). Bioinformatics analyses were performed. In our cohort of 50 patients, 16 had a SYNE1 mutation, and 15 had recurrent disease. Median TMB for SYNE1 mutated patients was 25 compared to 7 for SYNE1 wild-type patients (p < 0.0001). Compared to the TCGA cohort, our cohort had higher SYNE1 mutation rates (32% vs. 6%, p < 0.001). Gene expression related to immune cell trafficking, inflammatory response, and immune response (z > 2.0) was significantly increased in SYNE1 mutated patients. SYNE1 mutation is associated with increased TMB and immune cell infiltration in ovarian cancer and may serve as an additional biomarker for immunotherapy response.
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Efendic, Nirha, Edin Pasovic e Adnan S. Efendic. "Understanding the Informal Economy in Practice – Evidence from Bosnia and Herzegovina". e-Finanse 14, n. 4 (1 dicembre 2018): 77–89. http://dx.doi.org/10.2478/fiqf-2018-0029.
Testo completoAbstract (sommario):
AbstractThis paper provides insights into the informal economy of Bosnia and Herzegovina (BiH), a post--conflict transition economy in the Western Balkan region aspiring to became part of the European Union. After the introductory section and literature review, we introduce the economic outlook of BiH and then provide evidence estimating the size of the informal economy, which is identified to be around 30% over the last couple of years. As the size of the informal economy is high and persistent, this implies that current policy approaches are not efficient in tackling this economic challenge. To understand how the informal economy operates in practice, we use data from two different surveys to assess tax morality, undeclared work and the structure of the participants in the informal economy. In the next section, we supplement the study with ethnographic insights. In particular, we identify how participants in the informal economy use it for different purposes and with different motives. This includes reliance on the informal economy as a survival strategy for households, as a way to supplement insufficient formal income, to compensate for economic insecurity, or to decrease costs of formal business by using “envelope wage” practices, but equally importantly to overcome formal institutional rigidities linked to current contradictory laws. Still, we find indications that the growth of informal business is converging to formalisation, as informality at some stages of business development becomes a burden to higher entrepreneurial growth aspirations.
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Beto, Judith A., Mark C. Geraci, Patricia A. Marshall e Vinod K. Bansal. "Pharmacy Computer Prescription Databases: Methodologic Issues of Access and Confidentiality". Annals of Pharmacotherapy 26, n. 5 (maggio 1992): 686–91. http://dx.doi.org/10.1177/106002809202600515.
Testo completoAbstract (sommario):
OBJECTIVE: To examine methodologic issues of access and confidentiality regarding the use of pharmacy computer prescription databases (PCPDs) for participant selection to receive mailed, self-administered, hypertensive quality-of-life survey outside a primary-care setting. DESIGN: Two separate PCPD searches by pharmacist owners for patients prescribed at least one of 130 potential antihypertensive medications. The first PCPD used a nonrandom sample of all patients (n=635); the second PCPD used a random sample (n=100) of three specific antihypertensive drug groups. Research protocol was approved by the investigators' institutional review board. SETTING: Two independent, privately owned PCPDs. PATIENTS OR OTHER PARTICIPANTS: Individuals prescribed at least 1 of 130 PCPD medications potentially used in antihypertensive treatment. INTERVENTIONS: Individually addressed cover letter on pharmacy letterhead signed by a pharmacist requesting voluntary completion of the enclosed, self-administered, opinion survey on quality of life. MAIN OUTCOME MEASURE: Anonymous survey return to off-site post office box in envelope provided. RESULTS: Favorable or no opposition to PCPD methodology from pharmacist or participants. Ethical opposition was encountered when incorporating PCPD sampling technique into grant proposal. CONCLUSIONS: The American Pharmaceutical Association Code of Ethics is used as a basis to provide recommendations to examine and justify PCPD investigative use. Increasing availability of PCPD technology encourages more efficient and easier methods of research strategy. PCPD use, however, demands identical stringent guidelines used in traditional research and raises potential issues regarding pharmacist-patient confidentiality as well as the right of PCPD use by others.
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Choudhary, Nirmala, Neerja Banerjee, Jyoti Singh, Meena Kumari e Mohandeep Kaur. "Comparison of Success Rate of Abducted and Neutral Arm Position for Right Infraclavicular Subclavian Vein Cannulation Under Real-Time Ultrasound Guidance in Patients Undergoing Elective Neurosurgery Under General Anesthesia". Annals of Cardiac Anaesthesia 26, n. 4 (2023): 418–22. http://dx.doi.org/10.4103/aca.aca_32_23.
Testo completoAbstract (sommario):
ABSTRACT Background: Classically subclavian vein catheterization is done in neutral arm position; recently, it has been done in different arm positions to compare success rate and catheter misplacement. There is a paucity of literature for comparing abducted and neutral arm position for right infraclavicular subclavian vein cannulation. Aim: Comparison of success rate of abducted and neutral arm position for right infraclavicular subclavian vein cannulation under real-time ultrasound guidance in patients undergoing elective neurosurgery under general anesthesia. Design: Randomized comparative study. Materials and Methods: After approval from Institutional Review Board and Ethical Committee, 100 patients of 18–70 years of age, of either sex, posted for elective neurosurgery under general anesthesia, requiring right subclavian vein cannulation were included in our study. They were randomly divided into two groups: abducted arm position (group 1-AG) and neutral arm position (group 2-NG) using sealed envelope technique. Results: First attempt success rate was higher in AG group compared to NG group (P value- 0.741). Times taken (seconds) for cannulation in NG and AG group, catheter misplacement and hematoma (P value- 0.37, P value- 0.37, P value- 1, respectively) were lesser in AG Group. Conclusion: For USG-guided infraclavicular subclavian vein cannulation, abducted arm position, and neutral arm position in terms of first attempt success rate, number of attempts and associated complications has comparable results; however, further studies with larger group of patients are required to assess the overall advantage of abducted arm position over neutral arm position.
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N, Amulya. "Abstract No.: ABS1786 : A prospective randomised double blinded conteolled study: impact of intrathecal magnesium sulfate as an adjuvant on perioperative shivering in parturients undergoing caeserean section". Indian Journal of Anaesthesia 66, Suppl 1 (gennaio 2022): S33. http://dx.doi.org/10.4103/0019-5049.340725.
Testo completoAbstract (sommario):
Background &Aims: Incidence of shivering is 55% with neuraxial anaesthesia. It increases the metabolic rate by 400% ,with consequent oxygen consumption. This study was designed to assess the effectiveness of intrathecal magnesium sulphate as an adjuvant in preventing shivering in parturients undergoing caesarean section. Methods: After institutional ethical committee clearance, a prospective randomised double blinded study was conducted on 80 parturients of age 18-45 years of American Society of Anesthesiologists (ASA) grade II undergoing caesarean section. Parturients were randomised into two groups of 40 each by computer generated random numbers, allocation concealment was done by closed envelope technique, double blinding followed. Group M received 2ml 0.5% heavy bupivacaine+ 0.1ml 25mg MgSo4. Group P received 2ml 0.5% heavy bupivacaine + 0.1ml saline. Intraoperative Shivering score was assessed as primary outcome, Vital signs, temperature, sensory and motor blockade were recorded as secondary outcome, calculated using unpaired T test and chi square tests. Results: Overall incidence of shivering in Magnesium sulfate group was low, though during 10, 15, 20, 30, 40 minutes post spinal, it was statistically significant(p < 0.001%). Core body temperature was significantly reduced in Magnesium sulfate group compared to the normal saline group30minutes post spinal (p <0.001%). JOURNAL/ijana/04.03/01762628-202203001-00049/inline-graphic1/v/2022-09-30T091728Z/r/image-tiff Conclusion: From the present study it can be concluded that Intrathecal Magnesium sulfate decrease the incidence and intensity of shivering during caesarean section under spinal anaesthesia, without having any serious side effects.
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Sytnyk, Ye А. "Is there a general equivalent of transaction costs?" Management of Economy: Theory and Practice. Chumachenko’s Annals, n. 2021 (23 dicembre 2021): 226–39. http://dx.doi.org/10.37405/2221-1187.2021.226-239.
Testo completoAbstract (sommario):
The article raises the question of the existence of a general equivalent of transaction costs other than money. A distinction was made between the concepts of transaction costs and transaction actions. The definition of transaction costs is given as a cost (in the sense of costs of value and time) trace of transactional actions. The concept of a continuum of transactional actions was introduced. the composition of the continuum of transactional actions is outlined and the main reasons for its increase in the modern economy are identified. among these reasons are specific to the economy, which is transitioning from a Soviet-type command-administrative system to a market one. The mechanism of displacement of market transactions by the firm has been specified. Transactional substitution is a process (processes) of the firm’s performance of a certain set of transactional actions that accompany transformational processes from their beginning to their end. Transaction substitution is related to the transaction capacity of the institute. Correspondence between subsets of the continuum of transactional actions and transformational (production) processes is established. The concept of an agerative system is introduced as one of the two large systems that support symmetry in the economy, and which exists in parallel with the market or commodity-money system. Agerative system is built on the basis of management actions and is a complex of management, transactional actions of all types and types. A table was created in which the main correspondences between transformational and transactional types of processes and the economic phenomena generated by them are placed. Transformational and transactional processes generate different types of economic phenomena. If in transformational processes goods are created, more precisely, natural-material bodies of goods as carriers of value, then institutions are created in transactional processes. If as a result of the development of transformational (production) processes there is an accumulation of capital (which, in fact, is the goal of capitalist production), then as a result of the development of transactional processes there is an accumulation of managerial power. The goal of bureaucracy is to increase and concentrate managerial power. Keywords continuum of transactional actions, transactional actions, transactional costs, transformational processes, the transaction envelope of the production process, the total equivalent of transaction costs, physical goods, carriers of value, agerative system, levels of hierarchy, unit of hierarchical complexity, transactional capacity of institutions, institutional (institutional) competition.
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Rai, DIllisher, e Gajendra Prasad Rauniar. "Comparative bioavailability study of phenytoin in healthy Nepalese volunteers". Journal of Drug Delivery and Therapeutics 9, n. 1-s (15 febbraio 2019): 144–47. http://dx.doi.org/10.22270/jddt.v9i1-s.2376.
Testo completoAbstract (sommario):
Our study aimed to assess and compare the bioavailability of Eptoin 100 mg and Epileptin 100mg tablets in Nepalese healthy volunteers. A randomized, two-treatment cross-over study with two weeks’ wash-out period was conducted in 12 healthy non-smoker and non-alcoholic Nepalese male volunteers over a period of 6 months in the department of Clinical Pharmacology and Therapeutic at B. P. Koirala Institute of Health Sciences, Dharan, Nepal after approval from the Institutional Review Committee. The participants were randomized using sealed envelope system and received a single 100 mg oral tablet of either of the formulations with a two week washout period. Blood samples were collected predose and at regular intervals postdose upto 72 hours. Plasma phenytoin levels were estimated by reverse phase high performance liquid chromatography. The analytical method was validated prior to the start of study. Cmax (Peak Plasma Concentration), Tmax (Time to achieve maximum Plasma Concentration), AUC0-72 (Area under plasma concentration time curve 0 to 72 hours), AUC0-∞ (Area under plasma concentration time curve 0 to ∞) and T½ (Elimination half-life) and Kel (Elimination rate constant) were calculated and 80-120% margin (90% confidence interval) was used to assess bioequivalence. ANOVA test was used to analyze the data at P-value of 0.05. All volunteers completed the study. The log-transformed values of Cmax, Tmax, AUC0-t, and AUC0-∞ of the both formulations were within the specified limits and were bioequivalent according to the regulatory definition of bioequivalence based on the rate and extent of absorption. Both products can be considered equally effective in medical practice.
Keywords: Bioavailability, Bioequivalence, healthy volunteer, Nepal, phenytoin sodium.
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Chang, J., T. Stauffer, K. Grant e W. Jiranek. "ARTICULATING VERSUS STATIC SPACERS IN THE TREATMENT OF HIP ARTHROPLASTY PROSTHETIC JOINT INFECTION (PJI)". Orthopaedic Proceedings 105-B, SUPP_12 (23 giugno 2023): 22. http://dx.doi.org/10.1302/1358-992x.2023.12.022.
Testo completoAbstract (sommario):
Surgical treatment of Hip PJI by resection of the infected implants and tissue and placement of a “spacer” which elutes antibiotic via antibiotic loaded cement is an accepted treatment option. There is some controversy over whether this “spacer” should be articulating or static. Proponents of the articulating option argue that there is improved function and maintenance of the soft tissue envelop. Critics have suggested that additional biomaterials may compromise eradication of infection. This study compares our results of the 2 treatment options.A review of our institutional PJI database between 2016 and 2021 identified 87 patients who were treated with resection arthroplasty for unilateral total hip PJI. The cohort was analyzed for demographics and type for surgery, as well as medical comorbidities, survivorship, and treatment success.44 patients were female, the mean age of all patients was 62. 44 patients were treated with Articulating apacers, and 43 patients treated with static spacers. There was no significant difference between ASA or Elixhauser score, and no significant difference between mortality or treatment failure.This study did not show any difference between the patients who receive static spacers, from those who received articulating spacers, and deomstrated similar treatment success rates. From this data there does not appear to be any difference in success rates between those patients that were treated with static spacers and those that were treated with articulating spacers.
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Shafi, Hina, Muhammad Faheem Afzal, Manan Haider Khan, Madiha Ashfaq e Sana Bashir. "Role of Post-Isometric Relaxation of Quadriceps and Core Stability Exercises in Vertical Jump Performance". Annals of King Edward Medical University 29, n. 1 (4 luglio 2023): 39–43. http://dx.doi.org/10.21649/akemu.v29i1.5346.
Testo completoAbstract (sommario):
Objective: To determine the role of post isometric relaxation of quadriceps and core stability exercises in vertical jump performance. Methods: A Randomized Clinical Trial, conducted in Islamic International University after having the ethical permission from Institutional review Board of Riphah International University Islamabad. Sampling technique was Non-probability convenience sampling with the sample size of 30 athletes, that were divided by sealed and envelop method into core stability exercise treated group (n=17) and Post isometric relaxation treated group (n= 13). Male Athletes within age range of 20-35 years and playing at the domestic level were
included and athletes with history of sprain or strain in lower limbs within last 6 month, having neuromusculoskeletal and cardiovascular pathology were excluded from the study. Force plate was used to measure the different parameters of jump. Data were entered and analyzed through SPSS version 22. Results: The mean age of group A and B was 20.35 + 2.01 and 20.03 + 2.42 in years respectively. BMI of core stability exercise treated group and Post isometric relaxation treated group was 22.35 + 2.32, 22.58 + 1.95 respectively in kg/m2. Comparison between core stability exercise treated group and Post isometric relaxation treated group showed that there was no significant immediate effects (F= 1.235; p= 0.852) of treatment on three style of jumps.
Conclusion: No significant immediate effects of treatment on three styles of jumps was found.
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Assefa, Ayenew, Dibekulu Shiferaw, Zewdu Bishaw e Teklehaimanot Kiros. "Seroprevalence of Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) among Blood Donors from Bahir Dar, Ethiopia". Advances in Public Health 2022 (29 settembre 2022): 1–9. http://dx.doi.org/10.1155/2022/5073171.
Testo completoAbstract (sommario):
Background. Hepatitis B virus (HBV), a highly contagious virus, is a circular partial double-stranded DNA virus. Hepatitis C virus (HCV) is an enveloped, single-stranded RNA virus with a major blood-borne infection worldwide. Infection of HBV and HCV among blood donors is an important public health problem. Objective. To assess the seroprevalence of hepatitis B and C viruses and associated factors among blood donors at Bahir Dar Blood Bank, Northwest Ethiopia. Method. Institutional-based cross-sectional study was conducted at Bahir Dar Blood Bank from May 18, 2020 to July 27, 2020. A systematic random sampling technique was used to select 426 participants. Variables having a p value of <0.05 with 95% CI and AOR were considered statistically significant. Results. From 426 proposed participants, 418 (98.1%) of them completed the face-to-face interview. The seroprevalence of HBV and HCV among study participants was 4.07% and 0.48%, respectively. Having multiple sexual partners (AOR = 10.356: 95% CI: (2.277–47.099)), having a family history of hepatitis (AOR = 8.106: 95% CI: (1.278–51.403)), and having sharp materials sharing experience (AOR = 11.313, 95% CI: (1.144–111.864)) have a significant association with HBV infection. No risk factors were found for HCV infectious markers. Conclusion and Recommendations. This study showed that the seroprevalence of HBV and HCV infections confirmed with positive tests among voluntary blood donors in Bahir Dar Blood Bank was 4.07% and 0.48%, respectively. HBV seroprevalence among blood donors in this study has remained stable when compared to a study done in 2013 in the same population. Strict donor selection, safe sex practice, using proper safety precautions when offering care to a family member, and immunization of people at risk could constitute an important package of a prevention program.
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Brixen, Kim, Roland Chapurlat, Angela M. Cheung, Tony M. Keaveny, Thomas Fuerst, Klaus Engelke, Robert Recker et al. "Bone Density, Turnover, and Estimated Strength in Postmenopausal Women Treated With Odanacatib: A Randomized Trial". Journal of Clinical Endocrinology & Metabolism 98, n. 2 (1 febbraio 2013): 571–80. http://dx.doi.org/10.1210/jc.2012-2972.
Testo completoAbstract (sommario):
Abstract Context: Odanacatib, a cathepsin K inhibitor, increases spine and hip areal bone mineral density (BMD) in postmenopausal women with low BMD and cortical thickness in ovariectomized monkeys. Objective: The objective of the study was to examine the impact of odanacatib on the trabecular and cortical bone compartments and estimated strength at the hip and spine. Design: This was a randomized, double-blind, 2-year trial. Setting: The study was conducted at a private or institutional practice. Participants: Participants included 214 postmenopausal women with low areal BMD. Intervention: The intervention included odanacatib 50 mg or placebo weekly. Main Outcome Measures: Changes in areal BMD by dual-energy x-ray absorptiometry (primary end point, 1 year areal BMD change at lumbar spine), bone turnover markers, volumetric BMD by quantitative computed tomography (QCT), and bone strength estimated by finite element analysis were measured. Results: Year 1 lumbar spine areal BMD percent change from baseline was 3.5% greater with odanacatib than placebo (P < .001). Bone-resorption marker C-telopeptide of type 1 collagen was significantly lower with odanacatib vs placebo at 6 months and 2 years (P < .001). Bone-formation marker procollagen I N-terminal peptide initially decreased with odanacatib but by 2 years did not differ from placebo. After 6 months, odanacatib-treated women had greater increases in trabecular volumetric BMD and estimated compressive strength at the spine and integral and trabecular volumetric BMD and estimated strength at the hip (P < .001). At the cortical envelope of the femoral neck, bone mineral content, thickness, volume, and cross-sectional area also increased from baseline with odanacatib vs placebo (P < .001 at 24 months). Adverse experiences were similar between groups. Conclusions: Over 2 years, odanacatib decreased bone resorption, maintained bone formation, increased areal and volumetric BMD, and increased estimated bone strength at both the hip and spine.
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Williams, Colin C., e Ioana Alexandra Horodnic. "Cross-country variations in the participation of small businesses in the informal economy". Journal of Small Business and Enterprise Development 23, n. 1 (15 febbraio 2016): 3–24. http://dx.doi.org/10.1108/jsbed-02-2015-0021.
Testo completoAbstract (sommario):
Purpose – The purpose of this paper is to advance a new explanation for cross-country variations in the participation of small businesses in the informal economy. Drawing upon institutional theory, it proposes that the greater the asymmetry between the codified laws and regulations of formal institutions (state morality) and the unwritten socially shared rules of informal institutions (civic morality), the greater is the propensity of small businesses to participate in the informal economy. To analyse this, the extent to which small businesses evade payroll taxes by paying employees an undeclared (envelope) wage in addition to their official declared salary is analysed. Design/methodology/approach – To evaluate this, data are reported from a 2013 Eurobarometer survey involving 5,174 face-to-face interviews with employees in small businesses across the 28 member states of the European Union (EU-28). Findings – The finding is that small businesses display a greater propensity to engage in this informal wage practice in countries where there is a higher degree of asymmetry between the codified laws and regulations of formal institutions (state morality) and the unwritten socially shared rules of informal institutions (civic morality). A multi-level logistic regression analysis reveals these to be countries which have lower qualities of governance, lower levels of taxation and intervention in the labour market and less effective social transfer systems. Research limitations/implications – The major limitation of this study is that it has only examined whether employees in small businesses receive informal wages. Future cross-country surveys should analyse a wider range of ways in which small businesses participate in the informal economy such as under-reporting turnover. Originality/value – This is the first known analysis of cross-country variations in the participation of small businesses in the informal economy.
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Dinesh Babu, Dhamodharan, Jacob Plakkeel, Suneeth P Lazarus, Shanmugam Balasubramanian e Rajaraman Rajprasath. "Comparison of Gabapentin and Pregabalin Premedication for Attenuation of Hemodynamic Changes in Elective Laparoscopic Appendicectomy". Indian Journal of Anesthesia and Analgesia 8, n. 1 (15 febbraio 2021): 27–34. http://dx.doi.org/10.21088/ijaa.2349.8471.8121.4.
Testo completoAbstract (sommario):
Introduction: General anaesthesia is the gold standard anaesthetic technique for laproscopic appendicitis. However, this procedure is not risk free. Carbon dioxide is used to create pneumoperitoneum in laproscopic surgeries causes various hemodynamic changes such as abrupt elevation of arterial pressure, systemic vascular resistance and decreased cardiac output. These changes are well tolerated in healthy patients. There is also an increase in circulatory catecholamines during laryngoscopy and intubation. Many pharmacological techniques were evaluated either in the premedication or during the induction to attenuate the hemodynamic response to pneumoperitoneum such as – deepening the anaesthesia, pretreatment with vasodilators, adrenoceptor blockers, calcium channel blockers and opiods. This study is designed to evaluate the hemodynamic changes associated by laryngoscopy, tracheal intubation and pneumoperitoneum in laparoscopic appendicectomy by premedicating the patients with Gabapentin (900mg) and Pregabalin (150mg). Materials and Methods: The study was carried out as a hospital based double blinded randomized prospective comparative study after obtaining institutional ethics committee approval in the Department of Anaesthesiology, SMVMCH Puducherry. The sample size was calculated as 72 with 36 in each group. Patients scheduled for elective laparoscopic appendicectomy were selected for the study based on predetermined inclusion and exclusion criteria. The study drug, Gabapentin 900mg or Pregabalin 150mg, was sealed in a black covered envelope and was given to the patient with sips of water 1 hour before the induction of anaesthesia by an anaesthetist not involved in study. Anaesthetic and surgical techniques were standardized for all patients. HR, SBP, DBP, MAP, SpO2 were recorded at the following points of time:(i) Prior to induction, (ii) 2-3 minutes after intubation, (iii) Before creating pneumoperitoneum, (iv) After creating pneumoperitoneum, (v) 2 minutes after extubation, (vi) Intra op,every 5 mins till the end of surgery, (vii) Post op, every 10 mins for the 1st 30 minutes and then every 30 minutes till 3 hours, along with Ramsay sedation score.
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DEWICK, PAUL, e MARCELA MIOZZO. "FACTORS ENABLING AND INHIBITING SUSTAINABLE TECHNOLOGIES IN CONSTRUCTION: THE CASE OF ACTIVE SOLAR HEATING SYSTEMS". International Journal of Innovation Management 06, n. 03 (settembre 2002): 257–76. http://dx.doi.org/10.1142/s1363919602000598.
Testo completoAbstract (sommario):
The domestic building sector across Europe accounts for around 40% of total energy consumption. Mitigation strategies for greenhouse gas emissions have focused on improving the energy efficiency of buildings, both in terms of electricity use and space heating. In addition to improving the thermal properties of the building envelope and developing mechanisms to encourage energy conservation, the use of new energy technologies in new build and retro-fit residential buildings has the capacity to reduce significantly energy consumption. Active solar heating (ASH) systems are one such technology, suitable for widespread use across new and existing buildings in the housing stock, which have the potential to make a significant contribution to sustainable building and regeneration. Their generally slow adoption can be attributed to high capital cost and unknown cost effectiveness, but these factors do not adequately explain considerable differences between European countries in the take-up of new sustainable technologies in construction. This suggests that there are sets of more important factors and institutions inhibiting or facilitating their adoption. This paper examines the structural and institutional factors behind these differentials and draws implications for the management of innovation by construction firms and government policy for those countries under-exploiting the potential of ASH systems. Regulation, legislation and fiscal and financial incentives can encourage innovation and can help to promote solar technology. For countries such as the UK and France, lessons can be learned from the fixed price schemes, direct capital grant support, tax incentives and other such initiatives employed in Denmark, Germany, the Netherlands and Sweden. However, manufacturers and suppliers of ASH systems cannot be considered independently of other firms along the building chain. By raising the visibility of the adoption of this sustainable technology, construction firms can benefit their organisations from the reputation for installing this innovation, while confining the risk to this particular technology. Government can also play a role in increasing the capacity of construction firms to identify appropriate sustainable technologies and evaluate their potential costs and benefits.
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Binnie, Ian. "Judging The Judges: “May They Boldly Go Where Ivan Rand Went Before”". Canadian Journal of Law & Jurisprudence 26, n. 1 (gennaio 2013): 5–21. http://dx.doi.org/10.1017/s0841820900005932.
Testo completoAbstract (sommario):
Justice Ivan Rand was perhaps the greatest exponent of the rule of law in the history of the Supreme Court of Canada. He was a great judge. He scorned as impractical the admonition that judges should “apply the law, not make it”. His judgements frequently broke new ground, but it should be understood that in “making the law” great judges like Ivan Rand respond to fundamental considerations of order and fairness and not to personal whim. It is sometimes necessary for judges to return to first principles to provide legislators with a framework within which to operate in unforeseen situations. The word “activism” is usually used by critics to imply that a judge is pushing the envelope beyond the proper boundaries of the law, but properly understood the term may equally indicate a judicial tightening of the boundaries to deny the bench a power seemingly conferred by the Constitution or legislation. Restraint, as much as expansion, is governed by the judges’ recognition of the limits of their institutional competence and their appreciation of their role in the constitutional scheme.In the absence of statutory authority the courts have not yet addressed issues related to globalization and human rights with the sort of boldness and creativity we associate with great judges like Ivan Rand. Order and fairness have acquired a global dimension. Globalization offers a different kind of challenge, but is no less demanding of the rule of law. In the case of creating some form or forum of relief for Third World victims of globalization, we seem to have used restraint as an excuse for inertia. Judges need to be practical, but their greatness will rest on their capacity to see not only what the law is but what it should become. There is a time for boldness and a time for restraint and judges should be judged on their ability to tell the difference.
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Ng, Danielle Wing Lam, Richard Fielding, Catherine Tsang, Carmen NG, Joyce Chan, Amy Or, Izy Wing Man Kong et al. "Study protocol of ConquerFear-HK: a randomised controlled trial of a metacognition-based, manualised intervention for fear of cancer recurrence among Chinese cancer survivors". BMJ Open 13, n. 1 (gennaio 2023): e065075. http://dx.doi.org/10.1136/bmjopen-2022-065075.
Testo completoAbstract (sommario):
IntroductionFear of cancer recurrence (FCR) is a prevalent and frequently debilitating response to a cancer diagnosis, affecting a substantial proportion of cancer survivors. Approximately 30% of local Hong Kong Chinese cancer survivors in a recent survey reportedly experienced persistent high FCR over the first-year post-surgery. This was associated with lower levels of psychological well-being and quality of life. A manualised intervention (ConquerFear) developed primarily based on the Self-Regulatory Executive Function Model and the Rational Frame Theory, has been found to reduce FCR effectively among Caucasian cancer survivors. The intervention now has been adapted to a Chinese context; ConquerFear-HK. The primary aim of this study is to evaluate its efficacy vs a standard-survivorship-care control (BasicCancerCare) in FCR improvement in a randomised control trial (RCT).Methods and analysisIn this RCT, using the sealed envelope method, 174 eligible Chinese cancer survivors will be randomised to either the ConquerFear-HK or BasicCancerCare intervention. Both interventions include six sessions over 10 weeks, which will be delivered via face to face or online by trained therapists. The ConquerFear-HK intervention incorporates value classification, metacognitive therapy, attentional training, detached mindfulness and psychoeducation; BasicCancerCare includes relaxation training, dietary and physical activity consultations. Participants will be assessed at prior randomisation (baseline; T0), immediately postintervention (T1), 3 months (T2) and 6 months postintervention (T3) on the measures of FCR (Fear of Cancer Recurrence Inventory) as a primary outcome; metacognition (30-item Metacognitions Quesionnaire) and cognitive attentional syndrome (Cognitive-attentional Syndrome Questionnaire) as process outcomes; psychological distress (Hospital Anxiety and Depression Scale), cancer-related distress (Chinese Impact of Events Scale), quality of life (European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire) and treatment satisfaction are secondary outcomes.Ethics and disseminationEthics approval has been obtained from HKU/HA HKW Institutional Review Board (ref: UW19-183). The patients/participants provide their written informed consent to participate in this study. The study results will be disseminated through international peer-review publications and conference presentations.Trial registration numberNCT04568226.
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RAJA, RA, MH ABBASI, MRU TAJ, TALHA e T. QAYYUM. "THE OUTCOME OF ANTIBIOTICS VS OPEN APPENDECTOMY FOR ACUTE NON-PERFORATED APPENDICITIS". Biological and Clinical Sciences Research Journal 2024, n. 1 (10 aprile 2024): 804. http://dx.doi.org/10.54112/bcsrj.v2024i1.804.
Testo completoAbstract (sommario):
Acute appendicitis is a common surgical emergency. While appendectomy has been the conventional treatment for this condition, recent advancements in antibiotic therapy have led to exploring the use of antibiotics as a non-surgical alternative for treating non-complicated acute appendicitis. Objective: The objective of the present study was to compare the outcomes of administering antibiotics and performing emergency appendicectomy in a cohort of individuals diagnosed with non-perforated acute appendicitis based on CT evaluation. Methods: After the ethical approval from the institutional review board, this randomised control trial was conducted at Combined Military Hospital Jhelum from July 2022 to December 2023. The patients were randomly assigned, using a closed envelope method, to either have open appendectomy (Group A, n=60) or receive antibiotic therapy (Group B, n=60) with intravenous ertapenem. Open appendectomy was conducted utilising the McBurney technique. The patient’s outcomes were assessed during their hospitalization period, specifically on days 0, 1, and 2, and by telephone interviews one week and two months following the intervention. Pain scores were collected at two specific time points, one week and two months after randomisation, utilising a visual analogue scale (VAS). Results: No significant differences were observed in the baseline characteristics in both groups. Mean± S.D of the pain experience of the study participants in both groups was 4.16±1.04 and 3.68±1.02 (days) (P value=0.008). Mean± S.D of the hospital stay of the study participants in both groups was 3.13±0.87 and 3.16±0.83 (days) (P value=0.843). A significant difference in the VAS score was observed (p <0.0001) in the participants of both groups at discharge and after a one-week follow-up period. Conclusion: The findings of the study indicate that a significant proportion of individuals who received antibiotic therapy for non-perforated acute appendicitis did not necessitate the surgical procedure of appendectomy within the two-month post-treatment observation period.
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Zhou, Chuanlong, Biqing Zhu, Steven J. Davis, Zhu Liu, Antoine Halff, Simon Ben Arous, Hugo de Almeida Rodrigues e Philippe Ciais. "Natural gas supply from Russia derived from daily pipeline flow data and potential solutions for filling a shortage of Russian supply in the European Union (EU)". Earth System Science Data 15, n. 2 (1 marzo 2023): 949–61. http://dx.doi.org/10.5194/essd-15-949-2023.
Testo completoAbstract (sommario):
Abstract. Russia is the largest natural gas supplier to the European Union (EU). The invasion of Ukraine was followed by a cutoff of gas supplies from Russia to many EU countries, and the EU is planning to ban or drastically reduce its dependence on Russia. We provide a dataset of daily gas consumption in five sectors (household and public building heating, power, industry, and other sectors) with supply source shares in the EU27 (27 EU member countries) and UK from 2016 to 2022. The datasets are available at Zenodo platform: https://doi.org/10.5281/zenodo.7549233 (Zhou et al., 2022). The dataset separates the contributions of Russian imports, liquefied natural gas (LNG) imports, and other supply sources to both direct supply and storage supply for gas consumption estimations. The dataset was developed with a gas network flow simulation model based on mass flow balance by combining data from multiple datasets including daily ENTSOG (European Network of Transmission System Operators for Gas) pipeline gas transport and storage, ENTSOE (European Network of Transmission System Operators for Electricity) daily power production from gas, and Eurostat monthly gas consumption statistics per sector. The annual consumption data were validated against the BP Statistical Review of World Energy and Eurostat datasets. We secondly analyzed the share of gas supplied by Russia in each country to quantify the “gap” that would result from a cessation of all Russian exports to Europe. Thirdly, we collected multiple data sources to assess how national gaps could be alleviated by (1) reducing the demand for heating in a plausible way using the lower envelope of gas empirical consumption – temperature functions, (2) increasing power generation from sources other than gas, (3) transferring gas savings from countries with surplus to those with deficits, and (4) increasing imports from other countries like Norway, the USA, Australia, and northern African countries from either pipelines or LNG imports, accounting for existing capacities. Our results indicate that it should be theoretically possible for the EU to collectively make up for a sudden shortfall of Russian gas by combining the four solutions together, provided a perfect collaboration between EU countries and the UK to redistribute gas from countries with surplus to those with deficits. Further analyses are required to investigate the implications with respect to the costs, including social, economic, and institutional dimensions; political barriers; and negative impacts on climate policies, with inevitable increases in CO2 emissions if the use of coal is ramped up in the power sector.
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Mulligan, Ryan, Samuel Adams, James DeOrio, Mark Easley e James Nunley. "Posterior Achilles Tendon-Splitting Approach and Intramedullary Nailing versus Lateral Trans-Fibular Approach with Fixed-Angle Plating for Tibiotalocalcaneal Arthrodesis". Foot & Ankle Orthopaedics 2, n. 3 (1 settembre 2017): 2473011417S0003. http://dx.doi.org/10.1177/2473011417s000302.
Testo completoAbstract (sommario):
Category: Ankle, Ankle Arthritis, Hindfoot Introduction/Purpose: A variety of operative approaches and fixation techniques have been described for tibiotalocalcaneal (TTC) arthrodesis. As a durable, load-sharing device with favorable biomechanical properties, the intramedullary (IM) nail is commonly used. Lateral, fixed-angle plating continues to be popular as well, due to ease of use and lack of significant clinical inferiority. A lateral approach with distal fibula resection allows for direct access to the tibiotalar and subtalar joints, but the posterior, Achilles tendon-splitting (PAS) approach offers a robust soft tissue envelope. The purpose of this study was to compare the results of TTC arthrodesis with either PAS approach and IM nailing or lateral, trans-fibular (LTF) approach with lateral, fixed- angle plating. Methods: Following institutional review board approval, all patients who underwent simultaneous tibiotalar and subtalar arthrodesis were identified with minimum one year clinical and radiographic follow up. A retrospective review of all clinic notes, operative details, and radiographs was performed by a fellowship-trained orthopaedic foot and ankle surgeon not associated with the procedures. Patients were excluded if they underwent TTC arthrodesis through an approach other than PAS or LTF, and received fixation without an IM nail or lateral, fixed-angle plate. Primary outcomes examined were union rate and complications. Statistical analysis was performed with student’s t-test for continuous data and Chi-square test for categorical variables. P-values less than 0.05 were considered significant. Results: 38 patients underwent TTC arthrodesis with a PAS approach and IM nailing, and 28 with a LTF approach and lateral plating. The overall union rate for the PAS/IM nail group was 76.3% (29 of 38), and 64.3% (18 of 28) for LTF/lateral plating group (p=0.41). 15.8% (6 of 38) in the PAS/IM nail group underwent revision arthrodesis versus 7.1% (2 of 28) in the LTF/lateral plating group (p=0.45). Nonunion at the subtalar joint occurred in 25.0% (7 of 28) in the LTF/lateral plating group and 5.3% (2 of 38) in the PAS/IM nail group (p=0.03), but there was not a significant difference in tibiotalar union. Patients were allowed to bear weight 3 weeks earlier in the PAS/IM nail group (11.2 vs 14.4 weeks, p=0.01). Conclusion: Despite similar overall union rates, nonunion of the subtalar joint was significantly increased in the LTF/lateral plating group. This could be due to disruption of blood supply during exposure, insufficient stability, or inadequate compression of the arthrodesis site. However, revision arthrodesis rates were similar between groups because some nonunions were not symptomatic enough to warrant correction. Patients were allowed to fully weight bear significantly earlier in the PAS/IM nail group. PAS approach and IM nailing for TTC arthrodesis may allow for quicker recovery and increased likelihood of radiographic union at the subtalar joint.
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Mace, Ryan A., James D. Doorley, Paula J. Popok e Ana-Maria Vranceanu. "Live Video Adaptations to a Mind-Body Activity Program for Chronic Pain and Cognitive Decline: Protocol for the Virtual Active Brains Study". JMIR Research Protocols 10, n. 1 (4 gennaio 2021): e25351. http://dx.doi.org/10.2196/25351.
Testo completoAbstract (sommario):
Background Chronic pain (CP) and cognitive decline (CD) are costly, challenging to treat, prevalent among older adults, and worsen each other over time. We are iteratively developing Active Brains-Fitbit (AB-F), a live video program for older adults with CP and CD that teaches mind-body skills and gradual increases in step count. AB-F has demonstrated feasibility; acceptability; and signs of improvement in emotional, physical, and cognitive functions when delivered in person to older adults. Objective We are conducting a feasibility randomized controlled trial (RCT) of AB-F versus a time- and dose-matched educational control (health enhancement program [HEP]) in older adults with CP and CD. Here, we describe virtual adaptions to our study protocol, manualized treatments, evaluation plan, and study design in response to feedback from former participants and COVID-19. We will evaluate the feasibility benchmarks and the potential of AB-F to improve physical, emotional, and cognitive functions. Methods This is a single-blind pilot RCT. Participants are randomized to AB-F or HEP. Patients are recruited through pain clinic referrals, institutional registries, and flyers. Interested participants are screened for eligibility via telephone and provide electronic informed consent. After randomization, participants are mailed all study documents, including their treatment manual, an ActiGraph accelerometer, and a Fitbit (separate envelope for AB-F only). Both conditions are manualized and delivered over 8 weekly sessions via Zoom. Participants complete self-report and performance-based (6-min walk test and Montreal Cognitive Assessment) outcome measures via Zoom at baseline and post intervention. Primary outcomes are a priori set feasibility (recruitment, quantitative measures, and adherence), acceptability, credibility, expectancy, and satisfaction benchmarks. Secondary outcomes are physical, cognitive, and emotional functions as well as intervention targets (social function, pain intensity, pain-specific coping, and mindfulness). Results The trial is ongoing. We have recruited 21 participants (10 AB-F and 11 HEP) across 2 rounds. Only 2 participants have withdrawn (1 before baseline and 1 before the first session). All 19 remaining participants have completed the baseline assessment. In the first round, attendance is high (11 out of 12 participants completed all 4 sessions so far), and AB-F participants are adherent to their Fitbit and step goals (5 out of 6 participants). Conclusions Preliminary findings are promising for the feasibility of our completely virtual AB-F intervention. However, these findings need to be confirmed at the trial conclusion. This study will answer important questions about the feasibility of delivering a completely virtual mind-body activity program to older adults with comorbid CP and CD, which, to our knowledge, is unprecedented. Details on integrating multiple digital platforms for virtual assessments and intervention delivery will inform treatment development for older adults and those with comorbid CP and CD, which is crucial during the COVID-19 pandemic. Trial Registration ClinicalTrials.gov NCT04044183; https://clinicaltrials.gov/ct2/show/NCT04044183 International Registered Report Identifier (IRRID) DERR1-10.2196/25351
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Tatekawa, Shotaro, Junya Kuroda, Yoshiaki Chinen, Yuji Shimura, Hisao Nagoshi, Tsutomu Kobayashi, Eri Kawata, Nobuhiko Uoshima, Hiroshi Handa e Masafumi Taniwaki. "The Epigenetic Repression of Mir-375 Is the Dominant Mechanism for the Constitutive Activation of PDPK1/RSK2 Signaling Axis in Multiple Myeloma". Blood 126, n. 23 (3 dicembre 2015): 4182. http://dx.doi.org/10.1182/blood.v126.23.4182.4182.
Testo completoAbstract (sommario):
Abstract [Introduction] Multiple myeloma (MM) is a cytogenetically/molecularly heterogeneous hematologic malignancy that remains mostly incurable, and the identification of a universal and relevant therapeutic target molecule is essential for the further development of therapeutic strategy. We have recently identified that 3-phosphoinositide-dependent protein kinase 1 (PDPK1), a serine threonine kinase, and its major downstream substrate RSK2, a member of the 90 kDa ribosomal S6 kinase family of serine threonine kinases, were universally active in eleven human MM-derived cell lines (HMCLs) examined regardless of the type of cytogenetic abnormality, the mutation state of RAS, RAF and FGFR3 genes and myeloma cells of approximately 90% of symptomatic patients at diagnosis. Our study also disclosed that PDPK1/RSK2 signaling axis played pivotal roles in myeloma pathophysiology by regulating series of downstream molecules, such as c-MYC, IRF4, D-type cyclins, or PLK1, while the inactivation of either PDPK1 or N-terminal domain of RSK2 resulted in the induction of apoptosis in myeloma cells which was accompanied by the activation of BH3-only proteins BIM and BAD (Shimura Y, Mol Caner Ther 2012; Chinen Y, Cancer Res 2014). Here we assessed the underlying mechanism for PDPK1 overexpression in MM. [Methods] The miR-375 expression level was analyzed by the quantitative RT-PCR in 11 HMCLs and 92 patient-derived myeloma cells isolated by CD138-positive cell sorting (normal plasma cells (N=10), MGUS (N=21), newly diagnosed MM (NDMM) (N=27), relapsed/refractory (RRMM) (N=34). The pre-miR-375 precursor molecule (miR-375 mimics), the siRNA targeted against PDPK1, or a negative control RNA-oligonucleotides was transfected into 8 cell lines by utilizing Hemagglutinating Virus of Japan (HVJ)-envelope vector. The copy number abnormality of PDPK1 gene was assessed by double-color FISH for PDPK1 gene and the centromere of chromosome 16. The methylation status of miR-375 promoter site was analyzed by methylation-specific PCR (MSP). This study was conducted in accordance with the Declaration of Helsinki and with the approval of the Institutional Review Boards. Patient-derived samples were obtained with informed consent, and normal bone marrow plasma cells were obtained from volunteers who were not affected by hematologic disease. [Result] The level of miR-375 expression was calculated with 2-ΔCt methods. Human U6 snRNA was examined as the reference. The median log102-ΔCt ± SD of normal plasma cells, MGUS, NDMM, RRMM and HMCLs were -2.46 ± 0.67, -3.64 ± 0.68, -4.23 ± 0.95, -3.92 ± 1.24 and -3.69 ± 0.29 respectively. When compared to normal plasma cells, the miR-375 expression was significantly decreased in NDMM and RRMM (p<0.01, respectively), and tended to be decreased in MGUS (p=0.083) and HMCLs (p=0.097). As the causative of miR-375 repression, our study disclosed that the promoter sites of miR-375 gene were hypermethylated in 8/8 of HMCLs when examined by MSP. The interphase FISH for PDPK1 with centromere chromosome 16 indicated the copy number of PDPK1 gene was increased in 11/11 HMCLss, however, this was never the case with patient-derived myeloma cells (0/7). Importantly, the miR-375 gene transfection resulted in the reduction of PDPK1 expression in 7 of 8 HMCLs, and it simultaneously caused the reduction of the expression levels of IGF1 receptor and JAK2, the known targets of miR-375. Furthermore, when treated with 5-Azacitidine and/or Trichostatin A, miR-375 was markedly upregulated, suggesting that the overlapping epigenetic deregulations, such as DNA hypermethylation or histone deacetylation, are involved in the silencing of miR-375. [Conclusion and Discussion] PDPK1 is activated by autophosphorylation and, therefore, its expression level is the crucial determinant for its activity, Because our study revealed the miR-375 expression as the major regulator of PDPK1 expression, it is suggested that the abnormally repressed miR-375 is the major causative for the constitutive hyperactivation of the PDPK1/RSK2 signaling axis in MM. Moreover, since the decreased miR-375 expression was observed in plasma cells of MGUS and was more pronounced in MM, miR-375 repression by epigenetic deregulation may be involved in both disease development and progression of MM. Disclosures No relevant conflicts of interest to declare.
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Huard, Matthieu, Xueqin Gao, Johnny Huard, Johnny Huard e Ping Guo. "Poster 206: TIPE2 Mitigates the Histopathology of Osteoarthritis in An Accelerate Aging Mouse Model". Orthopaedic Journal of Sports Medicine 10, n. 7_suppl5 (1 luglio 2022): 2325967121S0076. http://dx.doi.org/10.1177/2325967121s00767.
Testo completoAbstract (sommario):
Objectives: It has been reported that pain occurs after the onset of OA and is often associated with inflammatory synovial expression of tumor necrotic factor (TNFα), suggesting that TNFα is one of the main factors causing inflammation, pain and OA development in the joints (1). Inhibition of TNFα could be a potential approach to reduce inflammation in patients with OA. However, most anti-TNFα treatments in clinical trials with antibodies or inhibitors to reduce inflammation in OA have yielded conflicting results (2). It is essential to explore novel and more efficient approaches to modulate the expression of TNFα and inflammation in patients with painful OA. TNFα-induced protein 8-like 2 (TIPE2) was found to regulate the immune system’s homeostasis, and thus regulate inflammation. Zmpste24 deficient mouse (Z24-/-) is a reliable model of human Hutchinson-Gilford progeria. They are incapable of producing lamin A, an essential component of the nuclear envelope, and exhibit profound nuclear architecture abnormalities and multiple histopathological defects that phenocopy an accelerated aging process (3). Z24-/- mice are spontaneously and progressively developed OA around three months old. To investigate the role of TIPE2 on OA in this accelerated aging model, we have performed intra-articular injections of adeno-associated virus(AAV) carrying the TIPE2 gene in the knee of Z24-/- mice. Our results indicate that the overexpression of TIPE2 ameliorates osteoarthritis phenotype through the reduction of inflammation and senescent cells, suggesting that TIPE2 gene delivery may provide a novel anti-inflammatory therapy to alleviate the aging related OA in the clinic. Methods: Construction of the AAV-TIPE2 gene expression vector. Construction was performed as previously described (4). AAV production and titration. Viral production and purification of AAV2 were carried out as previously described (5). The concentration was determined using an AAV titration kit (Takara). The titer for AAV2-TIPE2 was 4.7 × 10⁁12 GCP/ml. Animals. Both male and female Z24-/- (B6.129SZmpste24tm1Sgy/Mmucd) mice at 12 weeks old were used for this study. The animal protocol was approved by the Institutional Animal Welfare Committee at the Colorado State University. TIPE2 treatment. AAV2-TIPE2 (20ul) was intra-articular injected into the right knee joint of Z24-/- mice and the same volume of PBS was injected into their left knee joint, which was used as control. At four weeks post-injection, mice were euthanized, and the knee joints were excised for decalcification, paraffin embedding, sectioning and histology analysis. Histology. H&E and Safranin O staining were performed following the manufacture protocol. The AC damage shown in the Safranin O staining images will be further evaluated using the Mankin scoring system(6). Immune staining. TNF-α and p16 immune staining was performed as the previous description(7). Immunofluorescence images were taken using a Nikon upright microscope. β-Gal staining. β-Gal staining was performed using the senescence staining kit (Cell Signaling). Statistical analysis. All values are expressed as the means ± SD. Statistical analyses were performed using Microsoft Excel software. Data were analyzed by the independent samples t-test compared between 2 groups at each time point using 2 tails. A value of P < 0.05 was considered statistically significant. Results: TIPE2 alleviates OA progression by regulating cell inflammatory responses. Since the inflammatory factor TNFα plays a key role in OA progression we first confirmed that TNFα is highly expressed in OA chondrocytes in the knee joint of Z24-/- mice at three months old (Fig.1). As we expected, TIPE2 treatment significantly decreased TNFα expression in chondrocytes of the OA knee (Fig. 1). TIPE2 treatment prevents cartilage degradation. We saw the difference in Safranin O–positive staining intensity in the AC (articular cartilage) of TIPE2 treated mice and PBS control mice. The glycosaminoglycan content (red) is degraded in the Z24-/- cartilage (PBS control), but cartilage degradation was reduced in Z24-/- mice treated with TIPE2 (Fig.2). TIPE2 treatment decreased β-Gal + senescent cells in the OA knee. OA as a whole joint disease, we observed the Z24 -/- mice chondrocytes exhibiting a variety of senescent-associated phenotypes. β-gal staining was observed in a subset of chondrocytes and subchondral bone close to the lesion sites of the OA. TIPE2 alleviates OA progression by targeting senescent cells. We observed that a significant decrease of TNFα positive cells (Fig. 1) and β-Gal positive cells (yellow arrow indicated in Fig.3, # p<0.05) by intra-articular injection of AAV TIPE2. This decrease is further confirmed by the determination of p16 expression in the Z24 -/- mice by TIPE2 treatment (Fig.3, *p<0.03). These findings suggest that TIPE2 can suppress OA progression via targeting inflammation factor TNFα in vivo. Conclusions: OA has become an emerging health challenge that occurs in older people. TNF-α is one of the main factors causing inflammation, pain and OA development in the joints. Here we first report that OA spontaneously occurred in aging joints of Z24-/- mice, and using a TNF-α antagonist, TIPE2, could attenuate OA development by decreasing inflammation through a reduction in the number of senescent cells. It has been reported that cellular senescence and the senescence-associated secretory phenotype (SASP) that drive and promote chronic inflammation in multiple age-related chronic diseases(8). Our results provide evidence that the downregulation of the inflammation factor TNF-α is capable to reduce cell senescence in this OA animal model. In conclusion, our research demonstrated a connection between TNF-α and senescence in aging caused OA. Our results indicate that TIPE2, as a TNF-α regulator, modulates inflammation can be used as a treatment for OA. [Figure: see text][Figure: see text][Figure: see text]
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Marti, Emilio, Thomas B. Lawrence e Christopher W. J. Steele. "Constructing Envelopes: How Institutional Custodians Can Tame Disruptive Algorithms". Academy of Management Journal, 8 febbraio 2024. http://dx.doi.org/10.5465/amj.2019.1343.
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