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Central and Eastern European (CEE) countries have recently implemented reforms to health care provider payment systems, which include changing payment methods and related systems such as contracting, management information systems, and accountability mechanisms. This study examines factors influencing provider payment reforms implemented since 2010 in Bulgaria, Croatia, Czechia, Estonia, Latvia, Lithuania, Hungary, Poland, and Romania. A four-stage mixed methods approach was used: developing a theoretical framework and data collection form using existing literature, mapping payment reforms, consulting with national health policy experts, and conducting a comparative analysis. Qualitative analysis included inductive thematic analysis and deductive approaches based on an existing health policy model, distinguishing context, content, process, and actors. We analyzed 27 payment reforms that focus mainly on hospitals and primary health care. We identified 14 major factor themes influencing those reforms. These factors primarily related to the policy process (pilot study, coordination of implementation systems, availability of funds, IT systems, training for providers, reform management) and content (availability of performance indicators, use of clinical guidelines, favorability of the payment system for providers, tariff valuation). Two factors concerned the reform context (political willingness or support, regulatory framework, and bureaucracy) and two were in the actors’ dimension (engagement of stakeholders, capacity of stakeholders). This study highlights that the content and manner of implementation (process) of a reform are crucial. Stakeholder involvement and their capacities could influence every dimension of the reform cycle. The nine countries analyzed share similarities in barriers and facilitators, suggesting the potential for cross-country learning.

The mechanisms and conditions under which urinary stones, pathological biominerals in the kidneys and bladder, are formed have not yet been fully clarified. This study aims to understand the role of the system complexity and seven different amino acids (alanine, phenylalanine, glycine, serine, cysteine, histidine, and aspartic acid) in the spontaneous precipitation of calcium oxalate. To elucidate these effects, the conditions simulating hyperoxaluria (ci(Ca2+) = 7.5 mmol dm−3 and ci(C2O42−) = 6.0 mmol dm−3) were used for the first time. In this work, systematic research on calcium oxalate precipitation was performed in three systems of different chemical complexities: (a) only calcium and oxalate ions, (b) increased ionic strength, and (c) artificial urine at two initial pHs (pHi = 5.0 and 9.0). In all the investigated systems, the dominant precipitation of calcium oxalate monohydrate (COM) was observed, except in the artificial urine system at pHi = 9.0, in which a mixture of COM and calcium oxalate dihydrate (COD) was obtained. In all the investigated systems, a significant influence of the selected amino acids on the morphology and crystal growth of COM was observed, with more pronounced changes at pHi = 9.0. Overall, polar amino acids and nonpolar phenylalanine inhibit the growth of COM, which is a more pathogenic hydrate form. The artificial urine system proved to be more relevant for the observation of effects relevant to kidney stone formation in the human body.

This paper concerns new forms of collective agency in the area of health care in Croatia from 2015 until 2018. These new forms developed in the midst of the growing privatization and commodification of health care and the simultaneous decrease in the accessibility to health care. Privatization has taken place slowly, but continuously over the last 29 years. The traditional civil society organizations in the field of health care used to be characterized by a narrow set of activities, with vertical structures, and were frequently focused on a single-disease approach and collaboration with the pharmaceutical industry. Such practices produced limited results, hence improved forms of activism emerged. In this research, we illustrate their development using the example of three case studies of collective agency. The first case study is looking at the policy analysis and the activist group started by the Organization for Workers' Initiative and Democratization (OWID); the second one focuses on the informal group of medical students called U3 formed at the Andrija Štampar School of Public Health with the aim of developing critical thinking; and the third case study considers the Karika Association, started as an attempt to rethink health care in the community. The main research methods employed included process tracing analysis and research data comparison aimed at showing the differences between the traditional and the new forms of healthcare activism, in addition to the secondary sources of information such as scientific and professional literature. The results show that the new forms of collective agency in the healthcare area include various groups of citizens not necessarily connected with a specific disease, that they have a horizontal structure and are focused on the healthcare system in general. In conclusion, they represent the beginning of a paradigmatic shift in activism from a single-disease approach towards comprehensive health care that has the potential to deal with the growing issue of commercialization, commodification and inequalities in today's healthcare systems.

This study compared different groups yearly based on the different annual quota of Physical Education (PE) classes in anthropometric parameters, physical fitness tests, and grades achievements. The study included adolescents from 14 to 18 years of age, at the Croatian Industrial School in Slavonski Brod. They were 225 participants in the 2015-2016 academic year, 213 in 2016-2017, 200 in 2017-2018, and 318 in 2017-2018. Groups were determined yearly by the different annual quota of PE classes (1 or 2 per week) in the teaching program. Anthropometric measures (body height, body weight, BMI), physical fitness tests (standing long jump, sit-ups, run for 1000 m), grade in the PE class, and the general achievement grade at the end of the school year were conducted. Data collected from the 2015-2016 until the 2018-2019 academic year. Analysis of variance (ANOVA) was used to assess the differences between groups for each school year separately. Results for sit-ups and run for 1000 m test in 2015-2016, BMI in 2018-2019, and the grade of PE class in 2017-2018 and 2018-2019 academic year indicated significant differences between groups (p

In this Special Issue, we focus on biomineralization/pathological biomineralization systems and the synthesis of bioinspired materials [...]

CaCO3 precipitation is physical-chemical basis of biomineral formation of hard tissue (shells, skeletons) in marine calcifying organisms (=biomineralization). Processes controlling biomineralization are still not fully clarified, so the study of influence of pH on basic processes of CaCO3 precipitation should contribute to better understanding of biomineralization under climate change. This paper reports on the effect of initial pH (pH0) and type of stirring (mechanical and magnetical) on spontaneous precipitation and phase composition, size and morphology of spontaneously precipitated CaCO3 formed at the identical initial supersaturation, ionic strength and a(Ca2+)/a(CO32−) ratio. The initial pH varied in a range 8.50 ≤ pH0 ≤ 10.50 and included values relevant for mimicking the conditions related to biomineralization in marine organisms. In all systems two CaCO3 polymorphs were found: calcite and/or vaterite. The increase of pH0 favoured the formation of rhombohedral calcite no matter the type of stirring. This was exclusively influenced by the systems’ pH0 (other relevant initial parameters were identical). Furthermore, increase of pH0 caused change of vaterite morphology from cauliflower-like spheroids to regular spherulites. The mechanically stirred systems produced larger calcite and vaterite particles and higher content of calcite.

Plate-like calcite crystals with expressed unstable {001} planes are interesting research model for investigations of interfacial interactions of different additive molecules, but also the crystal growth mechanisms. The aim of this study is to reproducibly prepare a significant amount of well-defined plate-like calcite crystals and to investigate the critical experimental parameters. Thus, in precipitation system c(NaHCO3) = c(CaCl2) = 0.1 mol dm−3, the influence of hydrodynamic parameters (mode of mixing of the reaction components) and a presence of lithium ions Li+ within a wide range of concentrations, 0.0 mol dm−3 < c(Li+) < 1.0 mol dm−3, have been studied. In addition, the kinetics of the solution mediated transformation of the initially formed metastable polymorph, vaterite, were followed in order to reproducibly describe the formation of stable calcite with expressed unstable morphology. The results indicate that the plate-like calcite is formed predominantly when the ultrasound irradiation is applied at c(Li+) ≥ 0.3 mol dm−3. On the other hand, when the magnetic and mechanical stirring are applied at higher Li+ concentrations, truncated rhombohedral crystals in a mixture with plate-like crystals are obtained. It was also found that the Li+ addition significantly prolonged the transformation, mainly by inhibiting the crystal growth of calcite.

It is feared that reprogramming may introduce DNA mutations. Here Bhutani et al. take three different reprogramming methods and using comparative whole genome analyses do identify nucleotide variations that are different in reprogrammed cells from the original fibroblasts, but none convey oncogenic potential.

The treatment of patients with oral cancer is complex: a multidisciplinary approach needs to be taken and maxillofacial and oral surgeons, an oncologist, a prosthodontist should be included, and a psychologist is often needed. This case report describes the prosthetic rehabilitation of a patient after surgical removal of oral cancer with obturator prosthesis. Resection cavity was located in central part of the hard palate and the condition belonged to Aramany class 3 maxillary defects. The two-step impression technique of denture bearing area and the resection cavity was performed. A primary impression- the impression of denture bearing area was made using irreversible hydrocolloid material, while the second impression – the impression of resection cavity was made using condensation silicone material and obturator prosthesis framework. The obturator prosthesis replaced lost teeth, improved oral function and esthetics at minimal costs.

Hall effect is a very popular technique and is widely used to quantify important electrical parameters such as carrier concentration, resistivity, mobility and Hall coeffi cient of different types of samples. In this paper, electrical characteristics of three ceramic samples will be analyzed using a Hall effect measurement system (Ecopia, HMS-3000), which is based on the van der Pauw method. Measured results for mobility and electrical resistivity at three temperatures (25°C, 50°C and 80°C) will be presented. Current-voltage and current-resistance dependence between terminals of four point contact of different samples will be also demonstrated.

The precondition for implementation of decentralisation in healthcare is the education and empowerment of medical professionalsand local politicians for management and decision-making. Thedecentralisation in health care has to be planned to suit the needsof regions and population (bottom-up), and not to follow the uniformmodel devised by the central government. The processes ofdecentralisation can have a negative effect on the quality of healthcare, increase prices and emphasise inequity in health. The poorlymanaged decentralisation can slow down the development andblock the changes.

Circulating cell-free (ccf) fetal DNA comprises 3-20% of all the cell-free DNA present in maternal plasma. Numerous research and clinical studies have described the analysis of ccf DNA using next generation sequencing for the detection of fetal aneuploidies with high sensitivity and specificity. We sought to extend the utility of this approach by assessing semi-automated library preparation, higher sample multiplexing during sequencing, and improved bioinformatic tools to enable a higher throughput, more efficient assay while maintaining or improving clinical performance.Whole blood (10mL) was collected from pregnant female donors and plasma separated using centrifugation. Ccf DNA was extracted using column-based methods. Libraries were prepared using an optimized semi-automated library preparation method and sequenced on an Illumina HiSeq2000 sequencer in a 12-plex format. Z-scores were calculated for affected chromosomes using a robust method after normalization and genomic segment filtering. Classification was based upon a standard normal transformed cutoff value of z = 3 for chromosome 21 and z = 3.95 for chromosomes 18 and 13.Two parallel assay development studies using a total of more than 1900 ccf DNA samples were performed to evaluate the technical feasibility of automating library preparation and increasing the sample multiplexing level. These processes were subsequently combined and a study of 1587 samples was completed to verify the stability of the process-optimized assay. Finally, an unblinded clinical evaluation of 1269 euploid and aneuploid samples utilizing this high-throughput assay coupled to improved bioinformatic procedures was performed. We were able to correctly detect all aneuploid cases with extremely low false positive rates of 0.09%,