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Technological advancements fueled by the internet revolution have transformed the financial services industry's image, resulting in modifications to electronic financial services. These service changes can be seen in almost all forms of financial services, such as banking, insurance, and stock trading, which are carried out using electronic media, such as E-wallets services. The primary purpose of this study is to determine the behavior of the Millennial class for digital wallet applications in terms of perceived ease of use, perceived usefulness, trust, social influence. This study utilized a quantitative method using exploratory surveys and online questionnaires, as well as a literature and field research design. For data analysis, this research uses the Smart PLS application with the PLS-SEM approach oriented. Data was collected using non-probability sampling using a purposive sampling approach, yielding a sample size of 146 respondents for this research. This research provides information about the behavior of using digital wallet applications, which are significantly influenced by perceived ease of use, trust, and social influence. Furthermore, the Perceived Usefulness factor does not significantly impact the behavior of using digital wallet applications. These findings highlight the importance of trust as a motivator for customers when utilizing an E-Wallet application. It is preferable to expand the number of study samples in order to appropriately generalize findings, as well as to include research factors that are believed to influence behavioral intention to use. This research will look at the effects of perceived ease of use, perceived utility, trust, and social influence on Generation Millennial behavior when it comes to using digital wallets.

Fire has been an intrinsic ecological component of the ecosystems, affecting the public, economic, and socio-cultural policies of human-nature interactions. Using fire over grassland vegetation is a traditional practice for livestock in the highland grasslands and has economic and environmental consequences that have not yet been understood. A better description of the spatio-temporal biomass burning patterns is needed to analyze the effects of creation and application in these areas. This study used remote sensing techniques based on Sentinel-2 data and machine learning algorithms to identify burning scars and compare them with a national fire collection database for the highland grasslands in the Atlantic Forest Biome in Brazil. The aim is to evaluate public management tools and legislation evolution during the 35 years of the time series analyzed. The results indicated that 12,285 ha of grasslands were converted to other uses, losing about 24% of their original formation, with 10% occurring after banned this practice in 2008. The burned areas classification using the Random Forest algorithm obtained an AUC = 0.9983. Divergences in the burned area’s extent and frequency were found between the municipality’s authorized license and those classified as burned. On average, only 43% of the burned area in the Parque Estadual do Tainhas and its buffer zone had an environmental permit in the last 5 years. This research’s results provide subsidies for revising and creating public policies and consequently help territorial management.

Coral reef health in the U.S. Virgin Islands (USVI) is in decline due to land-based sources of pollution associated with watershed development and global climate change. Water quality is a good indicator of stress in these nearshore environments as it plays a key role in determining the health and distribution of coral reef communities. Conventional water quality assessment methods based on in situ measurements are both time consuming and costly, and they lack the spatial coverage and temporal resolution that can be achieved using satellite remote sensing techniques. Water quality parameters (WQPs) such as Chlorophyll a (Chl-a), can be studied remotely using models that account for the inherent optical properties (IOPs) of the water. In this study, empirical based standard ocean color algorithm (OC4) and two semi-analytical algorithms, the Garver–Siegel–Maritorena (GSM) and the Generalized Inherent Optical Properties (GIOP) model, were evaluated in retrieving Chl-a in the nearshore waters of the USVI. GSM and GIOP were also evaluated for modeling inherent optical properties such as absorption coefficient of phytoplankton (aph (443)). Analysis of the results from each model using a field database from six cruises during May/June and December between 2016 and 2018, showed that the OC4 performed poorly with R2 of 0.14 and RMSE = 0.15. Effects of suspended particulates and benthic reflectance most likely contributed to the poor performance of the algorithm. GSM is a slightly better estimator for aph (443) and Chl-a (R2 = 0.55, RMSE = 0.04; R2 = 0.60, RMSE = 0.09) than GIOP (R2 = 0.52, RMSE = 0.05; R2 = 0.17, RMSE = 0.15). Performance of the semi-analytical models are limited in estimating particulate back scattering (bbp (443)) also due to the benthic albedo effects in the shallow waters. The calibrated GSM model was applied to Landsat 8 OLI satellite imagery spanning 2016–2018 to develop a time series of the spatial changes in Chl-a concentrations in the coastal waters of the USVI. The Landsat GSM Chl-a model produced promising results of R2 = 0.45, RMSE = 0.07, in an environment where signal-to-noise ratio is significantly low.

This paper investigates whether non-primary exports directly or indirectly cause economic growth in the United Arab Emirates (UAE). This study performs the Johansen test to examine the presence of co-integration between the variables in an augmented production function. The Granger causality test is performed to investigate the short-run causality between non-primary exports and economic growth, while the long-run causality is investigated by employing the Toda and Yamamoto procedure. The empirical analysis indicates that the variables are co-integrated, and that short-run causality runs from non-primary exports to economic growth; results exhibit no evidence of direct causality from non-primary exports to economic growth in the long-run.

This paper examines the impact of an important financial reform, namely a collateral reform extending the assets, which could qualify as collateral for bank loans to the firms’ own equipment and moveable assets, so as to increase the access to such credit by small private firms. The reform studied was undertaken in the Palestinian territories of West Bank and Gaza (WBG) in the Middle East and North Africa (MENA) region where bank credit and financial markets have been especially heavily constrained. First, we apply two different synthetic control techniques to panel data covering both pre- and postreform years from both the WBG and a sample of comparable countries that did not undertake collateral reform. The results from both synthetic control methods show that such credit increased significantly after the reform in WBG but not in the nonreformed comparator countries. Then, we use comparable firm-level data obtained from a panel of all available firms in WBG from the Enterprise Survey of the World Bank, both 3 years before and 3 years after the reform to trace the impacts of the reform on various financial and other outcomes at the firm level. Despite the other difficulties that WBG was going through over the period, we find considerable evidence at the firm level that this collateral reform has been effective in stimulating credit, investment, and employment growth, especially among small firms, underscoring its potential for use by other low- and middle-income countries.

Allergen-specific immunotherapy (AIT) is currently the only treatment with potential long-term disease-modifying effects for patients suffering from allergic diseases such as allergic rhinitis, allergic asthma, venom allergy, or IgE-mediated food allergy. A better understanding of the molecular mechanisms underlying immune responses during successful AIT is of utmost importance and it may help to develop more effective and safer treatments.PubMed literature review was performed using keywords such as allergen-specific immunotherapy; regulatory T cells; regulatory B cells; regulatory innate lymphoid cells; and allergen-specific antibody from years 2018 to 2021.The proposed mechanism of long-term tolerance induction in AIT, even upon treatment discontinuation, involves basophils, mast cells, innate lymphoid cells, dendritic cells, allergen-specific regulatory T and B cells, downregulation of effector type 2 responses, decrease in the production of IgE and increase in production of allergen-specific blocking antibodies, such as IgG2 and IgG4.We summarize the most recent advances related to mechanisms involved in the restoration of healthy immune responses to allergens during AIT. Our knowledge in this regard has significantly improved over the last years, which might well contribute to design novel and improved therapeutic approaches.

Background: There is variation in care and hospital length of stay following surgical repair of ventricular septal defects. The use of clinical pathways in a variety of paediatric care settings has been shown to reduce practice variability and overall length of stay without increasing the rate of adverse events. Methods: A clinical pathway was created and used to guide care following surgical repair of ventricular septal defects. A retrospective review was done to compare patients two years prior and three years after the pathway was implemented. Results: There were 23 pre-pathway patients and 25 pathway patients. Demographic characteristics were similar between groups. Univariate analysis demonstrated a significantly shorter time to initiation of enteral intake in the pathway patients (median time to first enteral intake after cardiac ICU admission was 360 minutes in pre-pathway patients and 180 minutes in pathway patients, p < 0.01). Multivariate regression analyses demonstrated that the pathway use was independently associated with a decrease in time to first enteral intake (–203 minutes), hospital length of stay (–23.1 hours), and cardiac ICU length of stay (–20.5 hours). No adverse events were associated with the use of the pathway, including mortality, reintubation rate, acute kidney injury, increased bleeding from chest tube, or readmissions. Conclusions: The use of the clinical pathway improved time to initiation of enteral intake and decreased length of hospital stay. Surgery-specific pathways may decrease variability in care while also improving quality metrics.

Derin çekme, zımba kuvveti uygulanarak sac malzemenin kalıp boşluğuna akışıdır. Derin çekmede, düz ince tabakalar arasında sacı istenen şekle getirmek için zımba kullanılarak sacı merkez kısmından kalıp boşluğuna iterek kaplar üretilmektedir. Derin çekilmiş kaplarda kabın köşe yarıçaplarında boyun oluşumu veya çatlamaların oluşması nedeniyle daha yüksek çekme oranları elde edilememektedir. Bunun için derin çekme işleminin başarılı olmasında uygun işlem parametrelerinin doğru seçilmesi önemlidir. Bu makalede, dikdörtgen geometriye sahip kapların derin çekilmesinde matris üst yüzeyine ve pot çemberinin alt yüzeyine açılar verilerek matris geometrisinin, kap kesit incelmeleri ve hasarları üzerinde olan etkileri tespit edilmiştir. Bunun için matris üst yüzeyine/pot çemberi alt yüzeyine 0°, 3°, 6° ve 9°’lik açılar verilmiştir. Pot çemberi kuvveti sabit 1800 daN ve stampa hızı da sabit 4 mm/s olarak uygulanmıştır. Derin çekme işlemlerinde, matris/stampa arası boşluk 1.2 mm, stampa uç ve kenar radyüsleri ile matris ağız yarıçapları 6 mm alınmıştır. Çalışmada kalınlığı 1 mm olan St37 çeliği kullanılmıştır. Cidar kalınlıkları Mitutoyo LH-600E hassas lineer ölçüm cihazında 0.001 hassasiyetinde nokta temaslı olarak ölçülmüştür. Kap yükseklikleri artıkça kaplardaki cidar incelmelerinin arttığı, maksimum incelmenin kabın alt kısımlarındaki köşelerde meydana geldiği ve bu değerin 0,373 mm olduğu tespit edilmiştir. Plastik deformasyonun en çok etkilediği bölge kap alt bölgesidir. Bu bölgede deformasyon sertleşmesi nedeniyle maksimum basma ve çekme kuvvetleri oluşmakta ve dolayısıyla maksimum gerilme ve sertlik bu kısımda meydana gelmiştir. Maksimum sertlik kabın tabanının olduğu bölgede ve 61.4 HRC olarak ölçülmüştür. Minimum sertlik kap üst bölgesinde ölçülmüştür. Kabın üst ağız kısımlarına doğru sertliğin daha da düştüğü ve 43.8 HRC olduğu görülmüştür. Ortalama sertlik değeri ise 53.1 HRC olarak tespit edilmiştir. Sonuç olarak, dikdörtgen geometriye sahip kapların soğuk derin çekilmesinde, matris üst yüzeyine ve pot çemberinin alt yüzeyine açılar verilerek kalıp geometrisinin, kap cidar kalınlık değişimleri ve kap hasarları üzerinde önemli bir etkisinin olduğu tespit edilmiştir.

Introduction Multiple smart devices capable of “screening” for atrial fibrillation (AF) based on single-lead electrocardiogram (SL ECG) are presently available. Manufacturers' algorithm capabilities and accuracy for the automated detection of AF vary. Reliable artificial intelligence (AI) algorithms would be valuable to assist physicians with managing the large amount of data. We aimed to assess the clinical value of applying a smart device agnostic AI-based algorithm for the detection of AF from five different smart devices (four smartwatches, one handheld device) and compared the results to the cardiologist-interpreted 12-lead ECG in a real world cohort of patients. Methods This is a prospective, observational study enrolling patients presenting to a cardiology service at a tertiary referral center. Patients were prescribed a 12-lead ECG, followed by five consecutive smart device recordings from five different manufacturers. SL ECGs were exported as PDF files from the devices and analyzed by a deep neural network (DNN) based platform which allows automated AI assisted cardiac rhythm interpretation. Results We prospectively enrolled 157 patients (32% female, median age 66 years). AF was present in 48 patients (31%) at time of recording, as documented by the 12-lead ECG. Accuracy for the detection of AF by the DNN-based algorithm was 96.6% for the Apple Watch 6, 95.2% for the AliveCor Kardia Mobile, 96.0% for the Fitbit Sense, 95.7% for the Samsung Galaxy Watch 3 and 93.8% for the Withings Scanwatch, respectively (Figure 1, left). While diagnostic accuracy of the DNN-based algorithm was similar compared to each manufacturer's individual algorithm, the proportion of SL ECGs with a conclusive diagnosis was significantly higher for all smart devices when using the DNN-based algorithm, p Conclusion In this clinical validation, a DNN-based algorithm reported significantly more conclusive diagnoses for each smart device compared to the manufacturers' algorithms, whilst showing similarly high accuracy in the detection of AF compared to the cardiologist-interpreted standard 12-lead ECG. Given further validation, SL ECG assisted rhythm interpretation through a cross-platform AI-algorithm presents a promising clinical value for AF detection and offers a possible solution for managing the data surge for smart device-acquired ECGs. Funding Acknowledgement Type of funding sources: None.

O presente artigo descreve objetivamente e analisa o Controle Judicial de Políticas Públicas de Saúde do Idoso na perspectiva da Sustentabilidade, especialmente em tempos de Pandemia. A tarefa proposta e ora relatada segue disposta de forma a descrever sobre a situação do Idoso no Brasil: o cenário atual é projetado frente ao Direito à Saúde, com o intuito de avaliar a necessidade de Controle Judicial de Políticas Públicas de Saúde do Idoso, e especialmente sob a perspectiva da Sustentabilidade em tempos de Pandemia. Os resultados permitem concluir que a Sustentabilidade pode ser um relevante parâmetro para o Controle Judicial das Políticas Públicas de Saúde do Idoso. Assim o pode, porque considera também a sua necessária fruição coletiva em um horizonte temporal mais adequado e em plena sintonia, também, com os Objetivos do Desenvolvimento Sustentável.

Countries emerging from armed conflict face tremendous challenges in restoring peace and development. One of the most serious challenges in this regard is mobilizing adequate resources for financing the reconstruction process. In many post-conflict countries, the resort to external financing resources becomes inevitable. This paper aims to understand how conflict intensity shapes the financing modalities in the post-conflict phase. The study uses statistical inference to compare the differences in key financing resources between two groups of post-conflict developing countries with different conflict intensity. The results show that countries severely affected by the conflict rely more heavily on external financing resources compared to countries moderately affected by the conflict. In particular, foreign aid, foreign investments, and external debt were significantly higher in the severely affected countries relative to moderately affected ones. The differences in most external financing resources between the two groups become more obvious when accounting for major income categories differences. The results were robust for different levels of conflict severity.

Adverse reactions to food or food ingredients are more often perceived than objectively verifiable. However, reliable laboratory tests are often lacking. As a result, people with perceived adverse reactions to food often follow extensive elimination diets for years and unnecessarily restrict their diet, as in the case of the frequently suspected histamine intolerance. In this condition, laboratory parameters such as the determination of diamine oxidase in serum have been shown to be inconclusive. The lack of symptom reproducibility calls into question the clinical picture of adverse reactions to ingested histamine. In order to approach persons with perceived histamine intolerance and to support them in moving from blanket restrictions, which are often unnecessarily strict, to effective personalized therapeutic strategies, the present guideline of the Working Group on Food Allergy of the German Society of Allergology and Clinical Immunology (DGAKI) in cooperation with the Medical Association of German Allergists (AeDA), the Pediatric Allergology and Environmental Medicine (GPA) as well as the Swiss Society of Allergology and Immunology (SGAI) and the Austrian Society of Allergology and Immunology (ÖGAI) recommends a practicable diagnostic and therapeutic approach.

Wealthy nations must step up support for Africa and vulnerable countries in addressing past, present and future impacts of climate change The 2022 report of the Intergovernmental Panel on Climate Change (IPCC) paints a dark picture of the future of life on earth, characterised by ecosystem collapse, species extinction, and climate hazards such as heatwaves and floods.1 These are all linked to physical and mental health problems, with direct and indirect consequences of increased morbidity and mortality. To avoid these catastrophic health effects across all regions of the globe, there is broad agreement—as 231 health journals argued together in 2021—that the rise in global temperature must be limited to less than 1.5oC compared with pre-industrial levels. While the Paris Agreement of 2015 outlines a global action framework that incorporates providing climate finance to developing countries, this support has yet to materialise.2 COP27 is the fifth Conference of the Parties (COP) to be organised in Africa since its inception in 1995. Ahead of this meeting, we—as health journal editors from across the continent—call for urgent action to ensure it is the COP that finally delivers climate justice for Africa and vulnerable countries. This is essential not just for the health of those countries, but for the health of the whole world.

An important tactile function is the active detection of small-scale features, such as edges or asperities, which depends on fine hand motor control. Using a resting-state fMRI paradigm, we sought to identify the functional connectivity of the brain network engaged in mapping tactile inputs to and from regions engaged in motor preparation and planning during active touch. Human participants actively located small-scale tactile features that were rendered by a computer-controlled tactile display. To induce rapid perceptual learning, the contrast between the target and the surround was reduced whenever a criterion level of success was achieved, thereby raising the task difficulty. Multiple cortical and subcortical neural connections within a parietal-cerebellar-frontal network were identified by correlating behavioral performance with changes in functional connectivity. These cortical areas reflected perceptual, cognitive, and attention-based processes required to detect and use small-scale tactile features for hand dexterity., Neuroimage: Reports, 2 (4)

Entropy is one of the most fundamental quantities in physics. For systems with few degrees of freedom, the value of entropy provides a powerful insight into its microscopic dynamics, such as the number, degeneracy and relative energies of electronic states, the value of spin, degree of localisation and entanglement, and the emergence of exotic states such as non-Abelian anyons. As the size of a system decreases, the conventional methods for measuring entropy, based on heat capacity, quickly become infeasible due to the requirement of increasingly accurate measurements of heat. Several methods to directly measure entropy of mesoscopic quantum systems have recently been developed. These methods use electronic measurements of charge, conductance and thermocurrent, rather than heat, and have been successfully applied to a wide range of systems, from quantum dots and molecules, to quantum Hall states and twisted bilayer graphene. In this Review, we provide an overview of electronic direct entropy measurement methods, discuss their theoretical background, compare their ranges of applicability and look into the directions for their future extensions and applications., Comment: 13 pages, 3 figures

A propriedade, conforme se verá nas linhas que se seguem, se apresenta, de longa data, como um direito fundamental, indispensável ao ser humano, seja ele individualmente considerado, seja na pluralidade da família. Integra aquilo que os norte-americanos alcunharam, ainda no crepúsculo do século XVIII, como the pursuit of Happiness, “busca pela Felicidade”, o que demonstra o caráter central, fundamental e indispensável desse direito. A isso, em parte, se propõe o presente artigo, discorrer sobre a relevância do direito à propriedade, os primeiros documentos iluministas que lançaram um olhar sobre ele, sua evolução constitucional no Brasil, até a moradia ser elevada à condição de direito social.

Dengan luas konsesi sebesar 118.400 hektar dan memperkerjakan hingga lebih dari 21.694 karyawan dan mitra kerja, pengelolaan operasional dan keselamatan, kesehatan kerja, dan lingkungan (K3L) adalah hal yang harus diperhatikan. Tantangan yang harus dihadapi PT Berau Coal adalah lokasi yang tersebar di 4 (empat) wilayah operasional terpisah: Lati, Binungan, Sambarata, dan Marine. Selain itu, karyawan juga tidak memiliki banyak waktu untuk mengakses informasi, karena sebagian besar waktunya dihabiskan untuk bekerja dengan minimal waktu kerja 8 (delapan) jam perhari. Dengan latar belakang berbagai tingkat pendidikan, mulai dari SD hingga perguruan tinggi, juga menjadi tantangan tersendiri. Disamping itu, berdasarkan data, mayoritas karyawan PT Berau Coal dan mitra kerja berada pada rentang umur 24-40 tahun yang dapat dikategorikan sebagai generasi melek teknologi. PT Berau Coal telah membangun sebuah platform pembelajaran bernama SINTESIS+ (Sistem Informasi Pelatihan dan Edukasi yang Sinergis) dan SID (Single Identity System). SINTESIS+ dan SID memiliki tujuan, antara lain (1) sebagai platform pembelajaran dan informasi terkait dengan operasional dan K3L, (2) meningkatkan kapasitas dan membangun kompetensi karyawan terkait operasional dan K3L, terutama peran pengawas sebagai posisi kunci dalam program pengawasan keselamatan, (3) meningkatkan kontrol operasional terhadap kompetensi karyawan yang terkait dengan ijin masuk, ijin kerja, lisensi, serta spesialisasi, serta (4) mengintervensi perilaku untuk mewujudkan safety culture di karyawan internal dan mitra kerja. Fitur dan konten yang dimiliki SINTESIS+ saat ini adalah online learning dengan konten pembelajaran multimedia, online testing dengan hasil yang real time, sertifikat yang otomatis muncul setelah pengguna lulus dalam online testing , webinar, berita insiden dan operasional pertambangan, repositori untuk portofolio kerja, sistem registrasi event dan pelatihan, terintegrasi dengan SID terkait perekaman data dan kontrol kompetensi karyawan dari segi operasional, baik itu ijin kerja, ijin masuk, lisensi, dan spesialisasi, serta proses yang dapat meningkatkan awareness terhadap K3L secara kontinyu. Sejak peluncurannya, SINTESIS+ telah diakses oleh lebih dari 7867 karyawan, menguji pengetahuan untuk lebih dari 1024 ujian, menyelenggarakan webinar yang diikuti oleh 330 karyawan, serta menjalankan proses yang lebih efektif dan efisien, mulai dari pendaftaran hingga evaluasi. Dampak dari segi operasional atas integrasinya dengan sistem SID adalah meningkatnya compliance level terhadap pemenuhan kompetensi karyawan menjadi sebesar 98% dan proses pemantauan menjadi lebih efisien. Dengan peningkatan tersebut, selain kompetensi karyawan yang meningkat, kontrol terhadap operasional juga menjadi semakin baik, kesadaran terhadap K3L meningkat, dan dengan harapan tingkat insiden dapat menurun. Kedepannya, untuk meningkatkan akses dan safety culture , PT Berau Coal sedang membangun platform mobile apps untuk SINTESIS+. Kata kunci: keselamatan, operasional, pelatihan, platform , teknologi, kompetensi, kontrol ABSTRACT With 118.400 hectare of concession area and employed people for more than 21.694 employees within company and from business partners, Berau Coal needs to put more concern in managing operational and health, safety and environment (SHE). The challenges that need to be faced are location that scattered into 4 operational areas, limited time for employees to access information because most of time exploited for working, various educational background, and technology literacy. Berau Coal has been developed a learning platform, named SINTESIS+ and SID. The aims in development of those platforms are; (1) as a operational and HSE-themed learning platform, (2) to increase capacity and to build HSE and operational competencies, (3) to increase operational control for competencies related to entry permit, work permit, license, and specialization, and (4) to intervene employees’ behaviour to build safety culture. Features and contents that has been embedded in SINTESIS+ are online learning with multimedia materials, online testing with real time result, webinar, incident and mining operational news, repositories for employees’ portfolio, event and training registration, integrated with SID to record employees’ historical competency-related data, and sustainable process to increase HSE awareness. Since its launching, SINTESIS+ has been accessed by 7867 employees, tested for 1024 exams, conducted webinar that participated by 330 employees, and run more effective and efficient processes. Impacts from integration process with SID are the increase of compliance level for competencies to 98% and the increase of process control efficiency. With those increments, beside the employees’ competency and HSE awareness is increased, hoped to lower incident rate. In the future, to improve access to the platform, Berau Coal is willing to develop mobile apps for SINTESIS+. Keywords: safety, operational, training, platform, technology, competency, control

Este ensayo reflexiona sobre cómo la alta definición digital de nuestras pantallas es un fenómeno que conjuga con la noción de racismo simbólico a través de la construcción de experiencias placenteras de marcas audiovisuales. Ello sucede porque el HD va sujeto a estructuras neoliberales digitales que llevan a obtener ingresos y fidelidad, pero que construyen paradojas de autorregulación y estructuras racistas inmutables. La interacción de los medios, los productores y las audiencias se ampara en lo que se ha nombrado ignorancias audiovisuales, creencias falsas o ausencia de creencias reales que se condicen con prácticas antirracistas cuestionables que sitúan el problema racista en lo circunstancial, sin llegar a reconfiguraciones críticas ni estructurales.

Background Traumatic experiences tend to be preserved in altered biomarker profiles. These profiles can be traced back from cross-sectional data regarding the age of exposure. Consequently, the change across developmental stages, e.g. from childhood to adulthood, can also be reconstructed. This study introduces a backtrace procedure that is illustrated using white blood cell (WBC) counts in full / partial post-traumatic stress disorder (PTSD). The procedure was applied separately on men's and women's data to provide a replication of the analysis based on different subsamples. Methods The analysis was carried out with data from the CoLaus|PsyCoLaus study (N = 5111, 2370 men and 2741 women, age range 35-88 years). It was restricted to traumatic experiences that occurred until the age of 35, i.e., the lower age limit of the sample. The WBC counts from up to two assessments were standardized, pooled and assigned to the reported age of trauma exposure. This resulted in age series for each marker, whereas the reference values were based on subjects who did not experience any trauma exposure. The backtrace procedure ascertained the peaks and troughs of the age series and determined the best-fitting critical age range surrounding each peak or trough based on the best p-value from simple t-tests. Results In CoLaus|PsyCoLaus, 750 participants reported trauma exposure until the age of 35, and 86 (out of 329 ) men and 187 (out of 421) women thereof were coded with a full or partial PTSD. Full / partial PTSD after trauma exposure in childhood was characterized by increased WBC counts (lymphocytes, eosinophils – in women also neutrophils). This pattern was partly retained during adolescence, in men due to eosinophils counts and in women due to lymphocyte counts. For exposure in young adulthood, the deviations were in the negative direction – in men with decreased basophils, in women with decreased lymphocytes and monocytes. Conclusions Summarizing, the backtrace approach revealed WBC profiles in PTSD that were specific to particular developmental age stages. The strongest persistent upregulation of the immune system related to trauma exposure was traceable to childhood / early adolescence both in men and in women. Further research will show which biomarkers are similarly suitable for backtracing as WBC counts. As in PTSD, the backtrace approach could also be applied to identifying persistent biomarker profiles in other mental disorders, as well as autoimmune and other chronic diseases.

This paper provides short and long-run estimates of price and income elasticities of Egypt’s natural gas demand using the ARDL bounds testing approach to cointegration over the period 1983–2015. The results show that the long-run income and price elasticities, in absolute values, are greater than their counterparts in the short run. This result is due to the fact that consumers can modify their consumption habits and plans in the long run as a response to changes in the income or the price. Moreover, natural gas demand is more responsive to changes in income than changes in price in both the short and long run. Finally, the study examines the causality relationship between natural gas consumption and economic growth for the gas-consuming sectors in Egypt. The results indicate that there is no causal relationship between the two variables for the electricity, petroleum, and household sectors in the short-run. By contrast, there is a unidirectional causality running from natural gas consumption to the economic activity of the transportation sector and a unidirectional causality running from economic activity to natural gas consumption by the industry sector.

Diagnosis by biopsy is difficult in the ovary, since it is located deep in the abdomen. As a result, ovarian cancer is mostly found insidiously during exploratory laparotomy. Consequently, early diagnosis of ovarian cancer is often difficult. The likelihood of peritoneal dissemination increases with the progress of ovarian cancer. With further progression, ovarian cancer metastasizes to the omentum, retroperitoneal lymph nodes, large intestine, small intestine, diaphragm, spleen, and other organs. Ovarian cancer has been considered a tumor that has a favourable response to chemotherapy, but more effective treatments are still being explored. Tumors use their own immune escape mechanism to evade host immunity. The immune checkpoint (IC) mechanism, one of the immune escape mechanisms, is established by programmed cell death-1 (PD-1)/PDligand-1 (PD-L1) communication. It has been shown that inhibiting PD-1/PD-L1 communication in various malignancies produces antitumor effects. However, the antitumor effect of ICI monotherapy on ovarian cancer is limited in actual clinical practice. In this review, we describe a novel cancer immunotherapeutic agent that targets myeloid-derived suppressor cells (MDSCs).

Empreendimentos populares de todos os tipos perfazem uma progressiva ruptura com a subalternização da maioria do povo brasileiro, levando a uma inserção criativa na vida global, à revelia de projetos cupulistas de nação, conduzidos por pseudos demiurgos salvadores. Este ensaio pressupõe que uma reversão do processo colonial subalternizador esteja em curso, agora, autêntica e completamente, como se fora uma segunda descolonização que, em pleno século XXI, decola com vigor. Aos poucos o povo brasileiro desperta do secular coma étnico e livra-se do domínio dos paradigmas eurocêntricos e patriarcais. Suas iniciativas de buscar uma vida melhor perfazem lutas e processos ontológicos, pois permitem superar o histórico não-ser das maiorias, restabelecendo a plena humanidade de todos.

This paper documents for the first time the considerable increase of bilateral and multilateral financial institutions’ support to small- and medium-sized enterprises (SMEs) in the Middle East and North Africa (MENA), following the political unrest and civil strife across the region since 2011. Focusing upon intermediated lending, the main financing channel, it assesses the underlying economic logic and implementation of this kind of SME financing. It is found that SMEs’ contribution to economic development is insufficiently well understood and, to some extent, has been misinterpreted, which implies that development banks’ lending operations lack appropriate targeting to achieve economic and social lending objectives. A review of the academic literature on financial exclusion and development finance, moreover, concludes that the lenders’ reliance upon large, often foreign-owned, commercial banks is not likely to achieve the desired developmental impact.

In the literature, it has been common to use credit risk scores to investigate impacts of external sources of risk and political institutions on foreign investment location choice-decisions. However, only a few studies have specifically examined the relationship between importing country’s credit risk scores and exports. Side stepping the limited availability of statistics on ECAs activities in the Arab countries, this paper investigates empirically the relationship between merchandise exports and credit scores of importing countries. Based on a gravity equation augmented with the risks of default on international payments, measured by intra-country risk ratings, the principal contribution of the present research is to scrutinize the impact of commercial and political risks on merchandise trade in the Arab region. The findings suggest that in the absence of insurance contracts against the risk of defaulting payments, firms are more likely to export to countries with higher prior probabilities to secure payments. It logically follows that provisions of export credit guarantees well targeted towards reducing buyer risks are likely to boost-up exports.

Power supply in developing countries is often characterized by unreliability and inefficiency, resulting in disruption costs for operating firms. The extents of power outages in the Middle East and North Africa (MENA) region are more significant compared to other geo-economic regions. This paper examines the effects of power outages on the performance of manufacturing firms in the MENA region using a firm-level dataset derived from the World Bank’s Enterprise Surveys (WBES) database. Firm performance is represented by sales, employment, and productivity growth rates. The extents of power outages are depicted by objective measures characterizing durations and frequencies of power outages, and by perception-based measures reflecting firms’ perceived severity of power outages. The results emphasize the adverse consequences of power outages for the performance of manufacturing firms in the MENA region. They also suggest that different patterns of power outages have varying implications for firm performance, and that the effects of power outages exhibit variations with firm size.

This paper presents an empirical study of the Kuznets curve in Arab countries using a dataset from 12 Arab countries over the period between 1990 and 2015. The analysis is carried out by employing a panel data method, mainly the fixed-effect and interactive fixed-effect models, which take into account the economic integration of countries, and the frequent political, financial and social shocks. Our results show that the Kuznets curve does not characterize economic development in the Arab region and that trade, urbanization and education positively impact income inequality.

Adequate lifestyle changes significantly reduce the cardiovascular risk factors associated with prediabetes and type 2 diabetes mellitus. Therefore, healthy eating habits, regular physical activity, abstaining from using tobacco, and good sleep hygiene are recommended for managing these conditions. There is solid evidence that diets that are plant-based; low in saturated fatty acids, cholesterol, and sodium; and high in fiber, potassium, and unsaturated fatty acids are beneficial and reduce the expression of cardiovascular risk factors in these subjects. In view of the foregoing, the Mediterranean diet, the DASH diet, a low-carbohydrate diet, and a vegan-vegetarian diet are of note. Additionally, the relationship between nutrition and these metabolic pathologies is fundamental in targeting efforts to prevent weight gain, reducing excess weight in the case of individuals with overweight or obesity; and personalizing treatment to promote patient empowerment. This document is the executive summary of an updated review that includes the main recommendations for improving dietary nutritional quality in people with prediabetes or type 2 diabetes mellitus. The full review is available on the webpages of the Spanish Society of Arteriosclerosis (SEA, for its initials in Spanish), the Spanish Diabetes Society (SED, for its initials in Spanish), and the Spanish Society of Internal Medicine (SEMI, for its initials in Spanish).

This study empirically investigates the impact of bank profitability, as a complementary measure of financial development, on growth in the Arab countries between 1985 and 2016. Using a generalized method of moments (GMM) estimation to test the impact of the bank profitability on growth, this study utilises two variables in the econometric model which are return on assets and return on equity. This study reveals that both variables of bank profitability are positive and significant. This confirms that the bank profitability, beside other financial development variables, has positive impact on the growth. This study points out some important implications based on this result.

In this paper, we use a positional dominance approach to assess the desirability of eliminating food subsidies in Lebanon. The analysis is based on aggregate information from the 2004 to 2005 National Survey of Households Living Conditions. We use this aggregate information on expenditure patterns to reconstructroughestimates ofs-concentration curves and efficiency-cost ratio sets. Evidences suggest that the Lebanese government should probably find other avenues to reduce the fiscal deficit.

Can have long term negative effects on health and productivity Recent research shows that during a period of four weeks a third of doctors and nurses have worked when they should have taken sick leave, and that, on average, this nearly halves their working capacity.1 Presenteeism is the phenomenon of workers turning up to work despite medical conditions that should prevent them from attending.2 Although it has been associated with negative health effects and with loss of productivity, it is only in recent years that presenteeism has gained some focus in research.3 In July 2003 a word search for absenteeism in Web of Science produced 1262 hits, whereas presenteeism produced only 11 hits.4 The same search in May 2011 scored 3388 hits for absenteeism and 287 for presenteeism. Around 26% of healthcare workers report presenteeism in the past seven days and about 85% of general practitioners and hospital workers report being sick at work some time.5 Research has identified many risk factors for presenteeism, and much more work is needed to determine what factors are modifiable and what sort of impact successful …

We examine and test the validity of the expectation hypothesis of the term structure (EHTS) of interest rates in Saudi Arabia using the traditional single equation approach, Campbell and Shiller methodology, Error Correction Model, and monthly data over the period June 1983 to December 2014. The results of the single equation approach indicate that the test of validity of the expectation hypothesis cannot be rejected for all maturities. We also find that the validity of the EHTS of interest rates is supported through the stationarity of the term spreads between short- and long-term interest rates. Moreover, the cointegration test reveals the existence of a cointegration relationship between short- and long-term interest with ( 1 − 1 ) $\left(1-1\right)$ cointegrating vector, suggesting the validity EHTS of interest rates. Policy implications based on the empirical results suggest that the transparency of monetary policy in Saudi Arabia and the effective role of the Saudi Arabian Monetary Authority (SAMA) in conducting monetary policy increase the predictive power of market participants of future movements of short-term interest rates.

The structural transformation of countries moves them towards more sophisticated, higher-value products. Network analysis, using the Product Space Methodology (PSM), guides countries towards leading export sectors. The identification process rests on two pillars: (1) available opportunities, that is, products in the product space that the country does not yet export which are more sophisticated than its current exports; and (2) the stock of a country’s accumulated productive knowledge and the technical capabilities that, through spillovers, enable it to produce slightly more sophisticated products. The PSM points to a tradeoff between capabilities and complexity. It identifies very basic future products that match the two countries’ equally basic capabilities. Top products are simple animal products, cream and yogurt, modestly sophisticated plastics, metals and minerals such as salt and sulphur for Egypt; and slightly more sophisticated products such as containers and bobbins (plastics) and broom handles and wooden products for Tunisia, which is the more advanced of the two countries. A more interventionist approach steers the economy towards maximum sophistication, thus identifying highly complex manufactured metals, machinery, equipment, electronics and chemicals. Despite pushing for economic growth and diversification, these sectors push urban job creation and require high-skill workers, with the implication that low-skilled labour may be pushed into unemployment or into low-value informal jobs. A middle ground is a forward-looking strategy that takes sectors’ shares in world trade into account.

Depuis le debut de l’annee 20201, plus d’une centaine de revues academiques, en grande majorite issues des sciences humaines et sociales francaises, se declarent les unes « en lutte », les autres « en greve ». Prenant part au mouvement social en cours, leurs comites de redaction protestent a la fois contre le projet visant les retraites, contre la reforme de l’assurance chomage adoptee a l’automne 2019 et contre les propositions contenues dans les rapports pour la loi de programmation pluriannuelle de la recherche (LPPR)2. Par son ampleur et par sa forme – la greve et le vote de motions qui incitent les comites de redaction a sortir de leur reserve habituelle –, cette mobilisation est historiquement inedite. La dynamique collective qu’elle suscite, par-dela les disciplines, les ecoles et les conditions d’exercice de chacune des revues, temoigne du sentiment de revolte que provoquent ces reformes. Pour l’enseignement superieur et la recherche, la reforme des retraites telle qu’envisagee actuellement par le gouvernement conduira a l’accroissement general des inegalites (entre hommes et femmes, entre titulaires et precaires, etc.) et a l’appauvrissement futur de toutes et tous, fonctionnaires, contractuel·le·s ou precaires. La reforme de l’assurance chomage augmentera, elle aussi, la vulnerabilite deja difficilement supportable du tres grand nombre des travailleur·euse·s precaires sur lesquel·le·s repose massivement la vie des universites et des laboratoires : ils et elles repr

Our research is part of a technological research program in adult education conducted in reference to the "course of action" program. Using the activity-sign hypothesis of this programme, training situations are thought as opportunities to perturb/relaunch the participants’dynamics of meaning. Our contribution aims to (i) improve the conceptualization of training situations that are thought as aids to the understanding and transformation of the participants situations, and (ii) derive cross-cutting design principles that allow the enactment of these training situations in different contexts. We rely on the analysis of training programs aiming either at the management or at the overcoming of events experienced as unprecedented and critical by the individuals concerned. Depending on the case, these training programs have a "restorative" aim (resolving of impasse situations), or have a "preparatory" aim (prefiguration of crisis situations). The design principles of these training programs and their effects are analysed with the conceptual tools developed within the course-of-action, integrating two additional dimensions: fictional and event-driven. The conditions for the emergence of new meanings are described in terms of abduction, either for reparative purposes (resolution of deadlock situations) or for preparatory purposes (prefiguration of crisis situations). The contribution to course-of-action program and to research on adult education is discussed through the prism of the hypothesis of activity-sign., Notre recherche s'inscrit dans un programme de recherche technologique en formation des adultes conduit en référence au programme du « cours d'action » (Theureau, 2006, 2009, 2015). À partir de l'hypothèse d'activité-signe inscrite dans ce programme, nous concevons les formations comme des occasions de perturbation et/ou relance de la dynamique de signification des participant-es. Cette contribution a pour buts (i) de faire avancer la conceptualisation de formations conçues comme des aides aux participant-es pour la compréhension et la transformation de leur activité, et (ii) d'élaborer des principes de conception transversaux qui permettent la mise en oeuvre de ces formations dans différents contextes. Nous nous appuyons sur l'analyse de formations visant soit la gestion, soit le dépassement d'évènements vécus comme inédits et critiques par les individus concernés. Il s'agit, selon le cas, de formations ayant une visée « réparatrice » de situations vécues comme traumatisantes et/ou sclérosantes, ou ayant une visée « préparatrice » à des situations imprévues et pouvant avoir des conséquences majeures. À travers le concept d'abduction, les conditions d'émergence de nouvelles significations sont décrites, soit à des fins « réparatrices » (dénouement de situations d'impasse), soit à des fins « préparatrices » (préfiguration de situations de crise). Les principes de conception de ces formations et leurs effets sont analysés à l'aide des outils conceptuels du cours d'action, en intégrant deux dimensions supplémentaires : fictionnelle et événementielle. La contribution au programme du cours d'action et à la recherche en formation est discutée en fin d'article au prisme de l'hypothèse d'activité-signe.

Objective To compare the effectiveness of social behaviour and network therapy, a new treatment for alcohol problems, with that of the proved motivational enhancement therapy. Design Pragmatic randomised trial Setting Seven treatment sites around Birmingham, Cardiff, and Leeds. Participants. 742 clients with alcohol problems; 689 (93.0%) were interviewed at three months and 617 (83.2%) at 12 months. Interventions Social behaviour and network therapy and motivational enhancement therapy. Main outcome measures Changes in alcohol consumption, alcohol dependence, and alcohol related problems over 12 months. Results Both groups reported substantial reductions in alcohol consumption, dependence, and problems, and better mental health related quality of life over 12 months. Between groups we found only one significant difference in outcome, probably due to chance: the social network group showed significantly better physical health at three months. Non-significant differences at 12 months in the motivational group relative to the social network group included: the number of drinks consumed per drinking day had decreased by an extra 1.1 (95% confidence interval −1.0 to 3.2); scores on the Leeds dependence questionnaire had improved by an extra 0.6 (−0.7 to 2.0); scores on the alcohol problems questionnaire had improved by an extra 0.5 (−0.4 to 1.4); but the number of days abstinent from drinking had increased by 1.2% less (−4.5% to 6.9%). Conclusion The novel social behaviour and network therapy for alcohol problems did not differ significantly in effectiveness from the proved motivational enhancement therapy.

Background: Infiltrations of 18F-fluorodeoxyglucose (FDG) injections affect positron emission tomography/computed tomography (PET/CT) image quality and quantification. A device using scintillation sensors (Lucerno Dynamics, Cary, NC) provides dynamic measurements acquired during FDG uptake to identify and characterize radioactivity near the injection site prior to patient imaging. Our aim was to compare sensor measurements against dynamic PET image acquisition, our proposed reference in assessing injection quality during the uptake period. Methods: Subjects undergoing routine FDG PET/CT imaging were eligible for this Institutional Review Board approved prospective study. After providing informed consent, subjects had sensors topically placed on their arms. FDG was injected into subjects' veins directly on the PET imaging table. Dynamic images of the injection site were acquired during 45 min of the uptake period. These dynamic image acquisitions and subjects' routine standard static images were evaluated by nuclear medicine physicians for abnormal FDG accumulation near the injection site. Sensor measurements were interpreted independently by Lucerno staff. Dynamic image acquisition interpretation results were compared to the sensor measurement interpretations and to static image interpretations. Results: Twenty-four subjects were consented and enrolled. Data from 21 subjects were gathered. During dynamic image acquisition review, physicians interpreted 4 subjects with no FDG accumulation at the injection site, whereas 17 showed evidence of accumulation. In 10 of the 17 cases that showed FDG accumulation, the FDG presence at the injection site resolved completely during uptake corresponding to venous stasis, the temporary sequestration of blood from circulation. Static image interpretation agreed with dynamic images interpretation in 11/21 (52%) subjects. Sensor measurement interpretations agreed with the dynamic images interpretations in 18/21 (86%) subjects. Conclusions: Sensor measurements can be an effective way to identify and characterize infiltrations and venous stasis. Comparable to an infiltration, venous stasis may produce spurious and clinically meaningful measurement bias and possibly even scan misinterpretation. Since the quality and quantification of PET/CT studies are of clinical importance, sensor measurements acquired during the FDG uptake may prove to be a useful quality control measure to reduce infiltration rates and potentially improve patient care. Registration: Clinicaltrials.gov, Identifier: NCT03041090

With the entry into force of the Pan Arab Free Trade Area (PAFTA) in 2005, intra-Arab trade became tariff free, completing the trade liberalization process started in 1998. Making use of data covering the 1998–2012 period, we estimate the impact of PAFTA on intra-Arab trade in manufactured goods using a gravity model and applying panel data estimation techniques. Results suggest that PAFTA has increased intra-members’ trade by nearly 20 %. We also examine potential changes in the trends of Arab countries’ imports of manufactured goods from their main providers after the entry into force of PAFTA. In this respect, there is some evidence of an increase in Arab countries’ imports from Asia from 2005 onwards, in relation to the 1998–2004 period.

Extracorporeal membrane oxygenation (ECMO) is becoming increasingly utilized to manage neonates with cardiac and respiratory failure. The procedure involves extensive anticoagulation in a sick neonate with underlying disease pathology. In addition, the immature hemostatic system in the neonate adds to the complexity of titrating the necessary anticoagulation. This places the infant at greater risk for life threatening hemorrhage and thrombosis. Managing anticoagulation in these infants is extremely challenging and needs the expertise of a physician with a thorough knowledge of the intricacies of developmental hemostasis and limitations of the current laboratory techniques available to manage anticoagulation. This article provides a brief overview of the developing hemostatic system of the neonate and the challenges associated with managing anticoagulation in this vulnerable population of patients.