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The process of housing development is inseparable from labor productivity. This study aimed to determine the value of LUR (Labor Utilization Rate), workgroup productivity, and dominant factors that influence the masonry work in Griya Putri Tanjung Housing. The method used in the research was field observations for six houses by observing the effective work time, contribution work time, and ineffective work time, calculating the area of bricklaying and questionnaires to 12 workers. The questionnaires were processed with SPSS 24. The results obtained showed that the highest worker utility factor (LUR) was on day 2 of 88.89%. The Average LUR in Putri Tanjung Griya Housing is greater than 50%, so the work utility factor reaches the effective time. The highest average productivity of each workforce is on the 3rd day by a productivity value of 1.51 m 2 /hour/person. The most dominant factor was the time factor and implementation conditions (up to 82%), then the physical factor of labor (32,8%), managerial ( - 24,1%), the background of the employee (19,1%). The lowest factor was the group factor and the expertise of the workforce by a percentage of influence of -17,5%. Keywords : h ousing, l abor, b rick l aying.

Wear is an inevitable problem in abrasive belt grinding, and the material removal rate decreases with continuous wear of the abrasive belt. This indicates that the grinding control force is affected by two dynamic factors, namely the actual material removal and abrasive belt wear state. To obtain an accurate force-control model to achieve uniform material removal, a new method for online monitoring of abrasive belt material removal rates and their corresponding wear statuses is proposed herein using only the grinding sound signals. By performing material removal rate and abrasive belt wear experiments, the grinding sound signals during processing are obtained. The wear states of the abrasive belt are quantified using the newly defined gray-mean values of the topographical images of the belt into different levels. The grinding sound signals are quantitatively described via the statistical features of their sound wavelet signals. The statistical features related to material removal rates or belt wear states are selected on the basis of the Pearson correlation coefficients. The prediction models for material removal rate and wear levels of the abrasive based on the selected features are then established using the LightGBM learning algorithm. Experimental datasets are used to train and validate the established model. The test results show that the evaluation parameters of the prediction model of the material removal rate are all within 5%. Further, the accuracy of the wear levels of the abrasive belt can exceed 91%. Compared with other prediction models, the new LightGBM models exhibit superiority in terms of time factor without loss of accuracy of the model. It is thus proved that the proposed method can provide a good basis for monitoring the material removal rate and belt wear in the abrasive belt grinding process.

This study employs a mixed design to investigate the effects of time factor and clause type on ChineseEFL learners’ implicit and explicit knowledge of relative clauses. Eighty Chinese EFL learners wererandomly assigned to one of two-time factor conditions and then tested on a grammaticality judgment task as well as on a sentence combination task to elicit their implicit and explicit knowledge ofthree types of relative clauses. It was found that, the learners had more accurate performance in untimed tasks than in timed ones; this finding is consistent with some previous studies’ findings. Clausetype exerts a significant effect on Chinese EFL learners’ implicit and explicit knowledge of relativeclauses, besides time factor and clause type had interaction effects. According to these findings, thearticle deepens the study of NPAH and it is suggested that multiple timed and untimed tasks could bedesigned to measure learners’ implicit and explicit knowledge.

Purpose. The purpose of the article is to substantiate the methodological approach to forecasting the selling price of milk, which is produced and sold by agricultural producers in the Ukrainian market of raw milk. Methodology / approach. The basis of the methodological approach is the construction of models describing the change in sales prices for milk and certain types of dairy products (pasteurized milk with a fat content of up to 2.5 %, sour cream with a fat content of up to 15.0 %, soft fat cheeses) during 2017–2019 and forecasting the sale price of milk for a period of 6 months. The ARIMA model was used in the forecast, taking into account the degree of correlation between changes in the price of milk and the analyzed types of dairy products. The time factor (time lag) of one month and the share of milk in the price of the finished dairy products were also considered. Results. The forecast results allowed us to determine milk sales prices for January–June 2020. In addition, the study showed the lack of a single direction in their change during the bias period, namely – increase in milk sales price during February–January 2020 and its reduction till June 2020. The obtained forecast values of milk selling price, considering the share of milk in the selling price of finished dairy products, were adjusted according to the time lag. Originality / scientific novelty. Novelty is an algorithm for using a methodical approach to forecasting the purchase price of milk, taking into account the correlation between milk prices and prices for certain types of dairy products; time lag and the share of milk prices in the sale price of finished dairy products. Practical value / implications. Comparison of the obtained forecast data of the price with the actual prices of milk sales indicated the existence of insignificant differences between them, proving the adequacy of the proposed methodological approach to be used in forecasting of milk prices at the enterprises.

PURPOSE Melphalan flufenamide (melflufen) is a first-in-class peptide-drug conjugate that targets aminopeptidases and rapidly and selectively releases alkylating agents into tumor cells. The phase II HORIZON trial evaluated the efficacy of melflufen plus dexamethasone in relapsed and refractory multiple myeloma (RRMM), a population with an important unmet medical need. PATIENTS AND METHODS Patients with RRMM refractory to pomalidomide and/or an anti-CD38 monoclonal antibody received melflufen 40 mg intravenously on day 1 of each 28-day cycle plus once weekly oral dexamethasone at a dose of 40 mg (20 mg in patients older than 75 years). The primary end point was overall response rate (partial response or better) assessed by the investigator and confirmed by independent review. Secondary end points included duration of response, progression-free survival, overall survival, and safety. The primary analysis is complete with long-term follow-up ongoing. RESULTS Of 157 patients (median age 65 years; median five prior lines of therapy) enrolled and treated, 119 patients (76%) had triple-class–refractory disease, 55 (35%) had extramedullary disease, and 92 (59%) were refractory to previous alkylator therapy. The overall response rate was 29% in the all-treated population, with 26% in the triple-class–refractory population. In the all-treated population, median duration of response was 5.5 months, median progression-free survival was 4.2 months, and median overall survival was 11.6 months at a median follow-up of 14 months. Grade ≥ 3 treatment-emergent adverse events occurred in 96% of patients, most commonly neutropenia (79%), thrombocytopenia (76%), and anemia (43%). Pneumonia (10%) was the most common grade 3/4 nonhematologic event. Thrombocytopenia and bleeding (both grade 3/4 but fully reversible) occurred concomitantly in four patients. GI events, reported in 97 patients (62%), were predominantly grade 1/2 (93%); none were grade 4. CONCLUSION Melflufen plus dexamethasone showed clinically meaningful efficacy and a manageable safety profile in patients with heavily pretreated RRMM, including those with triple-class–refractory and extramedullary disease.

Background: To date, no prospective study has been conducted to investigate the role of socioeconomic status (SES) on clinical outcome of glioblastoma (GBM) in Italy, where there is a National Health Service that provides universal coverage regardless of the patient's economic status. Methods: We performed a prospective observational study investigating the association between SES and survival in GBM patients at our institution, a hub centre for brain cancer research and treatment. We included GBM patients who underwent medical treatment or chemo-radiation between April 2017 and December 2017. The SES was measured using the income-brackets, attributed by the Italian Ministry of Finance on the basis of the income of the fiscal family unit, referring to the previous year. Results: One hundred and six patients were included in the study. In multivariate analysis, overall survival (OS) correlated significantly with higher-income (HR = 0.623.95% CI 0.467–0.832; p = 0.001) and MGMT methylation status (HR = 0.158.95% CI 0.082–0.304; P < 0.001). When adjusted for age, performance status and extension of surgery, survival benefit remained superior for higher-income HR = 0.641 (95% CI 0.478–0.858; p = 0.003) and MGMT methylated tumours HR = 0.167 (95% CI 0.084–0.331; p < 0.001). Conclusions: SES is an important determinant of prognosis in GBM even in the Italian National Health Service, which provides universal, largely free and relatively comprehensive healthcare. Despite aspirations to achieve equality in healthcare, socioeconomic differences exist and may impact the clinical outcome.

Introduction The number of citations is considered as an indirect indicator of the merit of an article, journal or researcher, although it is not an infallible method to determine scientific quality. Our goal is to determine the characteristics of the articles most cited about pancreas and laparoscopy. Methods We performed a search of all articles published in any journal about pancreas and laparoscopy until September 2019 and selected the 100 most cited papers. We recorded number of citations, journal, year of publication, quartil, impact factor, institution, country, authors type of paper, type of surgery, topic and area. Results The top 100 citations account 10,970 citations in total. The journal with the most articles is Surgical Endoscopy and 2007 is the year with the highest number of articles in the top 100 citations. The percentage of publications from America and Europe are similar. Case series is the most frequently paper, outcomes/morbidity is the most frequently discussed topic, and distal pancreatectomy is the most frequently type of surgery. Conclusions This bibliometric study on pancreas and laparoscopy is conditioned by the time factor, since laparoscopy has arrived later at pancreatic surgery, probably due to the morbidity and mortality associated with pancreatic surgery and the need for a high specialization in this field. The literature is recent and scarce. More and better-quality studies are needed in this field.

Over time, the traffic density increases and the anti-collision capacity of the bridge decreases, the ship-bridge collision risk also changes. In order to dynamically predict the time-dependent ship-bridge collision risk, providing the basis for the design, management and maintenance of the bridge, taking Pinghai Bridge as the engineering background, introducing time factor, a dynamic ship-bridge collision risk decision method based on improved AASHTO model is proposed for the application of risk assessment during the bridge design stage and service stage. Based on AASHTO model, the time factor is introduced. In accordance with the navigation conditions in the bridge area, the annual ship traffic volume and the annual ship traffic densities are statistically counted. In accordance with the variations of the ship volume and ship traffic densities over time, the dynamic aberrance probability is calculated. The dynamic annual impact frequency is obtained by combining the above ship traffic volume, aberrance probability and geometric collision probability. In accordance with the probability of the acceptable criterion, the pier ultimate bridge strength is determined based on the design of the annual collision damage frequency. Considering the ultimate bridge strength attenuation result from concrete carbonation, steel corrosion and foundation scouring, the time-dependent annual collision damage frequency can be estimated. The method proposed in this paper can dynamically predict the collision damage probability of the bridge pier in future service times and has scientific significance and application prospect for the anti-collision design of bridges.

Introduction: The aim of this study was to assess whether antibiotic prophylaxis or therapy is sufficient for laparoscopic or vaginal prolapse surgery with mesh. Methods: This is a single-center prospective study. The study was divided into 3 groups. Protocol A: metronidazole (15 mg/kg) and piperacillin-tazobactam (2 g) 1 h before surgery and, for postoperative treatment, gentamycin (160 mg) 1 h before surgery in a single dose. Metronidazole and piperacillin-tazobactam were administered until hospital discharge. Protocol B: gentamycin and piperacillin-tazobactam in the same manner as group A. Protocol C: clindamycin (600 mg) and gentamicin (160 mg) 1 h before surgery in a single dose. Results: We included 87 consecutive patients who underwent prolapse surgery involving mesh prostheses: 57 by the laparoscopic approach and 30 by the vaginal route. Of these, 30 patients were included in protocol A, 30 in protocol B, and 27 in protocol C. There were no statistically significant differences among the 3 protocols regarding any postoperative complications, except for urinary tract infections that were more in the vaginal approach than in the laparoscopic route, in protocol A (p = 0.002). Conclusions: One-shot prophylaxis can be successfully used in prolapse surgery regardless of the surgical approach.

In this paper, we consider the dynamic k-level facility location problem, which is a generalization of the uncapacitated k-level facility location problem when considering time factor. We present a combinatorial primal-dual approximation algorithm for the problem which finds a solution within 6 times the optimum. This approximation ratio under a dynamic setting coincides with that of the simple dual ascent 6-approximation algorithm for the (static) multilevel facility location problem (Bumb, 2001) with a weak triangle inequality property.

The article studies factors that complicate the development of Russian export-oriented companies. The purpose of the current research is to create an innovative macro-logistics system to increase the traffic of export-oriented companies. The article describes an innovative algorithm for the interaction of export delivery counterparties that involves various modes of transport, foreign trade payment methods, costs and time under the Incoterms rules. Counterparties can choose any optimal delivery option. This algorithm provides export-oriented companies with an opportunity to find a balance between contract costs and benefits taking into account the time factor. An innovative logistic method has been developed for calculating delivery costs under the Incoterms rules. It accounts for bank guarantees and insurance, various modes of transport and short-term lending methods. The research results allow export-oriented companies to choose optimal delivery terms taking into account most of the key factors of the logistics strategy. The conclusions drawn can be used when implementing various export projects that solve urgent problems of optimization of logistics strategies and contribute to the entry into new markets.

The urgency of the problem of reducing delays in the execution of technological operations for the transportation of live poultry by road has been substantiated. The proposed methodology is based on a situational approach to organizing the interaction of the staff of the poultry complex, aimed at promptly adjusting the modes of their work, in order to reduce delays in loading, moving and unloading the poultry vehicle, and the time spent by the bird in its body. The methodology includes five stages associated with the formation of an electronic daily request for transportation and its coordination with the participants of the transportation process, with an automatic calculation of the parameters of resource provision of transportation, with on-line monitoring of delays at its various stages, as well as with the development of management of operational measures to reduce the arising delays. Management decisions to reduce the resulting delays are typified. The economic effect is calculated and the expediency of practical implementation of the proposed recommendations is substantiated.

The study found out the dependence of the manifestation of symptoms of chronic non-communicable diseases of the digestive system on the duration of a person’s own unit of time. It was identified that individual age points of exacerbations of chronic non-communicable diseases of the gastrointestinal tract are consistent with the duration of the individual’s own biological cycle. Method. In each patient examined by the chronometric test method the “ τ type” was determined, for which the classical method of reproducing intervals with a duration of tQ = 2, 3, 4, 5 c was used, which were set by the experimenter and reproduced by the surveyed using an electronic chronoscope with an accuracy of 0.001 c. Results. It was identified that individual age points of exacerbations of chronic non-communicable diseases of the gastrointestinal tract are consistent with the duration of the individual’s own biological cycle.

Resumen Introducción : se analizan variaciones del monitoreo intencional que realizan estudiantes universitarios sobre atributos y temporalidades del aprendizaje complejo. Objetivo: identificar relaciones estructurales entre atributos afectivos y cognitivos considerados en diferentes momentos del desempeño en dos tareas de habilidades académicas. Método : muestra intencional de 420 estudiantes de Educación Superior de México y Colombia, de ambos sexos, respondieron: a) un inventario del auto reporte sobre variaciones en atributos y momentos en dos tareas diferentes y b) dos pruebas, una de comprensión de textos y otra de habilidades matemáticas. Los modelos teóricos subyacentes al desempeño académico asumidos, fueron validados, empíricamente, mediante análisis de senderos. Resultados : altos índices de ajuste práctico en todos los modelos, lo que permite identificar influencias diferenciales dependientes de la condición temporal en la que operan los atributos, retrospectiva en lo afectivo y concurrente en lo cognitivo. Discusión : los hallazgos configuran avances teóricos sobre el impacto de la temporalidad sobre las disposiciones que el estudiante debe mostrar para actuar intencionalmente (es decir, para estar dotado de agencia), a fin de generar las transformaciones demandadas por sus metas. Estos pueden servir como marcadores eficientes para artefactos diagnósticos, tanto como para procedimientos didácticos al servicio del desarrollo de pericia. Abstract Introduction : the variations of the intentional monitoring carried out by university students on attributes and temporalities of complex learning are analyzed. Objective : to identify the structural relationships between affective and cognitive attributes considered at different times of performance in two tasks of academic skills. Method: intentional sample of 420 students of Higher Education of Mexico and Colombia, of both sexes, answered: a) an inventory of the selfreport on variations in attributes and temporal moments in two different tasks and b) two tests, one of comprehension of texts and another of mathematical skills. The theoretical models underlying the assumed academic performance were validated, empirically, through path analysis. Results : high rates of practical fit in all models, which allows identifying differential influences depending on the temporal condition in which the attributes operate, retrospective in the affective and concurrent in the cognitive. Discussion : the findings configure theoretical advances on the impact of temporality on the dispositions that students must show to act intentionally (that is, to be endowed with agency), in order to generate the transformations that their goals demand. These can serve as efficient markers for diagnostic artifacts, as well as for didactic procedures in the service of expert development.

The increase in product market share cannot be separated from the connectivity of the marketing system and media used. Marketing channels play an important role in increasing sales both in the short and long term. This study aimed to determine the role of social media in increasing the market share of MSME products in Pematangsiantar City. The research design used a literature study and field study models using a qualitative approach with a one-shot model. The research location was in 8 districts in Pematangsiantar City. The population in this study were MSME players scattered in 8 districts in Pematangsiantar City. The samples were collected using a non-probability sampling technique with purposive sampling technique, so that a total sample size of 240 respondents were obtained. Moreover, the data analysis technique used in this study was data analysis with a data reduction model that was obtained from data collection and data display. The results of this study concluded that the use of social media was very dominant in MSME players in the micro sector and Instagram was one type of social media that was often used. Furthermore, the results of the study also suggested that the time factor was the basis for MSME players using social media as a medium for promoting their products.

Aim: The study examined the effect of time on amount of voltage generated in a foot beat electricity generating system stored in a battery. Study Design: A system made of piezoelectric materials was designed such that the foot beats of dancers on a platform would cause a mechanical deformation that would lead to conversion of mechanical energy due to pressure from the foot beats to electrical energy; and can be stored in a rechargeable lead acid battery for future use. Place and Duration of Study: Awka Anambra State, Nigeria, between November 2018 and April 2020. Methodology: A sheet of plywood measuring 300 mm x 300 mm x 3 mm thick was placed on a hard wooden board of 300 mm x 300 mm x 25 mm thick where twelve piezoelectric sensors were connected in series with foam spring inserted as separators and to aid in returning after deformation. As the dancers step on the platform, multimeter was used to take the voltage and current readings, while Lead acid rechargeable battery could be connected at the output point to store energy generated in the system and or Light Emitting Diodes (LED) and Universal Serial Bus (USB) outputs. A stop clock was also used to take the time. Results: The study revealed that it would require 901 seconds for a 50kg dancer to increase a unit voltage state of charge in a battery. It also found that it would require 749 seconds for a 60 kg dancer; and 595 seconds for an 80kg dancer respectively to increase the same 1-unit voltage state of charge in a battery. The study showed that the voltage in the battery would continue to increase until the battery is fully charged at which point it is expected that there would no longer be any increase in charge in the battery irrespective of increase in the number of foot beats or time. Conclusion: The result implies that the charge in battery caused by pressure from the foot beats is subject to the maximum voltage capacity of the battery in the system. Likewise, the amount of time and number of foot beats required to add a unit voltage state of charge in a battery in the system is subject to the applied pressure from the foot beats. In view of this, the study craves for popularisation of this technology through large scale research supported by government, corporate organisations or international organisations and institutions that will support new products development in the building and construction industry as it is the case in India and other developed countries.

The paper deals with the time factor and its influ-ence on managerial decision making in organiza-tions. The technology of a set of situational factors of the company is proposed to determine the spheres of influence of the time factor on manageri-al decision making. The points of intersection of the time factor with management decisions, which are divided into internal and external by the influence exerted, are considered. Then the author refers them to accounting and regulation within operational and strategic management. The phenomenon of time discounting and its impact on management deci-sions are explained. Ways to improve the methodol-ogy of time management system for use in condi-tions of lack of time are presented. A method is pro-posed for calculating the economic efficiency of an enterprise, taking into account the time factor.

The work carried out by analyzes of the literature data on assessing the severity of acute pancreatitis and predicting its course and mortality. A comparison of traditional point scales for assessing the severity of AP was made.As a result of a comparative analysis, it was found that the most objective instrumental method for diagnosing acute pancreatitis and its complications was MSCT with the determination of the CT index of severity. Balthazar scale allows assessing the severity of the disease and forming a prognosis for the development of complications. However, computed or magnetic resonance imaging with intravenous contrast enhancement allows an accurate assessment of the severity of the disease not earlier than 72 hours and has some contraindications.Estimating and predictive systems Ranson, APACHE, Krasnorogov, Bozhenkov systems, Pugaeva and Achkasova, BISAP and HAPS allow identyfying the severity of the clinical course of acute pancreatitis, have a high sensitivity, but at the same time require significant time and resources for execution. Glasgow-Imrie, SAPS, MODS, and SOFA scales mainly calculate mortality and degree of multiple organ failure in critically ill patients; these severity assessment systems are not specific for patients with acute pancreatitis.The optimal scale for assessing the severity of AP should allow assessing the patient's condition and prognosis from the moment of admission to the outcome of the disease. The practicing surgeon will be interested in an affordable, inexpensive, easy-to-use system for determining the severity of acute pancreatitis. For surgeons, the time factor plays a key role in determining tactics, and, therefore, improves the prognosis of the disease.

Background and aims The most used indicator for the renal function is the glomerular filtration rate (GFR). Current used predictive GFR equations were calibrated on patients with chronic kidney disease. Thus, they are not very precise in healthy individuals. The estimation of skeletal muscle mass (SMM) allows the prediction of the daily urinary creatinine excretion (24hUCrE). This study proposes an equation for the estimation of GFR based on SMM (eGFRMuscle) and serum creatinine (SCr). Methods and results Four hundred sixty-six free-living men underwent a bioelectrical impedance analysis for the evaluation of SMM (kg), a blood withdrawal for the measurement of SCr (mg/dL), and a 24-h urinary collection for the assessment of 24hUCrE (g/24 h). The linear regression analysis between SMM and 24hUCrE and the measurement of SCr allowed developing a predictive equation of eGFRMuscle. The equation predicting eGFRMuscle (ml/min/1.73 m2) was SMM (kg) × 3.06/SCr (mg/dL). eGFRMuscle was statistically different from eGFR predicted by Cockroft–Gault, MDRD Study, and CKD-EPI equations (p = 0.017, p Conclusions The equation presented in this study results in age, weight, gender, and ethnicity independent because it arises directly from SMM estimation. Therefore, the proposed equation could allow evaluating the GFR also in healthy people with low, average, or high weight, and in older people, regardless of GFR and SCr levels.

A wearable sensor (WS) is a prominent technology application that senses and gathers information from a user for analyzing changes in physiological signs. Analyzing the physiological sign differences enables the better healthcare solutions. This paper introduces an unsynchronized sensor data analytics (USDA) model for the effective handling of wearable device data regardless of the time factor. Time-dependent healthcare treatments and diagnosis are the themes on which this analytics model focuses. The gathered WS data is classified depending on the time factor and data frequency of occurrence. This occurrence frequency is correlatively analyzed using the diagnosis module to identify defects and to fulfill the missing sensor data consideration. Healthcare diagnoses requiring immediate responses and timely solutions for patients/end-users rely on this model for uncompromising analysis. The vital changes in WS data and time factors are analyzed using sophisticated machine learning methods for previous diagnosis correlation and effective accuracy. Responsive healthcare solutions using unsynchronized WS data help to achieve better efficiency and reduce complications in assessing the performance of the healthcare systems.

Background and aims: Data from animals suggest that immunoglobulins G (IgG) play a mechanistic role in atherosclerosis and diabetes through endothelial dysfunction and insulin resistance. Patients with common variable immunodeficiency (CVID), who have low circulating levels of IgG and are treated with intravenous polyclonal IgG (IVIgG), may provide an ideal model to clarify whether circulating IgG modulate endothelial function and affect insulin sensitivity in humans. Methods and results: We studied 24 patients with CVID and 17 matched healthy controls (HC). Endothelial function was evaluated as flow mediated dilation (FMD) of the brachial artery at baseline and 1, 7, 14, and 21 days after IVIgG infusion in the CVID patients. We measured also plasma glucose, insulin, and calculated the HOMA-IR index. We also investigated the role of human IgG on the production of Nitric Oxide (NO) in vitro in Human Coronary Artery Endothelial Cells (HCAEC). Compared to HC, FMD of CVID patients was significantly impaired at baseline (9.4 ± 0.9 and 7.6 ± 0.6% respectively, p < 0.05) but rose above normal levels 1 and 7 days after IVIgG infusion to return at baseline at 14 and 21 days. Serum insulin concentration and HOMA-IR index dropped by 50% in CVID patients after IVIgG (p < 0.002 vs. baseline). In vitro IgG stimulated NO production in HCAEC. Conclusions: Reduced IgG levels are associated with endothelial dysfunction and IVIgG stimulates endothelial function directly while improving insulin sensitivity. The current findings may suggest an anti-atherogenic role of human IgG.

Defects of the peripheral nervous system are extremely frequent in trauma and surgeries and have high socioeconomic costs. If the direct suture of a lesion is not possible, i.e., nerve gap > 2 cm, it is necessary to use grafts. While the gold standard is the autograft, it has disadvantages related to its harvesting, with an inevitable functional deficit and further morbidity. An alternative to autografting is represented by the acellular nerve allograft (ANA), which avoids disadvantages of autograft harvesting and fresh allograft rejection. In this research, the authors intend to transfer to human nerves a novel technique, previously implemented in animal models, to decellularize nerves. The new method is based on soaking the nerve tissues in decellularizing solutions while associating ultrasounds and freeze–thaw cycles. It is performed without interrupting the sterility chain, so that the new graft may not require post-production γ-ray irradiation, which is suspected to affect the structural and functional quality of tissues. The new method is rapid, safe, and inexpensive if compared with available commercial ANAs. Histology and immunohistochemistry have been adopted to evaluate the new decellularized nerves. The study shows that the new method can be applied to human nerve samples, obtaining similar, and, sometimes better, results compared with the chosen control method, the Hudson technique.

Objectives To assess natural history and 12-month change of a series of scales and functional outcome measures in a cohort of 117 patients with primary mitochondrial myopathy (PMM). Methods Twelve months follow-up data of 117 patients with PMM were collected. We analysed the 6-min walk test (6MWT), timed up-and-go test (× 3) (3TUG), five-times sit-to-stand test (5XSST), timed water swallow test (TWST), and test of masticating and swallowing solids (TOMASS) as functional outcome measures; the Fatigue Severity Scale and West Haven-Yale Multidimensional pain inventory as patient-reported outcome measures. PMM patients were divided into three phenotypic categories: mitochondrial myopathy (MiMy) without extraocular muscles involvement, pure chronic progressive external ophthalmoplegia (PEO) and PEO&MiMy. As 6MWT is recognized to have significant test–retest variability, we calculated MCID (minimal clinically important difference) as one third of baseline 6 min walking distance (6MWD) standard deviation. Results At 12-month follow-up, 3TUG, 5XSST and FSS were stable, while TWST and the perceived pain severity (WHYMPI) worsened. 6MWD significantly increased in the entire cohort, especially in the higher percentiles and in PEO patients, while was substantially stable in the lower percentile ( Conclusions PMM patients showed a slow global decline valued by NMDAS at 12 months; 6MWT was a more reliable measurement below 408 m, substantially stable at 12 months. PEO patients had better motor performance and lower NMDAS than PEO&MiMy and MiMy also at 12 months of follow-up.

INTRODUCTION:Several scoring systems predict mortality in alcohol-associated hepatitis (AH), including the Maddrey discriminant function (mDF) and model for end-stage liver disease (MELD) score developed in the United States, Glasgow alcoholic hepatitis score in the United Kingdom, and age, bilirubin, international normalized ratio, and creatinine score in Spain. To date, no global studies have examined the utility of these scores, nor has the MELD-sodium been evaluated for outcome prediction in AH. In this study, we assessed the accuracy of different scores to predict short-term mortality in AH and investigated additional factors to improve mortality prediction.METHODS:Patients admitted to hospital with a definite or probable AH were recruited by 85 tertiary centers in 11 countries and across 3 continents. Baseline demographic and laboratory variables were obtained. The primary outcome was all-cause mortality at 28 and 90 days.RESULTS:In total, 3,101 patients were eligible for inclusion. After exclusions (n = 520), 2,581 patients were enrolled (74.4% male, median age 48 years, interquartile range 40.9-55.0 years). The median MELD score was 23.5 (interquartile range 20.5-27.8). Mortality at 28 and 90 days was 20% and 30.9%, respectively. The area under the receiver operating characteristic curve for 28-day mortality ranged from 0.776 for MELD-sodium to 0.701 for mDF, and for 90-day mortality, it ranged from 0.773 for MELD to 0.709 for mDF. The area under the receiver operating characteristic curve for mDF to predict death was significantly lower than all other scores. Age added to MELD obtained only a small improvement of AUC.DISCUSSION:These results suggest that the mDF score should no longer be used to assess AH's prognosis. The MELD score has the best performance in predicting short-term mortality. © 2021 by The American College of Gastroenterology.

ObjectivesTo analyse trajectories of retail pharmaceutical expenditures from 2010 to 2019 in Italy to investigate whether there was a switch from public to private expenditure, how the composition of private and public expenditure changed, and whether there are correlations with supply/demand variables. Answering these questions is important to assure pharmaceutical care to all citizens in a public health system where expenditure containment is the issue of pharmaceutical policies.Design and settingTime-trend analysis was carried out in the Italian National Health System (NHS), between 2010 and 2019. We considered the following: public pharmaceutical expenditure with/without direct distribution of drugs, copayments, household out-of-pocket payments for drugs reimbursable/non-reimbursable by the NHS, and for drugs without prescription requirement. Correlations were tested between expenditure items and relevant statistics (Gini coefficient, resident population demographics, ages and categories of physicians, and current expenditure on health).ResultsThe switch feared between public and private pharmaceutical expenditures was not found: private expenditure increased (average annual per cent change 1.5%; 95% CI 0.3% to 2.6%), but public spending remained stable (–1.0%; 95% CI –3.0% to 1.1%). Single items of expenditure exhibited significant pattern changes over the study period. A switch from public expenditure without direct distribution of drugs (–3.9%) to expenditure with direct distribution was found (+8.4%). Unexpected increases in household out-of-pocket payments for drugs reimbursable by the NHS (+6.1%) and in copayments (+4.9%) were shown. No notable correlations were found.ConclusionsThis study offers insights into Italian experience that can be applied to other contexts and the results provide policy-makers issues to reflect on. The findings suggest that policies of pharmaceutical-expenditure management may have multiple effects and unexpected combined effects over time that should be considered when they are designed, and suggest that health policies must be adopted with a systematic logic and a broad and unified vision.

У статті розглянуто методологію оцінювання ефективності інвестиційних проєктів з декарбонізації у нафтогазовидобувній галузі. Визначено, що в умовах сьогодення низьковуглецевий розвиток є базовою стратегією сталого розвитку будь-якої країни, що об’єднує пріоритети в сфері зміни клімату та національного економічного розвитку., The article considers the methodology for evaluating the effectiveness of investment projects for decarbonization in the oil and gas industry. It is determined that in today's conditions, low-carbon development is the basic strategy of sustainable development of any country, which combines priorities in the field of climate change and national economic development.

Long-term analyses of biodiversity data highlight a 'biodiversity conservation paradox': biological communities show substantial species turnover over the past century1,2, but changes in species richness are marginal1,3-5. Most studies, however, have focused only on the incidence of species, and have not considered changes in local abundance. Here we asked whether analysing changes in the cover of plant species could reveal previously unrecognized patterns of biodiversity change and provide insights into the underlying mechanisms. We compiled and analysed a dataset of 7,738 permanent and semi-permanent vegetation plots from Germany that were surveyed between 2 and 54 times from 1927 to 2020, in total comprising 1,794 species of vascular plants. We found that decrements in cover, averaged across all species and plots, occurred more often than increments; that the number of species that decreased in cover was higher than the number of species that increased; and that decrements were more equally distributed among losers than were gains among winners. Null model simulations confirmed that these trends do not emerge by chance, but are the consequence of species-specific negative effects of environmental changes. In the long run, these trends might result in substantial losses of species at both local and regional scales. Summarizing the changes by decade shows that the inequality in the mean change in species cover of losers and winners diverged as early as the 1960s. We conclude that changes in species cover in communities represent an important but understudied dimension of biodiversity change that should more routinely be considered in time-series analyses.

ObjectiveThe initial data of the International Study on Acute Coronary Syndromes - ST Elevation Myocardial Infarction COVID-19 showed in Europe a remarkable reduction in primary percutaneous coronary intervention procedures and higher in-hospital mortality during the initial phase of the pandemic as compared with the prepandemic period. The aim of the current study was to provide the final results of the registry, subsequently extended outside Europe with a larger inclusion period (up to June 2020) and longer follow-up (up to 30 days).MethodsThis is a retrospective multicentre registry in 109 high-volume primary percutaneous coronary intervention (PPCI) centres from Europe, Latin America, South-East Asia and North Africa, enrolling 16 674 patients with ST segment elevation myocardial infarction (STEMI) undergoing PPPCI in March/June 2019 and 2020. The main study outcomes were the incidence of PPCI, delayed treatment (ischaemia time >12 hours and door-to-balloon >30 min), in-hospital and 30-day mortality.ResultsIn 2020, during the pandemic, there was a significant reduction in PPCI as compared with 2019 (incidence rate ratio 0.843, 95% CI 0.825 to 0.861, p75 years) (p=0.015), and was not related to the peak of cases or deaths due to COVID-19. The heterogeneity among centres was high (pConclusionPercutaneous revascularisation for STEMI was significantly affected by the COVID-19 pandemic, with a 16% reduction in PPCI procedures, especially among older patients (about 20%), and longer delays to treatment, which may have contributed to the increased in-hospital and 30-day mortality during the pandemic.Trial registration numberNCT04412655.

Slovenian and Russian substantive internationalisms of different grammatical gender are compared in the present article. Five groups of internationalisms have been distinguished on the basis of the formed glossary based on the dictionaries of the two languages which includes about 450 pairs of lexemes with different gender characteristics: 1) Slovenian feminine ~ Russian masculine; 2) Slovenian masculine ~ Russian feminine; 3) Slovenian masculine ~ Russian neuter; 4) Slovenian feminine ~ Russian neuter; animated nouns constitute a separate group. The significant difference is the small number of neuter gender internationalisms in Slovenian, while there are a great number of such internationalisms in Russian; as well as the predominance of feminine gender borrowings in Slovenian. The analysis has illustrated that the internationalisms gender in both languages is determined by a common set of factors (the influence of gender of the prototype word, features of the morphological category of gender in language, lexical and semantic characteristics), which have different importance in the two languages. The influence of the prototype word gender is mainly characteristic in Slovenian, while structural and paradigmatic factors play a much larger role in Russian. The differences in the donor languages are of great importance for understanding the gender distinction of internationalisms in Slovenian and Russian. The time factor is more evident in Russian, where there is a gradual increasing importance of a paradigmatic factor in the gender determination of a number of borrowings, whereas for Slovenian, where a number of borrowings-internationalisms were formed later, the time factor does not play a big role.

O objetivo do trabalho foi investigar o efeito agudo do óleo essencial de eucalipto (OEE) nas respostas cardiovasculares de repouso e após sessão de exercício resistido isométrico (ERI). Vinte idosos, após serem submetidos a sessões experimentais com inalação de OEE ou condição controle, permaneceram em recuperação durante 60 min (Rec-60’) para depois realizaram três séries de 1 min (1 min de recuperação entre séries) no ERI, para membro superior dominante em aparelho de preensão manual, com intensidade de 30% da contração voluntária máxima (ERI-30%). Intervalos R-R (iRR) e medidas no domínio da frequência (low frequency – LF e high frequency – HF) além da pressão arterial (PA), frequência cardíaca (FC) e duplo produto (DP) foram avaliados. Não ocorreram diferenças (p>0,05) quando comparadas as sessões (OEE vs.controle) na Rec-60’ e ERI-30%. Diferenças foram encontradas no fator tempo do repouso para Rec-60’ nas variáveis FC e iRR e do repouso para ERI-30% na PA sistólica, PA diastólica e DP. A inalação do OEE não proporcionou alterações significativas nas respostas cardiovasculares e autonômicas de idosos no repouso e após sessão de ERI-30%.

Environmental pollution problems and energy-saving issues of urban tunnels have increasingly been attracting people’s attention. The paper aims at investigating a reasonable time factor for CO-based emission factors in the ventilation design of urban road tunnels. The study results show that the prediction curve of CO-based emission factor for passenger cars consists of two stages. The average reduction rates of Stage I (2004–2010) and Stage II (2010–2030) are 38% and 14% per year, respectively. The CO emission factor series of passenger cars conforms to exponential function distribution. The time factors of CO-based emission backcalculated from the measured data range from 4.9% to 12.6%, which are 2.4–6.3 times the specified value in the Chinese ventilation specification but slightly smaller than predicted ones. Based on four aspects of predicted results, back analysis results, related references, and engineering applications, it is indicated that the time factor of CO-based emission factor (2%) in the current ventilation specification is conservative. And when defining 2000 and 2010 as base years, respectively, 4% and 3% can be used as the time factors of CO-based emission factors respectively for the ventilation design of urban tunnels. This study can provide a reference for ventilation design of urban tunnels in other regions.

Aspirin is the most commonly used medication worldwide. Beside its well-known anti-inflammatory effects, a role has emerged in the prevention of cardiovascular events. However, a significant benefit has been demonstrated in secondary cardiovascular prevention only, while there is limited evidence supporting a role in primary prevention. This discrepancy might depend on the that so far, the high-risk populations that will achieve the greatest benefits yet experiencing minimal harmful side effects have not been identified. Patients with autoimmune systemic rheumatic diseases have an increased risk of cardiovascular complications compared with the general population, which makes aspirin of potential value in these subjects. Moving from general aspects of aspirin pharmacology and specific issues in general population, the aim of this study is to review the evidence about the role of low-dose aspirin in primary cardiovascular prevention in autoimmune systemic rheumatic diseases.