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To assess the efficacy of a novel interim intervention technique using retrospective, blinded, professional continuous glucose monitoring system (pro CGM) with the Freestyle Libre Pro system over a 14-day single sensor wear-period.A retrospective analysis comprised of 105 consecutive adults at single centre in India with Type 2 diabetes, HbA1c 53 mmol/mol (7%), on non-insulin divabetes agents and/or insulin. The interim intervention technique included three visits over 14 days: Visit 1, sensor placed and patients asked to keep a food log while on pro-CGM; Visit 2 (within 1 week), interim assessment of pro CGM and diet or pharmacotherapy modifications made accordingly; Visit 3 at day 14, pro CGM re-evaluated to assess glycemic control. Glucose target range was set at 70-180 mg/dL. Analyses included prepost daily average glucose, time in range, time above range, and time below range.Average time for interim analysis was 5 days after pro CGM initiation. At Visit 3, daily average glucose decreased from 191.3 mg/dL at baseline to 137.4 mg/dL (p 0.001). Time in range improved from 42.2% to 80.2% (p 0.001). Time above range decreased from 52.1% to 18.3% (p 0.001), with a concurrent decrease in time below range from 5.7% to 1.5% (p 0.001). Recurrent hypoglycemia was detected in 27 (25.7%) individuals, whose average baseline time below range reduced from 21.1% to 1.9% (p 0.001).The interim intervention technique is a cost effective and efficient method for improving glucose outcomes through lifestyle and pharmacotherapy modifications and while utilizing a single pro-CGM sensor.Wockhardt Hospital, Mumbai, India. CLINICAL REGISTRATION: not applicable due to retrospective chart review study design.

Surface incident solar radiation (Rs) is important for providing essential information on climate change. Existing studies have shown that the Rs values from current reanalyses are significantly overestimated throughout China. The European Centre for Medium-Range Weather Forecasts (ECMWF) recently released the fifth generation of atmospheric reanalysis (i.e., ERA5) with a much higher spatiotemporal resolution and a major upgrade compared to its predecessor, ERA-Interim. This study is to verify whether ERA5 can improve the Rs simulation using sunshine duration–derived Rs values at ~2200 stations over China from 1979 to 2014 as reference data. Compared with the observed multiyear national mean, the Rs overestimation is reduced from 15.88 W m−2 in ERA-Interim to 10.07 W m−2 in ERA5. From 1979 to 1993, ERA-Interim (−1.99 W m−2 decade−1; p < 0.05) and ERA5 (−2.42 W m−2 decade−1; p < 0.05) estimates of Rs in China continued to decrease and the decline of the latter is closer to the observed. After 1993, they both show a strong brightening (i.e., 2.26 W m−2 decade−1 in ERA-Interim and 1.49 W m−2 decade−1 in ERA5) but observations show a nonsignificant increase by 0.30 W m−2 decade−1. Due to the improvement of total cloud cover (TCC) simulation by ERA5, its Rs trend bias induced by the TCC trend bias is smaller than that in ERA-Interim. In addition, the reason why the simulation trend in ERA5 remains biased might be that ERA5 still ignores aerosol changes on interannual or decadal time scales. Therefore, subsequent reanalysis products still need to improve their simulation of clouds, water vapor, and aerosol, especially in aerosol direct and indirect effects on Rs.

The Central Bank of Nigeria (CBN) introduced the cashless policy in 2011, which eventually took effect in 2012. The aim of the policy amongst others is to reduce the amount of physical cash circulating in the economy and encouraging more electronic-based transactions. The objective of this study is to review the CBN cashless policy in Gombe State and assess peoples’ behavior and attitudes towards the policy in the State since its inception. Questionnaires were administered on 300 bank customers across the 11 Local Government Areas (LGAs) of the State. The findings revealed that 65% of respondents do not know what the cashless policy is all about, 80% are happy with the introduction of cash-lite (Cashless) points such as Automated Teller Machines, Point of Sales, and Internet Banking etc. As an interim verdict, 25% of the respondents believe that the cashless policy is necessary, 24% believe that the CBN approach to its implementation is the best and 43% believe that the policy will succeed. The study recommends that more banks’ branches and cash-lite channels need to be established especially in other LGAs; there is also the need to consolidate in infrastructural development; and financial literacy for all.

This technical report describes a workflow to fabricate an implant overdenture via digital duplication of an interim complete removable dental prosthesis and additive manufacturing (3D printing). An edentulous patient was provided with an interim maxillary denture after implant placement. After 4 months of healing, the existing interim denture was scanned, duplicated via 3D printing, and used to make the final impression, record the maxillomandibular interocclusal relationship, and transfer the esthetic information to the definitive implant overdenture. The framework of the implant overdenture was digitally designed and manufactured using a direct metal printing (DMP) system. This digital duplication workflow facilitated the implant overdenture fabrication with favorable clinical outcomes.

The purpose of this survey was to determine removable partial denture (RPD) framework design concepts, new materials, and digital technology that are currently being taught in the predoctoral RPD curriculums in the U.S. dental schools. A questionnaire including RPD framework design concepts, materials, and digital technology was created on Qualtrics. The link to the questionnaire was distributed by email in May 2018 to U.S. dental schools. Thirty-nine of the sixty-six schools responded, yielding a response rate of 59%. Most schools are utilizing textbooks by McCracken and/or Stewart as their primary reference (90%). Only a few schools teach incisal rest (24%) and intra-coronal retainers (8%) in the clinic. The majority of schools teach three or less clasp assembly variations for distal extension RPD scenarios and utilize altered cast impression techniques only for selective patient scenarios. Half of schools currently utilize digital technology in their RPD curriculum. Although twenty-five schools (69%) indicated that implant-assisted RPD (IARPD) is being taught in the curriculum, only nineteen of them teach IARPDs in the clinic. Half of schools are utilizing non-metal clasp denture (NMCD) in their curriculum, most of these school provide this treatment as immediate/interim partials or long-term interim partials. Many U.S. dental schools are simplifying RPD design concepts and principles that are being taught. More schools are introducing new concepts and materials such as IARPD and NMCDs while incorporating digital technology in their predoctoral RPD curriculum.

On February 27, 2021, the Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) for the Janssen COVID-19 (Ad.26.COV2.S) vaccine (Janssen Biotech, Inc., a Janssen Pharmaceutical company, Johnson & Johnson; New Brunswick, New Jersey), and on February 28, 2021, the Advisory Committee on Immunization Practices (ACIP) issued interim recommendations for its use in persons aged ≥18 years (1,2). On April 13, 2021, CDC and FDA recommended a pause in the use of the Janssen COVID-19 vaccine after reports of six U.S. cases of cerebral venous sinus thrombosis (CVST) with thrombocytopenia, a rare thromboembolic syndrome, among Janssen COVID-19 vaccine recipients (3). Two emergency ACIP meetings were rapidly convened to review reported cases of thrombosis with thrombocytopenia syndrome (TTS) and to consider updated recommendations for use of the Janssen COVID-19 vaccine in the United States. On April 23, 2021, after a discussion of the benefits and risks of resuming vaccination, ACIP reaffirmed its interim recommendation for use of the Janssen COVID-19 vaccine in all persons aged ≥18 years under the FDA's EUA, which now includes a warning that rare clotting events might occur after vaccination, primarily among women aged 18-49 years. Patient and provider education about the risk for TTS with the Janssen COVID-19 vaccine, especially among women aged

This study focuses on the functioning and political significance of the figure of the cardinal protectors of the Hispanic kingdoms in Rome at the time of the reign of Felipe II and Felipe III, based on the study of the documentation of the Spanish monarchy embassy to the Holy See, which is conserved in the General Archive of Simancas and in the National Historical Archive of Spain. The work here was not only to identify the different cardinals holding the role of protectors but also to highlight the mechanisms that supported their appointment, including the interim protectors and the vice-protectors or "pro-protectors". Moreover, this work explores the political and diplomatic role that cardinal protectors played beyond their official task, as, for example, the recommendation and presentation in consistory, to the Holy See, of the candidates proposed by the monarch capable to occupy an ecclesiastical vacant and benefit in the sphere of the monarch’s royal patronage.

Bu çalışma, Gümrük Tarifeleri ve Ticaret Genel Antlaşması (GTTA) Madde XIX, Dünya Ticaret Örgütü (DTÖ) Korunma Önlemleri Anlaşması (KÖA) ve Anlaşmazlıkların Halli Prosedürü’nün (AHP) korunma önlemleri kapsamında teorik bir model kullanılarak değerlendirilmesine odaklanmaktadır. Adil bir karşılaştırma yapabilmek adına, Anlaşmazlıkların Halli Prosedürü’nün toplam süreci, korunma önlemi uygulayan ülke ile ihracatları mezkûr önlemden etkilenen diğer ülkeler arasındaki siyasi bağlar ile önceden planlanan korunma tariflerine karşı anlık hesaplanan tarifeler analiz edilmiş ve Beshkar (2009) modeline eklemeler sunulmuştur. Bu amaçla, Beshkar’ın analizini genişletmek maksadıyla, AoS kapsamında siyasi refahı en üst düzeye çıkaran teşvik uyumlu anlaşmayı bulmak için GATT, WTO ve DSP için bir model tasarımı geliştirilmiştir. Korunma tarifelerinin önceden planlananlar yerine anlık olarak belirlenmesinin bir ülke için optimal tarifeye değil, politik olarak o anda uygulanabilecek en iyi tarifeye yol açtığı bulunmuştur. Sonuç olarak, korunma önlemlerine ilişkin olarak Dünya Ticaret Örgütü prosedürlerinin taraflar için her zaman en iyi tarife seçenekleri üretemediği ortaya koyulmaktadır., This study focuses on evaluating the General Agreement on Tariffs and Trade (GATT) Article XIX, the World Trade Organization’s (WTO) Agreement on Safeguards (AoS), and the Dispute Settlement Procedure (DSP) for the safeguards by developing a theoretical model. To make a fair comparison, we analyse the timing of the DSP, the political ties between the safeguard imposing country and the countries whose exports are affected from these duties, ex-ante against interim safeguard tariffs, and we present respective extensions over the model initially developed Beshkar (2009). For this purpose, a model design is introduced for GATT, WTO, and DSP to find the incentive- compatible agreement that maximizes political welfare under the AoS, aiming to extend Beshkar’s analyses. We find that determining the safeguard tariff level at an interim step instead of ex-ante leads to the tariff that is politically the best for a country at that instant but does not necessarily lead to an optimal tariff. As a result, we reveal that WTO procedures do not always produce the best tariff options for the parties in safeguard measures.

During the activity of the Interim Treasury Committee for Polish Questions from 7 July 1945 to 31 March 1947, several thousand Polish citizens were given the opportunity to study abroad. Despite th...

Background: Squamous cell carcinoma is prevalent in middle asia due to prevalence of tobacco chewing. Management includes removal of mandibular bone along with adjacent muscles and nerves. Mandible is attached to cranium with the support of muscles. Removal of muscles results in deviation of mandible and loss of occlusion, which is necessary for functions such as chewing, swallowing and to some extent in speech. Prosthetic appliances help in restoration of position of mandible and thus restoring the function. Case Report: This is a case of 58 year old male with hemimandibulectomy due to moderately differentiated squamous cell carcinoma. Treatment Plan: Interim guiding prosthesis was planned for mandibular repositioning as the patient did not report before the surgical excision. Conclusion: a definitive management would be undertaken by using cast partial dentures after mandibular repositioning with interim prosthesis is done.

Mediation that is carried out by the mediator in a juridical manner must be carried out before the main examination of the case, and if it is not implemented it will result in the decision being null and void (Supreme Court Regulation Number 1 of 2008). Meanwhile, the legal process that originates from each family party, juridically it is an initiative of the panel of judges to implement (Law on Religious Courts), because in the existing regulations it is stated with the phrase "can", which is based on an interim decision by the panel of judges. those who examine, in fact, in practice, the role of Hakam in divorce proceedings in religious courts is no longer relevant and implemented, because his function has been replaced by a mediator as required by a Supreme Court Regulation, and the litigants tend to be determined to separate.

Introduction: At the College of Languages and Translation (COLT), the students take four speaking courses in the first four semesters of college. In each course, they take two interm tests and a final exam. Aims: The study aims to find out which speaking assessment method EFL students and instructors at COLT prefer: Face to face, or lab testing, and reasons for their preferences. Procedures: Face-to-face assessment is the most common method at COLT. The students are tested individually. Each student randomly draws one topic from a basket and engages in a conversation or interview with the teacher who asks 3-5 questions about it. The test session for all the students lasts from 8 a.m. to 1 p.m. non-stop. The second method is language lab testing used by few instructors where all the students take the test at the same time and they all answer the same set of questions in about 60 minutes. The lab test consists of several questions. The students read the printed questions, take short notes, then record their answers on an MP3 player. Results: Most students prefer lab assessment, whereas most instructors prefer face-to-face assessment. Students reported that lab test questions are comprehensive and help them improve their speaking skills better than face-to-face assessment. Testing conditions are the same. They are less anxious. They lose few marks if they miss a question. On the other hand, instructors reported that face-to-face test questions are easy and only cover part of the material. All students pass. Students are more anxious. Comparisons of students’ test score showed that lab tests are more reliable, valid and have a better discriminating power between students who have mastered and those who have not mastered the speaking skills than face-to-face tests. Recommendations for effective speaking assessment methods are given.

In Big Catch Fishing Tackle Proprietary Limited v Kemp (17281/18) 2019 ZAWCHC 20 (5 March 2019) the Western Cape Division, Cape Town had to determine whether a former director of a company continued to owe fiduciary duties to the company after he had resigned, and if so, whether he could temporarily be interdicted from competing with the company until the main action was heard in court. The court dismissed the company's application for an interim interdict. This article critically analyses the judgment in regard to the post-resignation fiduciary duties of directors. The judgment is noteworthy as it sheds light on the post-resignation fiduciary duties of directors – an area of law which is still developing in South African law. This article contends that the court incorrectly conflated the legal principles relating to the appropriation of corporate opportunities with the misuse of confidential information. It is further argued that courts should not lay down a closed list of instances when directors' fiduciary duties will continue post-resignation, as the court attempted to do in this case. It is suggested that courts should adopt a flexible and pragmatic approach in determining when a director's fiduciary duties will survive after his or her resignation.

This article presents a study on the Italian stay-behind network ‘Gladio’ based on documentary evidence from the Italian secret services made available in recent years. The aim is to re-contextuali...

The purpose of tax audits is to verify that the taxpayer complies with the norms of tax legislation. As a rule, in conditions of instability, constantly changing tax legislation, taxpayers violate the norms of the Tax Code of the Russian Federation. In this regard, as a rule, each tax audit ends with additional charges to the taxpayer of taxes, penalties and penalties, which negatively affect their financial position. At the same time, according to the Federal Tax Service of Russia, with a sharp reduction in the number of ongoing on-site tax audits, the amount of additional charges for one on-site audit increases сonstantly: in 2016 – 13.6 million rubles, in 2017 – 15.7 million rubles, 2018 – 22.2 million rubles, 2019 – 33.5 million rubles. The tax authority, by charging additional taxes and penalties to the taxpayer, is interested in collecting them. The current Tax Code of the Russian Federation makes it possible to enforce the decision by taking measures in accordance with paragraph 10 of Art. 101 of the Tax Code of the Russian Federation, the application of which in practice raises many issues. The article considers the practice of applying interim measures.

This paper seizes Ivan Illich's recurring notion of corruption to reflect on medicine's immanent spiral of maleficence. For Illich, the institutionalization of any 'good' necessarily corrupts it, and the institutionalization of health and care under the tutoring hand of medicine has produced counterproductive consequences on every plane. The paper explores the nemetic character of contemporary biomedicine - whose growth in technique has meant a corresponding growth in its capacity for corruption and harm - in an autoethnographic project that apprises and names the escalation from iatrogenic harm to iatrogenic violence that the author discovered at two UK hospitals in 2014. In January, she went to the hospital for a colonoscopy; in November, she finally left, disabled and unmade. In the interim, she suffered infection, sepsis, pneumonia, cardiac arrest, and - worst of all - a factitious psychiatrizing diagnosis embedded in spiralling loops of iatrogenic harm. By reflecting critically on this experience, interlocuting personal memory and writings with doctors' inscribed notes and insights from medical anthropology, the paper elucidates an iatrogenic spiral, showing how unknowable bodies pose an insurmountable epistemic and existential challenge to medicine's technic mandate, how medicine locates and uses an 'epistemic escape valve' in the face of such challenges, and how snowballing nosocomial harm escalates into brutality and vice. The argument, in short, is that iatrogenic violence (destructive, subjective or agentic, and intentional) is the natural endpoint of iatrogenic harm (destructive but objective or systemic, and unintentional).

With its March 2021 Interim National Security Strategic Guidance, the Biden administration set down its first markers on nuclear policy. On international nuclear diplomacy, it committed to “head of...

SARS-CoV-2, the virus that causes COVID-19, can spread rapidly in prisons and can be introduced by staff members and newly transferred incarcerated persons (1,2). On September 28, 2020, the Wisconsin Department of Health Services (DHS) contacted CDC to report a COVID-19 outbreak in a state prison (prison A). During October 6-20, a CDC team investigated the outbreak, which began with 12 cases detected from specimens collected during August 17-24 from incarcerated persons housed within the same unit, 10 of whom were transferred together on August 13 and under quarantine following prison intake procedures (intake quarantine). Potentially exposed persons within the unit began a 14-day group quarantine on August 25. However, quarantine was not restarted after quarantined persons were potentially exposed to incarcerated persons with COVID-19 who were moved to the unit. During the subsequent 8 weeks (August 14-October 22), 869 (79.4%) of 1,095 incarcerated persons and 69 (22.6%) of 305 staff members at prison A received positive test results for SARS-CoV-2. Whole genome sequencing (WGS) of specimens from 172 cases among incarcerated persons showed that all clustered in the same lineage; this finding, along with others, demonstrated that facility spread originated with the transferred cohort. To effectively implement a cohorted quarantine, which is a harm reduction strategy for correctional settings with limited space, CDC's interim guidance recommendation is to serial test cohorts, restarting the 14-day quarantine period when a new case is identified (3). Implementing more effective intake quarantine procedures and available mitigation measures, including vaccination, among incarcerated persons is important to controlling transmission in prisons. Understanding and addressing the challenges faced by correctional facilities to implement medical isolation and quarantine can help reduce and prevent outbreaks.

PURPOSE This study aimed to compare the accuracy (trueness and precision) of interim crowns fabricated using DLP (digital light processing) according to post-curing time. MATERIALS AND METHODS A virtual stone study die of the upper right first molar was created using a dental laboratory scanner. After designing interim crowns on the virtual study die and saving them as Standard Triangulated Language files, 30 interim crowns were fabricated using a DLP-type 3D printer. Additively manufactured interim crowns were post-cured using three different time conditions-10-minute post-curing interim crown (10-MPCI), 20-minute post-curing interim crown (20-MPCI), and 30-minute post-curing interim crown (30-MPCI) (n = 10 per group). The scan data of the external and intaglio surfaces were overlapped with reference crown data, and trueness was measured using the best-fit alignment method. In the external and intaglio surface groups (n = 45 per group), precision was measured using a combination formula exclusive to scan data (10C2). Significant differences in accuracy (trueness and precision) data were analyzed using the Kruskal-Wallis H test, and post hoc analysis was performed using the Mann-Whitney U test with Bonferroni correction (α=.05). RESULTS In the 10-MPCI, 20-MPCI, and 30-MPCI groups, there was a statistically significant difference in the accuracy of the external and intaglio surfaces (P

Background Involving the end-users of scientific research (patients, carers and clinicians) in setting research priorities is important to formulate research questions that truly make a difference and are in tune with the needs of patients. We therefore aimed to generate a national research agenda for Juvenile Idiopathic Arthritis (JIA) together with patients, their caregivers and healthcare professionals through conducting a nationwide survey among these stakeholders. Methods The James Lind Alliance method was used, tailored with additional focus groups held to involve younger patients. First, research questions were gathered through an online and hardcopy survey. The received questions that were in scope were summarised and a literature search was performed to verify that questions were unanswered. Questions were ranked in the interim survey, and the final top 10 was chosen during a prioritisation workshop. Results Two hundred and seventy-eight respondents submitted 604 questions, of which 519 were in scope. Of these 604 questions, 81 were generated in the focus groups with younger children. The questions were summarised into 53 summary questions. An evidence checking process verified that all questions were unanswered. A total of 303 respondents prioritised the questions in the interim survey. Focus groups with children generated a top 5 of their most important questions. Combining this top 5 with the top 10s of patients, carers, and clinicians led to a top 21. Out of these, the top 10 research priorities were chosen during a final workshop. Research into pain and fatigue, personalised treatment strategies and aetiology were ranked high in the Top 10. Conclusions Through this study, the top 10 research priorities for JIA of patients, their caregivers and clinicians were identified to inform researchers and research funders of the research topics that matter most to them. The top priority involves the treatment and mechanisms behind persisting pain and fatigue when the disease is in remission.

The understanding of coronavirus disease 2019 (COVID-19) is evolving periodically. There is also a marked increase in COVID-19 patients’ demand for the provision of COVID-19 convalescent plasma (CCP) therapy. With the review of the literature, the stage of speculation is quickly moving towards conformity, with the interim guidelines given by the Food and Drug Administration (FDA) in the United States, United Kingdom’s blood transfusion services, Saudi’s FDA, and the Indian Council for Medical Research, in addition to the European health authorities. It is prudent to address the ethical concerns that merit consideration while harvesting and utilizing CCP as a therapeutic tool in local hospital setting.

Based on Article 72 of the Indonesia Limited Company Law, companies are allowed to distribute dividends before the company closes the annual book and the General Meeting of Shareholders (GMS) by giving temporary dividends (interim). In this case, if the company suffers a loss at the closing of the annual book according to the Indonesia Limited Company Law, the shareholders must return the dividends they have received. If the shareholders do not return it, the directors and commissioners must be joint responsibility to cover company losses. Based on these reasons, the researcher examined the useful aspects of the interim dividend arrangement in Article 72 of the Indonesia Limited Company Law based on Jeremy Bentham's Utilitarianism theory and found the form of norms regarding the return of interim dividends in Indonesian legislation using Hans Kallsen's Hierarchy theory. This research is a normative study with a conceptual approach. The results of the study suggest that; Article 72 paragraphs 1 to 4 of the Indonesia Limited Company Law can benefit the public because Bentham places benefits on individual happiness on a materialistic basis and practical social goals that can balance various interests. However, paragraphs 5 and 6 discussing the return of interim dividends that have been distributed, if, at the end of the closing of the book the company suffers a loss, in terms of the principle of benefit, Bentham does not provide benefits because it cannot provide a happiness effect for many people. The form of regulation on the distribution and return of interim share dividends in Indonesia is Statutes and Bylaws (C & B). C & B are a creative dimension in the form of living law or actions taken by the community. In terms of civil law, C & B has the same position as the law but cannot apply to the public.

While an independent judiciary is considered an indispensable component of the rule of law, attacks of the domestic political power on the independence of the judicial branch are observed today in several European States. The European judges (CJUE, ECtHR) appear to be the “last soldier standing” in the defense of judicial independence and they have in no case remained indifferent. This contribution contains an analysis of the dynamic approaches that the CJEU and the ECtHR have adopted in order to reinforce the guarantees of independence that domestic judges enjoy under European Law (EU and ECHR law). An emphasis is put on the international judicial function of these Courts as protective and promoting judicial independence at the national level, arguing that both Courts assumed their role as guarantors of the common European value of the rule of law through a proactive stance, without going, however, to the extremes. Furthermore, the paper provides an examination on the fact that the European Courts have adopted measures in order to assure the effectiveness of the European guarantees of judicial independence. A particular focus is put on the protection through interim measures as a means of assuring an effective protection of the independence of national judges. Considering a comparative analysis, the issue of the ECtHR’s potential in this regard is hereby tackled, notably after the recent evolution in the case-law of the CJEU.

Zusammenfassung Der Artikel beschreibt den Umfang und die Organisation ehrenamtlicher Mitarbeit in einer Mittelstadtbibliothek sowie deren (bisherige) Veränderung durch die Coronapandemie.

We use data from the UK Household Longitudinal Study (UKHLS) to compare measures of socioeconomic inequality in psychological distress, measured by the General Health Questionnaire (GHQ), before (Waves 9 and the Interim 2019 Wave) and during the first wave of the COVID‐19 pandemic (April to July 2020). Based on a caseness measure, the prevalence of psychological distress increased from 18.5% to 27.7% between the 2019 Wave and April 2020 with some reversion to earlier levels in subsequent months. Also, there was a systematic increase in total inequality in the Likert GHQ‐12 score. However, measures of relative socioeconomic inequality have not increased. A Shapley‐Shorrocks decomposition analysis shows that during the peak of the first wave of the pandemic (April 2020) other socioeconomic factors declined in their share of socioeconomic inequality, while age and gender account for a larger share. The most notable increase is evident for younger women. The contribution of working in an industry related to the COVID‐19 response played a small role at Wave 9 and the Interim 2019 Wave, but more than tripled its share in April 2020. As the first wave of COVID‐19 progressed, the contribution of demographics declined from their peak level in April and chronic health conditions, housing conditions, and neighbourhood characteristics increased their contributions to socioeconomic inequality.

A paradigm shift in the government’s energy policy was reflected in its declaration of early closure of old nuclear plants as well as cancellation of plans for the construction of new plants. To this end, unit 1 of Kori Nuclear Power Plant was permanently shut down and is set for decommission. Based on these changes, the off-site transport of spent fuels from nuclear power plants has become a critical issue. The purpose of this study is to develop an optimized method for transportation of spent fuels from Kori Nuclear Power Plant’s units 1, 2, 3, and 4 to an assumed interim storage facility by simulating the scenarios using the Flexsim software, which is widely used in logistics and manufacturing applications. The results of the simulation suggest that the optimized transport methods may contribute to the development of delivery schedule of spent fuels in the near future. Furthermore, these methods can be applied to decommissioning plan of nuclear power plants.

Tuberculosis (TB) is a communicable systemic infectious disease with high morbidity and mortality associated with it. Resistance to medications used to treat tuberculosis has been on the rise in recent years. (multidrug-resistant tuberculosis) (MDR-TB) is a significant challenge to (TB) control around the world. An observational research was conducted in a tertiary care teaching hospital to determine the interim pharmacological and microbial results of Rifampicin resistance TB patients. Data from Santhiram Medical College and General Hospital, Nandyal, Kurnool Dist. Andhra Pradesh were obtained from Aug 2020 to Feb 2021, after receiving ethical approval from the Institutional Ethics Committee. The effects of the regimen are determined in terms of cure, finished treatment, treatment failure, number of patients moved to MDR-TB, number of patients who died in long-term MDR-TB regimen patients. Microsoft Excel 2007 was used to analyse the data. There were 82 male and 23 female out of 105 patients included in the study. Of these 75 patients were from rural areas and 40 from urban areas Using the Chi-square test and X2=12.1026, p=0.0005, which was important, the correlation between geographical spread and treatment result was determined. Out of 115 patients, 99 (86.09 percent) were cured of their disease, 06 (5.22 percent) died, 10 (8.69 percent) developed MDR-TB, and 2 (1.74 percent) were deemed medication errors. Males between the ages of 51 and 70 are more vulnerable to TB than females, according to our results. Compared to females of the same age, male patients over 40 years of age are more vulnerable to MDRTB. this was not part of the research objectives, emphasis should not be placed on this as either conclusion or recommendation.

Comprehensive participatory planning and evaluation (CPPE), a model used in community engagement research, has not been applied to patient engagement in research. We describe our methodology and interim results using CPPE in a project focused on improving research engagement of rural and distant patients and stakeholders. Specifically, we describe our development of a causal map and the subsequent use of the map to guide patient and stakeholder-driven evaluation.

In large quasilinear economies, we provide sufficient conditions to establish the nonemptiness of several versions of approximate interim cores with endogenous communication. This is done by proving nonemptiness of approximate ex post cores satisfying incentive compatibility. Our model features a finite number of agents whose information is exclusive, whom we shall term “monopolists of scarce information.” When the number of agents with exclusive information remains finite, the main argument relies on an adaptation of the small group effectiveness condition, previously proposed for games of complete information.

Non-proportional hazards (NPH) have been observed in many immuno-oncology clinical trials. Weighted log-rank tests (WLRT) with suitable weights can be used to improve the power of detecting the difference between survival curves in the presence of NPH. However, it is not easy to choose a proper WLRT in practice. A versatile max-combo test was proposed to achieve the balance of robustness and efficiency, and has received increasing attention recently. Survival trials often warrant interim analyses due to their high cost and long durations. The integration and implementation of max-combo tests in interim analyses often require extensive simulation studies. In this report, we propose a simulation-free approach for group sequential designs with the max-combo test in survival trials. The simulation results support that the proposed method can successfully control the type I error rate and offer excellent accuracy and flexibility in estimating sample sizes, with light computation burden. Notably, our method displays strong robustness towards various model misspecifications and has been implemented in an R package.

Introduction The work's relevance is related to the health system's challenges associated with the pandemic of new coronavirus infection The study aims to explore the experience of organizing the response to the COVID-19 epidemic by the medical service of JSC "Russian Railways" in March-August 2020 Materials and methods We used the statistical reporting materials of the Ministry of Health of the Russian Federation and JSC "Russian Railways" to analyze the availability of bed fund and medical personnel The official information of стопкоронавирус рф website of the Russian Federation is used to analyze the incidence of COVID-19 in the Russian Federation and in the world To analyze the morbidity of JSC "Russian Railways", we used data from daily monitoring conducted by the company Results The incidence of COVID-19 among health care workers in the pre-trip examination rooms of the holding was lower than in the whole of the Russian Federation The bed fund of JSC "Russian Railways" in terms of 10 thousand people corresponds to the Russian average The indicators of availability of medical personnel are higher than in the Russian Federation During the "first wave" of the epidemic, 4 hospitals of Russian Railways were redesigned to provide medical care to patients with COVID-19 Two thousand one hundred twenty medical workers were involved A total of 3 6 thousand patients with COVID-19 were treated According to the treatment regimens described in the interim guidelines, the early start of therapy allowed to prevent the development of severe forms and minimize mortality Russian railways medical institutions participated in the fight against the epidemic in 19 regions of the Russian Federation 20 PCR laboratories were opened Conclusions The activities of Russian railways medical institutions were adequately reformed, which allowed not only to prevent the spread of a new coronavirus infection among the holding's employees © 2021 Common Ground Research Networks All rights reserved

The positron emission tomography (PET) could predict the prognosis of DLBCL patients, but the exact procedure on interim PET (iPET) to determine chemoresistant patients remains elusive.We retrospectively analyzed 593 newly diagnosed DLBCL patients uniformly treated with R-CHOP regimen. Among them, 352 patients diagnosed from August 2010 to December 2016 were included in the test cohort and 241 patients diagnosed from January 2017 to December 2019 were included in the validation cohort. The iPET was evaluated with Deauville criteria and ΔSUVmax method. The reduction of maximal SUV between baseline and after 4 cycles of chemotherapy were defined as ΔSUVmax. The survival functions were depicted using the Kaplan-Meier method and compared with the log-rank test.Patients with iPET Deauville 4 had heterogeneous outcome and end of treatment complete response rates (eCRR). Combined Deauville with ΔSUVmax method, we proposed a modified-Deauville model: patients with Deauville 4 and ΔSUVmax70%, as well as those with Deauville 1-3, were reclassified into the modified-Deauville negative group, while patients with Deauville 4 and ΔSUVmax ≤ 70%, as well as those with Deauville 5, into the modified-Deauville positive group. In the test cohort, 3-year PFS, OS and eCRR of modified-Deauville negative group were 80.2%, 89.9% and 91.8%, significantly higher than those of positive group (12.5%, 27.3% and 29.2%,The modified-Deauville model could better distinguish DLBCL patients with poor response to chemotherapy. Accordingly, these patients could be recognized early and provided with alternative therapeutic agents, which might improve the clinical outcome of refractory DLBCL patients.

Purpose of Review Five years have passed since the World Health Organization released its Global Technical Strategy for Malaria (GTS). In that time, progress against malaria has plateaued. This review focuses on the implications of antimalarial drug resistance for the GTS and how interim progress in parasite genomics and antimalarial pharmacology offer a bulwark against it. Recent Findings For the first time, drug resistance–conferring genes have been identified and validated before their global expansion in malaria parasite populations. More efficient methods for their detection and elaboration have been developed, although low-density infections and polyclonality remain a nuisance to be solved. Clinical trials of alternative regimens for multidrug-resistant malaria have delivered promising results. New agents continue down the development pipeline, while a nascent infrastructure in sub-Saharan Africa for conducting phase I trials and trials of transmission-blocking agents has come to fruition after years of preparation. Summary These and other developments can help inform the GTS as the world looks ahead to the next two decades of its implementation. To remain ahead of the threat that drug resistance poses, wider application of genomic-based surveillance and optimization of existing and forthcoming antimalarial drugs are essential.

Ensuring the thermal stability of heat-generating nuclear waste glass canisters in interim storage and the thermal stability of bentonite in the deep geological repository are crucial to preserving...

Adaptive enrichment designs for clinical trials may include rules that use interim data to identify treatment-sensitive patient subgroups, select or compare treatments, or change entry criteria. A common setting is a trial to compare a new biologically targeted agent to standard therapy. An enrichment design's structure depends on its goals, how it accounts for patient heterogeneity and treatment effects, and practical constraints. This article first covers basic concepts, including treatment-biomarker interaction, precision medicine, selection bias, and sequentially adaptive decision making, and briefly describes some different types of enrichment. Numerical illustrations are provided for qualitatively different cases involving treatment-biomarker interactions. Reviews are given of adaptive signature designs; a Bayesian design that uses a random partition to identify treatment-sensitive biomarker subgroups and assign treatments; and designs that enrich superior treatment sample sizes overall or within subgroups, make subgroup-specific decisions, or include outcome-adaptive randomization.

Background/Aim In clinical trials, there is potential for bias from unblinded observers that may influence ascertainment of outcomes. This issue arose in the Strategies to Reduce Injuries and Develop Confidence in Elders trial, a cluster randomized trial to test a multicomponent intervention versus enhanced usual care (control) to prevent serious fall injuries, originally defined as a fall injury leading to medical attention. An unblinded nurse falls care manager administered the intervention, while the usual care arm did not involve contact with a falls care manager. Thus, there was an opportunity for falls care managers to refer participants reporting falls to seek medical attention. Since this type of observer bias could not occur in the usual care arm, there was potential for additional falls to be reported in the intervention arm, leading to dilution of the intervention effect and a reduction in study power. We describe the clinical basis for ascertainment bias, the statistical approach used to assess it, and its effect on study power. Methods The prespecified interim monitoring plan included a decision algorithm for assessing ascertainment bias and adapting (revising) the primary outcome definition, if necessary. The original definition categorized serious fall injuries requiring medical attention into Type 1 (fracture other than thoracic/lumbar vertebral, joint dislocation, cut requiring closure) and Type 2 (head injury, sprain or strain, bruising or swelling, other). The revised definition, proposed by the monitoring plan, excluded Type 2 injuries that did not necessarily require an overnight hospitalization since these would be most subject to bias. These injuries were categorized into those with (Type 2b) and without (Type 2c) medical attention. The remaining Type 2a injuries required medical attention and an overnight hospitalization. We used the ratio of 2b/(2b + 2c) in intervention versus control as a measure of ascertainment bias; ratios > 1 indicated the likelihood of falls care manager bias. We determined the effect of ascertainment bias on study power for the revised (Types 1 and 2a) versus original definition (Types 1, 2a, and 2b). Results The estimate of ascertainment bias was 1.14 (95% confidence interval: 0.98, 1.30), providing evidence of the likelihood of falls care manager bias. We estimated that this bias diluted the hazard ratio from the hypothesized 0.80 to 0.86 and reduced power to under 80% for the original primary outcome definition. In contrast, adapting the revised definition maintained study power at nearly 90%. Conclusion There was evidence of ascertainment bias in the Strategies to Reduce Injuries and Develop Confidence in Elders trial. The decision to adapt the primary outcome definition reduced the likelihood of this bias while preserving the intervention effect and study power.

For people experiencing homelessness, COVID-19 underscores existing health and social inequities, introduces additional threats to health and safety, and calls for rapid and creative solutions to reduce risk. This column focuses on the particular challenges of two frequently intersecting subpopulations of individuals experiencing homelessness: pregnant women and survivors of domestic violence. The authors describe rapid efforts and cross-agency collaboration in Los Angeles-home to the nation's largest number of unsheltered individuals-to provide these groups with safe interim housing in the context of COVID-19. The authors discuss gaps in care and recommendations for the future, calling attention to the unique mental health and social needs of these highly vulnerable women.

This report highlights a selection of the most important UK patent decisions from 2020, including: two Supreme Court judgments (one concerning insufficiency and one concerning FRAND); two Court of Appeal judgments (considering SPC fees and Arrow declarations); and four High Court judgments (regarding the Crown use exception, injunctions and the public interest, the treatment of experts in patents trials and technical primers, and interim injunctions).

This project involved the implementation of a simulation session followed by interviews to assess and improve foundation interim year 1 (FiY1) preparedness. The session focused on the interpretation of investigations, clinical examinations, the implementation of management plans and appropriate escalation. Preparedness was measured quantitatively using Likert-type scales and qualitatively using interviews. Following the simulation, there was a significant increase in median preparedness for giving treatment (3 vs 4; p=0.04), paperwork (2 vs 4; p=0.03) and independent, responsible working (3 vs 4.5; p=0.03), before and after, respectively. Following the FiY1 period, participants demonstrated significant improvement in median preparedness for giving treatment (3 vs 4.5; p=0.01), paperwork (2 vs 5; p=0.01), independent, responsible working (3 vs 4.5; p=0.02), and communication and teamworking (4 vs 5; p=0.01), before and after, respectively. This simulation and the FiY1 period increased preparedness. This study suggests that future medical apprenticeships should provide the same opportunities and responsibilities as the FiY1 programme.

One of a handful of texts written by Sarah Kofman in the interim between the publication of her Explosion (1992, 1993), a 700-page analysis of Ecce Homo, and her sudden death in 1994, ‘And Yet It Quakes!’ is an unflinching contribution to her perennial analysis of Nietzsche's legacy. The essay opens with a presentation of the responses of Voltaire and Nietzsche to natural catastrophe: an earthquake in Lisbon in the case of the former, an earthquake in Ischia for the latter. Drawing on a metaphoric architecture of quaking or shakenness to draw together a variety of themes and problematics, the essay elaborates a rich comparative study of these two thinkers on the basis of their hasty passing-on from the ‘“humanitarian” considerations’ which such catastrophes might evoke. After analysing the influence of Voltaire on Nietzsche and the rich synergies between the two, with particular reference to irony and laughter, to aristocratism, and to the function of a polemical hostility to Rousseau within their various projects, Kofman's essay closes with a complex — and somewhat ambivalent — affirmation of the radicality of the Nietzschean project. (This text, first published in Furor shortly before Kofman's death, is collected in the posthumous Imposture de la beauté et autres textes (Galilée, 1995) and in Tributs à Voltaire (Furor, 2017). The ayant-droit is favourable to publication.)

In this paper, we show that the right to determine the sequence of moves in a dynamic team tournament improves the chances of winning the contest. Because studying dynamic team tournaments – like R&D races – with interim feedback is difficult with company data, we examine decisions of highly paid professionals in soccer penalty shootouts and show that teams whose captains can decide about the shooting sequence are more likely to win the shootout. So, managerial decisions matter for outcomes of dynamic tournaments and we discuss potential reasons for this finding.

BACKGROUND Patients undergoing a 2-stage revision for periprosthetic joint infection (PJI) often require a repeat spacer in the interim due to persistent infection. This study aims to report outcomes for patients with repeat spacer exchange and to identify risk factors associated with interim spacer exchange in 2-stage revision arthroplasty. METHODS A total of 256 consecutive 2-stage revisions for chronic infection of total hip arthroplasty and total knee arthroplasty with reimplantation and minimum 2-year follow-up were investigated. An interim spacer exchange was performed in 49 patients (exchange cohort), and these patients were propensity score matched to 196 patients (nonexchange cohort). Multivariate analysis was performed to analyze risk factors for failure of interim spacer exchange. RESULTS Patients in the propensity score-matched exchange cohort demonstrated a significantly increased reinfection risk compared to patients without interim spacer exchange (24% vs 15%, P = .03). Patients in the propensity score-matched exchange cohort showed significantly lower postoperative scores for 3 patient-reported outcome measures (PROMs): hip disability and osteoarthritis outcome score physical function (46.0 vs 54.9, P = .01); knee disability and osteoarthritis outcome score physical function (43.1 vs 51.7, P < .01); and patient-reported outcomes measurement information system physical function short form (41.6 vs 47.0, P = .03). Multivariate analysis demonstrated Charles Comorbidity Index (odds ratio, 1.56; P = .01) and the presence of Enterococcus species (odds ratio, 1.43; P = .03) as independent risk factors associated with 2-stage reimplantation requiring an interim spacer exchange for periprosthetic joint infection. CONCLUSION This study demonstrates that patients with spacer exchange had a significantly higher risk of reinfection at 2 years of follow-up. Additionally, patients with spacer exchange demonstrated lower postoperative PROM scores and diminished improvement in multiple PROM scores after reimplantation, indicating that an interim spacer exchange in 2-stage revision is associated with worse patient outcomes.

Summary This article aims to highlight the mechanisms for avoiding constitutional bottle-necks, in particular if the head of state refuses to fulfill his constitutional duties. Thus, the political will of the heads of state cannot be a source of institutional deadlock. To remove constitutional bottlenecks Both the Parliament and the Prime Minister are to use the in-struments expressly established by the provisions of the Basic Law, in particular the sus-pension of the Head of State and the establishment of an interim function. Therefore, the application of government reshuffles is a solution to eliminate institutional bottlenecks, given that there are currently no alternative mechanisms to overcome a possible institu-tional deadlock, {"references":["1. Iorgovan A. Tratat de drept administrativ, vol. I, București: Ed. All Beck, 2001","2. Muraru I, Tănăsescu E. S. Drept constituțional și instituții politice, ediția a 15. București: Editura C. H. Beck, 2017","3. Selejan-Guțan, B. Drept constituțional și instituții politice, vol. II. Ediția a 3-a revăzută și adăugită. Editura Hamangiu, 2016","4. Legea Republicii Sovietice Socialiste Moldovenești cu privire la instituirea funcției de Președinte al RSS Moldovenești și la introducerea unor modifi-cări și completări în Constituția RSS Moldovenești din 3 septembrie 1990, în legi și hotărâri adoptate la sesiunea a doua, extraordinară a Sovietului Suprem al RSSM de legislatura a douăsprezecea, Chișinău, 1990","5. HCC nr. 28 din 17 octombrie 2017, pct. 72. [citat 16.12.2021]. Disponibil: https://weblex.md/item/view/iddbtype/1/id/64a757a8457f1f6f17174ef8 d465d914","6. Hotărârea Curții Constituționale nr. 2 din 24 ianuarie 2017 pct. 27. [citat 16.12.2021]. Disponibil:https://weblex.md/item/view/iddbtype/1/id/176 7e05e19828ea66ea3604c32bafc3a","7. Muraru I., Tănăsescu E. S. Constituția României. Comentariu pe articole. București: C. H. Beck, 2008","8. Avizul Curții Constituționale nr. 2 din 20 octombrie 2017. [citat 16.12.2021]. Disponibil: https://weblex.md/item/view/iddbtype/1/id/7721496a3cb06 ecf0a14c1a0dd27c7a1","9. Avizul Curții Constituționale nr. 1 din 2 ianuarie 2018, [citat 16.12.2021]. Disponibil: https://weblex.md/item/view/iddbtype/1/id/e1f7b2479c9a-b1f8ff3e3376f0a2b93e","10. Avizul Curții Constituționale nr. 2 din 5 ianuarie 2018. [citat 16.12.2021]. Disponibil: https://weblex.md/item/view/iddbtype/1/id/f50db0fdc1b-c363034373f27a7068072","11. Cîrnaț T. Drept constituțional și instituții politice. Partea II. Chișinău: Ti-pografia \"Print-Caro\", 2020","12.\tHotărârea Curții Constituționale nr. 28 din 17 octombrie 2017 pentru in-terpretarea prevederilor articolului 98 alin.(6) în coroborare cu articolele 1, 56, 91, 135 și 140 din Constituție (neîndeplinirea obligațiilor constituționale de către președinte). [citat 16.12.2021]. Disponibil: https://weblex.md/item/view/iddbtype/1/id/64a757a8457f1f6f17174ef8d465d914","13. Muraru I., Tănăsescu E. S. Constituția României. Comentariu pe articole. București: C. H. Beck, 2008","14.\tLegea privind organizarea și funcționarea Curții Constituționale nr. 47 din 18 mai 1992. În: Monitorul Oficial al României, 22.05.1992, nr.101. [citat 16.12.2021]. Disponibil: http://legislatie.just.ro/Public/DetaliiDocumentAfis/2248","15.\tLegea privind organizarea și funcționarea Curții Constituționale nr. 47 din 18 mai 1992. În: Monitorul Oficial al României, 22.05.1992, nr.101. [citat 16.12.2021]. Disponibil: http://legislatie.just.ro/Public/DetaliiDocumentAfis/2248","16. Hotărârea Curții Constituționale nr. 28 din 17 octombrie 2017, pct. 34-37.[citat 16.12.2021]. Disponibil: https://weblex.md/item/view/iddbtype/1/i d/64a757a8457f1f6f17174ef8d465d914"]}