Contextual determinants of CHILDREN'S health care and policy in Europe

BACKGROUND: The main objective of this study was to explore the contextual determinants of child health policies. METHODS: The Horizon 2020 Models of Child Health Appraised (MOCHA) project has one Country Agent (CA) in all 30 EU and EEA countries. A questionnaire designed by MOCHA researchers as a semi-structured survey instrument asked CAs to identify and report the predominating public and professional discussions related to child health services within the last 5 years in their country and the various factors which may have influenced these. The survey was issued to CAs following validation by an independent Expert Advisory Board. The data were collected between July and December 2016. The data was qualitatively analysed using software Nvivo11 for data coding and categorization and constructing the scheme for identified processes or elements. RESULTS: Contextual determinants of children's health care and policy were grouped into four categories. 1) Socio-cultural determinants: societal activation, awareness, communication, trust, freedom, contextual change, lifestyle, tolerance and religion, and history. 2) Structural determinants which were divided into: a) external determinants related to elements indirectly correlated with health care and b) internal determinants comprising interdependent health care and policy processes. 3) International determinants such as cross-nationality of child health policy issues. 4) The specific situational determinants: events which contributed to intensification of debates which were reflected by behavioural, procedural, institutional and global factors. CONCLUSIONS: The influence of context across European countries, in the process of children's health policy development is clearly evident from our research. A number of key categories of determinants which influence child health policy have been identified and can be used to describe this context. Child health policy is often initiated in reaction to public discontentment. The multiple voices of society resulted, amongst others, in the introduction of new procedures, action plans and guidelines; raising levels of awareness, intensifying public scrutiny, increasing access and availability of services and provoking introduction of structural changes or withdrawing unfavourable changes

How does societal reaction to children's health issues contribute to health policy in Europe? Results of a survey

BACKGROUND: In the European context the awareness of societal responsibility for children's health has increased with greater attention to children's rights and child empowerment processes. Child health issues are considered particularly sensitive; thus, they often provoke strong societal reactions, which, as a consequence, influence national health policies across Europe. Effectiveness of societal influences increases with the involvement of various actors in the context. METHODS: A qualitative approach was used to identify the level of societal involvement in health decision-making. A questionnaire was sent to the Country Agents (CAs) of the Models of Child Health Appraised (MOCHA) project. CAs are contact points in each of the 30 participating in the project countries and were asked to identify strong public and professional discussions related to child health services in their countries. Data collection was undertaken between July and December 2016. RESULTS: Based on 71 case studies, we identified eight thematic patterns, which characterize societal reactions to the currently worrisome child health issues across Europe. We devoted our attention to the three most controversial: child vaccination, child poverty and child abuse. The cases described by the CAs show the broad perspective in the perception of child health problems. Child health issues involve the public and raise nationwide debates. Public concerns were directly or indirectly related to child health and depicted the national overtone. CONCLUSIONS: Concerns in Europe about child health care are twofold: they are devoted to systemic issues (indirect patient orientation) and to child health and well-being (direct patient orientation). The phenomenon of societal responsibility for children's health is important for the support of public acceptance of child health policy

Plasma dynamics studies in development of IPD method of surface engineering

During the Impulse Plasma Deposition (IPD) process of surface engineering plasma is generated in the working gas due to a high-voltage high-current discharge, ignited within an interelectrode region of a coaxial accelerator. The paper presents computational studies of working medium dynamics during the IPD discharge. Plasma has been investigated with a two-dimensional two-fluid magnetohydrodynamic code. Presented analysis of discharges outside the typical exploitation parameter range increases the understanding of phenomena relevant to process of coatings deposition.Во время процесса импульсного плазменного осаждения (ИПО) в рабочем газе генерируется поверхностная плазма благодаря развитию высокоточного разряда с высоким напряжением, который инициируется в межэлектродном пространстве коаксиального ускорителя. Приведены расчетные исследования динамики средних условий работы во время ИПО-разряда. Плазма исследовалась с помощью двумерного магнитогидродинамического кода для двух жидкостей. Представленный анализ разрядов за пределами типичного диапазона эксплуатации параметров увеличивает понимание явлений, имеющих отношение к процессу нанесения покрытий.Під час процесу імпульсного плазмового осадження (ІПО) в робочому газі генерується поверхнева плазма, через розвиток високоточного розряду з високою напругою, який ініціюється в міжелектродному просторі коаксіального прискорювача. Приведені розрахункові дослідження динаміки середніх умов роботи під час ІПО-розряду. Плазма досліджувалась за допомогою двомірного магнітогідродинамічного коду для двох рідин. Представлений аналіз розрядів за межами типового діапазону експлуатації параметрів збільшує розуміння явищ, що мають відношення до процесу нанесення покриттів

Comparative MHD analysis of IPD plasma accelerator work with different electrode polarization

During the Impulse Plasma Deposition (IPD) process of surface engineering plasma is generated in the working gas due to a high-voltage high-current discharge, ignited within an interelectrode region of a coaxial accelerator. A continually growing demand for deeper understanding of the process was the reason to investigate the plasma flow phenomena numerically. The paper reports computational studies of the IPD accelerator with internal cathode. The detailed structure of the discharge region was described by a two-dimensional, two-fluid magnetohydrodynamic approach. In particular, the presented computations suggest the paraboloidal shape of discharge region for device work with the internal cathode. It has been found that for the considered IPD discharge parameters plasma dynamics differs from commonly accepted pattern of concave current-sheet for negative polarization of electrodes (rod cathode and external tube anode).При імпульсному плазмовому напилюванні (ІПН) плазма генерується з робочого газу унаслідок високовольтного потужнострумового розряду в міжелектродній області коаксіального прискорювача. Зростаючі потреби зрозуміння процесів, що відбуваються у плазмовому потоці, стимулювали проведення чисельного моделювання. Дана робота присвячена комп'ютерним дослідженням ІПН прискорювача з внутрішнім електродом-катодом. Детальна структура розрядної області описана в наближенні двовимірної двурідинної магнітогідродинаміки. Зокрема, представлені розрахунки рекомендують параболічну геометрію розрядної області при роботі з внутрішнім електродом-катодом. Показано, що для розглянутих ІПН розрядівПри импульсном плазменном напылении (ИПН) плазма генерируется из рабочего газа вследствие высоковольтного сильноточного разряда в межэлектродной области коаксиального ускорителя. Возрастающие потребности понимания происходящих процессов в плазменном потоке стимулировали проведение численного моделирования. Данная работа посвящена компьютерным исследованиям ИПН ускорителя с внутренним электродом–катодом. Детальная структура разрядной области описана в приближении двумерной двужидкостной магнитогидродинамики. В частности, представленные расчеты рекомендуют параболическую геометрию разрядной области при работе с внутренним электродом–катодом. Показано, что для рассматриваемых ИПН разрядов динамика плазмы отличается от общепринятой формы вогнутого токового слоя при отрицательной полярности электродов (стержневой катод и внешняя труба- анод)

Statistical classification of soft solder alloys by laser-induced breakdown spectroscopy: review of methods

This paper reviews machine-learning methods that are nowadays the most frequently used for the supervised classification of spectral signals in laser-induced breakdown spectroscopy (LIBS). We analyze and compare various statistical classification methods, such as linear discriminant analysis (LDA), quadratic discriminant analysis (QDA), partial least-squares discriminant analysis (PLS-DA), soft independent modeling of class analogy (SIMCA), support vector machine (SVM), naive Bayes method, probabilistic neural networks (PNN), and K-nearest neighbor (KNN) method. The theoretical considerations are supported with experiments conducted for real soft-solder-alloy spectra obtained using LIBS. We consider two decision problems: binary and multiclass classification. The former is used to distinguish overheated soft solders from their normal versions. The latter aims to assign a testing sample to a given group of materials. The measurements are obtained for several laser-energy values, projection masks, and numbers of laser shots. Using cross-validation, we evaluate the above classification methods in terms of their usefulness in solving both classification problems

242. Analiza ekspresji EGFR i angiogenezv w utkaniu niedrobnokomórkowego raka płuc oraz związku z czasem przeżycia pacjentów w stadiach zaawansowania klinicznego I-IIIA

Cel pracyWciąż niezadowalające wskaźniki przeżycia pacjentów z rakiem płuca, mimo radykalnego leczenia operacyjnego, skłaniają do poszukiwań nowych czynników prognostycznych. Wiadomym jest, że receptor naskórkowego czynnika wzrostu (EGFR) wpływa na wzrost komórek guza i jego progresję, jak również tworzenie przerzutów – głównie poprzez oddziaływanie na tworzenie nowych naczyń krwionośnych. Jego prognostyczna rola u pacjentów z niedrobnokomórkowym rakiem płuca (NRP) jest niejasna. Natomiast gęstość naczyń krwionośnych (GNK), będąca miernikiem angiogenezy w guzie, jest podawana jako marker prognostyczny w wielu nowotworach. Celem naszego badania była ocena zależności między ekspresją EGFR i GNK w utkaniu guza nowotworowego a przeżyciem pacjentów z NRP.Materiał i metodyBadaniem objęto 75 pacjentów z NRP w stadiach zaawansowania klinicznego I-IIIA. Wycinki z guza pobierano z materiału operacyjnego, utrwalonego w formalinie. Na uzyskanych skrawkach parafinowych wykonywano odczyny immunohistochemiczne z zastosowaniem monoklonalnego przeciwciała przeciw receptorowi naskórkowego czynnika wzrostu oraz monoklonalnego przeciwciała przeciw CD31.WynikiWśród 75 pacjentów było 5 kobiet (6.7%) i 70 mężczyzn (93.3%) w wieku od 42 lat do 74 lat (średnio 59 lat). W badanej grupie chorych stwierdzono raka płaskonabłonkowego u 53 pacjentów (70.7%), gruczolakoraka u 11 chorych (14.7%) i raka wielkokomórkowego także u 11 pacjentów. Analizując uzyskane dane nie stwierdzono istotności statystycznej między ekspresją EGFR i czasem przeżycia pacjentów. Również GNK nie miała istotnego wpływu na przeżycie pacjentów. Jedynie stan węzłów chłonnych (cecha N; p<0.05), typ histologiczny raka (p<0.001) oraz wiek (p<0.05) w badanej grupie chorych miały istotny statystycznie wpływ na czas przeżycia.WnioskiUzyskane w tym badaniu wyniki nie są zgodne z wynikami innych doniesień mówiących o tym, że ekspresja EGFR i GNK w NRP mogą być traktowane jako czynniki prognostyczne. Należy jednak podkreślić, że analizowana grupa pacjentów była mała, a większość chorych (59 pacjentów, 78.7%) znajdowała się w stadium znacznego zaawansowania nowotworu

Raman imaging of changes in the polysaccharides distribution in the cell wall during apple fruit development and senescence

Main conclusion Du ring on-tree ripening, the pectin distribution changed from polydispersed in cell wall to cumulated in cell wall corners. During apple storage, the pectin distribution returned to evenly dispersed along the cell wall. The plant cell wall influences the texture properties of fruit tissue for example apples become softer during ripening and postharvest storage. This softening process is believed to be mainly connected with changes in the cell wall composition due to polysaccharides undergoing an enzymatic degradation. These changes in polysaccharides are currently mainly investigated via chemical analysis or monoclonal labeling. Here, we propose the application of Raman microscopy for evaluating the changes in the polysaccharide distribution in the cell wall of apples during both ripening and postharvest storage. The apples were harvested 1 month and 2 weeks before optimal harvest date as well as at the optimal harvest date. The apples harvested at optimal harvest date were stored for 3 months. The Raman maps, as well as the chemical analysis were obtained for each harvest date and after 1, 2 and 3 months of storage, respectively. The analysis of the Raman maps showed that the pectins in the middle lamella and primary cell wall undergo a degradation. The changes in cellulose and hemicellulose were less pronounced. These findings were confirmed by the chemical analysis results. During development changes of pectins from a polydispersed form in the cell walls to a cumulated form in cell wall corners could be observed. In contrast after 3 months of apple storage we could observe an substantial pectin decrease. The obtained results demonstrate that Raman chemical imaging might be a very useful tool for a first identification of compositional changes in plant tissue during their development. The great advantage Raman microspectroscopy offers is the simultaneous localization and identification of polysaccharides within the cell wall and plant tissue

When Covid-19 first struck: analysis of the influence of structural characteristics of countries - technocracy is strengthened by open democracy

Context: The Covid-19 pandemic hit the developed world differentially due to accidental factors, and countries had to respond rapidly within existing resources, structures, and processes to manage totally new health challenges. This study aimed to identify which pre-existing structural factors facilitated better outcomes despite different starting points, as understanding of the relative impact of structural aspects should facilitate achieving optimal forward progress. Methods: Desk study, based on selecting and collecting a range of measures for 48 representative characteristics of 42 countries’ demography, society, health system, and policy-making profiles, matched to three pandemic time points. Different analytic approaches were employed including correlation, multiple regression, and cluster analysis in order to seek triangulation. Findings: Population structure (except country size), and volume and nature of health resources, had only minor links to Covid impact. Depth of social inequality, poverty, population age structure, and strength of preventive health measures unexpectedly had no moderating effect. Strongest measured influences were population current enrolment in tertiary education, and country leaders’ strength of seeking scientific evidence. The representativeness, and by interpretation the empathy, of government leadership also had positive effects. Conclusion: Strength of therapeutic health system, and indeed of preventive health services, surprisingly had little correlation with impact of the pandemic in the first nine months measured in death- or case-rates. However, specific political system features, including proportional representation electoral systems, and absence of a strong single party majority, were consistent features of the most successful national responses, as was being of a small or moderate population size, and with tertiary education facilitated. It can be interpreted that the way a country was lead, and whether leadership sought evidence and shared the reasoning behind resultant policies, had notable effects. This has significant implications within health system development and in promoting the population’s health