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1.
Journal of Organizational Behavior Research ; 8(1):214-230, 2023.
Article in English | Web of Science | ID: covidwho-2326889

ABSTRACT

This study investigates macro and micro determinants of the ratio of non-performing loans (MPG ratio) of Vietnam commercial banks between 2015 and 2021. Data were collected from fifteen banks with total assets accounting for 62.9% of the total banking industry assets. The regression analytical technique is used to determine the impact of some independent variables on the MPG ratio of sample banks. The results reveal that the non -performing loan ratio is negatively correlated with the bank's asset size and loan growth rate but positively correlated with the net interest margin and the credit risk. The variable of Covid-19 has no statistically significant correlation with the non-performing loans ratio. Although a range of previous studies on that topic has been carried out, none of them digs deeper into the impact of these explanatory variables on the ratio of non-performing loans of Vietnamese commercial banks, especially the impact of Covid-19, whereas the banking industry of Vietnam is far-affected by that epidemic. Therefore, these findings can be used by creditors, investors, bank managers, and policy-makers when they have to give decisions relating to commercial banks in this complex period.

2.
Journal of Risk and Financial Management ; 16(4):211, 2023.
Article in English | ProQuest Central | ID: covidwho-2304710

ABSTRACT

The role of Information and Communications Technology (ICT) cannot be ignored in today's era of working. Its effects are studied in several sectors by various researchers. This study covers the impact of ICT on the profitability of banks. Thirty-three banks are operating in India. A sample period of 10 years (2010 to 2019) was studied. The study also provides insight into how ICT helps the banks' profitability during and post-COVID-19. A panel data analysis is performed to estimate the results. This study found that ICT adversely impacts banks' profitability (NIM) in India in a linear association. However, the quadratic association indicates a positive U-curved relationship between ICT and profitability. In addition, the Net of Non-Performing Assets significantly but negatively impacts the connectivity of ICT and profitability. The findings imply that banks should invest in ICT to maximize the long run. The findings have no significant implication on all stakeholders, including policymakers, shareholders, and managers, to consider implementing ICT tools as an essential factor in enhancing a bank's profitability in the long run. In addition, the level of otherwise lowered investments in ICT cannot be a fruitful step. The current study augments the existing literature on banking by providing novel evidence on the association of ICT with profitability under the influence of NPA. This study argues for the application of ICT in banks in order to increase their profitability. ICT helps the bank maintain transparency, accountability, and even the reach of financial services increases. This situation again leads to the enhancement of the country's economy.

3.
Production Engineering ; 2023.
Article in English | Scopus | ID: covidwho-2296166

ABSTRACT

Existing literature on optimizing inventory levels in pharmaceutical supply chains has focused on a limited set of drivers. However, the global supply chain disruptions produced by the Covid-19 pandemic demonstrated the need for a more nuanced picture of the inventory management drivers in this sector to identify profitable inventory configurations while fulfilling demands and safety margins. To address this gap in the literature, this paper identifies key drivers impacting inventory levels and develops a framework for assessing inventory configurations in pharmaceutical supply chains. The framework is tested using a single case study approach. The case study showed that while external and downstream supply chain factors were recognized as being critical to pursuing inventory reduction initiatives, internal factors prevailed when making inventory management decisions. The framework developed in this paper may assist practitioners in identifying the most important factors impacting inventory levels within a specific pharmaceutical supply chain configuration and is in use in the industry today. © 2023, The Author(s) under exclusive licence to German Academic Society for Production Engineering (WGP).

4.
Cardiovasc Intervent Radiol ; 46(3): 327-336, 2023 Mar.
Article in English | MEDLINE | ID: covidwho-2301473

ABSTRACT

PURPOSE: The aim of this study was to analyze the impact of using intra-procedural pre-ablation contrast-enhanced CT prior to percutaneous thermal ablation (pre-ablation CECT) of colorectal liver metastases (CLM) on local outcomes. MATERIALS AND METHODS: This retrospective analysis of a prospectively collected liver ablation registry included 144 consecutive patients (median age 57 years IQR [49, 65], 60% men) who underwent 173 CT-guided ablation sessions for 250 CLM between October 2015 and March 2020. In addition to oncologic outcomes, technical success was retrospectively evaluated using a biomechanical deformable image registration software for 3D-minimal ablative margin (3D-MAM) quantification. Bayesian regression was used to estimate effects of pre-ablation CECT on residual unablated tumor, 3D-MAM, and local tumor progression-free survival (LTPFS). RESULTS: Pre-ablation CECT was acquired in 71/173 (41%) sessions. Residual unablated tumor was present in one (0.9%) versus nine tumors (6.6%) ablated with versus without using pre-ablation CECT, respectively (p = 0.024). Pre-ablation CECT use decreased the odds of residual disease on first follow-up by 78% (CI95% [5, 86]) and incomplete ablation (3D-MAM ≤ 0 mm) by 58% (CI95% [13, 122]). The odds ratio for residual unablated tumor for larger CLM was lower when pre-ablation CECT was used (odds ratio 1.0 with pre-ablation CECT vs. 2.52 without). Pre-ablation CECT use was not associated with improvements on LTPFS. CONCLUSIONS: Pre-ablation CECT is associated with improved immediate outcomes by significantly reducing the incidence of residual unablated tumor and by mitigating the risk of incomplete ablation for larger CLM. We recommend performing baseline intra-procedural pre-ablation CECT as a standard imaging protocol. LEVEL OF EVIDENCE: Level 3 (retrospective cohort study).


Subject(s)
Catheter Ablation , Colorectal Neoplasms , Liver Neoplasms , Male , Humans , Middle Aged , Female , Retrospective Studies , Contrast Media , Bayes Theorem , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/surgery , Liver Neoplasms/pathology , Tomography, X-Ray Computed/methods , Colorectal Neoplasms/pathology , Catheter Ablation/methods , Treatment Outcome
5.
International Journal of Technology Management ; 91(1-2):68-81, 2023.
Article in English | Scopus | ID: covidwho-2278942

ABSTRACT

In order to improve the economic benefits of enterprises under continuing influence of COVID-19, the technological innovation effect of industrial chain under the ‘double cycle' pattern in the post epidemic era is studied in this paper. The fractional planning and integral planning functions of the industrial chain are obtained by constructing the CCR model, and the BCC model calculation of the innovation effect of the enterprise industrial chain is realised by the Chames-Cooper transformation. The data efficiency value of technological innovation effect of industrial chain under the ‘double cycle' pattern is obtained via the SBM network model for analysis on the technological innovation effect of industrial chain. The experimental results show that the effect of industrial chain technological innovation is analysed from the aspects of main business income and the profit margin of enterprises extending the industrial chain and connecting the industrial chain. The highest profit margin after connecting the industrial chain technological innovation is 34.2%, which proves that technological innovation can improve the economic benefits of enterprises. Copyright © 2023 Inderscience Enterprises Ltd.

6.
Journal of Pediatric Surgery Case Reports ; 88, 2023.
Article in English | Scopus | ID: covidwho-2244314

ABSTRACT

Spitzoid melanoma is very rare tumour in the pediatric population, with clinical and non-uniform behaviour, different from adult melanoma [1]. It can be difficult to differentiate an atypical Spitz nevus from a Spitzoid melanoma, resulting in diagnostic problems. In addition, in our clinical case, the COVID-19pandemiccaused significant delays both in the diagnosis and in the surgical treatment of our patient. We present the clinical case of a 4-year-old child suffering from a localized polypoid cutaneous neoformation on the dorsum of the left hand, which started immediately before the lockdown and steadily increased during the COVID-19 pandemic. After a general clinical framing, the child underwent an excisional biopsy at our Department of Plastic and Reconstructive Surgery, at the Policlinico of Foggia. Subsequently, two independent anatomic pathology groups examined the specimen. Definitive diagnosis was made only after careful genetic analysis in combination with supporting histological and immunohistochemical examinations. This clinical case shows how during the pandemic we have been facing advanced forms of tumours, compared to the previous period and highlight show an interdisciplinary and multicenter collaboration allowed a quick diagnosis of certainty, demonstrating the utility of molecular pathology as a fundamental aid in clinical/surgical practice. © 2022 The Authors

7.
J Surg Res ; 283: 867-871, 2023 03.
Article in English | MEDLINE | ID: covidwho-2229041

ABSTRACT

INTRODUCTION: The COVID-19 pandemic was a potential threat to the viability of trauma centers and health systems in general. We sought to answer the question of how COVID-19 was associated with patient characteristics as well as trauma center volume, finances, and viability. METHODS: We reviewed 6375 patients admitted to our verified Level 1 trauma center during two time periods: pre-COVID (February 2019-February 2020) and COVID (March 2020-March 2021). Three thousand ninety-nine patients were admitted pre-COVID and 3276 were admitted during COVID. Data including case-mix index (CMI), total contribution margin, insurance status, age, race, gender, ethnicity, and injury mechanism were collected from the trauma registry and finance databases and analyzed. A P < 0.05 was considered significant. RESULTS: Trauma admissions decreased initially during COVID but returned to and ultimately surpassed admission trends pre-COVID. Trauma revenue and patient acuity increased significantly along with a decrease in the number of underinsured patients during COVID. When evaluating all service lines, the trauma center was the highest contributor to overall hospital revenue. CONCLUSIONS: Despite a decrease in admissions for other service lines and a pause in elective surgeries during the pandemic, the trauma center remained unaffected. In addition, trauma was the most significant contributor to the bottom line of the health system. These findings underscore the need to maintain and even increase trauma center resources and staffing to ensure that optimal care is provided to critically ill and injured patients.


Subject(s)
COVID-19 , Trauma Centers , Humans , COVID-19/epidemiology , Hospitalization , Pandemics , Retrospective Studies
8.
Journal of Pharmaceutical Negative Results ; 13:1481-1498, 2022.
Article in English | EMBASE | ID: covidwho-2206720

ABSTRACT

This paper aims to ingress the position of sale from the year 2016- 2022 . This current study aims to examine the profitability and working capital management of SAIL with the important statistical tools like mean, standard deviation, minimum and maximum coefficient of variation etc and ratios.Profitability is financial standard of Corporate ability to gain profit and it can be measured through profitability ratios such as Gross Profit ratio, Net profit ratio, return on capital employed etc.Working Capital Management incorporatethe relationship between a firm's current assets and current liabilities. It represent that a company can afford itsday to day operating expenses to continue its operations. It can be examine through current ratio, liquid ratio, current assets turnover ratio, total assets turnover ratio, working capital turnover ratio, debtor turnover ratio and inventory turnover ratio.Hence, it was concluded that the overall performance of SAIL regarding profitability was negative during the first two years of study period though the company's sales are growing but after that company started earning profit, but again during the covid period profit started declining, but again it recovered and profitability started rising with the increase in sales.This paper analysis that management of working capital detect the liquidity position and the area of weaknesses and also provide recommendation for removal of the weaknesses of the public sector enterprises with special reference to SAIL. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

9.
Journal of Agricultural and Food Industrial Organization ; 2022.
Article in English | Scopus | ID: covidwho-2197336

ABSTRACT

This research determines the impacts of COVID-19 US on crawfish production and consumption for 2020 and 2021 using an Equilibrium Displacement Model. In the US, crawfish is one of the seafood commodities where most production is consumed by domestic consumers (7% of domestic consumption is from imports). Crawfish and rice are complementary. Therefore, the impacts of COVID-19 on crawfish consumption simultaneously influence rice production and crawfish producers and consumers. In the first year of COVID-19 (2020), the reduction in crawfish retail demand caused negative effects on final consumers and producers. However, crawfish consumption recovered significantly in the second year (2021), which could compensate for the loss in 2020. Overall, consumer and producer gains ranged from $549 to $626 million if the COVID-19 pandemic only impacted retail consumption. However, in 2021, the increase in production costs due to higher oil/diesel prices and other input prices caused the farm supply to decrease. As a result, total welfare gains ranged from $200 to $228 million. If the demand in 2021 did not increase, but the crawfish farm supply decreased, consumer and producer losses ranged from $929 to $1045 million. Overall, the total effects of COVID-19 on consumers and producers for 2020 and 2021 depend on its effects in 2021. If the demand in 2021 increased following the decrease in farm supply, consumers and producers would benefit from the shocks of COVID-19 due to higher post-COVID-19 demand. © 2022 Walter de Gruyter GmbH, Berlin/Boston 2022.

10.
Applied Mathematical Finance ; 2022.
Article in English | Scopus | ID: covidwho-2186815

ABSTRACT

In this research we investigate the impact of stochastic volatility on future initial margin (IM) and margin valuation adjustment (MVA) calculations for interest rate derivatives. An analysis is performed under different market conditions, namely during the peak of the Covid-19 crisis when the markets were stressed and during Q4 of 2020 when volatilities were low. The Cheyette short-rate model is extended by adding a stochastic volatility component, which is calibrated to fit the EUR swaption volatility surfaces. We incorporate the latest risk-free rate benchmarks (RFR), which in certain markets have been selected to replace the IBOR index. We extend modern Fourier pricing techniques to accommodate the RFR benchmark and derive closed-form sensitivity expressions, which are used to model IM profiles in a Monte Carlo simulation framework. The various results are compared to the deterministic volatility case. The results reveal that the inclusion of a stochastic volatility component can have a considerable impact on nonlinear derivatives, especially for far out-of-the-money swaptions. The effect is particularly pronounced if the market exhibits a substantial skew or smile in the implied volatility curve. This can have severe consequences for funding cost valuation and risk management. © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

11.
Int J Biostat ; 2022 Dec 30.
Article in English | MEDLINE | ID: covidwho-2197326

ABSTRACT

For non-inferiority/superiority and equivalence tests of two Poisson rates, the determination of the required number of sample sizes has been studied but the studies for the number of events to be observed are very limited. To fill the gap, the present study first is aimed toward determining the number of events to be observed for testing non-inferiority/superiority and equivalence of two Poisson rates, respectively. Also, considering the cost for each event, the second purpose is to apply an exhaustive search to find the unequal but optimal allocation of events for each group such that the budget is minimal for a user-specified power level, or the statistical power is maximal for a user-specified budget. Four R Shiny apps were developed to obtain the number of events needed for each group. A simulation study showed the proposed approach to be valid in terms of Type I error and statistical power. A comparison of the proposed approach with extant methods from various disciplines was performed, and an illustrative example of comparing the adverse reactions to the COVID-19 vaccines was demonstrated. By applying the proposed approach, researchers also can estimate the most economical number of subjects or time intervals after determining the number of events.

12.
12th International Conference on Virtual Campus, JICV 2022 ; 2022.
Article in English | Scopus | ID: covidwho-2161456

ABSTRACT

This study was carried out to evaluate the perception that the teaching staff of a private university in southern Peru had about the quality of virtual teaching conditioned by the COVID-19 pandemic. The study was conducted in 2022 with 341 participants, for a confidence level of 95% and a margin of error of 5%, measuring dimensions such as: academic aspect, materials and connectivity, participation and evaluation, and research and university social responsibility. The results showed that figures greater than the minimum proposed were reached, the best valued dimension was that of materials and connectivity and the least valued was research and university social responsibility. This change in teaching modality has represented an opportunity to improve the quality of university teaching, leaving interaction with other people-typical of attendance-in areas such as health sciences as a pending task. © 2022 IEEE.

13.
Q Open ; 2(1), 2022.
Article in English | Scopus | ID: covidwho-2135556

ABSTRACT

COVID-19 has raised questions about the resilience of agri-food trade to global shocks to the system. This paper analyses the changes in agri-food trade (values, extensive and intensive margin, and diversification) during the pandemic at global and regional levels. It also considers parallels in the changes in agri-food trade and changes of various COVID-19-related factors (infections, deaths, mobility, policy stringency, and industrial production output). The results show that changes in trade remained limited to short-term disruptions that mostly occurred at the extensive margin of trade and, primarily, at the height of policy stringency, mobility reductions, and the overall reduction of economic output. The trade of staples was most resilient, while that of other agri-food products declined considerably. Inter-regional trade of Asia, Africa, and Latin America and the Caribbean proved generally more resilient than these regions' intra-regional trade. © 2022 The Author(s). Published by Oxford University in association with European Agricultural and Applied Economics Publications Foundation.

14.
Ann Glob Health ; 88(1): 87, 2022.
Article in English | MEDLINE | ID: covidwho-2080770

ABSTRACT

Lack of transparency in vaccine pricing practices is a problem that has been under discussion for a long time. To tackle this, the World Health Assembly adopted the resolution Improving the transparency of markets for medicines, vaccines, and other health products in 2019. However, despite the appalling effects of the current pandemic and the unequal global distribution of vaccines, the 2019 resolution has not been included as a fundamental pillar in the global health response to COVID-19. Governments and public health agencies have provided public funding to pharmaceutical companies for research and development of new vaccines. Yet, information on pricing strategies and methodologies is still inaccessible. Furthermore, these companies are profiting from publicly funded research and development. But secrecy and opacity prevails in the pharmaceutical industry, affecting low and middle income countries. Situating the demand for transparency, accountability and fair pricing of pharmaceutical products as a global health justice issue, I suggest an independent global observatory for accountability and transparency in the pharmaceutical global market should be created to help international organizations, governments and civil society in their quest for affordable and safe vaccines and therapeutics.


Subject(s)
COVID-19 , Vaccines , Humans , COVID-19/prevention & control , Pandemics/prevention & control , Costs and Cost Analysis , Pharmaceutical Preparations
15.
J Vasc Surg ; 76(6): 1710-1718, 2022 Dec.
Article in English | MEDLINE | ID: covidwho-1991191

ABSTRACT

OBJECTIVE: The financial effects of the coronavirus disease 2019 (COVID-19) pandemic have fundamentally changed the healthcare environment, with hospitals expected to have lost billions in 2021. A preexisting nationwide nursing shortage became drastically worse during the pandemic amid dramatically increasing labor costs. We examined the evolution and financial effects of these changes during repeated pandemic surges within a vascular surgery division at a tertiary medical center. METHODS: Operating room, inpatient unit, and outpatient clinic financial data were examined retrospectively. The monthly averages for a 14-month control cohort before COVID-19 (January 2019 to February 2020) were compared to the averages for seven interval groups of sequential, 3-month cohorts from March 2020 through November 2021 (groups 1-7). RESULTS: The monthly relative value unit (RVU) generation had returned to the mean before the COVID-19 pandemic (2520 RVUs) after an isolated decrease early in the pandemic (group 1; 1734 RVUs). The RVUs ranged from 2540 to 2863 per month for groups 2 to 5, with a slight decline in groups 6 and 7. The average monthly RVUs in the COVID-19 period (2437 RVUs) were nearly equivalent (P = .93) to those for the pre-COVID-19 cohort. An analysis of payor mix demonstrated an increase in commercial and Medicaid payors, with a respective decrease in Medicare payors, during COVID-19. The contribution to indirect, or profit, from inpatient hospital and outpatient clinical revenue showed a drastic decrease in group 1, followed by a swift rebound when the government restrictions were eased (group 2). The total monthly vascular nursing unit expense demonstrated a marked increase with each sequential group during COVID-19, with an average monthly upsurge of +$82,171 (+47%; P < .001). An increase in the nursing labor expenses of +$884 per vascular case (from $1630 to $2514; +54%; P < .001) was observed in the COVID-19 era. The nursing labor costs per patient day had increased from $580 to $852 (+$272; +53%; P < .001). The nursing labor cost per RVU had increased from $69.5 to $107.7 (+$38.2; +55%; P < .001). On a system-wide level, the agency-related nursing costs had increased from $4.9 million to $13.6 million per month (+178%; P < .001) in 2021 compared with 2020. CONCLUSIONS: The COVID-19 pandemic has had severe, nationwide effects on healthcare delivery, exacerbating the deleterious effects of an existing, critical nursing shortage. To the best of our knowledge, the present study is the first detailed analysis of this phenomenon and its effects on a surgical division. Our results have demonstrated a progressive, drastic increase in nursing labor costs during the pandemic, with a resultant sustained erosion of financial margins despite a level of clinical productivity, as measured in RVUs, equal to the prepandemic standards. This precarious trend is not sustainable and will require increased, targeted government funding.


Subject(s)
COVID-19 , Pandemics , Aged , Humans , United States/epidemiology , COVID-19/epidemiology , Retrospective Studies , Medicare , Vascular Surgical Procedures , Hospitals
16.
Financial and Credit Activity-Problems of Theory and Practice ; 2(43):146-156, 2022.
Article in English | Web of Science | ID: covidwho-1980063

ABSTRACT

The article considers the problem of ensuring the economic security of trade enterprises by forming an optimal pricing policy. The methodology of formation the minimum and maximum selling prices of trade enterprise, maintenance of margin of economic security, which is based on research of turnover costs and working capital of trade enterprise is offered. Based on statistical data of trade enterprises, the types of prices by product range are determined, which form a stable economic situation and ensure economic security of trade enterprise. The necessity of forming the optimal price policy and selling prices of trade enterprises with the use of Pareto efficiency tools and construction of single-criteria and multi-criteria tasks, indicators of quality of commodity resources of trade enterprises is substantiated. Using the Excel software processor and the "Regression" function, economic-mathematical models of optimal prices for the product range of trade enterprises are built. The results testified to the effectiveness of the proposed model of the optimal pricing policy of trade enterprises, as the obtained values are within the minimum selling prices, which provides economic security of trade enterprises. The process of forming the pricing policy of trade enterprises to ensure economic security is proposed, which is based on the principles of pricing, appropriate methodological tools and monitoring of market environment factors. Organizational, economic, legal, social and market (marketing) mechanisms for the formation of effective pricing policy of trade enterprises aimed at ensuring economic security are identified. This study is practically interesting for personnel of trade enterprises, regardless of organizational-legal forms of ownership and activities, and theoretically - for researchers dealing with pricing.

17.
Radiotherapy and Oncology ; 170:S1169, 2022.
Article in English | EMBASE | ID: covidwho-1967476

ABSTRACT

Purpose or Objective We designed a hypofractionated radiotherapy protocol for adjuvant or salvage treatment after radical prostatectomy. In this first report we present the implementation of this protocol in the context of a COVID-19 pandemic. Materials and Methods Patients meeting the inclusion criteria (high-risk features on histopathology or biochemical recurrence) received radiotherapy to the prostate bed 51 Gy in 17 fractions, elective treatment of the pelvis at a dose of 36 Gy in 12 fractions was permited. Acute gastrointestinal (GI) and genitourinary (GU) toxicity was evaluated according to the National Cancer Institute Common Terminology Criteria for Adverse Events versión 4.03. The disease-related quality of life, urinary, gastrointestinal, sexual and hormonal function were evaluated with the Expanded Prostate Cancer Index Composite (EPIC), QLQc30 and PR25 questionnaires at baseline before the start of radiotherapy and at one month after radiotherapy, then every six monts for two years. In addition, the incidence of COVID-19 cases was reported in the patients recruited in the trial and in those who underwent standard fractionation treatment (1.8-2.0 Gy per fraction), and in health personnel involved in the treatment of patients in study period. Results From August 2020 to March 2021, 22 patients have been registered. Fourteen patients have completed treatment and are included in this report. The median age was 64 years and most had a Gleason 3 + 4 (50%), with a pT3a (35.7%) and negative surgical margins (71.4%). Three patients (21.4%) were staged as pN1. Most patients were treated for salvage (57.1%), with an median PSA prior to the start of RT of 0,29 ng/ml. Most patients report minimal or low acute radiation effects in terms of GI and GU toxicity, with an acute toxicity grade 2 GI and GU of 50% and 14.3%, respectively. Without Grade 3 or higher GI / GU toxicity. Of the 14 patients who received the trial protocol, none had a clinical of COVID-19 infection, while one patient who received treatment with conventional fractionation development a COVID-19 infection. Conclusion We present the implementation of an protocol of hypofractionated schedule of postoperative prostate radiotherapy in an academic center in a developing country in the context of a COVID-19 pandemic. Preliminary results show the absence of COVID infection in the included patients, and low GU and GI toxicity.

18.
Radiotherapy and Oncology ; 170:S1024-S1025, 2022.
Article in English | EMBASE | ID: covidwho-1967471

ABSTRACT

Purpose or Objective external beam whole breast irradiation (WBI) for low-risk early-stage breast cancer patients after breast conserving surgery. We present the experience at our center treating patients with PBI using an IORT technic with Xoft® Axxent® Electronic Brachytherapy (eBx®) System®. Materials and Methods Between April 2019 and August 2021, 44 patients diagnosed with low-risk early-stage breast cancer who met international criteria for PBI, received IORT in a single fraction of 20 Gy to the tumor bed after lumpectomy. Toxicities and follow up were prospectively registered. Results 3 of the 44 initial patients were discarded for IORT due to non-compliance with the minimum safety distance (<1 cm) between the applicator and the skin. Of the remaining patients, 32/41 patients (78%) received a PBI, while 9/41 (22%) required adjuvant WBI due to adverse prognostic factors identified on the definitive biopsy. The most frequent risk factor was close resection margins (<2mm), present in 8/9 patients (88,8%). Two patients additionally presented sentinel node involvement and in 1 case no axillary sample was obtained. The most used IORT applicator was the 3-4 cm balloon, with most likely filling volumes between 30cc and 40 cc. For all treatments, the mean filling volume of the applicator was 45 cc and there were no complications during the irradiation procedure. Surgical bed seroma was the most common acute effect, observed in 29/41 patients (70,7%), although only 8/29 (27,5%) required drainage. We observed wound dehiscence in 7/41 cases (17%), inflammatory complications requiring antibiotics in 9/41 cases (19,5%), and 4/41 cases of hematoma (9,7%). Regarding late toxicity, at the time of the analysis it was only assessable for 37 patients. We observed low rates of local grade I fibrosis (21,6%) and only 1 case of tumor bed G2 fibrosis. Hyperpigmentation G1 was observed in 8,1% of patients and 10,8% presented occasional mild local discomfort. With median follow-up of 17.14 months (range 4-29 months), no relapses were observed, but 1 patient died from covid-19 pneumonia. Conclusion Intra operative PBI with Xoft® Axxent® Electronic Brachytherapy (eBx®) System® is a feasible approach to treat low-risk early-stage breast cancer patients. Our preliminary results show that it presents advantages over conventional WBI allowing for less toxic and shortened treatment courses while maintaining good local tumor control.

19.
The American Journal of International Law ; 116(3):579-585, 2022.
Article in English | ProQuest Central | ID: covidwho-1960135

ABSTRACT

For the Court, this conclusion was bolstered by the observations that vaccination was not administered against the will of the applicants;that there is no consensus between member states over a single model to achieve the highest level of vaccination;that the introduction of a legal duty to vaccinate children raises sensitive moral or ethical issues;and that the case concerns matters of healthcare policy (paras. 276–79). [...]the Court considered that the measure satisfied the proportionality test. Furthermore, the Court underlined the temporal nature of the exclusion, as all children—also when not vaccinated—can still be enrolled in primary school (para. 307). [...]the Court concluded that the Czech Republic had not overstepped its margin of appreciation and consequently that there was no violation of the right to private life (paras. 310–11). [...]the Court held, also by sixteen votes to one, that it was unnecessary to examine separately the complaints of the five child applicants under Article 2, Protocol No. 1 in light of the previous findings under Article 8 (para. 345).

20.
High Educ (Dordr) ; : 1-21, 2022 Jul 22.
Article in English | MEDLINE | ID: covidwho-1955983

ABSTRACT

This essay will look at the key challenges public Higher Education Institutions (HEIs) faced in Brazil during the COVID-19 lockdown. The pandemic led universities to close their campuses and adopt an online interface for academic activities. However, many of these institutions do not have the technological infrastructure for such, nor did the staff and students who suffered further social exclusions. The president of Brazil referred to the pandemic as a "little flue" and later on responded to measures adopting the lockdown as a "hysteric" act that "will lead to an economic crash". Considering the lack of support from the government and the process of dismantling resources for public HE since the beginning of the new presidency elected in 2018, the COVID-19 lockdown quickly revealed the institutional racism, elitism and ableism evident in this administration's agenda. The consequence of the agenda is the cuts on research funds and lack of infrastructure to provide online classes, as examples of the severe policies that promote the erasure of marginalised groups. Such policies follow Sylvia Wynter's "Argument", revealing a code of symbolic life and death of how human order organises itself through the coloniality of power/being. In order to show how such symbolic code is engraved in the Brazilian educational system, this study explores narratives of staff and students from three universities per region of Brazil to identify how the colonial legacies are correlated with postulates of power in the Brazilian HEIs setting during the pandemic. The paper discusses the challenges experienced while keeping the HE sector active during a pandemic that the government has belittled. The conclusions advocate for organised strategies at the union and social movements level to dismantle the colonial occupation put in place in the foundation of the HEIs and reinforced by the current necropolitical administration.

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