Choice Of Instruments Research Articles

Operative vaginal delivery: practice patterns and outcomes at a tertiary general hospital.

There has been a global decrease in operative vaginal deliveries, with a marked shift towards the vacuum extractor. However, little is known about the trends in operative vaginal delivery in Singapore. A retrospective study was conducted on all operative vaginal deliveries performed from 2012 to 2017 at Singapore General Hospital (SGH). Maternal outcomes in terms of postpartum haemorrhage and obstetric anal sphincter injuries were compared between forceps- and vacuum-assisted deliveries. Neonatal outcomes in terms of neonatal intensive care unit (NICU) admission and clinically significant neonatal events were compared. The instrument preference of obstetricians was analysed. A total of 906 consecutive operative vaginal deliveries were included in the study, comprising 461 forceps- and 445 vacuum-assisted deliveries. The rate of operative vaginal delivery was maintained at approximately 10% from 2012 to 2017. Neonatal cephalohematomas were more common after vacuum-assisted deliveries. Other maternal and neonatal outcomes did not differ significantly between the two groups. Clinically significant neonatal events were mostly due to shoulder dystocia, whereas all cases of NICU admissions were not directly related to the mode of delivery. Obstetricians' choice of instrument appeared to reflect personal preference and was not affected by the year of graduation. The rates of neonatal and maternal morbidity were low at SGH. Overall instrument use of forceps and vacuum was balanced, and proficiency in both was demonstrated by all operators. Operative vaginal delivery remains an essential skill in facilitating safe vaginal delivery, which should be maintained to keep Caesarean section rates in check.

Revisiting monetary policy effectiveness in Turkey using a FAVAR model

This study aims to perform a comparative analysis of the effectiveness of pass-through of policy rates in Turkey. We explore monetary transmission with different choices of instruments, i.e., the Turkish Lira Reference Interest Rate (TRLIBOR rate), BIST overnight rate, and Divisia money, and under different policy regimes, i.e., inflation targeting and new monetary policy regimes. We estimate a two-stage FAVAR model to use all of the available information set and obtain direct responses of disaggregated/sectorial series for the period 2005:12-2018:4. We extend the model setting proposed by Bernanke, Boivin, and Eliasz (2005) by considering the multiple-policy environment in Turkey. Our findings promote arguments that regard policy rate as a poor indicator of the policy stance in Turkey.

High-Throughput Analysis of Protein Turnover with Tandem Fluorescent Protein Timers.

Tandem fluorescent protein timers (tFTs) are versatile reporters of protein dynamics. A tFT consists of two fluorescent proteins with different maturation kinetics and provides a ratiometric readout of protein age, which can be exploited to follow intracellular trafficking, inheritance and turnover of tFT-tagged proteins. Here, we detail a protocol for high-throughput analysis of protein turnover with tFTs in yeast using fluorescence measurements of ordered colony arrays. We describe guidelines on optimization of experimental design with regard to the layout of colony arrays, growth conditions, and instrument choice. Combined with semi-automated genetic crossing using synthetic genetic array (SGA) methodology and high-throughput protein tagging with SWAp-Tag (SWAT) libraries, this approach can be used to compare protein turnover across the proteome and to identify regulators of protein turnover genome-wide.

Податкове регулювання розвитку мультимодальних перевезень

Multimodal transportation is an important component of the transport system. The development of multimodal transportation requires coordination of various modes of transport and their integration into a single organizational system that operates on the basis of the formation of logistics centers. The article considers the problem of forming an ecosystem of multimodal transportation in Ukraine, reveals the peculiarities of its taxation and interaction in the digital economy. The existing regulatory and legal support of logistic activities in Ukraine is also analyzed. At present, multimodal transportation is of great importance for the economy of Ukraine. This is one of the important innovative directions in the development of the transport system at both the national and the international levels. Despite the fact that this direction is actively developing, today there is no clear legal and contractual support for this institution. The article analyzes the role of tax regulation of multimodal transportation along with the risks of environmental burden. It is noted that in Ukraine, amendments to the legislation in the field of regulation of multimodal transportation are extremely important, as well as the need to adopt a separate law that would allow to develop modern methods of cargo delivery, improve the quality of service for consumers of transport services, and reduce transportation costs. Among the main reasons that hinder the development of mixed transportation are the following: imperfection of the regulatory and legal settlement of multimodal transportation issues and the disparity between the levels of development of the capacity of ports for processing goods and railway infrastructure. The prospect of further research is the development of a theoretical and methodological approach to the choice of strategies and instruments for the development of transport infrastructure and tax regulation of multimodal transportation.

Analysis of computed tomography scans for development of differentiated approach to repair of ethmoid roof defects

Study of the images before surgery in order to analyze the individual characteristics of the anatomy is the key to a successful surgery. Materials and Methods: Analysis of computed tomography data of 43 patients with defects in the ethmoid roof operated from 2010 to 2020 at the Burdenko National Medical Research Center for Neurosurgery. Patients were divided into two groups according to the localization of the defect and relapses. Results. With anterior defects, the angle between the line drawn through the nasal dorsum and the perpendicular drawn through the center of the defect to the bottom of the cavity is sharper than with posterior ones, p < 0.001. The height from the bottom of the nasal cavity to the ethmoid roof was greater with anterior defects than with posterior defects (p = 0.011). The height from the bottom of the nasal cavity to the cribriform plate with anterior defects is greater than with posterior ones (p = 0.006). When analyzing the ratio of the height of the middle turbinate and the distance from the septum to the orbit and when determining the length of the lattice roof anteriorly or posteriorly from the basal lamella, depending on the location of the defect with the length of the middle turbinate, it was found that the differences were statistically significant (p < 0.05). Conclusions. The posterior parts of the ethmoid roof are more likely to develop iatrogenic defects due to their lower location in relation to the bottom of the nasal cavity. For the correct choice of optics and instruments, the angle between the line drawn through the nasal dorsum and the perpendicular drawn through the center of the defect to the bottom of the nasal cavity matters. A middle turbinate flap can be used to seal both anterior and posterior ethmoid roof defects. The anatomical features of the ethmoid roof do not affect the incidence of relapses.

МІЖНАРОДНА КООРДИНАЦІЯ МАКРОПРУДЕНЦІЙНОЇ ПОЛІТИКИ ЯК ІНСТРУМЕНТ ФІНАНСОВОЇ ІНТЕГРАЦІЇ

The article provides a comprehensive analysis of the problem of international macroprudential regulation from the standpoint of benefits and threats produced for national economies in the process of its implementation. It has been established that the macroeconomic situation in each individual country is increasingly being influenced by forces that go beyond both traditional cycle theories and the conventional understanding of non-economic factors. As a result, long-term macroeconomic stability, the key to which is the stability of the national financial and, above all, the banking system, to external shocks, is called into question, and the main way to ensure it is to conduct a risk-weighted macroprudential policy. Capital inflows driven by changes in financial regulations in the country of origin of capital could lead to excessive credit growth and asset price pressures in capital recipient countries, which could be partly mitigated by regulatory and macroeconomic policies in those countries. Conversely, effective domestic macroprudential policies that help contain systemic risks in one country can contribute to financial stability in other countries by generating positive externalities. Reducing the likelihood of a financial crisis in one country through timely macroprudential policies can reduce the scale of negative trade and financial spillovers or spillovers at the regional or international level. Based on the assumption that, when policymaking is inconsistent, each country's regulator is free to choose policy instruments to minimize its own political losses or maximize public welfare, assuming that regulators in other countries can make similar arbitrary choices of macroprudential instruments as a given, it has been found that such policy, generally does not take full account of cross-border spillovers, that is, the real and financial externalities caused by domestic shocks, or the consequences of national policy responses to those shocks. The article determines that, theoretically, international coordination of macroprudential policies can achieve a reduction in political losses or contribute to an increase in public welfare. Both domestic macroprudential policies and prudential capital controls produce spillover effects internationally, which can lead to “capital wars” based on races to lower interest rates. Keywords: macroprudential policy, international economic policy, international capital flows, financial integration, international policy coordination, global instability, regulatory wars.

COVID-19 PSYCHOLOGY AND FINANCIAL BEHAVIOUR: THE URBAN MIDDLE CLASS IN BANGLADESH

The analysis, using an online survey, captures the adjustments in economic behaviour and changes in the choice of financial instruments by the urban middle class in Bangladesh due to Covid-19 pandemic. It shows that 43 per cent of the surveyed households suffered income losses—57 per cent belonging to lower middle class (LMC) and 19 per cent to upper middle class (UMC) households. Nearly one-third of the LMC households reduced their food costs compared with 6 per cent of the UMC households. The pandemic has also initiated large scale changes in their financial behaviour more towards digital and online markets with nearly twothirds reporting high reliance on online purchases. The observed changes indicate a long term transformation in the financial behaviour of the middle class households. Complementary evidence highlights the need for reducing their vulnerability since rising expectations of the expanding middle class are the critical drivers of social change in Bangladesh. The key to such dynamic transformations is the creation of a more learning middle class—a dynamic middle class that would be ready to exploit the opportunities of the ‘new normal’ after the Covid-19 pandemic.

Raising capital amid economic policy uncertainty: an empirical investigation

This paper investigates how economic policy uncertainty affects firms’ frequency and their choice of financial instruments to raise capital. By applying a three-step sequential framework over a sample of 6834 publicly listed US non-financial firms, we find that during periods of high economic uncertainty, firms raise capital more frequently with a preference toward debt financing. The empirical findings suggest that firms prefer debt financing over equity financing to avoid ownership dilution and high equity premia. The rise in leverage during periods of high economic uncertainty highlights the importance of scrutinizing policy tools used to stabilize the economy during such times.

Mitigating economic volatility: When building efficient financial markets should supersede conventional economic policy

The choice of instruments for mitigating economic volatility is a serious consideration for policymakers and important question in government and economics. Using a DSGE model with endogenous technology creation, we show that efficient financial markets are more effective than conventional economic policies, such as fiscal interventions, in reducing economic volatility. Our findings are consistent with data from the Chinese and the US economies who contrast in structure perfectly for the purpose of our comparison. The implication is that rather than focusing on conventional economic policies, a government should help establish efficient financial markets to allow producers a hedge into equity finance during times of financial stress.

TOOLS OF BUDGET AND TAX REGULATION OF THE ECONOMY

Introduction. Today, budget and tax instruments play an important role in implementing the policy of state regulation of economic development. The implementation of effective economic policy involves the use of fiscal instruments that contribute to long-term financial and economic goals. Given this, the choice of fiscal instruments, the time of their implementation and their combination - these are important issues, so to address them it is necessary to conduct a balanced assessment of the financial and economic condition of the economy. Methods. In the process of writing the article used general scientific techniques and methods of economic research. The theoretical and methodological basis of intelligence is the analysis of scientific works of domestic and foreign scientists on the study of tools of budget and tax regulation of the economy, Internet resources. The article uses general and special research methods, in particular: general and special – to ensure the achievement of this goal; dialectical, abstract and logical – to substantiate theoretical positions and conclusions. Results. The article analyzes the theoretical aspects of the concept of «fiscal regulation». The decisive role of budgetary and tax instruments in the development of the state economy is stated. It is determined that in the vast majority of cases, fiscal instruments are considered by scholars as a general system of budgetary and fiscal instruments. It is proved that effective budget and tax regulation helps to ensure the way out of crisis processes of the state. The results of the study allow us to state the existence of a significant number of fiscal instruments. Discussion. Further research will focus on the study of budget and tax tools as the main element of the system of regulation of economic development of the state. Keywords: budget and tax regulation, budget instrument, tax instrument, economic development.

Estimated policy rules for capital controls

Are capital controls macroprudential or mercantilist? I explore this question using a novel, weekly dataset on policy actions in 21 emerging-market economies (EMEs) from 2001 to 2015, and a new proxy for mercantilist motivations: the weighted appreciation of a country’s currency against those of its trade competitors. Capital controls arebothmercantilist and macroprudential. Moreover, the choice of instruments is systematic: policymakers use two instruments—inflow tightening and outflow easing—to respond to mercantilist concerns, while using only inflow tightening in response to macroprudential concerns. Inflow tightening is countercyclical to bank credit to GDP gap but acyclical to the specific macroprudential concerns related to external or foreign currency borrowing. However,high level of some types of foreign debt reduces countercyclicality to mercantilist concerns. Higher exchange rate pass-through to export prices, and inflation targeting regime with managed exchange rates, increase countercyclicality to mercantilist concerns.

Comparison of the Approach of the Czech National Bank and the European Central Bank to the Effects of the Global Financial Crisis

The latest global crisis, which fully erupted in 2008, can have a significant impact on central banks credibility in the long run. During the last crisis, monetary authorities encountered zero interest rate levels and, as a result, started to use non-standard monetary policy instruments. The Czech National Bank decided to use a less standard instrument in November 2013, when it started to intervene on the foreign exchange market in order to keep the Czech currency at level 27 CZK / EUR. However, the European Central Bank also adopted a non-standard instrument, when chose a path of quantitative easing in 2015 in order to support the euro area economy by purchasing financial assets. The question remains whether the approach of Czech National Bank or the approach of European Central Bank in the crisis and post-crisis period was a more appropriate alternative. With the passage of time from the global financial crisis, it is already possible to compare the approaches of these two central banks and at least partially assess what approach was more appropriate under the given conditions. When comparing the central banks approaches to the crisis, the Czech National Bank was better, both in terms of the rate of interest rate cuts and the resulting inflation with regard to the choice of a non-standard monetary policy instrument. The recent financial crisis has revealed the application of moral hazard in practice, both on behalf of the European Central Bank and the Czech National Bank, which may have a significant impact on their credibility and independence in the coming years.

Has consumption inequality mirrored income inequality: new evidence from a Korean household panel

ABSTRACT We examine how consumption inequality tracks income inequality in a Korean household panel. To adjust for measurement errors in consumption, we employ the double-differencing correction of Aguiar and Bils (2015) (AB hereafter). In the first stage of the double-differencing, AB used current income as an instrument for unobserved true total expenditure, and we use permanent income as the instrument instead. For the U.S. Consumer Expenditure Survey data, AB found that after correcting for measurement errors, consumption inequality tracks income inequality more closely. We find that the same conclusion holds for the Korean panel data and the estimate of consumption inequality is robust to the choice of instrument for the total expenditure in the first stage regression.

Validating GIC Modeling in the Spanish Power Grid by Differential Magnetometry

AbstractA series of experiences and recommendations are presented concerning the derivation of geomagnetically induced currents (GIC) by use of the differential magnetometry method (DMM) under power lines. This indirect technique, intended to obtain observations to validate GIC models, is an alternative to measuring the current flow in the transformer neutrals. It is a non‐intrusive and autonomous technique, as the procedure does not depend on the grid operator. In contrast, the selection of suitable sites devoid of human interferences, the need for power to supply the magnetometer, the data acquisition and transmission system, along with the choice of the appropriate instrumentation are difficulties that make not just any site suitable for installation and often require costly solutions. We focus on the methodology followed to estimate the GIC flowing in several transmission lines of the Spanish power grid with the aim of validating our GIC models, and we share our experience on the installation of the measuring points. Uncertainty inherent in the DMM is assessed, showing that noise is the main handicap, although it can be minimized with appropriate filtering. According to such experience, on some occasions only total DC currents above a significant fraction of 1 A give magnetic signatures well above the noise level, so this figure can roughly be considered as the threshold limit for detection. The low solar activity, combined with the mid‐latitude condition of Spain, limited the significance of available recorded data, but we can already report and analyze the results for several minor geomagnetic storms.

Biało-ruskij mir. Reaktywacja reintegracyjna w relacjach rosyjsko-białoruskich White-Russian world.

The relations between the Russian Federation and Belarus in the 21st century are characterized by dynamics and volatility. The integration processes of both countries, initiated in the 1990s, are an element of the strategy of domination in the post-Soviet area, which is consistently implemented by Russia. The authors conclude that this strategy in the case of Belarus is a kind of mixture of soft power and hard power, and the choice of instruments depends on the stability of the authoritarian regime, which is embodied by Alyaksandr Lukashenka. The rigged presidential elections triggered a wave of protests, leading to the gradual loss of social legitimacy by the Belarusian president. Russia has a dilemma: whether to continue to support Lukashenka, who is losing support, or to look for a “new personal alternative”, a politician that would guarantee the implementation of a “pro-Russian vector” in Belarus’s domestic and foreign policy. Regardless of how the situation develops, Russia’s strategic goal remains to keep Belarus in its sphere of influence using the already existing mechanisms of cooperation between the two countries.

Legal Instruments to Support Borrowers (Consumers and Entrepreneurs) in Connection with the COVID-19 Pandemic in Poland, and Vietnam

Abstract The COVID-19 pandemic restrictions introduced in 2020 in many countries on economic activity and gainful employment have in many cases, reduced the incomes of individual households. As a result, the actual ability to meet credit obligations has declined, particularly for those who have lost their jobs or livelihoods. The COVID-19 pandemic has become a significant challenge for economies, national authorities, and entrepreneurs, including borrowers. This article aims to analyse the legal regulations in Poland, and Vietnam, introducing instruments to support borrowers, consumers, and entrepreneurs, in connection with the COVID-19 pandemic. The authors will present the legal basis for the instruments to support borrowers provided in the studied countries, indicate their legal nature, forms, and conditions of using them. They also compare legal solutions introduced in connection with the pandemic aimed at mitigating its adverse effects on borrowers in Poland, and Vietnam, to indicate whether cultural differences and differences in legal systems, as well as individual approaches to the domestic credit market, affected the choice of legal instruments for supporting borrowers in connection with the COVID-19 pandemic, or not.

Assisted Vaginal Delivery - Preference of Vacuum or Forceps among Obstetricians

Objective: To determine the instrument preference among obstetricians practicing operative vaginal deliveries and to determine the prevalence and risks of vacuum or forceps Assisted Vaginal Delivery (AVD).
 Methods: This cross-sectional study was carried out in ACS Medical and Hospital, Chennai. A total of 520 obstetricians were included in the study. An online questionnaire was sent to all obstetricians in Chennai. The choice of procedure for specific circumstances, instrument preference [use of vacuum or forceps] and views on the complications encountered in both vacuum and forceps use at vaginal delivery were explored. For the replies, we computed means and percentages for the entire group and distinct subgroups. Risk assessment of outcome with exposure as suitable p-value was included in the statistical analysis.
 Results: Response rate for the questionnaire was 97% (504/520). The findings suggest that obstetricians preference was more towards vacuum due to their ease of usage. Baseline characteristics were similar between the two groups. Failed vacuum due to slipping of the cup was the most common complication faced - 62%, followed by caput succedaneum 25%, both were statistically significant. The most significant finding was that maternal injuries in the vacuum group were only 2% which was way less than those who had forceps delivery (68%) with a p-value of < 0.001.
 Conclusion: In this research, physician instrument choice is a significant predictor of results that should be taken into account. Use of vacuum for delivery seemed to be the choice of majority of obstetricians [334 (66%)]. Vacuum extractor rather than forceps for assisted delivery appears to reduce maternal morbidity, whereas neonatal injuries were more common in newborns delivered by vacuum. The choice of instrument should be personalized based on the patient's condition and the obstetrician's experience and expertise.

Evaluation methods for low-cost particulate matter sensors

Abstract. Understanding and improving the quality of data generated from low-cost sensors represent a crucial step in using these sensors to fill gaps in air quality measurement and understanding. This paper shows results from a 10-month-long campaign that included side-by-side measurements and comparison between reference instruments approved by the United States Environmental Protection Agency (EPA) and low-cost particulate matter sensors in Bartlesville, Oklahoma. At this rural site in the Midwestern United States the instruments typically encountered only low (under 20 µg m−3) concentrations of particulate matter; however, higher concentrations (50–400 µg m−3) were observed on 3 different days during what were likely agricultural burning events. This study focused on methods for understanding and improving data quality for low-cost particulate matter sensors. The data offered insights on how averaging time, choice of reference instrument, and the observation of higher pollutant concentrations can all impact performance indicators (R2 and root mean square error) for an evaluation. The influence of these factors should be considered when comparing one sensor to another or when determining whether a sensor can produce data that fit a specific need. Though R2 and root mean square error remain the dominant metrics in sensor evaluations, an alternative approach using a prediction interval may offer more consistency between evaluations and a more direct interpretation of sensor data following an evaluation. Ongoing quality assurance for sensor data is needed to ensure that data continue to meet expectations. Observations of trends in linear regression parameters and sensor bias were used to analyze calibration and other quality assurance techniques.

A comparative study on the measurement properties of Dermatology Life Quality Index (DLQI), DLQI-Relevant and Skindex-16.

Dermatology Life Quality Index (DLQI) and Skindex-16 are among the most commonly used dermatology-specific health-related quality-of-life (HRQoL) instruments. DLQI has two common scoring methods, the original and the DLQI-Relevant (DLQI-R) modification. Head-to-head comparisons of the measurement properties of the DLQI, DLQI-R and Skindex-16 are currently lacking. We aim to compare the measurement properties of the DLQI, DLQI-R and Skindex-16. We analysed data from 618 patients with self-reported physician-diagnosed dermatological conditions from a cross-sectional survey carried out in Hungary in early 2020. DLQI, DLQI-R and Skindex-16 were compared in terms of ceiling and floor effects, informativity, convergent validity and known-group validity. Mean DLQI, DLQI-R and Skindex-16 total scores were 3·76±5·03, 4·11±5·34 and 29·36±26·62, respectively. Among patients with a DLQI/DLQI-R total score of zero, 64% reported problems on Skindex-16. Overall, 23-38% of patients with 'not relevant' responses on DLQI items 3 (shopping/home/gardening), 7 (working/studying), 8 (interpersonal problems) and 9 (sexual difficulties) reported problems on their corresponding Skindex-16 items. Average relative informativity (Shannon's evenness index) was the highest for Skindex-16 (0·85), followed by DLQI-R (0·66) and DLQI (0·54). DLQI, DLQI-R and Skindex-16 demonstrated similar convergent validity. DLQI was able to better discriminate between known groups of patients based on overall skin-related HRQoL impairment, whereas DLQI-R and Skindex-16 performed better with respect to self-perceived health status. Skindex-16 seems to be more sensitive than DLQI/DLQI-R in capturing mild impairment in HRQoL. Our findings help to provide a fuller understanding of the difference between DLQI, DLQI-R and Skindex-16 and support the informed choice of instrument for clinical and research purposes.

Clinical Trials and Outcome Measures in Adults With Hearing Loss.

Clinical trials are designed to evaluate interventions that prevent, diagnose or treat a health condition and provide the evidence base for improving practice in health care. Many health professionals, including those working within or allied to hearing health, are expected to conduct or contribute to clinical trials. Recent systematic reviews of clinical trials reveal a dearth of high quality evidence in almost all areas of hearing health practice. By providing an overview of important steps and considerations concerning the design, analysis and conduct of trials, this article aims to give guidance to hearing health professionals about the key elements that define the quality of a trial. The article starts out by situating clinical trials within the greater scope of clinical evidence, then discusses the elements of a PICO-style research question. Subsequently, various methodological considerations are discussed including design, randomization, blinding, and outcome measures. Because the literature on outcome measures within hearing health is as confusing as it is voluminous, particular focus is given to discussing how hearing-related outcome measures affect clinical trials. This focus encompasses how the choice of measurement instrument(s) affects interpretation, how the accuracy of a measure can be estimated, how this affects the interpretation of results, and if differences are statistically, perceptually and/or clinically meaningful to the target population, people with hearing loss.