Partial Funding Research Articles

PENGARUH CORPORATE SOCIAL RESPONSIBILITY TERHADAP LABA BANK SYARIAH

This research is motivated by a phenomenon that knowledge and understanding of forms of accountability are carried out by a company to its environment, when a major contribution, the better the image of the company and also increasing public confidence to entrust part of the funds entrusted to the Bank Syariah. Furthermore, with the increasing number of third party funds acquisition is expected to affect the profit Islamic Bank, and vice versa. In this case the researchers analyzed the effect of the allocation of the disclosure of Corporate Social Responsibility Qardh Fund and Zakat Fund, Infaq and Shadaqah against Profit Islamic Bank. The problem of this research is there a significant relationship between Corporate Social Responsibility Qardh Funds and Zakat Fund, Infaq and Shadaqah simultaneously against Profit Islamic Bank. The purpose of this study was to determine the influence of Corporate Social Responsibility Qardh Fund and Zakat Fund, Infaq and Shadaqah against Profit Islamic Bank and how significant influence. This study uses a quantitative method or approach with cross sectional study design. This study uses a type of associative research. The data used is the time series. Source of data used are secondary data semesters Financial Statements PT. Bank BNI Syariah, PT. Bank Syariah Mandiri and PT. Bank Mega Syariah consisting of sources and uses of qardh, sources and uses of funds ZIS and profit and/or loss with the observation period 2010-2014. The results showed that in partial funds qardh no significant effect on earnings Islamic Bank, while variable zakat, infaq and shadaqah significant effect on Profit Islamic Bank. Simultaneously showed that both variables are analyzed had an influence on earnings Islamic Bank and prove that variable Qardh Fund and Zakat Fund, Infaq and Shadaqah have a significant impact on Profit Islamic Bank.

Formalising E-waste in Ghana: An emerging landscape of fragmentation and enduring barriers

ABSTRACT Since 2016 Ghana has introduced several initiatives to formalise parts of the e-waste economy. This e-waste management system is based on the experiences, expert policy advice and partial funding from the Global North. Employing serial interviewing, we assess the rolling out of this formalisation pathway, the evolving e-waste management landscape and reflect on informal terrain’s reconstitution and remaining barriers, such as inadequate funding, low levels of awareness about informal e-waste management among policymakers and the general populace and inadequate training programmes to equip informal operators with technology. Several formal/informal economy overlaps are now visible in a ‘gray space.’ Some low-skilled e-waste work, ancillary collection services and workplaces are being upgraded and integrated but informal infrastructure remains very deficient. Downgrading of some e-waste work is taking place. Fragmentation of the main hub is occurring as rival informal operations continue in various locations, and new small ventures are emerging in peripheral locations.

Russian experience of per capita payment for primary health care (PHC) with elements of fund holding

The article examines the historical aspect of the effectiveness of the compulsory health insurance system in Russia, the search for rational methods of paying for medical care both in outpatient and inpatient settings, the reform of Russian health care based on the insurance model and the introduction of per capita payment methods. In order to substantiate the per capita payment for PHC with elements of fund holding and the consolidation of social equality in the provision of medical services, the article analyzes the types of payment for medical services from fees (for the volume of services provided — visits, beddays, etc.) to per capita (for the number of attached to a medical organization of the insured, taking into account the results of activities, in conditions of partial or full fund holding). A deep analysis of the opinions of scientists and experts on the issue under consideration is given. The article was prepared based on the results of research carried out at the expense of budgetary funds on the state order of the Financial University in 2020.

Peculiarities of Land Reform and Introduction of the Land Market in Ukraine: Legal Security and Consequences

During the years of Ukraine's independence, the issue of land reform and the opening of the market for agricultural land was on the agenda of the legislative and executive branches of government. According to the Constitution of Ukraine, land is the most valuable wealth and property of the Ukrainian people. Land reform is not the first attempt by the authorities to change land relations in Ukraine, but it was to resolve the controversial issues of Ukrainian land. The implementation of land reform provided not only the introduction of effective mechanisms of land tenure and land use, but also the development of a modern land market on the basis of a market economy. Land reform has been hampered by corruption, a moratorium on the sale of agricultural land, and the desire of some politicians to speculate on the issue. Therefore, the moratorium in Ukraine was introduced as a temporary tool to protect landowners in the underdeveloped infrastructure of the land market. The adopted Law of Ukraine in 2020 removes the moratorium and gives the right to owners of agricultural land to dispose of their land at their own discretion. In the future, the opening of the land market should be a significant change in the life of Ukrainian society. However, the villagers face a number of unresolved issues that need to be clarified. Parliament and the government are expected to adopt and implement new land laws, such as decentralization of land management, the state e-auction, and the establishment of an independent Partial Lending Fund to increase smallholder access to flexible financing.

A Comparative Study on the Herd Behavior of Chinese Equity and Partial Equity Hybrid Funds-Empirical Analysis Based on Market Fluctuations

This paper uses the LSV model and the VOL volatility index, as well as the quarterly position data of equity funds and partial equity hybrid funds from the first quarter of 2007 to the fourth quarter of 2019 to conduct an empirical study on the herd behavior of both kinds of funds. Then establish a connection with the volatility of the Shanghai Stock Exchange over the same period. The results show that the overall trend of herd behavior between equity funds and partial equity hybrid funds is almost completely opposite. Equity funds have a stronger herd behavior in buying, while partial equity hybrid funds have a stronger herd behavior in selling. Meanwhile, when the volatility of the Shanghai Composite Index increased significantly, the herd behavior in selling both increased.

Mobile Application for Parkinson's Disease Deep Brain Stimulation (MAP DBS): An Open-Label, Multicenter, Randomized, Controlled Clinical Trial

Mobile Application for Parkinson's Disease Deep Brain Stimulation (MAP DBS): An Open-Label, Multicenter, Randomized, Controlled Clinical Trial

Class Size and COVID-19: A Probabilistic Metric of Contacts Made in a School Setting and How It Matters

Background: In the spring and summer of 2020, most of the world’s schools were closed to prevent the spread of COVID-19. Reopening schools safely for both the students and the community is now a social and economic priority, but recent research has warned about the importance of the prevention and intensive tracing of infectious cases in schools to reduce the risks of reopening. The nature of school activities – including multiple close interactions with large numbers of people in a limited space – has made it particularly difficult to meet those objectives. We aim to predict the impact of number of students in each class on the network of contacts made in a school setting. The number of close contacts is a well-accepted proxy for both the risks of spreading an infection and the opportunities for effective tracing.Methods: We propose a probabilistic metric to measure the influence of class size policies on the number of close contacts made in a school setting using different assumptions about school population and family situation. Our model uses an estimation of the most likely number of additional classes that would expand the network of contacts through siblings each day by analyzing a tree of conditional probabilities based on the relative weight of attending a class already in the network versus the total number of options. Our modelling contributes by considering the class size effects, not only through contacts in the same classroom but also through siblings in other classrooms and by analyzing the evolution of the network of contacts as a function of time.Findings: Our results show that the number of students in contact at school grows very quickly at first where there are higher class sizes compared to the more steady growth of contacts for smaller class sizes. Employing different scenarios, our results show that the network of contacts grows exponentially as a function of the number of students in the class. Using the example of a school with 600 children, we demonstrate that the number of contacts expands up to six times faster in class sizes of 30 students than in small classes of 10 students. Consequently, the time required for all the 600 students in the school to be in contact varies from 5 days for class sizes of 30 to 28 days for class sizes of 10. The incremental effect of the class size on the number of contacts intensifies when the total number of children in the school is larger. For example, in a school of 960 children, the saturation times are 7 and 44 days for class sizes of 30 and 10, respectively. Additionally, our results also show that siblings may be a relevant and often under analyzed source of indirect contacts in a school.Interpretation: The number of students in contact at school may grow quickly as a consequence of indirect contacts, even when classes are completely isolated during school hours. However, having a low number of students in a class generates a strong exponential reduction in the likely number of days in which the infection spreads in a specific school. Consequently, limiting class sizes may have a strong effect on the opportunities for tracing potential infections in a school and reduce the risks for their communities of keeping the school open.Funding Statement: Spanish Ministry of Industry and Competitiveness (research grant ECO2016-75909) and Spanish Ministry of Science and Innovation (research grant PID2019-106725GB-I00) for partial funding.Declaration of Interests: J.A.A.C. has received funding from the Spanish Ministry of Industry and Competitiveness (ECO2016- 75909) to analyze how to improve the sustainability of organizations. He has also received funding from the Regional Government of Andalucia (A-SEJ-291-UGR18), and the Spanish Ministry of Science, Innovation, and Universities & European Commission (PID2019-106725GB-I00) to analyze how organizations may be effective in a COVID-19 situation. The other author declares no competing interests.

Who Conducts Health Economic Evaluations of Laboratory Tests? A Scoping Review.

Health economic evaluations (HEEs) are effectively used to inform decision making in healthcare. We sought to assess the level of involvement of laboratory professionals (LPs) in HEEs of laboratory tests. A systematic literature search was conducted in Medline (2013 to November 28, 2018) for original articles reporting HEEs of medical laboratory tests. Eligible studies were characterized by indication, utilization, region, setting, study design, primary outcome measures, and sponsorship. Authors were classified based on stated affiliation as clinician, scientist, public health expert, or LP. In total, 140 HEEs were included in the study, of which 24 (17.1%) had contributions from LPs. Studies were primarily focused on infectious disease (n = 68), oncology (n = 23), and cardiovascular disease (n = 16). Cost-utility or cost-effectiveness analyses (n = 117) were the most frequent study types, with effectiveness measured mainly in terms of quality-adjusted life-years (n = 57) and detected cases (n = 41). Overall, 76% of HEEs followed a social or health system perspective, whereas 15% took a hospital viewpoint. Partial or full funding was received from public health organizations or industry in 39% and 16% of studies, respectively. The involvement of LPs was associated with test utilization, secondary care, analytic perspective, and an immediate time horizon (all P < 0.05). Quality of studies was found to be lower in HEEs coauthored by LPs. Multidisciplinary collaboration is essential to understanding the complexity of clinical pathways. HEEs are used effectively to inform healthcare decision making. The involvement of LPs in HEEs is low. This implies that laboratory expertise is frequently not considered in decision processes.

Letter: Evaluation and Surgical Treatment of Functional Neurosurgery Patients With Implanted Deep Brain Stimulation and Vagus Nerve Stimulation Pulse Generators During the COVID-19 Pandemic.

Author(s): Gross, Robert E; Buetefisch, Cathrin M; Miocinovic, Svjetlana; Bullinger, Katie L; Okun, Michael S; Ostrem, Jill L; Foote, Kelly D; Starr, Phillip A

Talking about the Cost of Care: A Critical Component of Shared Decision Making Patient and Provider Perspectives

Transparency about the costs that patients incur is an increasingly important factor in making decisions throughout the course of diagnosis and treatment. Both patients and providers regard honest, informed discussions about these costs as critical to providing person-centered care, but often encounter a range of barriers to initiating and maintaining these conversations. The Patient Advocate Foundation/National Patient Advocate Foundation with partial funding from the Robert Wood Johnson Foundation has conducted both quantitative and qualitative research with patients and providers designed to identify key issues related to cost of care discussions. These include components of financial toxicity for patients, both related to direct costs and to quality of life, as well as questions as to who should initiate these conversations, when they should take place, and what kind of information and training are needed to make these conversations meaningful. This article reports the results of this work with recommendations for providers about how to incorporate cost of care discussions into the normal clinical work flow and patient life flow.

Preface

The First International Conference of Pure and Engineering Sciences (ICPES2020)The current volume contains 97 articles selected after rigorous peer review process. We are pleased to present this volume of the selected contributed articles, submitted and presented in the First International Conference of Pure and Engineering Sciences (ICPES2020) “ organized by the Iraqi Academic Syndicate Holy Karbala Branch in cooperation with Imam Hussain Holy Shrine, and Nanotechnlogy and Catalysis Research Center (NANOCAT) Malaya University-Malaysia which held in Holy Karbala-IRAQ during 26-27 February 2020, https://sites.google.com/view/iraq-academic-syndicate-/home. The theme of the conference has been kept broad enough to include diverse areas of pure science (Biology, Chemistry, Physics, and Mathematics) and Engineering Science and their interdisciplinary applications.Over hundred papers were selected for oral presentation in the conference after an initial review. Every submitted full length paper was sent for peer review to at least two potential reviewers in the related areas of expertise once it is passed by the program committee. Ninety-seven papers could have been finally selected on the recommendation of the peer review committees in the form of the present volume. We hope this volume of the proceedings from ICPES2020 will be a very useful contribution to the academicians, engineers, researches and scientists for enthusing new vistas of research and development in these emerging areas. The authors will be solely responsible regarding the authenticity and ethical issues related to their article contained in this volume. There were 10 invited talks delivered by the leading experts from Czech Republic, Malaysia, Lebanon, USA, Australia, etc. in the areas mentioned above besides the oral presentations in ten tracks. The fruitful discussions, exchanges and deliberations recorded among the delegates in every session of the conference marked the very success of the event.It is a great honour and opportunity for us to record our heartfelt deep appreciation to all the eminent guests including the keynote speakers, plenary speakers and other delegates who made their valuable contributions towards the success of the conference. We are very much grateful to the members of the steering and review committee for their continuous guidance and support leading to the selection of the oral presentation, contributed talks and the papers published in this volume. We would like to thank the Province of Holy Karbala for the partial funding of the conference. We also would like to thank Al-Zahrawi University College for providing the venue. We also record our sincere gratitude to the representatives of IOP for their collaboration and full cooperation.

Synthesis of Polycrystalline Diamond Compact with Selenium: Discovery of a New Se–C Compound**Supported by the National Natural Science Foundation of China (Grant No. 51402245), the Fundamental Research Funds for the Central Universities of China (Grant No. 2682016CX062), the China Scholarship Council (Grant No. 201707005071), the Shenzhen Peacock Plan (Grant No. KQTD2016053019134356), and the Guangdong Innovative & Entrepreneurial Research Team Program

Sintering of polycrystalline diamond with selenium was investigated under pressure of 6.5–10.5 GPa at a constant temperature of 1850 °C. A new carbon-selenium compound with a most plausible chemical formula of SeC and a WC-type hexagonal structure (space group ) has been discovered in the recovered samples sintered at 10.5 GPa and 1850 °C. Refined lattice parameters are as follows: a = 2.9277(4) Å, c = 2.8620(4) Å, V = 21.245(4) Å3. The diamond compacts hot-pressed at 10.5 GPa have excellent mechanical properties with a Vickers hardness of about 68 GPa at a loading force of 19.6 N. Diamond intergrowths observed in these samples may have benefited from the catalytic effects of Se/SeC on the nucleation and crystal growth of diamond.

Talking About the Cost of Care: A Critical Component of Shared Decision Making: Patient and Provider Perspectives

IntroductionTransparency about the costs that patients incur is an increasingly important factor in making decisions throughout the course of diagnosis and treatment. Both patients and providers regard honest, informed discussions about these costs as critical to providing person-centered care, but often encounter a range of barriers to initiating and maintaining these conversations. MethodsThe Patient Advocate Foundation/National Patient Advocate Foundation with partial funding from the Robert Wood Johnson Foundation has conducted both quantitative and qualitative research with patients and providers designed to identify key issues related to cost of care discussions. ResultsKey issues identified include components of financial toxicity for patients, both related to direct costs and to quality of life, as well as questions as to who should initiate these conversations, when they should take place, and what kind of information and training are needed to make these conversations meaningful. ConclusionsThis article reports the results of this work with recommendations for providers about how to incorporate cost of care discussions into the normal clinical work flow and patient life flow.

Changes in Individual and Team Cognition in High Stress Extreme Underwater Saturation Environment Under Intense Workload

The objective of this study was to measure potential changes in cognitive function in response to living in an extreme underwater habitat. Chronic high stress and intense workload can affect individual and team cognition. As such, associated variables were monitored during the NASA Extreme Environment Mission Operation (NEEMO) 23 mission at the Aquarius reef Base in June 2019.Individual cognition was measured on 6 subjects (2 males, 4 females) with 8 tests using a battery of cognitive assessments (Joggle Research platform), 1 day pre‐mission, at mid‐point of the mission and 1 day post‐mission. In addition, 4 cognitive tests were applied on 5 subjects (2 males, 3 females) at the beginning of Extravehicular Activities (EVA) and at the end of EVAs that lasted for ~3 to 5 hours. To monitor changes in stress level, Short Stress State Questionnaire (SSSQ) and Generalized Anxiety Disorder (GAD7) scores were collected. Effects of workload on performance were measured by NASA Task Load Index (TLX). Changes in team cognition was monitored using an assessment of cognitive process measures.There was a trend of increasing performance in individual cognition in‐habitat and post mission, compared to baseline. The NBACK test, a measure of working memory, significantly improved during the mission, compared to pre‐mission and it further improved post‐mission. The psychomotor vigilance test (PVT) results were non‐significantly lower during the mission. The Motor Praxis Task (MPT) scores decreased at the beginning of EVA and further decreased by the end of EVA. The end of EVA MPT performance was significantly lower, compared to baseline, in habitat, and post mission measurements, suggesting that long duration extravehicular activity had a significant negative effect on sensory motor speed. BART scores were significantly lower at the beginning of EVA, compared to baseline, suggesting that risk taking decreased with the start of the EVA. The PVT score was significantly lower at the end of EVA, compared to baseline, in habitat, and the beginning of EVA, suggesting that the long duration EVAs had negative effect on the ability to quickly respond to the sudden appearance of a stimuli. A trend of increasing GAD7 scores at half time of the mission and post‐mission could be observed. There were differences in NASA TLX and team cognition scores between subjects and at different time points.The present results suggests that sub‐components individual and team cognitive functions may be differently affected during this extreme environment mission. Further research is needed to isolate which cognitive functions might be altered and how these may be correlated with stress level and workload to affect mission success.Support or Funding InformationKetone Technologies LLC provided partial funding for the experiments. SIFT provided partial salary for CA.

Changes in Motor Function in Response to Living in an Extreme Underwater Saturation Environment under High Stress and Increased Workload

Understanding changes in individual motor function and how it relates to workload, personality types, and shared knowledge is vital to the success of team‐based missions. Such changes may present a challenge in long duration spaceflight and other missions in extreme environments. Therefore, we studied grip strength, dexterity, stress level, task load and the personality types of participants living in an extreme environment during the NASA Extreme Environment Mission Operation (NEEMO) 23 in June 2019. The Aquarius Reef Base is home to NEEMO missions and is located at 20 m (66 ft) with 2.6 atm (air) pressure inside the habitat, where CO2 levels are often elevated similar to the International Space Station.Motor strength was assessed using a grip dynanometer and dexterity was measured using a pegboard. The tests were performed by 6 subjects (2 males, 4 females) 1 day pre‐mission, during the mission (grip test twice) and 1 day post‐mission. Dexterity test was also performed at the beginning and at end of Extravehicular Activities (EVAs). NASA TLX tests measuring mental, physical, temporal effort, performance, general effort and frustration, were assessed immediately after returning from EVAs. To monitor changes in stress level, Short Stress State Questionnaire (SSSQ) and Generalized Anxiety Disorder (GAD7) scores were collected. Measures of social cognition, including Reading the Mind in Eyes and Big 5 personality tests, were performed once before the mission.There was a trend of decreased grip strength at the end of mission and post‐mission, compared to baseline and beginning of mission. The dexterity scores at the beginning of EVAs were significantly higher, compared to before and during mission. This suggests that tasks with fine motor function can be affected by context such as in‐water performance. At the end of the EVAs, the dexterity score was significantly higher compared to before mission and during mission as well. There was a trend of worse performance on the dexterity test at the end of EVA, compared to the beginning of EVA. A trend of increasing GAD7 scores at half time of the mission and post‐mission could be observed. There were several differences in NASA TLX scores between different subjects.These results indicate that strength and dexterity was influenced during EVAs. This may have been due to both physical and psychological stress during the extreme underwater mission in a saturation environment. Further examination of these trends is recommended.Support or Funding InformationKetone Technologies LLC provided partial funding for the study. SIFT provided partial salary for CA.

Stress Promotes a More Invasive Phenotype in Human Melanoma Cells

Growing evidence suggests that stress plays a vital role in metastasis and tumor development by activating the sympathetic nervous system. The catecholamines released into the tumor microenvironment (TME), specifically norepinephrine (NE), results in a cascade effect leading to a variety of pro‐metastatic activities that sustain tumor growth and increase melanoma aggressiveness. Most notable are the secretion of cytokines and the stimulation of tumor‐associated macrophages (TAMs). Using a co‐culture system of melanoma cancer cells and macrophages we found that sustained exposure of NE in the microenvironment induced the release of tumor‐growth and progression‐associated cytokines from TAMs. Of the upregulated cytokines found; IL‐11, IL‐24, GRO‐a, DKK‐1, and angiopoietin‐2 are known to induce growth, migration, invasion, and tumor development in human melanoma. Our next steps include validating the cytokine array using real time PCR and using an ELISA assay to quantify protein levels of antigens associated with the cytokines secreted from the cells and macrophages.Support or Funding InformationUS Department of Education for the HSI‐STEM Grant University of St. Thomas for Student Research for partial funding

Changes in Sensory Functions in Response to Living in an Extreme Underwater Saturation Environment

The present challenges of long duration spaceflight and other missions in extreme environments include changes of sensory functions, including vision impairment and changes in taste perception. In order to monitor and improve astronaut health and performance during long duration spaceflight and future spaceflight missions we studied sensory functions in response to living in an extreme environment during the NASA Extreme Environment Mission Operation (NEEMO) 23. The Aquarius Reef Base is located at 20 m (66 ft) with 2.6 atm (air) pressure inside the habitat, while levels of CO2 are elevated similarly to the International Space Station.This study assessed the changes in visual acuity and taste perception in 6 NEEMO 23 subjects (2 males, 4 females) 1 day before the mission, during the mission at half time and 1 day post mission. Visual changes were assessed using the NIH Toolbox protocol, while changes in taste perception were measured using solutions containing concentrations of either salty, sweet and bitter flavors in three different concetrations on the side of the tongue and in full mouth.We observed a trend of decreased salty and bitter taste sensation in the habitat and post mission, compared to baseline, while the sweet taste sensation did not change. When testing the full mouth, the salty taste sensation significantly decreased post mission, compared to baseline at low or medium concentration. Bitter taste sensation significantly decreased at low concentration in habitat and post mission, compared to baseline. At medium concentration the bitter taste sensation significantly decreased post mission, compared to baseline and in‐habitat, while at high concentration it significantly decreased post mission, compared to baseline. There was a signifcant reduction in the Overall Raw and in Overall Uncorrected Vision Scores between baseline and post mission indicating a significant reduction in visual acuity during the 9 days mission that was not restored immediately after the mission.Living in a saturation environment decreases certain sensory modalities that may persist for an unknown length of time after the exposure. Diminished sensitivity to taste can alter nutritional status and chemosensory changes may also relate to space sickness, stress and psychological factors, while changes in vision may impair operational tasks. These data indicate that mitigation strategies need to be developed and tested in space analog environments.Support or Funding InformationKetone Technologies LLC provided partial funding for the study. SIFT provided partial salary for CA.

Public legal means of investment of small and medium innovative entrepreneurship in the European Union

Problem setting. The development of social relations, the economic well-being of the population and the stable social structure of any state in the present circumstances are conditioned by a series of factors, one of which is the development of innovative infrastructure. One of the most important directions of development of the economic sector of our country was the formation of an innovative model of the economy, which puts to law the new tasks of clarifying the purpose and social value of law as a regulator of social relations. Analysis of recent researches and publications. The current state of the study of the selected issues indicates that the sources from which public-law organizations are investing innovative activities of small and medium-sized innovative entrepreneurship in the EU are insufficient. At the same time, the state policy of the EU countries in the scientific and technical sphere is realized through the use of various instruments, which include: legislation, tax policy, size and nature of the allocation of budget funds, including for the implementation of works in priority areas, the formation and maintenance of infrastructure, personnel, etc. Target of research is to identify the public and legal means of investing small and medium innovative entrepreneurship in the EU. Article’s main body. In the EU, the innovative component of public policy encompasses the scope of national scientific institutions (institutes, research centers, university laboratories, etc.). There are government programs that receive partial funding from the state budget. The state is guided by different criterias when deciding on the financing of specific works. First, the prospect of each specific direction is evaluated from the point of view of preserving the country’s achieved position on the world market in the future. Second, the recognition at the governmental level of innovation as a vital factor of economic development, the conduct of a broad government company on the problems of innovation. The current state of regulatory support suggests that structural funds such as the European Regional Development Fund and the European Social Fund should be considered as the main public sources of investment for innovative enterprises. In particular, such funds are implementing EIC Pathfinder Pilot, FET Innovation Launchpad, EIC Transition to Innovation Activity, EIC Accelerator, Programme for the Competitiveness of Enterprises and Small and Medium-sized Enterprises (COSME) etc. Conclusions and prospects for the development. In the EU, the investment of small and medium enterprises is not homogeneous, but a large part of them, despite the large number of investment support tools for such companies, face significant challenges in accessing investment resources. Developing a successful pan-European policy requires an indepth understanding of the problems and specifics of financing the innovation activities of small and medium innovative enterprises in EU Member States.

Self-administered versus provider-administered medical abortion.

The advent of medical abortion has improved access to safe abortion procedures. Medical abortion procedures involve either administering mifepristone followed by misoprostol or a misoprostol-only regimen. The drugs are commonly administered in the presence of clinicians, which is known as provider-administered medical abortion. In self-administered medical abortion, drugs are administered by the woman herself without the supervision of a healthcare provider during at least one stage of the drug protocol. Self-administration of medical abortion has the potential to provide women with control over the abortion process. In settings where there is a shortage of healthcare providers, self-administration may reduce the burden on the health system. However, it remains unclear whether self-administration of medical abortion is effective and safe. It is important to understand whether women can safely and effectively terminate their own pregnancies when having access to accurate and adequate information, high-quality drugs, and facility-based care in case of complications. To compare the effectiveness, safety, and acceptability of self-administered versus provider-administered medical abortion in any setting. We searched Cochrane Central Register of Controlled Trials, MEDLINE in process and other non-indexed citations, Embase, CINAHL, POPLINE, LILACS, ClinicalTrials.gov, WHO ICTRP, and Google Scholar from inception to 10 July 2019. We included randomized controlled trials (RCTs) and prospective cohort studies with a concurrent comparison group, using study designs that compared medical abortion by self-administered versus provider-administered methods. Two reviewers independently extracted the data, and we performed a meta-analysis where appropriate using Review Manager 5. Our primary outcome was successful abortion (effectiveness), defined as complete uterine evacuation without the need for surgical intervention. Ongoing pregnancy (the presence of an intact gestational sac) was our secondary outcome measuring success or effectiveness. We assessed statistical heterogeneity with Chi2 tests and I2 statistics using a cut-off point of P < 0.10 to indicate statistical heterogeneity. Quality assessment of the data used the GRADE approach. We used standard methodological procedures expected by Cochrane. We identified 18 studies (two RCTs and 16 non-randomized studies (NRSs)) comprising 11,043 women undergoing early medical abortion (≤ 9 weeks gestation) in 10 countries. Sixteen studies took place in low-to-middle income resource settings and two studies were in high-resource settings. One NRS study received analgesics from a pharmaceutical company. Five NRSs and one RCT did not report on funding; nine NRSs received all or partial funding from an anonymous donor. Five NRSs and one RCT received funding from government agencies, private foundations, or non-profit bodies. The intervention in the evidence is predominantly from women taking mifepristone in the presence of a healthcare provider, and subsequently taking misoprostol without healthcare provider supervision (e.g. at home). There is no evidence of a difference in rates of successful abortions between self-administered and provider-administered groups: for two RCTs, risk ratio (RR) 0.99, 95% confidence interval (CI) 0.97 to 1.01; 919 participants; moderate certainty of evidence. There is very low certainty of evidence from 16 NRSs: RR 0.99, 95% CI 0.97 to 1.01; 10,124 participants. For the outcome of ongoing pregnancy there may be little or no difference between the two groups: for one RCT: RR 1.69, 95% CI 0.41 to 7.02; 735 participants; low certainty of evidence; and very low certainty evidence for 11 NRSs: RR 1.28, 95% CI 0.65 to 2.49; 6691 participants. We are uncertain whether there are any differences in complications requiring surgical intervention, since we found no RCTs and evidence from three NRSs was of very low certainty: for three NRSs: RR 2.14, 95% CI 0.80 to 5.71; 2452 participants. This review shows that self-administering the second stage of early medical abortion procedures is as effective as provider-administered procedures for the outcome of abortion success. There may be no difference for the outcome of ongoing pregnancy, although the evidence for this is uncertain for this outcome. There is very low-certainty evidence for the risk of complications requiring surgical intervention. Data are limited by the scarcity of high-quality research study designs and the presence of risks of bias. This review provides insufficient evidence to determine the safety ofself-administration when compared with administering medication in the presence of healthcare provider supervision. Future research should investigate the effectiveness and safety of self-administered medical abortion in the absence of healthcare provider supervision through the entirety of the medical abortion protocol (e.g. during administration of mifepristone or as part of a misoprostol-only regimen) and at later gestational ages (i.e. more than nine weeks). In the absence of any supervision from medical personnel, research is needed to understand how best to inform and support women who choose to self-administer, including when to seek clinical care.

A Mathematical Model Impact Analysis of a Pre-Exposure Prophylaxis and Treatment-As-Prevention Study Among Female Sex Workers in Cotonou, Benin

Background: Daily pre-exposure prophylaxis (PrEP) and treatment-as-prevention (TasP) reduce HIV acquisition and transmission risk, respectively. With a 2015 HIV prevalence of 17%, female sex workers (FSW) are a key group for HIV prevention in Cotonou, Benin. A demonstration study (2015-2017) assessed the feasibility of TasP and PrEP among FSW. We aimed to assess the population-level impact of the study and various extended and scaled-up PrEP and TasP interventions. Methods: We developed a dynamic HIV transmission model, featuring PrEP, and ART among FSW, clients and the low-risk population, parameterised with the demonstration study data and historical demographic, behavioural, epidemiological and intervention data from Cotonou. The model was calibrated to HIV prevalence, ART coverage, and demonstration study data, reflecting observed lower PrEP uptake, adherence and retention compared to TasP. We modelled the two-year study and several twenty-year intervention scenarios, varying coverage and adherence. We estimated the median (2.5th-97.5th percentile uncertainty interval (95%UI)) percentage and number of incident HIV infections averted comparing the intervention and counterfactual (2017 coverages: 0% PrEP, 49% ART) scenarios. Findings: The two-year study (2017 coverages: 9% PrEP, 83% ART) prevented an estimated 8% (95%UI 6-11) and 5% (2-9) infections among FSW over two and twenty years, respectively, compared to 16% (9-28) and 7% (3-12) among clients, and 6% (3-11) and 4% (2-8) overall. Twenty-year PrEP and TasP scale-ups (2035 coverages: 47% PrEP, 88% ART) prevented 23% (18-28) and 15% (9-23) infections among FSW respectively, and 5% (3-9) and 14% (8-25) overall. Compared to TasP scale-up alone, scaling up PrEP and TasP together prevented 107% and 29% more infections among FSW and overall, respectively. PrEP impact doubled when assuming perfect adherence. Interpretation: The demonstration study had a modest impact, mostly due to TasP. Increasing PrEP adherence and coverage improves impact substantially among FSW, but little in the overall population. TasP should be offered in future prevention packages. Funding Statement: This study was funded by the Bill and Melinda Gates Foundation (grant no. OPP1098973). Complementary funding was provided by the Canadian Institutes of Health Research (grant numbers ROH-115205 and FDN-143218). Truvada for pre-exposure prophylaxis was provided free of charge by Gilead Sciences, Inc. Studentship funding was provided by the United Kingdom Medical Research Council. KM and MCB acknowledge partial funding from the HPTN modelling centre, which is funded by the U.S. National Institutes of Health (NIH UM1 AI068617) through HPTN. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: The authors received approval from the Imperial College Research Ethics Committee (ICREC reference: 18IC4641) to carry out our analysis.