Cortisol Levels in Infants with Central Coordination Disorders during Vojta Therapy

Background: Due to the decrease in the percentage of perinatal mortality, which is one of the Millennium Development Goals, the number of children with a central coordination disorder (CCD) has increased, present in up to 40% of premature babies. Neurodevelopmental disorders detected in the diagnostic process require early interventions that will eliminate or overcome existing dysfunctions. These treatments often cause discomfort in the infant, which induces insecurity and activation of basic defense mechanisms. The aim of the work is to assess changes in cortisol concentration in infants treated with the Vojta method. Methods and findings: The study included 35 children with CCD aged between three and nine months. The participants had no comorbidities that could have affected the obtained results. The activities were planned to occur in three stages: 1. Collection of a saliva sample directly before the physiotherapy appointment. 2. Collection of saliva immediately after rehabilitation. 3. Collection of saliva 20 min after the end of rehabilitation. The physiotherapeutic intervention included the assessment of seven reactions of the body position in space according to Vojta and the conduct of a therapeutic session consisting of the first phase of rotation and creeping reflex according to Vojta. The concentration of free cortisol in saliva was assessed with LC-MS/MS. In the first measurement, none of the children presented an excess of the normative concentration of cortisol. The cortisol measurement performed directly after rehabilitation showed above-normative values in three children. In the third measurement, all of the children presented a decreased concentration of free cortisol. The analysis (paired two-tailed t-test, p < 0.05) showed statistically significant differences between particular stages of the measurements. The analysis of the scores obtained in the second measurement showed the concentration of scores in the area of “normal” at a level of 0.83 (normal concentration) and the area “above normal” at the level of 0.005 (very weak concentration). Based on the analysis of significance of the obtained scores, it was found that the result was not accidental, and the Vojta method used in the treatment of children with CCD was suitable. Conclusions: Here, for the first time, we presented how Vojta therapy was correlated with cortisol levels among children with a central coordination disorder.

Factors affecting rehabilitation of infants with Central Coordination Disorders during a three-month-long observation

Background Central coordination disorders (CCD) encompass various abnormalities observed in infants but early therapy may have an impact on their condition. The aim was to seek factors that may affect the early results of therapy of infants with CCD. Methods We analyzed the outcomes of a three-month period of rehabilitation of infants living with CCD. Children were treated at Non-public Specialist Healthcare Institution Medi-Reh in Kalisz in the period from 1 Jan 2014 to 31 Nov 2019. In our retrospective study results of three-month therapy of infants, aged 1 to 6 months, with CCD were analysed regards to the effectiveness and the potential impact of different factors. Therapy and assessment of children were conducted with the use of the Vojta method, which was performed during the first visit (WW) and the follow-up visit (after 3 months- 1WK). The analysis of the influence of various factors on the effect of therapy included: mother's age at the time of delivery, duration of breastfeeding, child APGAR, gestational age in which the child was born, sex of the child, birth weight, age of the child at WW, type of delivery, craniosacral therapy as an additive treatment. Results Based on the examination results from 66 medical records it was demonstrated that after active period of the therapy, improvement was observed in 54 (81.81%) (p=0.48) children (condition during WW versus 1WK among the group). The sole factor impacting improvement after 3 months was the age of the child at WW, when the child started therapy. This factor significantly (p=0.002) increased the chance of achieving improvement - by 3.2 times (OR= 3,2; CI= 95). No statistically significant differences were shown for the other studied factors. Conclusions Prompt implementation of rehabilitation in children with CCD provides a better chance of improving their motor function. The rehabilitation should be started as soon as possible after the diagnosis is constituted.

Internationalization of Chinese Research and Development

The internationalization of Chinese research and development (R&D) is a fairly recent phenomenon and still ongoing process. What makes the rise of international Chinese R&D remarkable is that this is—alongside India—one of the first such endeavors by a developing country with already one of the most substantial global R&D footprints, even including Western countries. Similar motivations and challenges of earlier R&D globalization are replicated and observed also in the recent Chinese internationalization, with a few emerging country-specific nuances, such as the focus on technology acquisition through merger and acquisition (M&A) and suspected central coordination by the Chinese government, which has given rise to challenges of its own for Chinese multinational corporations (MNCs). In this respect, China seems to have been the victim of its own success; the future of Chinese R&D internationalization bears both opportunities and challenges for the global innovation community.

Probing Electron Excitation Characters of Carboline-Based Bis-Tridentate Ir(III) Complexes

In this work, we report a series of bis-tridentate Ir(III) metal complexes, comprising a dianionic pyrazole-pyridine-phenyl tridentate chelate and a monoanionic chelate bearing a peripheral carbene and carboline coordination fragment that is linked to the central phenyl group. All these Ir(III) complexes were synthesized with an efficient one-pot and two-step method, and their emission hue was fine-tuned by variation of the substituent at the central coordination entity (i.e., pyridinyl and phenyl group) of each of the tridentate chelates. Their photophysical and electrochemical properties, thermal stabilities and electroluminescence performances are examined and discussed comprehensively. The doped devices based on [Ir(cbF)(phyz1)] (Cb1) and [Ir(cbB)(phyz1)] (Cb4) give a maximum external quantum efficiency (current efficiency) of 16.6% (55.2 cd/A) and 13.9% (43.8 cd/A), respectively. The relatively high electroluminescence efficiencies indicate that bis-tridentate Ir(III) complexes are promising candidates for OLED applications.

Factors Affecting Rehabilitation of Infants With Central Coordination Disorders During a Three-month-long Observation

Background:Central coordination disorders (CCD) encompass various abnormalities observed in infants but early therapy may have an impact on their condition.The aim was to seek factors that may affect the early results of therapy of infants with CCD.Methods: In our retrospective study results of three-month therapy of infants, aged 1 to 6 months, with CCD were analysed regards to the effectiveness and the potential impact of different factors. Therapy and assessment of children were conducted with the use of the Vojta method, which was performed during the first (WW) and the follow-up visit (after 3 months- 1WK). The analysis of the influence of various factors on the effect of therapy included: mother's age at the time of delivery, duration of breastfeeding, child APGAR, gestational age in which the child was born, sex of the child, birth weight, age of the child at WW, type of delivery, craniosacral therapy as an additive treatment.Results:Based on the examination results from 66 medical records it was demonstrated that after 3 months of therapy, improvement was observed in 54 (81.81%) children. The sole factor impacting improvement after 3 months was the age of the child at WW, when the child started therapy. This factor significantly (p=0.002) increased the chance of achieving improvement - by 3.2 times. No statistical differences were shown for the other studied factors.ConclusionsThe age of the child at the beginning of the treatment had a significant impact on early (3 mo) improvement.

Following the Old Road: Organizational Imprinting and the Regional Development of Russia

ABSTRACT In this article, I draw from organizational imprinting theory to illuminate the impact of the Soviet legacy on contemporary Russian economic geography and regional policy. I argue that central coordination in the creation and regulation of Russian urban agglomerations is connected to a socialist imprinted paradigm associated with the Soviet economic regionalization model and territorial-production complexes (TPCs). I conduct a qualitative historical study to analyze the role of the foundational environment and the dynamics in the development of this imprint. I propose that this imprint effect is prone to reproduction in contemporary regional development strategies and community-based paradigms due to exaptation and cultural-cognitive persistence. The article extends the literature of socialist imprinting by demonstrating how imprints may emerge, transform, and affect localized organizational communities in transition economies and highlights the role of imprinted paradigms in policymaking and regional development.

MSE minimized joint transmission in coordinated multipoint systems with sparse feedback and constrained backhaul requirements

In a joint transmission coordinated multipoint (JT-CoMP) system, a shared spectrum is utilized by all neighbor cells. In the downlink, a group of base stations (BSs) coordinately transmit the users’ data to avoid serious interference at the users in the boundary of the cells, thus substantially improving area fairness. However, this comes at the cost of high feedback and backhaul load; In a frequency division duplex system, all users at the cell boundaries have to collect and send feedback of the downlink channel state information (CSI). In centralized JT-CoMP, although with capabilities for perfect coordination, a central coordination node have to send the computed precoding weights and corresponding data to all cells which can overwhelm the backhaul resources. In this paper, we design a JT-CoMP scheme, by which the sum of the mean square error (MSE) at the boundary users is minimized, while feedback and backhaul loads are constrained and the load is balanced between BSs. Our design is based on the singular value decomposition of CSI matrix and optimization of a binary link selection matrix to provide sparse feedback—constrained backhaul link. For comparison, we adopt the previously presented schemes for feedback and backhaul reduction in the physical layer. Extensive numerical evaluations show that the proposed scheme can reduce the MSE with at least $$25\%$$ 25 % , compared to the adopted and existing schemes.

National ownership of family planning: What do FP2020 commitments have to do with it?

Background: In 2020, we reached a family planning (FP) temporal milestone. This paper seeks to understand the political economy of commitments and normative best practice within FP national programs, contributing to “stock taking” of change objectives for national ownership and domestic financing of FP programs post FP2020. Stock taking is needed to understand, for example, do we expect our current approaches to deliver greater commitment or do we need to change our approach? Is time the limiting factor for FP2020 commitments or are other, contextual, mechanistic and implementation factors more critical? Methods: This paper uses mini-case studies to offer insights in response to these questions. It drew from country status updates of national FP program commitments published on the FP2020 website. These included country self-assessments, country action for acceleration plans and revitalised commitments using standard templates provided by FP2020. Results: Critical factors emerging from the case study analysis suggest the following. Context: Country programs that adapted best practices through thoughtful selection, regular monitoring, and course correction, were more responsive to context and better able to scale interventions. Mechanism: Programs that embedded commitments within national health reforms and transformative agendas were able to sustain commitment and mechanism more effectively over time. Implementation: Programs that were able to balance central coordination with devolved implementation, more effectively translated commitments to action. Monitoring: Programs that placed emphasis on monitoring progress and course correct were better able to steward national commitments and partner inputs. Conclusions: National FP programs included within the country comparative analysis benefitted from their engagement with FP2020. However, not all were able to convert FP2020 commitments into national ownership. In many FP2020 contexts, there is less need for a technical intervention and greater need for engaging politically on sensitive issues that constrain women’s and adolescent empowerment and rights and access to FP.

A Sociotechnical Approach to Analyze Pharmaceutical Policy and Services Management in Primary Health Care in a Brazilian Municipality

The decentralization of the Brazilian health system required that municipalities took responsibility for the local Pharmaceutical Policy and Services (PPS) system. This article presents and analyses an innovative experience of diagnosis of municipal PPS as a sociotechnical system. We adopted a multi-methods approach and various data sources. Sociotechnical theory was the framework of the methodology of evaluation and design of systems, analyzing the External System (health system, stakeholders, financing) and Internal System (goals, management, workforce, infrastructure, processes, technology and culture). The “objective” component of the PPS system was identified as the central element. The lack of a unified objective and of a central coordination and unmanaged pharmaceutical services prevented integrated internal planning and planning with other sectors. Stakeholders and documents referred only to technical elements of the system: Infrastructure, technical process, and technology. The social components of the workforce and culture were not mentioned. The organizational culture established was the culture of isolation: “Each one does his own”. The pharmacists working in the municipal health system did not know each other. There was no integration strategy between pharmacists and their work processes. Consequently, the municipal PPS had limited scope as a public policy. It had constrained the characteristics of PPS as a complex and open system. Understanding the municipal PPS as a sociotechnical system can push the development of a new level of policy and practice to ensure the population’s right to the access to and rational use of medicines.

MSE Minimized Joint Transmission in Coordinated MultiPoint Systems with Sparse Feedback and Constrained Backhaul Requirements

In a joint transmission coordinated multipoint (JT-CoMP) system, a shared spectrum is utilized by all neighbor cells. In the downlink, a group of base stations (BSs) coordinately transmit the users’ data to avoid serious interference at the users in the boundary of the cells, thus substantially improving area fairness. However, this comes at the cost of high feedback and backhaul load; In a frequency division duplex (FDD) system, all users at the cell boundaries have to collect and send feedback of the downlink channel state information (CSI). In centralized JT-CoMP, although with capabilities for perfect coordination, a central coordination node (CCN) have to send the computed precoding weights and corresponding data to all cells which can overwhelm the backhaul resources. In this paper, we design a JT-CoMP scheme, by which the sum of the mean square error (MSE) at the boundary users is minimized, while feedback and backhaul loads are constrained and the load is balanced between BSs. Our design is based on the singular value decomposition (SVD) of CSI matrix and optimization of a binary link selection matrix to provide sparse feedback -constrained backhaul link. For comparison, we adopt the previously presented schemes for feedback and backhaul reduction in the physical layer. Extensive numerical evaluations show that the proposed scheme can reduce the MSE with at least 25%, compared to the adopted and existing schemes.