A paper by Francis and colleagues1 in this issue of the Journal, as well as other recent articles evaluating the effects of various models of "continuity clinics" on patient and resident satisfaction, remind me of Darwin's descriptions of the natural selection and extinction or adaptation of species. The authors of these studies grapple with permutations of curricula to achieve more "continuity," but toward what outcome is not always clear. I am reminded that successful training models follow the premise "Make training like practice" as much as possible, rather than "Make practice like training." I submit that "practice" today has changed significantly. The "continuity" we trained for in the past may be no longer apropos, nor even desirable.

In the 1960s and 1970s we taught that maximizing the 1∶1 physician-patient encounters at all times and in all settings provided optimal continuity. I have defined continuity, in this context, as having all critically important information for the care and caring of the patient in a long-term, professional relationship between physician and patient. This continuity occurred in most practices, particularly for primary care physicians. It ensured consistent information transfer as the patient was treated in different settings by the same physician. It was comforting to the patient and rewarding for the clinician. With radical changes in practice patterns in the 1980s, which accelerated in the new millennium, continuity has declined significantly—almost disappearing (extinction?). Yet educators are still trying to recapture the essence of that continuity, with varying degrees of success, and to the consternation of the population (physicians or patients) who receive questionable value from such attempts. Findings from the study by Francis and colleagues1 suggest that there is disagreement between what patients believe is good continuity and what students or residents value.

In 1970, when we created a new family practice residency at Sparrow Hospital/Michigan State University Medical School in Lansing, our number one goal was to "make training like practice." We implemented a nonrotational residency that, though quite successful at the time, has since been extensively modified to fit practice changes and Residency Review Committee requirements. Residents were placed into small teams (2 second-year, 2 third-year, and 2 incoming first-year residents) who cared for the same patient population throughout their training in almost all settings. Most of the residents' clinical training was derived from caring for this large patient population. Each resident had short, regularly occurring times for training in other specialty interests to fill individualized learning needs. Continuity in this setting with the identified resident physician was very high (85%), and with the physician team even higher. Continuity as defined then was optimized.

During the 1980s, practices changed with the arrival of health maintenance organizations (HMOs) that hired young primary care physicians to their largely ambulatory settings, simultaneously diverting them from hospital care. We witnessed a decrease in total continuity as physicians assumed fewer, but regular, working hours and spent less time on call. After-hours care occurred in urgent care centers and emergency rooms, while inpatient care migrated to the new specialists, "hospitalists." Continuity suffered another hit as medical records were no longer immediately available to the treating physicians. Current electronic health record systems still have challenges in compatibility and availability—a notable exception is the Veterans Administration VistA system, a nationwide success story of integrated electronic health records.

Today, we have an essentially new primary care practice paradigm. The old 1∶1 physician-patient, 24/7 × 365-day relationship rarely exists now outside of some rural settings and concierge practices. The dinosaur general practitioner of yore has almost become extinct. In the study by Francis and colleagues,1 different models of continuity clinic structure resulted in different continuity metrics, as measured from the patient point of view versus the resident point of view. In today's medical practices, perhaps only a tightly knit team, rather than a single primary clinician, can commit to an adequate level of continuity as measured from the patient's viewpoint.

With team continuity, we may be able to achieve critical components of the old continuity as well as greater patient satisfaction. Continuity might be further enhanced as our ability to capture, store, collate, integrate, and share critical medical information increases. Just using an electronic health record will not achieve that end. Rather we require a "virtual continuity" that facilitates access to critical patient information across all practice settings. Virtual continuity necessitates 3 components:

A repository of critical patient information and primary care management is maintained. In this aspect of the medical home, a patient population clearly identifies with, and maintains, a long-term relationship with a group practice that manages the population's medical care.

Critical patient information is accessible 24/7 by the patient and the practice, and shared as needed with other clinicians who become involved in the patient's care. There must be more involvement in sharing information than simply passing along medical records. On-call providers from the system need to be available to work with other providers to interpret the nuances of the medical record and advocate for the patient's values.

The virtual practice needs to include continual and participatory monitoring of care. The patient cannot be transferred to others and forgotten. The practice must provide ongoing monitoring, via appropriate-level staff, for all treatments given outside of the practice. This monitoring may be 1 of the most effective and efficient assurances of appropriate care possible. There are too many examples of critical patient information dropped, ignored, or misunderstood, leading to preventable adverse outcomes. Technological initiatives with telemedicine make this ongoing monitoring feasible. Improved reimbursement systems and savvy business managers may make it cost effective.

Such a proposed Darwinian adaptation of continuity can move us into the more complex, virtual continuity of today. Whether continuity is measured from the patient or resident point of view, training for actual practice requires that new continuity structures be taught during residency, particularly primary care residencies. Next research steps should measure quality of care given to populations of patients, in these virtual continuity models, both by physicians in training and after graduation from residency. This also should include the provision of high-value care necessary to reduce health disparities and promote cost effectiveness.


Psoriasis is a chronic, inflammatory skin disorder that is associated with obesity. Independently, both psoriasis and obesity likely impose impressive physical and psychosocial burdens on affected patients.


for of in the operating for is derived propeller characteristic and DC motor equivalent circuit model. these new discharge cut-off conditions which enable us to determine the proper effective capacity in hovering flight are derived. The hover endurance analysis according to the estimated effective capacity is respect to the


Hereditary deficiency of phosphoglycerate kinase (PGK; ATP: 3-phosphoglycerate 1-phosphotransferase; E.C.18.104.22.168) associated with hemolytic anemia and mental disorders has been found in several unrelated families Biochemical characteristics of the variant enzymes from these subjects have been and the nature of these enzyme is not This describes the electrophoretic mobility, enzymatic properties, and immunologic characteristics of a variant enzyme from a hemizygous male subject who has an enzyme deficiency and hemolytic anemia. Clinical and hematologic studies of the subject and his relatives have been reported [6, in hematocrit tubes (1.2 X 75 mm) by a hematocrit centrifuge for 30 min at 12,500 rpm and at 40 C. Leukocytes were eliminated from younger red cell populations by the method devised by Kirkman et al. [10]. The frac- tionated red blood cells were hemolyzed by mixing with 5 vol of water and a few drops of toluene. The centrifuged supernatant was used for enzyme assay. Assay of enzyme activity. Phosphoglycerate kinase activity was assayed in a reaction This study


Incidental exposure to information when consuming entertainment oriented videos may lead to different levels of incidental learning. In this work we take the example of an Indian web-series which depicts rural society, lifestyle and culture but is targeted towards an urban audience [6], and design a between groups study to understand if the urban audience is exposed to new social, political and cultural artefacts and to understand the recognition and recall of the artefacts. Through an opt-in online survey we find evidence that the urban audience has become aware of new social, political and cultural artefacts through the web-series and are able to recognise these artefacts when presented with them, indicating that there has been incidental learning. We also qualitatively analyse conversations around the series on Twitter and find low recall of the artefacts covered in the online survey, hinting that the incidental exposure has led to implicit learning [25].


The family learning approach, home education, or homeschooling is an alternative pedagogical choice that enables parents to take charge of their school-aged child's education by replacing full-time school attendance. Scientific research on the family learning approach is emerging and mainly conducted and published in English-speaking contexts. This article presents a brief concept note of recent and international scientific literature on the family learning approach in order to identify studied dimensions and current knowledge. The following themes are addressed: history, current picture, place in society, and issues of the family learning approach.


Abstract : This handbook was developed to assist Air Force and Department of Defense (DOD) Contracting and Acquisition personnel in planning for, contracting for, and using technical data to foster competition. If DOD contracting is to be successful in obtaining and utilizing contractor, subcontractor and vendor data in competitive acquisitions it must: 1. Develop business strategies to acquire the data; 2. Establish contractual requirements for delivery of acquisition data for those items the Government intends to acquire competitively; 3. Obtain the rights to use the acquisition data; 4. Assure the acceptability of the acquisition data; and 5. Use the acquisition data in competitive acquisitions where it is economically and technically feasible.


Longhushan is a large geo-park,owning the specially characteristic landscape of Danxia landform,and 10 km far from Yingtan city,which located in northeast of Jiangxi Province in China.The Danxia landscape's layer in Longhushan mainly make up of the rock of sandstone,conglomerate,mudstone.With steep cliffs,intricate joints,the area developed a number of peculiar shape rock with the value of prominent tourism and aesthetic appreciation,which is named landscape-rockfall.Landscape-rockfall went through a long-term revolution of geological process,and was the results of many internal and external geological actions.The main factors are topography,lithology,geological structure,hydrogeological conditions and the carved-erosion action(including erosion and dissolution,the weathering in different temperature,micro-chemical weathering).The carved-erosion plays the core role in the process of formation.Landscape-rockfall disaster prevention ought to follows the five principles of nondestructibility,approximability,reversibility,no interference and compatibility.According to the present technology of preventing rockfall and the particularity of landscape-rockfall,the text proposed a hang-pull method that made by the rope,cable,etc.to provide some upward pull to make the unstable rock meet the required coefficient of stability.The hang-pull method has many advantages of wide application,simple theoretical calculation,better improving stability coefficient,convenient construction,easy maintenance and easy follow-up monitoring,etc,and it is suitable for protecting the rock landscape.


This attractive production sets a very high standard indeed. Fifty-nine ballad and song texts are presented with minimal editorial intervention, but with thoroughly researched background and history, together with detailed musical analyses. Not only is the important repertoire of the Harris sisters showcased, but also informative links with a number of nineteenth-century collectors such as Andrew and David Laing, Norval Clyne, and Peter Buchan are provided via a wealth of incidental detail and in the appendices. Those who have studied Child's English and Scottish Popular Ballads (and Bronson's related writings) will be well aware that "Harris" is given as the source of a considerable number of his versions, and that Harris tunes comprise half his musical examples. Is there any need, therefore, for a further treatment of this material? The answer must be "yes," for at least three reasons: first because the Harris sisters' repertoire contained more than "Child" ballads; second because—almost uniquely for the period—they provided tunes; and third because of the collection's illuminating history. The sisters sent Child these versions in 1873, with accompanying musical scores by the younger sister Jane (1823–97), but this was not in fact the first attempt the women had made to bring their repertoire to the notice of ballad scholars. The elder, Amelia (1815–91), had previously sent a set of their songs (without music) in 1859 to the Edinburgh professor, William Aytoun (1813–65), editor of The Ballads of Scotland (1858). Aytoun, greatly impressed, had even passed her fine version of "Patrick Spens" to the Aberdeen advocate and ballad scholar, Norval Clyne, to assist Clyne in his demolition of the "Lady Wardlaw Heresy" (that this ballad and others were fabrications). But Aytoun died before the Harris material could be incorporated into the third edition of his ballad book, and the material went missing until 1955 when the bound manuscripts were found by Hilary Corke of Edinburgh's department of Mediaeval Literature. This meant that there were now two sets of the manuscripts, assembled separately, fourteen years apart—a rare example of oral repertoire evolution. According to the sisters, the majority of their songs had been learned from their mother, who had in turn learned them from her nurse, and this placed them 150 years back in time "by direct transmission" (the accompanying CD claims the songs are "from Perthshire tradition," but in fact the nurse's origin and the source of her songs are not known). The sisters also maintained firmly that their texts were "exactly as heard" (with any gaps in their memories shown as blank spaces) and "traditionally pure," uninfluenced by publications such as Walter Scott's. The airs were given exactly as recalled "with great purity" (although Jane had added basses for accompaniment purposes). Emily Lyle provides an authoritative account of the manuscripts and the editing practice, and Kaye McAlpine gives a detailed account of the Harris family and their contacts (largely gained from the sisters' own descriptions). Anne Dhu McLucas discusses the music of the thirty song texts. She is somewhat sniffy about poor Jane's "sketchy" musical notation, especially with regard to time and pitch (not realising that this is the way we musically semi-literates attempt such records), and ominously states that "drastic editing" has been required "based on the editor's knowledge of the Scottish


The study assessed the effectiveness of knowledge sharing strategies to capture knowledge in the institution's knowledge assets at the National Archives of Zimbabwe (NAZ). The study was conceived against a background of performance gaps experienced by NAZ as a result of the loss of experienced members from the service. A survey research design was used on a purposively selected sample of 26 respondents. It was established that due to attrition knowledge is lost when experienced members leave service without sharing what they know with junior and new members. Consequently it was recommended that NAZ develops a knowledge sharing policy to ensure that knowledge is shared, captured and retained within the organisation. Thus it was concluded that effective knowledge sharing strategies are the basis for the capture, retention and exchange of critical job knowledge.


Intestinal or hepatic amoebiasis caused by Entamoeba histolytica is estimated to affect about 10 :/o of the world population (W.H.O. Expert Committee on Amoebiosis, 1969). Free living amoebae such as Acanthamoeba and Naeglaria are now implicated in fatal meningoencephalitis in man (Culbertson, Ensminger & Overton, 1966; 1968). Although a number of drugs are available which are effective against the vegetative or trophic form of pathogenic amoebae, the discovery of a cysticidal agent remains a challenge. With the urgency of the need for cysticidal agents in the eradication of amoebiasis, the W.H.O. Expert Committee on Amoebiasis (1969) has stressed the importance and relevance of basic studies directed towards the understanding of the nature of the amoebic cyst wall and the process of encystation and excystation. Employing the free-living amoeba Hartnianrzella culbertsoni, previous studies from this laboratory have shown that trophozoites can be transformed axenically into viable cysts by exposure to taurine and several other biogenic amines (Raizada & Krishna Murti, 1971 a ; Raizada, Verma & Kirshna Murti, 1972). Thesc amines exert their triggering action on encystation through the intermediary agency of cyclic 3',5'-adenosine monophosphate (Krishna Murti, 1971 ; Raizada & Krishna Murti, 1972a; Raizada et al. 1972). These cysts differ from trophozoites in having cellulose and mucopolysaccharides as their major cell components (Raizada & Krishna Murti, I 971 b ; 1972 b). Availability of enzymes degrading the cyst wall should lead to improved understanding of the localization of these components and the chemical linkages between them. An enrichment culture technique has been employed, using cysts of Hartmannella culbertsoni, to isolate organisms able to degrade the cysts. The present report summarizes the experiments on the isolation, characterization and cystolytic activity of Alternaria sp. capable of lysing the cysts of H. culbertsoni. Cysts of Hartmannella culbertsoni (Singh & Das, 1970) were prepared by methods described earlier (Raizada & Krishna Murti, 1972 b). Portions of 50 mg wet wt of cysts were suspended in 20 ml 50 mwphosphate buffer (pH 5-0 for fungus and pH 7.0 for bacteria), autoclaved at I 5 lb/in2 for 20 min and cooled ; to this was added 0.2 ml of a salt solution containing (g/l) : MgS04. 7H20 , 20; FeSO,. 7H20, 5 ; CaCI,, 2-0; MnCI,, 0-2 ; sodium molybdate, 0-1. The flasks were inoculated with soil samples and incubated with shaking at 30 "C. Samples were removed and examined periodically for disappearance of cysts. A fungus grew in one flask, which when inoculated into fresh medium containing cysts resulted in the complete disappearance of cysts in 3 to 4 days. This fungus was isolated by repeated streaking on potatodextrose agar medium (Difco, Detroit, Michigan, U.S.A.) and was stored as spores preserved in sterile sand.


The article reveals the essence of such notions as «literacy», «chemical literacy», «the process of chemical literacy development», as well as the structure of pupils' chemical literacy at a comprehensive school.


the paper instroduces the related technology using ASP.NET for developing Web applications base on data,including system structure 、ASP.NET and ADO.NET,in addition,give the developing method.


The value of research on effects of O{sub 3} done in greenhouse or field exposure systems is often questioned because chamber environments may affect plant response. Foliar injury, chlorophyll, and forage weight responses of two clones of white clover (Trifolium reopens L.) to ambient O{sub 3} were compared for plants grown in charcoal-filtered (CF) and nonfiltered air (NF) in a greenhouse and open-top field chambers and in ambient air (NF) in a greenhouse and open-top field chambers and in ambient air (AA) plots at Raleigh, NC. One clone is sensitive to O{sub 3} (NC-S), whereas the other is resistant (NC-R). Comparisons of individual clone responses in CF vs. NF treatments in the greenhouse and in the field and the proportional response of the clones (defined as the NC-S/NC-R response ratio) were used to indicate the relative response to O{sub 3} in the different environments. Foliar injury and chlorophyll responses of NC-S to O{sub 3} were similar in the NF greenhouse, NF open-top chambers, and in AA. However, for individual harvests, the percentage decrease in NC-S forage weight in NF compared with CF was 7 to 23% greater in the greenhouse than in open-top chambers. The NC-S/NC-R forage ratios indicated thatmore » clover response to O{sub 3} in NF open-top field chambers was the same as in AA. Large environmental differences between greenhouse and open-top chambers apparently caused differences in plant responses to O{sub 3}, whereas relatively small environmental differences between open-top chambers and ambient air did not. 22 refs., 4 figs., 2 tabs.« less


The composite membranes based on MF-4SC incorporating nanoparticles of silica, zirconia, and polyaniline were synthesized. The transport phenomena in obtained membranes were studied with the help of different techniques. It was shown that the composite membranes had the higher proton conductivity than the initial membrane. The diffusion permeability of HCl and NaCl solutions was found to decrease for MF-4SC/ZrO2 composite membranes and increase for MF-4SC membranes incorporating silica or polyaniline. Copyright © 2009 John Wiley & Sons, Ltd.


Objective: Evaluate patient-reported quality of life (QoL) over 6 years in alemtuzumab-treated relapsing-remitting MS (RRMS) patients with an inadequate response to prior therapy. Background: In CARE-MS II (NCT00548405), alemtuzumab improved clinical and MRI outcomes versus SC IFNB-1a over 2 years. In an extension study (NCT00930553), efficacy was durable through 6 years. Design/Methods: In the 2-year core study, patients received 2 courses of alemtuzumab 12 mg (baseline: 5 days; Month 12: 3 days) or SC IFNB-1a 44 μg 3×/week. In the extension, core study alemtuzumab patients could receive as-needed alemtuzumab retreatment or another disease-modifying therapy. QoL assessments: Functional Assessment of MS (FAMS); Short-Form 36-Item survey (SF-36) including both physical and mental component summary (PCS and MCS, respectively); EuroQol-5 Dimensions visual analog scale (EQ-5D). QoL changes from baseline were analyzed by mixed-effects linear model. Results: At Year 2 of the core study, alemtuzumab patients had significant improvements from baseline versus SC IFNB-1a on FAMS (treatment difference at Year 2, 5.23 [95% CI: 1.21, 9.26]), PCS (1.86 [95% CI: 0.54, 3.19]), and EQ-5D (5.09 [95% CI: 2.21, 7.97]), and numerical improvements on MCS (0.73 [95% CI: −0.91, 2.37]). Of 423 alemtuzumab patients who completed CARE-MS II, 393 (93%) entered the extension. At Year 6, alemtuzumab patients maintained significant improvements from baseline on FAMS (difference from baseline, 3.16 [95% CI: 0.07, 6.25]), MCS (1.58 [95% CI: 0.35, 2.82]), and EQ-5D (3.16 [95% CI: 0.93, 5.38]), and numerical improvements on PCS (1.0 [95% CI: −0.03, 2.03]). Conclusions: Alemtuzumab durably improved patient-perceived physical and mental well-being over 6 years in patients with an inadequate response to prior therapy. These results, concurrent with improved clinical and MRI outcomes, suggest that alemtuzumab may provide a unique treatment approach for RRMS patients, offering durable efficacy in the absence of continuous treatment. Study Supported by: Sanofi Genzyme and Bayer HealthCare Pharmaceuticals. Disclosure: Dr. Arroyo Gonzalez has received personal compensation for activities with Novartis, Teva, Biogen, Sanofi Genzyme, Bayer, Celgene and Roche. Dr. Margolin has received personal compensation for activities with Sanofi Genzyme as an employee. Dr. Huang has received personal compensation for activities with Sanofi Genzyme as an employee. Dr. Wang has received personal compensation for activities with Sanofi Genzyme as an employee. Dr. Zhang has received personal compensation for activities with Sanofi Genzyme as a consultant. Dr. Guo has received personal compensation for activities with Sanofi Genzyme as an employee. Dr. Cella has received personal compensation for activities with Pfizer, Astellas, Novartis, and Bayer. Dr. Investigators has nothing to disclose.


A practicum was developed and implemented to help identify, give direction to, and build self-motivation in high ability sixth-grade students attending a magnet school in a progressive, fast-growing southwestern school district. It was felt that students must be in the driver's seat for them to have ownership for working up to their potential. Goal setting would help direct students to focus on their educational and future desires. Reflective writing would provide students with a tool for self-assessment. Reflective thinking and writing would lead students to a greater sense of responsibility toward the goals they had set and to a greater understanding of their accomplishments resulting in self-motivation. The objectives for the practicum were for students to show a 207. increase in their goal accomplishment measured by student scoring through the use of a rubric and a 20% increase in ability to write reflectively measured by students and teacher scoring through the 'use of a rubric. Both objectives were met with the target group improving in both areas. Contains 16 references and 4 tables of data. Appendixes include goal setting forms and reflective thinking questions. (Author/RS) *********************************************************************** Reproductions supplied by EDRS are the best that can be made Ic from the original document. *********************************************************************** INCREASING REFLECTIVE WRITING AND GOAL SETTING SKILLS IN HIGH ABILITY SIXTH GRADE MATHEMATICS STUDENTS "PERMISSION TO REPRODUCE THIS MATERIAL HAS BEE% GRANTED BY TO THE EDUCATIONAL RESOURCES INFORMATION CENTER (ERIC).U S DEPARTMENT OF EDUCATION Unice 0 EducatIonal Resealcs and Irnprovernant EDUCATIONAL RESOURCES INFORMATION CENTER (ERIC) IVThis document has been reproduced as received from the person or organization originating il. 0 Minor changes have been made to improve reproduction quality. Points of view or opinions stated in this document do not necessarily represent official OERI position or policy


The year 2015 saw a continuation of the longest slump in the history of Russia's stock market, which had started in May 2008. In 1997–1998, after the RTS Index had dropped by 91.3%, and the MICEX Index - by 73.0%, from their pre-crisis highs over a period that lasted slightly more than a year, they both managed to recover their former quotes in 58 and 8 months respectively. Now, as of February 2016, after their plummet during the acute phase of the 2008 crisis, both these stock indices have never recovered: the MICEX Index over the period of 88 months, and the RTS Index – 85 months.


Outbreaks may start with a single infection, but where they go from there ranges from a few sporadic cases of no major global consequence to a full-scale pandemic. Predicting how big or small an outbreak will be has obvious use in mounting theappropriatepublichealthresponse; " gettingitright " allows national and international responders to gauge the human and material resources necessary, preparing and mobilizing commensurately to stem transmission and save lives. Getting it wrong risks not only severe consequences in human suf-feringbutalsoreputationalconsequences;whetherjusti fi edor not, the World Health Organization (WHO) was heavily criti-cized for both overreacting to the 2009 H1N1 in fl uenza virus pandemic and dragging its feet in recognizing the magnitude and severity of the 2013 – 2016 outbreak of Ebola virus disease in West Africa. 1


The method and apparatus is described for processing a satellite signal from one satellite navigation system (satellite navigation system) and the second satellite navigation system. In one embodiment, it is measured with a satellite signal receiver (satellite signal receiver) and the at least one first virtual distance (pseudorange) between the at least one satellite of the first satellite navigation system. At least the at least one second virtual distance between the one of the satellite is measured in the satellite signal receiver and the second satellite navigation system. It is the first time reference frame (frame time reference) and a second pickup (obtain) the difference between the second time reference frame of the satellite navigation system of the first satellite navigation system. Using at least one of a difference (difference) in claim 1 with a virtual distance and at least one second virtual distance time reference (time references) are combined (combine).


Car-following model is the basis of driving behavior modeling in microscopic traffic simulation. This paper proposes a car-following model based on Least Square-Support Vector Regression (LS-SVR). In order to reduce the computational complexity of LS-SVR, the maximum entropy theory is introduced to select typical samples from training data. Experimental results indicate that this selection method can ensure the accuracy of car-following model with the least samples. This car-following model is evaluated and validated by USTC Microscopic Traffic Simulation System (UMTSS). Simulation results of trajectory, speed and acceleration are accordance with those of field data. In addition, the proposed model is robust and reliable in the cases of both mild and severe disturbances.


Resumen en: The analysis, research and interpretation of the concept of identity in Latin America is far from over. In this article an outline of new proposals that...


Aiming at the demand of optimized geometry parameter design of CPR1000 reactor vessel insulation for in-vessel retention by external reactor vessel cooling(IVR-ERVC) under severe accident conditions,Relap5/Mod3 code calculations of ERVC uncertainty propagation,with parameter combinations acquired by Latin hypercube sampling(LHS) in possible parametric ranges as input,were carried out.The calculations,sensitivity of parametric effects on ERVC function and behavior were presented.Meanwhile,nominal values of the reactor vessel insulation design parameter of a certain type passive ERVC system of CPR1000 were preliminarily determined,based on suggested ERVC-related functional reliability criteria and related statistical analysis.And with the determined geometries,ERVC functional reliability analysis was performed,which might provide CPR1000 probabilistic safety assessment(PSA) with ERVC system reliability estimation.


The hypothesis of Jude's Alexandrian origin, which was set forth by Ernst Th. Mayerhoff in 1835 and has been supported by D. Schenkel, W. J. Mangold, H. Holtzmann, O. Pfleiderer and James Moffatt, deserves to be revived. Its associations with Syria and Palestine are superficial. Although the Apostolic Constitutions (Apost. Canon 85) canonizes all of the Catholic Epistles, it was not until the early sixth century that Philoxenus brought Jude into the Syriac canon. Eusebius (hist.eccl. ii,23.25; iii,25.3) placed it among the disputed writings. J. N. D. Kelly deems it unlikely that the readers 'were converts from Palestinian Judaism, for the Gnostic libertinism attacked cannot have had much attraction for people brought up to reverence the Law'. There is no evidence that libertine Gnostics ever were a problem anywhere in Syria either. There is no point of contact between Jude and either the Judas Thomas apocrypha or Ignatius or the Docetic and Judaizing errors he opposed at home or on the road. Hans Windisch remarked that the suppression of the blood relationship of Judas with Jesus bespeaks the non-Palestinian origin of the letter. The readers of the epistle did respect both Judas and James, who represented Palestinian dynastic Christianity. But such esteem did not prevail at Antioch (Acts 15.1; Gal. 2. 12) or where Matthew (12. 46–50) and Mark (3. 31–35), with their bias against the Lord's brothers, were written. The Synoptic Gospels did not influence Jude. The remoteness of Rome and the West from Judaean Christianity argues against any association with our epistle. Neither 1 Clement nor the Shepherd of Hermas reveals an awareness of the problems with which Jude deals. The epistle has nothing in common with Revelation or Asian millenarianism; Papias did not even include Judas in his list of disciples. Justin's ignorance of Jude tends to forbid its connection with Ephesus or Rome.


AbstractThis study illustrates that dual-Doppler-derived wind shear (vertical gradient of the horizontal wind) in stratiform, nonturbulent flow is structured in long, thin striations. The reason this has not been documented before is that scanning ground-based radars have inadequate vertical resolution, deteriorating with range. Here data from an airborne radar with a fine, range-independent vertical resolution are used. A comparison of the radar-derived wind shear with model output of isentropes in vertical transects in the comma head of two frontal disturbances suggests that the wind shear layers describe material surfaces. Model output itself further confirms the alignment of isentropes with wind shear in vertical transects. Thus, Doppler-radar-derived wind shear (a kinematic conserved variable) may serve as a suitable proxy for thermodynamic conserved variables such as equivalent potential temperature in stratiform precipitation. Furthermore, the presence of shear striations in vertical transects can ...


We compare a Global VAR model of actual and expected outputs with alternative models to assess the role of cross-country interdependencies and con fi dence in forecasting. Forecast performance is judged on point and density forecasts of growth, on probability forecasts of the occurrence of national and global recessionary events and, through a novel 'fair bet' exercise, on decision-making using probability forecasts. We fi nd multi-country data and survey data are needed to fully capture the in fl uence of global interactions and expectations in forecasts. We argue that output predictions should avoid simple point forecasts and focus on densities and events relevant to decision-makers.


Simulations of gas seeding into a hypersonic boundary-layer flow were performed using OpenFOAM® to investigate and quantify errors associated with quantitative planar laser-induced fluorescence thermometry and velocimetry techniques. A modified version of the compressible rhoCentralFoam solver was used to simulate multicomponent chemically reactive flows. Simulations replicated conditions used in NASA Langley Research Center's 31 in. Mach 10 facility with a wedge model oriented at various angles of attack with respect to the freestream flow in the test section. Adverse chemistry effects from the reaction of nitric oxide with molecular oxygen were investigated at various facility running conditions. Specifically, the effect of heat release on velocity and temperature profiles that would be obtained using the nonintrusive laser measurement techniques was assessed. The effect of any potential adverse chemistry reactions was found to be negligible.


We perform molecular dynamics (MD) and Monte Carlo computer simulations to test the ability of the recently developed formalism of mean first-passage time (MFPT) [J. Wedekind, R. Strey, and D. Reguera, J. Chem. Phys. 126, 134103 (2007); J. Wedekind and D. Reguera, J. Phys. Chem. B 112, 11060 (2008)] to characterize crystal nucleation in the Lennard-Jones liquid. We find that the nucleation rate, critical embryo size, Zeldovich factor, attachment rate, and the nucleation barrier profile obtained from MFPT all compare very well to the same quantities calculated using other methods. Furthermore, we find that the nucleation rate obtained directly through MD closely matches the prediction of classical nucleation theory.


We have polymerized 2-vinylthiophene (2-VTh) anodically at a potential of 2.75 V vs Ag/Ag + in acetonitrile solvent using tetrabutylammonium tetrafluoroborate as supporting electrolyte. Two products result: a semiconducting (10 -4 S/cm), dark coating on the electrode (polymer C) and a nonconducting precipitate from the anolyte solution (polymer B). Polymer B is spectroscopically similar to poly(2-vinylthiophene) (PVTh) produced by bulk, benzoyl peroxide-initiated polymerization of 2-VTh (polymer A) except that it has a lower molecular weight (1.5×10 3 vs 1.9×10 4 for polymer A by SEC using polystyrene as standard)


In this work, we present a metadata for Quality of Security Service (QoSS) for Service-Oriented Architecture, which supports the description of authentication, authorization and privacy features. The metadata is encapsulated by a QoSS service in order to assist the service consumer and provider to achieve a QoSS contract meeting both of their security requirements. This contract performs as an enforced policy for managing the interactions between the parties.


We present an experimental study of the preferential concentration of sub-Kolmogorov inertial particles in active-grid-generated homogeneous and isotropic turbulence, characterized via Voronoi tessellations.
We show that the detection and quantification of clusters and voids is influenced by the intensity of the laser and high values of particles volume fraction $\phi_v$. Different biases on the statistics of Voronoi cells are analyzed to improve the reliability of the detection and the robustness in the characterization of clusters and voids. We do this by adapting Big-Data techniques that allow to process the particle images up to 10 times faster than standard algorithms.
Finally, as preferential concentration is known to depend on multiple parameters, we performed experiments where one parameter was varied and all others were kept constant ($\phi_v$, Reynolds number based on the Taylor length scale $Re_\lambda$, and residence time of the particles interacting with the turbulence). Our results confirm, in agreement with published work, that clustering increases with both $\phi_v$ and $Re_\lambda$. On the other hand, we find new evidence that the mean size of clusters increases with $Re_\lambda$ but decreases with $\phi_v$ and that the cluster settling velocity is strongly affected by $Re_\lambda$ up to the maximum value studied here, $Re_\lambda = 250$.


Aiming at the standard not pointed out definite how to check double layer weak subjacent layer vertical bearing capacity,according to the checking type and calculation method of single layer weak subjacent layer,the checking type and calculation method of double layer weak subjacent layer were proposed so as to accumulate pile foundation design experience.


The appearance of damage in soft solder interconnections is shown in cross sections as polished and with additional etch. The microstructural analysis aims on the morphology of weak points: fracture proceeds along grain and phase boundaries and pores. Observed is the wrecking of the microstructure in thermo-mechanical cycling with concurrent coarsening of the eutectic microstructure. Crack initiation takes place from the very beginning of the thermal cycling


Abstract Thyroid hormones are essential in controlling numerous metabolic and regulatory processes in the human body. Thyroid storm is a medical emergency and is the most extreme manifestation of the overproduction of thyroid hormones. It is critical to recognize thyroid storm at its earliest state and conventional practice recommends initiating treatment immediately with steroids, thionamides, and beta-blockers.Here we present a case of a patient with Graves' disease in which thionamides could not be continued due to acute thionamide-induced hepatotoxicity. With the patient's worsening thyrotoxic state, declining mental status and clinical deterioration; the decision was made to initiate plasmapheresis as a life-saving therapy to remove the thyroid stimulating antibodies responsible for the patient's deteriorating status.After one session of plasmapheresis, the patients' clinical condition began to significantly improve to baseline, along with normalization of his thyroid function and the patient was discharged home with plans for emergent thyroidectomy.This case demonstrates the importance of considering plasmapheresis as a life saving measure in the treatment algorithm of patients with extreme thyrotoxicosis and thyroid storm in which traditional therapies such as thionamides, steroids, and beta-blockers cannot be used or are ineffective. Reference:Ono, Y., Ono, S., Yasunaga, H., Matsui, H., Fushimi, K., & Tanaka, Y. (2016, February 18). Factors Associated With Mortality of Thyroid Storm: Analysis Using a National Inpatient Database in Japan. Retrieved April 6, 2019, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4998648/


Despite of progression of medical and surgical treatment for patients with vascular disease, infected aneurysm still remains as a challenging vascular disease to treat in current practice.

In 1885, Osler coined "mycotic aneurysm" to provide the first description of infected aneurysm caused by bacterial endocarditis.1)

At that time, the term "mycotic" was applied to any infection by bacterial or fungal infection.

Infected aneurysm is a more comprehensive term, which encompasses primary infection of native artery resulting in aneurysm and infection of preexisting aneurysm. Although infected aneurysms are rare in its frequency, they nevertheless represent a life-threatening disease with high incidence of arterial rupture and recurrence even after treatment.


been raised against the rationale of the operation, practice has proved that it is often successful in relieving the patient from the distressing symptoms which so frequently accompany the disease-that is to say, the periodical attacks of fever and pain. The following brief notes of three cases speak for themselves in regard to this point: CASE i.-Mr. -, a Europealn, was attacked in the miiiddle of February, £897, with fever, accomiipanied by pain and swelling of tlle glands in the right groin, the attack lasting three or four days. Sinmilar attacks followed about once every week, and in six weeks he had seven attacks. In consequence of these frequently-recurring seizures he was prevented from attending to hiis businiess, and begged urgently for something to be done to relieve himii. The lylmiphatic glands in the right groin were found to be enlarged, forming a soft, collapsible mass having all the characters of a filarial ymphatic varix. An operation was performed, and the entire mass removed under cloroformii. Since that time, a period of four years, the patient has never lhad any trouble of any kind. CASE II.-A Hindu, aged 24, was admitted into hospital on February sgth, I889, for a tumour in the right femoral region. The disease had been in existence for eiglht years, during which time he had suffered from periodical attacks of fever accompanied by pain and swelling in the femoral region. On examination he was found to have a large lymphatic varix in the right femoral region, and the blood contained large numbers of embryo filariae. The great frequency of the attacks, which sometimes recurred only after five days interval rendered the patient's life miserable as well as useless, and he was ready to submit to any treatment that promised relief. A month after admission to hospital chloroform was administered and the tumour removed. The wound healed satisfactorily, and the patient was discharged from lhospital a month after operation. Two yeprs and a half later he wrote to me as follows: " It is beyond description to write of the benefits of the operation. Before this to draw a bucket of water, to walk a mile and return, to stand for more than fifteen minutes was imiipossible. The beneflt of the operation is such as to make ime undertake an enterprising life." This satisfactory result was maintained for nine years. during which time he was " healthy and active and able to earn his bread." At the expiry of this period of time he was unfortunately attacked with a disease of a similar nature in the left groin, and later on symptoms appeared which pointed to the site of lymphatic obstruction being seated high up in the intra-abdominal vessels. Putting aside this fresh attack of disease, there can be no question as to the benefit derived from operation in this case. Nine years of health and comfort were added to the patient's life, and during the whole of that time he was Able to earn a livelihood. CASE iII.-A European, aged I6, was admitted into hospital on August CtM, I894. The patient stated that he had noticed swellings in his groins for amonth previous to the date of admission, and had suffered from attacks of fever. On examination a large ympliatic varix was found in the right groin, and a smaller one in the left groin. The blood was examined,'and found to contain filariae. In addition to the inconvenience caused by the attacks of fever, the patient was suffering considerable imental anxiety owing to his knowledge of the nature of the disease, and he begged to have the s wellings renioved and the worms taken away if possible. Accordingly, a few days later chloroform was administered, and the varix in the riglht groin removed. On dissection of the tumour after removal it wasifound to contain one male and two female filariae. Healing of the wound was somewhat delayed by suppucation, but the patient was discharged quite well a month after the operation. Since the patient left hospital he has kept good health. The small varix in the left groin has not increased in size nor given rise to any trouble. During the month that the patient remained in hospital after operation no filariae could be found in the blood. Since that time there has been no opportunity of examining his blood. These three cases in themselves furnish a complete answer to the first objection. A further answer lies in the fact that these varices are often quite local; the upper or more central portion of the lymphatic system not being implicated. This was the condition of things present in the first and third of the cases related above. In connexion with this question it -is important to bear in mind that the objeet held in view in these operations is not so much the excision of the varix itself, as the removal along with it of the filarial worms themselves. The second of the objections that have been raised against these operations is the probability of their being followed by lymphorrhagia or by the establishment of a lympEhatic fistula. This is certainly not the experience of surgeons in Madras. I 'have never seen such a result myself, nor have I ever heard -of its occurring in the practice of any of my colleagues. The third objection raised against the operation is that such -cases are prone to be attacked by septic inflammation or by .erysipelas. Here again the experience of Madras is completely at variance with the dictum of the authors of the work -allded to above. I have never seen or heard of a fatality from one of these operations. In a few cases that I have seen, -where a large number of ligatures were required, suppuration took place in the wound; but no further trouble .enisued. If pressure is applied over the wound the lymphatic channels become rapidly sealed, and no more oozing of fluid takes place than would occur from any other wound. Therefore it is not evident, on theoretical grounds alone, why such wounds should be more liable to infection than others. The point that I desire especially to emphasize is that the object of these operations is, not to restore the circulation of lymph, but to relieve the patient from the sufferings entailed by the constantly recurring attacks of pain and serious constitutional disturbance. That this result is achieved in' a number of cases has beein proved by experience, and it is for this reason that I desire to press the advantages of the operation. No theoretical objections can carry any weight in the face of the favourable experience gained by those who have operated in these cases. The explanation of the pathology of the pericdical attacks of pain and fever is still obscure. Manson's original theory thait they were due to abortion on the part of the female parasite and consequent plugging of a number of lymph channels, is the most feasible explanation that has hitherto been pu-t forward. Whether this be the correct explanatifn or not, there can be no doubt that the parasites themselves are, in some way or other, the cause of the inflammatory attacks. Hence the first principle of preventive treatment in such eases should be to endeavour, if possible, to remove the parasites. Judging from the fact that in some cases no panasites have been found in the mass of tissue removed at the operation, it is possible that the succees of the latter may be due to other causes than the mere removal of the worms themselves. Assuming that the attacks of inflammation are coincident with, and due to, abortion of the female worm, the removal of those vessels by which the extruded ova are carried prevents further damage to the tissues beyond. Moreover, it is extremely probable that the stasis of lymph which follows ligature of the vessels results in the death,of the parasites.


We investigate an algebra describing q-deformed Fermion oscillators. We establish the nature of the basic numbers which follow from this algebra, study the Fock space of these generalized Fermions and determine the Jackson Derivative appropriate for these Fermions. The statistical thermodynamics of these Fermions is examined and it is demonstrated that a consistent formulation preserving its full Legendre structure is accomplished by the use of Jackson Derivatives in place of the ordinary thermodynamic derivatives. We determine the important thermodynamic functions and illustrate the thermodynamic properties of q-Fermions.


Recently, in [51, I formulated a second order logic of existence which centered around the distinction between those attributes ,that entail existence and those that do not.' The distinction provides an especially apt explication of the concept of existence and is for this reason especially pertinent to pragmatics and intensional logic, encompassing as they do such areas as tense, epistemic, deontic and modal logic.2 For example, apropos of tense logic some attributes, such as being red, being round, being hard, etc., cannot be possessed at a time except by objects existing at that time. Other attributes, especially relational attributes between objects whose "lifespans" need not overlap, such as being an ancestor of everyone (someone) now existing, being remembered by someone now existing,3 etc., may very well be possessed by objects which no longer


In the industrial motor drive systems, a torsional vibration is often generated because of the elastic elements in torque transmission One of general methods for this system is H∞ controller to suppress the torsional vibration and reject the torque disturbance Moreover, the two-degrees-of-freedom controller, which includes the H∞ controller, is designed in order to improve the command following property. In this paper, we propose a new H∞ controller with partial state feedback. This method having simple structure satisfies with the fast command following property and the attenuation of disturbances and vibrations simultaneously, just like the complicated TDOF H∞ controller.


The purpose of this essay is to reflect on the place of the city, both concept and habitat, in the historiography that was responsible for defining the Latin American condition of art and its policies during the twentieth century. I consider that raising this question is an invitation to redefine the image of the urban environment present in academic discourse today; to figure out how the city context influences the positions we take as researchers. In a first section I will develop some notions about the city, its constructive logic and ways of appropriation, and then highlight, based on some examples of performance and video art, the complexities of living and transiting through the urban space. Finally I will throw some questions about the role of art as a problemizing agent capable of highlighting some of the harmful circumstances that occur in the city on a daily basis and which, however, go unnoticed for the vast majority of city.


Background: The sacralization of the lumbar vertebra could be one of the cause for back pain. Though the relationship between Lumbosacral Transitional Vertebrae and low back pain was described a century before several contrast findings were also noted in the literature. Hence this study was conducted to assess the impact of sacralization on low back pain.
Methods: This retrospective cross-sectional investigation, which used lumbo-sacral X-rays taken at Sri Muthukumaran Medical College Hospital and Research Institute, was carried out in the orthopaedics department. The study contained 514 lumbrosacral X-rays in total. The Institutional Ethics Committee provided its ethical approval. Descriptive statistics, Chi square test was employed in SPSS version 19 to examine the relationship between sacralization and back discomfort.
Results: Prevalence of sacralisation was 10.1% with predominant complete sacralisation. Strong association was noted between sacralisation and lower back pain however sacralisation was not associated with age, gender and BMI.
Conclusion: As there is a association noted between sacralisation and back pain, early identification of LSTV could help in early lifestyle changes and routine exercise, which can help prevent additional issues including disc degeneration of the vertebrae above the LSTV.


OBJECTIVE
The aim of this double-blind study was to evaluate the clinical efficacy of the association of triclosan-containing mouthrinse and dentifrice on biofilm and gingivitis reduction.

METHOD AND MATERIALS
Forty patients with a diagnosis of gingivitis were selected and randomly divided into four groups (n = 10): group TT-triclosan-containing mouthrinse and triclosan-containing dentifrice; group CT-control mouthrinse and triclosan-containing dentifrice; group TC-triclosan-containing mouthrinse and control dentifrice; group CC-control mouthrinse and control dentifrice. Patients were evaluated by a calibrated examiner using a quantitative Plaque Index and Gingivitis Index at 0, 15, and 30 days. Intragroup analysis was performed by Friedman test and intergroup analysis by Kruskal-Wallis.

RESULTS
Intragroup evaluation revealed a statistically significant reduction in Plaque Index for groups that used triclosan, independently of the group (TT, CT, and TC) (P < .05). Intergroup analysis suggested that only the group that used the association of triclosan dentifrice and mouthrinse (group TT) demonstrated statistically reduced Plaque Index at 30 days, when compared to the control group (CC) (P < .05). With regard to gingivitis reduction, no difference was observed between groups, although the association presented a faster reduction in bleeding levels.

CONCLUSION
Only the association of triclosan dentifrice and triclosan mouthrinse statistically reduced Plaque Index, when compared to the control group; however, regarding the additional benefits to gingivitis control, more studies should be done to confirm the results.


Necessary elements to meet people's language learning needs; It is a good teacher (instructor), a good textbook, a good teaching method and a good educational environment. In order to examine, develop and bring innovations to this field by considering each of these elements that have an active role in language teaching separately in terms of qualitative and quantitative features, field experts should work on multi-faceted studies and interdisciplinary activities. In the process of teaching Turkish as a foreign language, updating the studies on "the qualifications of teachers, textbooks and educational tools, the method and educational environment applied" according to the time and needs is one of the important tasks that those who work in this field cannot give up. In this study, the nature of the subject continuous target audience by this context, Kyrgyzstan-Turkey Manas University since kept up to date textbooks is one of the most basic tools in the Turkish education field as a foreign language usually two of the works created for students with Kyrgyz Turkish mother tongue Golden Bridge Turkish Education Textbook (B2 and In terms of subject pattern, qualitative thoughts will be presented on the compatibility with the Language Level Indicators specified in the criteria of the European Language Portfolio (Common European Framework).


Evolution is the most striking feature of modern scientific thought, hence all that terms itself evolution must be scientific. Such seems to be the logic of the average reviewer, and, we regret to say it, of some men of science who ought to know better. The fact is, that the word evolution has been so terribly abused, first by biologists, then by pseudo-scientists, and lastly by the public, that it has become a cant term to cover any muddle-headed reasoning, which would utterly fail to justify itself had it condescended to apply the rule of


Theory and tools for analysis and design of millimeter- and submillimeter-wave multipliers are discussed. Experimental work is reviewed. The Schottky diode model at submillimeter frequencies, use of Schottky multiplier chains versus direct higher-order multipliers, and the effect of cooling on Schottky diode multipliers are discussed. Alternative diodes such as the high electron mobility varactor (HEMV), the barrier-intrinsic-n/sup +/ diode (BIN), the barrier-n-n/sup +/ diode (BNN), the quantum well diode (QWD), and the single barrier varactor (SBV) are discussed, with attention given to their potential submillimeter frequency multipliers. >


Epitaxial Si1−xGex layers, grown by molecular beam epitaxy (MBE) and by chemical vapor deposition (CVD) on Si(001) substrates, with thicknesses between 20 and 50 nm and Ge contents from 4% to 23% were investigated by micro Raman backscattering, x‐ray double crystal diffractometry, and transmission electron microscopy. A quite simple phenomenological model was developed to derive the Raman shift of the Si–Si mode as a function of the germanium content for the two limiting cases, the pseudomorphically strained layer, and the alloy‐like stress‐free layer. A measure for the degree of relaxation can be obtained from the measured Raman shift and from the independently determined germanium content, using the results of the model. The degree of relaxation was determined for a number of CVD‐ and MBE‐grown Si1−xGex layers. The as‐grown pseudomorphic layers relax partially after annealing at 900 °C. The Raman scattering allows the monitoring of the development of relaxation during the semiconductor device processing.


Based on three typical features, i.e. energy entropy, histogram distribution percentage and zero-crossing rate, we compared the classification accuracy of microseismic events between fiber-optic and electronic monitoring system using support vector machine.


: A new design method of planetary gear train's non-circular gear ratio of transplanting mechanism is presented by analyzing perfect seedling needle tip point's static trajectory, aiming at the limitation of non-circular gear pitch curve's design method in rice transplanter's rotary mechanism at present. The transmission ratio between planet carrier and rotation velocity of planet gear is solved by analyzing seedling needle tip point's static trajectory using the method of numerical analysis. The relationships of segmented transmission ratios, and the relationships between segmented transmission ratios and the transmission ratio between planet carrier and rotation velocity of planet gear are established by sectioning the transmission ratios of non-circular gear with a period of π on the basis of the symmetry of planetary gear train of rotary transplanting mechanism. Under the condition of total transmission ratios, the half spur gear assumption of non-circular gear is presented, and the problem of shortage of equations which are effective to solve the transmission ratios is solved. The correctness of computation method of non-circular gear based on seedling needle tip point's static trajectory in transplanting mechanism is verified by three dimensional mode design and kinematics simulation of calculated non-circular gear trains.


Background: Acinetobacter species are leading cause of nosocomial infections, causing significant morbidity and mortality globally including India. Being persistent in the hospital environment and rapidly developing resistance to a wide variety of antibiotics are the most important features of this pathogen. The present study aimed to compare Colistin MIC of Acinetobacter species isolated from the blood samples by E test and Vitek 2 to the standard broth micro dilution test.
Methodology: Two antibiotic susceptibility test methods, The Vitek-2 and the E test, against the reference broth micro dilution method in terms of the various parameters such as Reproducibility, reliability, cost and time effectiveness. Data obtained from the current study regarding antimicrobial resistance of Acinetobacter species recovered from clinical specimens referred to microbiology laboratory of SKIMS and was analyzed by using SPSS20.0.
Results: Out of 100 isolates of Acinetobacter species analyzed from blood specimens the distribution of Acinetobacter species according to different clinical diagnosis of patients 89% were A. baumannii and 11% were A. lwoffii. Seventy three percent of them were from males and 27% of them were from females with a mean age of 39.6 (SD±27.46). Regarding the specimen and isolate sources, the majority were from ICU (54%), Surgical ward (26%), Medical ward (16%) and 4% from Outpatient department of SKIMS. Significant descending trends of antimicrobial resistance was shown for Amoxicillin/Clavulanic acid, Cefoperazone/ Sulbactam combination, Cotrimoxazole (100%), Levofloxacin (92%) Piperacillin/Tazobactam, Ciprofloxacin (90%), Cephalosporins (>80%), Imipenem and Meropenem (76%), Amikacin (68%), Gentamycin (67%), Tigecycline (11%) and 0% for Colistin respectively.
Conclusion: from the study it could be concluded that the best reference method for testing susceptibility to the Polymyxins still remains to be defined. However, in routine clinical practice in most regions worldwide, where a reference method can hardly be implemented, the interpretation of Colistin susceptibility should preferably be based on results of automated systems such as Vitek-2 or the E test. The micro broth Dilution method remains the most reliable and reproducible, however most tedious and time-consuming method. Colistin remains a very effective, least resisted drug for MDR Acinetobacter species as compared by all the three methods.

Keywords: Acinetobacter species; Antimicrobial resistance; Colistin; E test and Vitek 2.


Marine inorganic photochemistry, as one of the important branches of marine chemistry, is significantly connected with marine biology, marine ecology, marine geochemistry and marine environment, and plays an important role in the development of marine sciences. To date, lots of investigations in the field have been conducted home and abroad. As for the following development of marine inorganic photochemistry, it is greatly of significance to summarize these research works. This paper detailedly summarizes the present research progress in the photochemistry of Fe, Mn and Cu, with an emphasis on investigations on photochemical processes which could affect existing forms of these metal elements in seawater. The problems and shortcomings in the study field are pointed out and some suggestions for the future study are put forward.


Background and objectives: Epidemiologic studies have attributed adverse health effects to air pollution; however, controversy remains regarding the relationship between ambient oxidants [ozone (O3) and nitrogen dioxide (NO2)] and mortality, especially in Asia. We conducted a four-city time-series study to investigate acute effects of O3 and NO2 in the Pearl River Delta (PRD) of southern China, using data from 2006 through 2008. Methods: We used generalized linear models with Poisson regression incorporating natural spline functions to analyze acute mortality in association with O3 and NO2, with PM10 (particulate matter ≤ 10 μm in diameter) included as a major confounder. Effect estimates were determined for individual cities and for the four cities as a whole. We stratified the analysis according to high- and low- exposure periods for O3. Results: We found consistent positive associations between ambient oxidants and daily mortality across the PRD cities. Overall, 10-μg/m3 increases in average O3 and NO2 concentrations over the previous 2 days were associated with 0.81% [95% confidence interval (CI): 0.63%, 1.00%] and 1.95% (95% CI: 1.62%, 2.29%) increases in total mortality, respectively, with stronger estimated effects for cardiovascular and respiratory mortality. After adjusting for PM10, estimated effects of O3 on total and cardiovascular mortality were stronger for exposure during high-exposure months (September through November), whereas respiratory mortality was associated with O3 exposure during nonpeak exposure months only. Conclusions: Our findings suggest significant acute mortality effects of O3 and NO2 in the PRD and strengthen the rationale for further limiting the ambient pollution levels in the area.


The present analysis improves previous measurements of self-broadening, self-shifting and self mixing of infrared ammonia in the wavenumber range 1000–1800 cm−1 at room temperature, based on spectra recorded using a high-resolution Fourier transform spectrometer Bruker IFS 120 HR. Previous studies in this spectral region catalogued numerous line-broadening, -shifting and -mixing. In the present paper, the corresponding spectroscopic parameters are obtained for 115 new lines in both ν4 and 2ν2 bands. The accuracies of self-broadening coefficients are about 3%. The mean accuracies of line-shifting and line-mixing data are estimated to be about 20% and 14%, respectively. As shown in a previous paper, the first-order Rosenkranz absorption coefficient taking into account line-mixing effects is adequate to extract with sufficient accuracy pressure-broadening as well as line-mixing and -shift parameters of self-perturbed NH3. Comparison of the results obtained with previous measurements and present theoretical calculations are given.


In global dermatological conditions, skin lesions are significant. Curable early in the diagnosis, only skin lesions can be accurately identified by highly trained dermatologists. Around 21 million patients are diagnosed with this disease and more than 10.12 million deaths worldwide.
 This paper presents basic work for the detection and ensuing purpose of the CNN to dermoscopic images of skin lesions with cancerous inclination. The models proposed are trained and evaluated in the 2018 International Skin Imaging Collaboration challenge, comprising 2100 training samples and
 750 test samples, on normal benchmark datasets. Skin-injured images were mainly segment based on person thresholds for channel intensity. The images were added to CNN to extract features. The extracted characteristics were then used to classify the associated ANN classification. In the past,
 many approaches have been used to diagnose subjects with variable success levels. The methodology described in this paper showed associated accuracy of 97.13% in comparison to the previous best of ninety seven.


Happiness is a concept that is difficult to understand to this date. Differences in individual perspectives in interpreting happiness also affect the processing construct of the measurement. This study aims to conduct convergent validation of the existing happiness scale. Convergent validation can test how good the happiness scale is by comparing the externally to another scale that is considered to have a relationship. The happiness convergent-scale validation adapted the Multi-trait Multi-method (MTMM) analysis. Respondents involved in this study were 186 students from traditional Muslim schools or Santri who were selected according to the specified characteristics and studied at UIN Sunan Gunung Djati Bandung. The three measuring instruments used are the Oxford Happiness Questionnaire (OHQ), the Indigenous Happiness Scale (IHS), and the World Health Organization Quality of Life-Bref (WHOQOL-Bref). The correlation coefficient (r) shows values of 0.52 (OHQ-IHS), 0.53 (OHQ-WHOQOL-Bref), and 0.45 (IHS-WHOQOL-Bref). The result indicated that the correlation of the three scales tested has a statistically high relationship so that the three measuring instruments used have convergent validity and can be used to measure the construct of happiness.


A small-signal model of GaN/AlGaN/GaN nanostructural diode with electron tunnel injection through AlGaN potential barrier and transit in GaN drift layer is created considering tunnel injection delay. Parameters and impedance characteristics are determined for the sub-millimeter diodes.


Abstract 2750 Neutrophil-derived microparticles (MP) have become important mediators of inflammation, coagulation and vascular homeostasis. MP carry surface antigens, proteins and adhesion molecules from their originating cell and can mediate intercellular cross-talk. Human neutrophil contain high levels of the anti-inflammatory protein annexin 1 (AnxA1), which contributes to mechanisms activated in the host to keep under control cell activation and trafficking in the resolution of inflammation. We investigated the role of MP released by all-trans retinoic acid (ATRA)-treated acute promyelocytic leukemic (APL; NB4) cells during the process of granulocytic differentiation. Materials & Methods: We determined the expression of AnxA1 and its receptor (FPRL1) on the NB4 cells and their MP by flowcytometry, real-time PCR and western blotting. The anti-inflammatory effect of AnxA1was determined by the transmigration assay. Results: AnxA1 was constitutively expressed on the surface of ATRA-untreated NB4 cells. ATRA treatment of NB4 cells can significantly enhance their surface expression of Anx-A1 in a time dependent manner, but did not change their mRNA expression or release of free AnxA1 into the conditioning medium. We further determined the amount of MP in the CM by flowcytometry. Significantly higher number of MP was released by the ATRA-NB4 cells, as compared with those by ATRA-untreated NB4 cells (p Conclusion: differentiated APL cells-derived microparticles contain functionally active AnxA1 that confers them anti-migratory properties which contributes to the control mechanism of cell recruitment. Disclosures: No relevant conflicts of interest to declare.


The article presents the latest experiences on engineering and geophysical tests when solving complex geotechnical problems in highway design. The examples are based on practice, construction of expressways, foundation of viaducts and on the Karavanke road tunnel construction.


We report the fabrication of GaAs pyramids using selected area organometallic vapor phase epitaxy (SA-OMVPE) and field emission characteristics obtained from these structures. The use of crystal planes to define structure surfaces offers an attractive way of fabricating atomically sharp tip apexes in field emitter arrays (FEAs). For example, diamond crystals typically form such sharp apex structures. To use crystal structures as field emitters in a FEA, the orientation and size of the crystal surfaces must be controllable and consistent over the array, and the crystal should have electronic properties compatible with field emission. When high transconductance or high emission currents are required, these electronic properties should include a low resistance electron injecting contact, high bulk conductivity, and a modest surface potential barrier for electron field emission. In addition, formation of the tip structure must be compatible with formation of an adequate gate aperture. III-V semiconductor crystals grown by SA-OMVPE may provide a material and fabrication system capable of satisfying all these requirements.


Layer forming method for a transparent, electrically conductive film, the transparent by sputtering using a target containing a zinc oxide-based material, a zinc oxide-based, is electrically-conductive layer on a substrate, the sputtering in a reactive gas atmosphere is performed, which includes two types or three types, which are selected from a group consisting of hydrogen gas, oxygen gas and water vapor.


THE short communication 'Effect of propofol and alfaxalone on pain after ovariohysterectomy in cats' ([Murison and Martinez-Taboada 2010][1]) provides useful information for evaluating analgesic requirements.

In the study, flank ovariohysterectomy was performed by a final-year veterinary


Anthropogenic change is a major threat to dwindling freshwater biodiversity. We present and synthesise available information regarding the fish community, ecology, threats and conservation options within The Cape Fold Ecoregion (CFE) of South Africa. The CFE is a particularly vulnerable region, with many range-restricted species and highly fragmented native fish ranges. The Rondegat River in the Olifants-Doring River System of the Western Cape province is of notable conservation value, as it hosts populations of important endemic CFE species despite being at risk from non-native invasive species, climate change, and agriculture intensification. This river is unique, being the site of the first alien fish eradication programme of its kind in South Africa. The recovering Rondegat River imperilled cyprinid assemblage is used to frame the manner in which future environmental change may continue to disturb the ecology of the system. Conservation options and priorities are discussed in the context of a southern hemisphere Mediterranean-climate freshwater system


We report about a design of 1x2 1310/1550 nm optical wavelength division multiplexer based on polymer waveguides. The polymer splitter was designed by using RSoft software based on beam propagation method. Epoxy novolak resin polymer was used as a core waveguides layer, a silicon substrate with a silica layer was used as a buffer layer and polymethylmethacrylate was used as a protection cover layer. The simulation shows that the output energy for the fundamental mode is 67.1 % for 1310 nm and 67.8 % for 1550 nm wavelength.


Planning theory, laws, and systems are essentially procedural in that they focus on the process of planning and decision-making but do not deal with the substance of the decisions nor their impact on cities. They emphasize the role of the many (f)actors that shape the built environment rather than the resultant properties of the built environment itself. This is true both for the rational comprehensive theory of the 1960s and the 1990s postmodern theory of communicative planning theory. In this article we claim that current planning weaknesses, on the one hand, and viewing cities as complex self-organizing systems, on the other, require re-linking planning theory, law, and administration to the substantive qualitative relations between the various urban elements. We then introduce, first, an example for theorizing such an `Urban Code' that turns the spatial relations into a planning rule and, second, a suggestion for a planning system that is responsive to these qualitative relations and is capable of updating them.


Abstract Salt-stressed plants often show Ca deficiency symptoms. The effects of NaCl salinity (1 to 150 mol m-3) and supplemental Ca (10 mol m-3) on Na and Ca transport in barley (Hordeum vulgare L.) and their relationship to growth were investigated. The adjustment of Na and Ca transport was investigated by examining young seedlings exposed to short-term (immediate) and long-term (7 d) exposure to salinity. When the plants were exposed to long-term treatments of salinity, the rate of sodium accumulation in roots was approximately 10 to 15% of short-term treatments. No significant adjustment in the transport to the shoot was observed. Rates of tracer (22Na) transport were compared to calculated rates based on relative growth rates and tissue element concentrations. Comparisons between measured tracer and calculated rates of transport indicate that 22Na transport may underestimate transport to the shoot because of dilution of the tracer in the root cytoplasm. Calcium uptake showed only minor adjustment with time. Measured rates of tracer transport to the shoot correlated well with calculated values. The transport and tissue concentrations of Na were significantly affected by supplemental Ca. Calcium transport and tissue concentrations were markedly inhibited by salinity. Supplemental Ca increased Ca transport and accumulation at all NaCl treatments above that of control plants without supplemental Ca. Salinity inhibited plant growth at 150 mol m -3NaCl, but not at 75 mol m-3.

Supplemental Ca significantly improved root length but not fresh weight after 7d of salinity, although differences in fresh weight were detected after 9d. There were significant Na-Ca interactions with ion transport, ion accumulation, and growth. The effects of salinity on Na and Ca transport to the shoot do not appear to play a major role in shoot growth of barley.


Anthrax has been developed as a biologic warfare agent. One millionth of a gram of anthrax spores constitutes a lethal inhalation dose, and a kilogram of it, has the potential to kill hundreds of thousands of people. Anthrax is a relatively common zoonosis in developing countries. The etiologic agent is Bacillus anthracis. Transmission to human is usually by contamination of skin abrasions with the bacilli or spores. The most common presentation is a black necrotic skin wound (95%). Fulminant sepsis, acute abdominal pain, and ascites are among rare forms of the disease, and it is especially very rare if all of them occur in one patient. Extracutaneous forms of anthrax are generally very dangerous and life-threatening. Therefore, early recognition and prompt treatment are the most crucial steps to save the life of patients.


Based on digital watermarking and applied cryptology, an authentication scheme for copyright protection of digital product is proposed. By introducing an intermediary agent, this scheme can provide distribution/consumption registration and evidence for copyright of digital product fairly and effectively, resulting in copyright protection of digital product,


The high-performance asphalt materials are used to replace the ordinary road asphalt that cannot meet the requirements of natural environment and traffic situation, which is the effective way to solve poor asphalt pavement durability. In this paper, polyphosphoric acid- (PPA-) modified asphalt and polyphosphoric acid (PPA)/styrene-butadiene-styrene (SBS) composite-modified asphalt with different PPA content were prepared by using two-type asphalt. The effect of PPA modifier on asphalt was analyzed by using the creep elastic recovery rate, accumulating strain and creep modulus tests. The results showed that asphalt types and the PPA could significantly improve the elastic recovery rate of asphalt, reduce the cumulative strain and creep stiffness of the viscosity part, improve the high-temperature performance, and reduce the permanent deformation of the asphalt under repeated load. The high-temperature performance and low-temperature performance of PPA-modified asphalt were studied by the chemical and physical modification techniques. The advantages of modified asphalt are well developed while reducing the price of it, which has important technical and economic significance.


Dear Editors, We read with interest the article by Marcello MS Nico and Silvia V Lourenço entitled 'Obsessive-compulsive behaviour related cutaneous ulcers: two cases with therapeutic considerations' (1). The authors state that anxiety, depression, psychosis, obsessive-compulsive disorder and classic dermatitis artefacta can be associated with self-inflicted skin lesions. We have a contribution regarding it. A 16-year-old female patient presented with an ulcer on the lower lip. Further history showed that the patient had a dental operation performed under local anaesthesia 6 hours ago. The patient's mother reported that she found the patient with bleeding lower lip. The patient admitted that she caused that self-inflicted ulcer by repetitive lip biting. She had no pain during the lip biting because of the anaesthetic lower lip. There was a bleeding ulcer, measuring 2× 1 cm in size, on the right half of the lower lip. After wound cleaning, antiseptic spray and analgesics were prescribed. The patient was referred to the psychiatry department for further investigation of possible psychopathology. We would like to suggest the dermatologist to advise patients with psychocutaneous disorders that dental procedures under local anaesthesia could cause self-inflicted injuries. Patients with psychocutaneous disorders should be advised to avoid any oral surgery under local anaesthesia if the procedure can be postponed. Physicians and dentists should question the medical history of the patient for psychocutaneous disorders in order to prevent self-inflicted lip injury. We believe these suggestions are of help.


The unique experience of Shi Tiesheng made him cannot avoid "disabled" as his subject.Many of his articles pay attention to predicaments of disabled,and he's thinking how they find a breakout:there's only a solution that they have to recognize they are not capable of handling their destinies,they have to recognize their purposes of life,and experience everyday in their uncommon lives.Shi Tiesheng exceeded his unfortunate,shown his attention to common situation and fate of human.


The short history of creation and current state of problems in the field of satellite navigation is considered, systems GPS and GLONASS in particular are considered. The basic problems of development GLONASS are allocated and decisions of the marked problems are offered. The problem of designing of navigating receivers is considered. The basic ways of the decision are allocated at designing of the big integrated schemes and microprocessor modules of management by the receiver of satellite navigation. The structure and structure of the integrated microprocessor for management of the navigating receiver capable to conduct reception of signals in four systems is offered: GPS, Galoleo, Bejdou and GLONASS. The basic ways of development GLONASS in the light of globalisation of satellite navigation on a global scale are planned.


The paper presents a novel ZVS buck converter topology. The proposed topology solves narrow duty cycle and hard switching problems of conventional buck converter in lower output voltage and higher output current. At the same times, the voltage stresses across main switches are also clamped at input voltage. In the topology, an adjustable inductor and a resonant capacitor are used to reduce charge voltage and extend the discharge time of filter inductor to achieve above target. To demonstrate the results, detailed steady-state analysis is presented. Finally, a 48V/1V, 10A simulation prototype is built to verify the theoretical analysis and shows the significant advantages.


Asian American (n =103) and non—Asian American college students (n = 121) estimated their subjective experience and emotional display in 24 hypothetical affect-eliciting situations. Each respondent also made the same estimations for an acquaintance. Both groups overestimated their own subjective experiences relative to those of their acquaintances and also overestimated their own undisplayed affect, suggesting that these basic self—acquaintance differences about emotions transcend cultural heritage. However, Asian Americans estimated that they would experience more socially undesirable affect than non—Asian Americans estimated that they would experience, and Asian Americans also estimated that they would display these less socially desirable emotions more. Asian Americans also scored higher on the Loss of Face Scale and displayed a greater tendency to evaluate their subjective experience from the perspective of another, as assessed by the Social Awareness Inventory. Additional analyses indicated that these measures of individual differences mediated ethnic differences in self-estimations of less socially desirable affect.


Veterinary autopsy requires a high level of expertise and skills that not all veterinarians necessarily master, especially in the context of the desertification of rural areas. The development of support systems is a challenging issue, since such a tool, to be considered relevant and accepted by practitioners in their diagnosis process, must avoid any black box effect. The diagnosis support system we introduce here, IVAN ("Innovative Veterinary Assisted Necropsy"), aims to engage the user in an explicit, understandable, validable and reviewable process, able to cope with the specific issues of cattle necropsy. Besides, it provides uncertainty management to deal with approximate lesion descriptions. IVAN relies on a Bayesian network to infer relevant proposals at each step of the diagnostic process. IVAN was trained on a set of real autopsy cases from autopsy reports, and its performance was assessed using another set of reports. In addition, the tool had to provide results in short response time and be able to run the application on mobile device and web server. In addition to demonstrating the feasibility of the approach, IVAN is a first step towards other support systems in other species and in broader contexts than autopsy.


The paper explores how information science knowledge can be used systematically in digital, interdisciplinary research settings and gives a conceptual analysis of the relationship between information science knowledge as donor and other research as receiver in an interdisciplinary project environment. The validity of the approach is demonstrated by the author's work on the project "The Primacy of Tense: A. N. Prior Now and Then." The study proposes a hybrid approach, combining analysis and synthesis. The analytical component identifies information systems, assigns an information system type to them, and accesses the information science knowledge associated with that type. The synthetic part focuses on the connections between information systems according to the receiver discipline's practices. The paper makes explicit the actions of experienced information professionals, thereby making their expertise accessible to others. The analytical and synthetic strategies are explained by linking them to two modes of researchers in the receiver discipline, how they act as researchers and what they know about it. The paper offers information professionals concrete assistance with identification of the appropriate strategy for accessing professional knowledge and taking appropriate actions and development decisions.


A stain for bacteria in soil is proposed different from that originally employed in the introduction of pre-treatment of the soil smears with dilute acid. The procedure found best is: A suspension of soil in a 0.015% solution of gelatin is dried on a slide, treated 1-3 minutes in 40% acetic acid, washed and dried on a boiling water bath; while still on the water bath it is stained about one minute with 1% aqueous rose bengal. It is suggested however that under certain conditions better results may possibly be obtained by substituting hydrochloric for acetic acid and one of the phloxines or one of the erythrosins for rose bengal.


OBJECTIVE
Two studies were conducted to examine the psychometric properties of a DSM-IV-referenced teacher-completed rating scale in children receiving special education.

METHOD
To assess reliability, teachers rated 74 students on two separate occasions (test-retest) using the teacher version of the Child Symptom Inventory-4 (CSI-4T), and teacher aides also rated the children on the first occasion (interrater). In a second study, teacher CSI-4T and Teacher's Report Form (TRF) ratings and consultant diagnoses were obtained for 101 students.

RESULTS
Internal consistency reliabilities (0.72-0.94), 2-week test-retest reliabilities (r = 0.61-0.88), and interrater agreement (r = 0.19-0.56) for the CSI-4T major symptom categories were comparable with dimensional rating scales. CSI-4T ratings showed a consistent pattern of convergent and divergent validity with TRF scores and with consultant diagnoses.

CONCLUSION
Findings provide preliminary support for the reliability and validity of the CSI-4T as a measure of DSM-IV symptoms in children receiving special education.


Focusing on the shortcomings of analog PI control DC PWM speed control method circuit complexity and poor reliability,digital DC PWM speed-regulation system was designed based on MCU.The design of hardware circuit and software programming was intruduced.And Matlab/Simulink,power system toolbox,and electrical schematic diagram for the system simulation method was used to build the simulation model of DC PWM reversible speed control system.The design program was simulated.


The study investigates specific information regarding the challenges of globalization faced by Bangladesh and how it should prepare itself to coup with the challenges. The result suggest that Bangladesh is not in comfort in coping with the winds of globalization, as it has less access to and use of different opportunities living at the margin in the hierarchies of global order with low technological base, poor infrastructures and governance in most arenas. The study also suggest that Bangladesh needs to be engaged with all its development partners in a healthy and constructive process of interaction on stabilization, reform programme and other critical issues like national capacity building, competitiveness, political stability, cross border terrorism, arms and drug trafficking, climate change and environmental degradation. The policy implication is that various economic policy orientation and utilization of resources should be as such that they can supplement economic growth in a sustainable manner and create avenues for employment. K EY W ORDS : Benefit; Environment; Globalization; Governance; Infrastructure; Poverty; Population; Policy; Political stability; Resource DOI: http://dx.doi.org/10.3329/mist.v3i0.8052


The article presents and analyzes features of preschooler's basic
mathematical notion formation and organization of possible forms of activity.
This work covers numerous research points of views which would allow to
efficiently organize and implement educational process; from where start
education, how to form and develop mathematical notions, concepts, logical
thinking. In order to ensure the effective implementation of this process it is
necessary to maintain a sequence, choose appropriate sequence, select suitable
tasks, exercises and games. There are a number of issues regarding the
formation of mathematical notions among preschool age children with
developmental problems, since their development differs from the
development of normal children of the same age.
The efficiency of formation of basic mathematical notions and its
development depends on the content, forms, means and the period of
implementation of the classes held.
The article also presents certain number of sections of program material
concerning the formation of mathematical notions among preschoolers such
as: "Quantity and tab," "Magnitude," "Shape," "Orientation in time" "Element
computing operation". The stages of the teaching material and their sequence
are also covered in the paper.
The article thoroughly substantiated the expediency and necessity of the
formation of mathematical notions among preschoolers during the process of
multifaceted development as well as during the effective school preparation
process.
The ways and means of conducting mathematics as a class subject are
presented in detail.


A series of experiments were carried out aiming at resource utilization of fresh green waste and sewage sludge. The green waste, rice straw and sewage sludge were chosen as raw materials and packing materials in composting experiments to study the variation characteristics of composting in different aeration patterns. It was found that the effect of intermittent aeration pattern during composting was better than continuous aeration pattern according to the results of detection of composting temperature, oxygen, carbon dioxide.


Aiming at the problem of the conversion efficiency of switching power supply under full load conditions, this paper proposes a design of a flyback quasi-resonant controller, which adopts a multi-mode control strategy, and adopts quasi-resonant soft switching under heavy load; Frequency flyback mode, using feedback control to achieve precise control of the output voltage.


In recent years,the contribution of resident consumption to the increase of GDP have decreased largely and constantly.since 2008,to Challenge the global economic crisis and promote the stable and fast develpment of economy,central and start an initiative amounting 40 trillion Yuan to realize the strategic goals of "stimulating the domestic demands,maintaining the economic growth and adjusting the structure".starting from this background,the author analyzes the reasons of the shrinking of domestic demands from macro-perspective and puts forward some suggestions by applying relative economic theories.


Available studies of the population-based costs of diabetes care generally refer to countries with the highest economic development. There are reliable data on the costs of diabetes in the United States (USA) that were calculated by the American Diabetes Association (ADA) in the years 2002, 2007, 2012 and 2017. As the methods used in These analyzes are similar, comparisons can be made with acceptable precision.


Abstract : The introduction of Objective Force formations, beginning with the first Unit of Action, will fundamentally change existing organizational structures, training requirements and operational constructs for the U.S. Army. At no point in modern history has the Army introduced such significant changes in both hardware and operations simultaneously. To support this change, the Army leadership must decide, early in the transformation process, on a plan for fielding and training Units of Action that leverages emerging training technologies, establishes standardization across the Army, minimizes personnel turbulence and is sustainable over an extended period. The challenges of introducing the Objective Force formations will be made more complex by near simultaneous conversion of the U.S. Army from the current individual replacement system to a unit manning/unit rotation system. As we move into the complex environment of transformation, the Officer education System (OES) will require review to insure it produces officers capable of performing within the new organizational constructs.


A prototype thermophotovoltaic (TPV) generation system based on super-adiabatic combustion with reciprocating flow in porous media was developed experimentally. Stacked porous quartz glass plates in the system were used as an optical filter and for heat storage. The distributions of temperature and spectral radiation indicated that both energy recirculation and spectral control were realized with the quartz glass plates. In addition, electric power was obtained by introducing the spectral controlled radiation into GaSb cells. The measured output power was in close agreement with that estimated using a parallel ray-tracing model. Application of a one-dimensional configuration to this system is expected to result in a total fuel to electricity conversion efficiency that would reach 10%. Consequently, a spherical super-adiabatic combustion TPV system is proposed as an idealized one-dimensional system to achieve this.


Method for blocking an ophthalmic lens to the edge molding of the present invention the first and second step to provide a spectacle lens having a lens surface, comprising: a first block for fixing the lens surface and the second for holding the lens the comprises the step of providing a second block. Thereafter, the first block, the method towards the step and the first lens surface to place films with adhesive properties between the steps, the adhesive layer and the first lens surface to place an adhesive layer on the first block, and the second and a step to push the second block toward the surface of the lens. Provide a sufficient bonding strength between the adhesive layer and the first surface of the lens films having the pressure-sensitive adhesive properties will be prevented from slipping from the spectacle lens edge in the block, while the molding. A spectacle lens, an adhesive layer, adhesive film, adhesive force, edge forming


In the present article we consider a new generalization of classical Fibonacci sequence and we call it as Fibonacci-Like sequence 〈Vk,n〉 and then we study Fibonacci-Like sequence 〈Vk,n〉 and k-Lucas sequence 〈Lk,n〉 side by side by introducing two special matrices for these two sequences. After that by using these matrices we obtain Binet formulae for Fibonacci-Like sequence and for k-Lucas sequence, we also give Cassini's identity for Fibonacci-Like sequence. 2010 Mathematics Subject Classification: 11B37, 11B39.


This paper briefly introduces the principles and processes of real iz ing the automatic control of the seepage and drainage system of the Pump Station of YRDP (Yeloow River Diversion Project) by using PLC programming, and expounds the programming of the control programme and the realized results.


4069 Background: Patients with localized esophageal adenocarcinoma (EAC) receive preoperative chemoradiation followed by surgery (trimodality [TM] therapy) or definitive chemoradiotherapy (bimodali...