Objective To investigate the relationship between Helicobacter pylori(Hp) infection and portal hypertensive gastropathy in patients with liver cirrhosis.Methods We retrospectively analyzed the clinical data of 51 patients with liver cirrhosis who had received gastroendoscopical examination and Hp rapid urease test between January 2000 and December 2010.Hp infection and its related factors were investigated.Results Hp positive rate was 41.2% in liver cirrhosis patients.It was not correlated with age(P0.05).The prevalence of Hp decreased as esophageal varices aggravated and liver function deteriorated.There was no relationship between the occurrence of portal hypertensive gastropathy and Hp infection.Conclusion Portal hypertensive gastropathy in patients with liver cirrhosis is not correlated with Hp infection.Eradication of Hp in patients with liver cirrhosis is not necessary.


A strong convective weather were analysed based on Dopplor radar echo in West Akesu Region on 8 August 2003,and the second products were preliminary analyzed and applied.


In recent years, the demand for miniaturization in analytical chemistry has risen [1]. The reason for its tremendous growth is that the application of microchips offers many advantages. Miniaturization allows reduction in costs, lower ancillary sample volume and sensitive measurements within a shorter span of time. Thus, time per analysis can be significantly lowered and the amount of chemical waste can be reduced.


This paper explores the implementation of environmental choreography in higher education dance teaching. The aim is to better engage students in social and environmental issues through movement, and to promote the development of a more sustainable and conscious society. The paper proposes a framework for implementing environmental choreography in dance courses, including strategies for selecting relevant topics, designing movement sequences, and evaluating outcomes. The paper also presents case studies from universities in different regions, illustrating how environmental choreography has been successfully integrated into dance curricula and highlighting some challenges that still need to be addressed. Ultimately, this research contributes to the ongoing discussion on the role of arts in promoting sustainability and social change.


The reopening of the Museo Sefardı́ in Toledo's fourteenth-century synagogue, El Tránsito, was typical of the flurry of activities that in 1992 marked Spain's commemoration of the 500th anniversary of the expulsion of the Jews. In a telling anecdote included in her study of the roles played by museums in post-Franco Spain, Selma Holo recounts that when the mayor, Juan Ignacio de Mesa Ruiz, was asked the reason why he, a non-Jew, had pledged his efforts to funding the restoration of this synagogue, he answered: ''Because we are all Jews in Toledo''. Yet when the tickettaker at the city's other historic synagogue, Santa Marı́a la Blanca, was asked if the Jews of his city were subsidizing its restoration too, he replied: ''There are no Jews left in Toledo'' (Holo 55). Physical traces of the Jewish presence*the still visible remnants of Jewish material culture and the genealogical links of present-day Spaniards to Jewish or converso ancestors*underscore the stark reality that at the turn of the twenty-first century Jews account for less than 0.0008% of Spain's total population (20,000 30,000 out of 40 million). The call issued to Spaniards in 1992 to recognize and memorialize their Hispano-Jewish patrimony arrived at a moment when Spain, as a signatory of the Maastricht Treaty, was engaged in promoting a new image in Europe as a democratic, (post)modern nation; not coincidentally, 1992 was also the year in which Barcelona hosted the summer Olympic games, Sevilla hosted the Exposición Internacional, Madrid was named Cultural Capital of Europe, and the government established the Comisión Nacional para la Conmemoración del V Centenario del Descubrimiento de América. In light of so much civic boosterism, the question inevitably arose: what form would the recall of this patrimony take? Would it emphasize exile or convivencia? Memory, it became clear, had the potential to resuscitate the past*or to erase it. For many, 1992 represented a failed opportunity ''to confront the realities of genocide and racism either then or now'' (Graham and Sánchez 416). Eduardo Subirats, one of the harshest detractors of ''la Gran Efemérides Hispánica de 1992'', contemptuously viewed such festivities as an example of the aestheticized, mass media-driven politics of the political Transition which, through its synthesis of ''zarzuela y espectáculos high-tech'', falsified national history and apotheosized ''el Quinto Centenario de la fundación de la Nación Católica'' (365). Even more than the ''theme-park vacuity'' of these official celebrations, what disturbed critics was Spain's inability to reconcile with its past, to assimilate ''the meaning of empire*in terms of the devastating experience of otherness visited not only on the colonized, but also on those cultures expelled from peninsular Spain (Arab, Jewish, and*later*Morisco)'' (Graham and Sánchez 416). Hazel Gold


1. A village district in light and shade 2. Rural scenes and sounds 3. The mandarin in embryo 4. Red letter days 5. Compensations 6. Records of an ancient city 7. Can any pathos come out of China 8. An historical romance 9. Problems domestic and national 10. Gods many and lords many 11. A Taiping camp 12. The longhaired have come 13. Suffering by deputy 14. An old, old story in a new edition 15. Imperial pop-guns 16. The mart of central China 17. Four miles of flame 18. Imperialists to the front 19. Art and artists 20. How to become a demigod 21. Changing scenes 22. Father and daughter 23. Resurrection 24. For better, for worse.


Abstract Feedbacks are widely considered to be the largest source of uncertainty in determining the sensitivity of the climate system to increasing anthropogenic greenhouse gas concentrations, yet the ability to diagnose them from observations has remained controversial. Here a simple model is used to demonstrate that any nonfeedback source of top-of-atmosphere radiative flux variations can cause temperature variability, which then results in a positive bias in diagnosed feedbacks. This effect is demonstrated with daily random flux variations, as might be caused by stochastic fluctuations in low cloud cover. The daily noise in radiative flux then causes interannual and decadal temperature variations in the model's 50-m-deep swamp ocean. The amount of bias in the feedbacks diagnosed from time-averaged model output depends upon the size of the nonfeedback flux variability relative to the surface temperature variability, as well as the sign and magnitude of the specified (true) feedback. For model runs produ...


Aiming at the harmfulness problem of center voids defects of connecting rod preforming in cross wedge rolling, the mechanism of defects formation was researched. The finite element model of cross wedge rolling was established.And the variation of the effective-strain, the effective-stress, and the damage, the first principal stress was analyzed. The results show that the first principal stress is the best observation field of analyzing center voids defects formation, which lays a foundation to slove the problem of center voids defects.


In order to offord a thory for planting of pear in the dry area,the characteristics of photosynthesis in leaves of Xiangli pear trees was studied.The results showed that the diurnal variation of net photosynthetic rate(Pn) of peripheral leaves and inner leaves were in double-peak curves with feature of decreasing at noon.The peak of peripheral leaves was recorded at 13:00 and 16:00;The peak of inner leaves was recorded at 13:00 and 15:00.The net photosynthetic rate Pn of peripheral leaves was higher than the Pn of inner leaves.The yearly changes of Pn were double-peak curves,peaks occurring at 6 month and 8 month.The light compensation point and light saturation point of peripheral leaves were 1 550 μmol/(m~2·s) and 51.1 μmol/(m~2·s).The change of the stomata conductance(Cs) of the tree was single curve,the highest value was recorded at 11:00.The highest value of transpiration rate was recorded at 11:00.


Abstract In this article, the author describes a lens for engaging in research and practice in urban education rooted in deep cultural understandings of the concept of building bridges and the impact of cultural agnosia.


ABSTRACT I argue, first, that testimony is likely a natural kind (where natural kinds are accurately described by the homoeostatic property cluster theory) and that if it is indeed a natural kind, it is likely necessarily reliable. I argue, second, that the view of testimony as a natural kind and as necessarily reliable grounds a novel, naturalist global reductionism about testimonial justification and that this new reductionism is immune to a powerful objection to orthodox Humean global reductionism, the objection from the too-narrow induction base.


Uterine torsion in pregnancy is a rare clinical entity with a non-specific clinical presentation. Here, we present a case of uterine torsion,which was diagnosed at laparotomy done for the lower segment cesarean section (LSCS) in a case of central placenta previa with thefetus in transverse lie. At 36.4 weeks period of gestation, the patient complained of severe left-sided abdominal pain which was notsuggestive of labor. This abdominal pain was refractory to analgesics. Emergency LSCS was done which confirmed uterine torsion aswell as anterior sacculation.


This final report represents the culmination of eight years of biological research devoted to increasing the productivity of short rotation plantations of Populus trichocarpa and Populus hybrids in the Pacific Northwest. Studies provide an understanding of tree growth, stand development and biomass yield at various spacings, and how patterns differ by Populus clone in monoclonal and polyclonal plantings. Also included is some information about factors related to wind damage in Populus plantings, use of leaf size as a predictor of growth potential, and approaches for estimating tree and stand biomass and biomass growth. Seven research papers are included which provide detailed methods, results, and interpretations on these topics.


Objective To discuss the effects of psychological nursing for patients with pulmonary embolism.Methods 52 cases of patients with pulmonary embolism were randomly divided into experimental group (n =26) and control group (n =26).Control group received routine nursing and health education for pulmonary embolism treatment,while experimental group patients received psychological nursing intervention in addition.Questionnaire was used to investigate patients' health knowledge,satisfaction and hospitalized days.Results Patient satisfaction was higher in the experimental group (96.1%) than in the control group (69.2%),and the difference was statistically significant (x2 =6.584,P < 0.05).Patients' health knowledge was also higher in the experimental group (92.3%) than in the control group (69.2%),and the difference was statistically significant (x2 =4.457,P < 0.05).Patients hospitalized days were shorter in the experimental group (16.33 ± 2.52) than in the control group (24.67 ± 2.08 day),and the difference was statistically significant (t =-4.419,P < 0.05).Conclusions Effective implementation of psychological nursing intervention for patients with pulmonary embolism is significant to help them understand their illness,relieve their tension,cooperate with clinical treatment,so as to improve cure rate,reduce mortality,enhance sense of self-care,improve health knowledge and reduce recurrence of pulmonary embolism.

Key words:
Pulmonary embolism; Psychological nursing; Satisfaction; Health education; Hospitalized days


Abstract Nozzle wear can cause overapplication of chemicals, which results in increased production costs, and may also cause environmental damage due to excess chemicals contaminating both ground and surface water. The objectives of this research were to predict the nozzle wear rates for four fan nozzles using regression and neural network techniques and drawing comparisons between the two techniques from the prediction results. Both regression and neural network methods were applied for modelling nozzles made of four different materials, namely, brass, nickel-coated brass, plastic and stainless steel. The model relates wear rates to usage time at three different operating spray pressures: 138, 256 and 552 kPa Dummy variables were used to represent different nozzle types. One hundred and sixty-eight observations were used to build a regression model. Forty-four observations, chosen from within the sample data, were used for model validation. One of the United States Department of Agriculture, Agricultural Research Service's (USDA-ARS) data set, considered to be out-of-sample data was also used for model validation. Log–log linear model was used to build the regression model by using Statistical Analysis System (SAS). A neural network software, NeuroShell Easy Predictor, was chosen to develop a neural network model. Model adequacy was established both by visual inspection and statistical techniques. Part of the actual data, which was not used for model building, was applied to the model for its validation. A comparison of the regression model and neural network model shows that the regression and the neural network models perform equally well for the predictions made with both sets of validation data.


contaminated soils, root and shoot parts of these plant species were found to be in the sequence of soil root shoot. In most cases, arsenic translocation factor of soil to root and root to shoot is 0.5 to 1.0 indicated that main application of these plants is for arsenic phytoaccumulation from soil. Highest bio-concentration factor (2300) values were found in barnyard grass root than water taro (2184.55) and water hyacinth (1336.36) and this values always 10 times higher (293-2300) in the plant parts grown in the contaminated site compare to uncontaminated site. Current study revealed that, these plant species can be used as arsenic accumulator in arsenic contaminated soils.


In recent years, concerns about computer security in general and network security in particular have become more and more relevant. Network administrators have grown increasingly insecure with the news - and sometimes their personal experiences - of virus propagations that shut down networks, black hats that posted confidential information on Web servers, and many other publicly known attacks. The solution Network Perimeter Security proposes to protect our assets focuses on defining and implementing security policy development instead of relying on often-improvised technological patches. So, the book's primary audience is the administrator who must deal with technology, devices, and users on one side and managers, budgets, and network responsibilities on the other. This book addresses a major problem of trying to protect a medium- or large-sized network: how can a computer-literate network administrator talk about security with a business-oriented manager.


-Five isolates of Phaeodactylum tricornutum Bohlin were examined in light and transmission electron microscopes. Although isolated from widely separated sites including both coastal marine and inland saline habitats, the morphology ofthe siliceous frustules ofall isolates was very constant. The fusiform and triradiate forms, which have been reported as being non-siliceous in the past, were found to have an amorphous particulate nature in TEM. These forms were examined using EDAX SEM elemental analysis and were found to contain silica in their cell walls.


The oblique wing concept has been investigated for subsonic transport application for a cruise Mach number of 0.95. Three different mission applications were considered and the concept analyzed against the selected mission requirements. Configuration studies determined the best area of applicability to be a commercial passenger transport mission. The critical parameter for the oblique wing concept was found to be aspect ratio which was limited to a value of 6.0 due to aeroelastic divergence. Comparison of the concept final configuration was made with fixed winged configurations designed to cruise at Mach 0.85 and 0.95. The crossover Mach number for the oblique wing concept was found to be Mach 0.91 for takeoff gross weight and direct operating cost. Benefits include reduced takeoff distance, installed thrust and mission block fuel and improved community noise characteristics. The variable geometry feature enables the final configuration to increase range by 10% at Mach 0.712 and to increase endurance by as much as 44%. (Author)


ONE of the most urgent demands facing teachers and administrators in the elementary school today is to find adequate means of appraising the growth of individual children as they go through the experiences of newer types of curriculums. There has been much discussion of cumulative folders, continuous or anecdotal records kept by teachers, flexible report cards, and other means of evaluation. Not until last year was a definite attempt made to determine exactly which of these methods have been found workable in the schools of New York State, the degree to which the schools used the methods, and what difficulties were being faced in the entire program of evaluation. Thirty schools, selected from a list compiled by the New York State Education Department, were surveyed both by questionnaire and by direct visiting. This list was made up from reports sent to the department by the schools. Although some schools doing an excellent piece of work in this direction were probably omitted, the list apparently represented an adequate sampling of New York schools that are attempting to obtain a complete picture of individual pupil progress.


Previous studies in underwater acoustics have shown that conventional beamforming of ocean noise with a vertical line array of hydrophones can be used to estimate the bottom loss (BL) as a function of frequency and grazing angle. The BL estimate is obtained by comparing the output power of beams steered toward the sea surface with that of beams reflected off the seabed. In practice, the finite aperture of arrays causes the beamwidths to be frequency dependent, and wider beams decrease the resolution of the BL estimate, blurring the interference patterns caused by seabed layering, and other distinct features such as the critical angle transition. This effect increases as frequency decreases and eventually sets the low‐frequency limit on BL estimation for this technique. To minimize these effects, high‐resolution adaptive beamforming techniques were applied to both measured and simulated ambient noise data. The results in this presentation show that some ABF techniques (e.g., the white‐noise‐gain‐constraint...


Abstract The recent and necessary jobs of emphasis on the environment and our energy resources has created new challenges for the industrial engineer. It has also created a need for the reexamination of our methods and their application. The purpose of this paper is to present and examine the application of selected techniques to selected problems in these areas of opportunity.


The combined effects of heat and ultrasonic waves operating at absolute pressures between 1.5 and 7.2 kg/cm 2 on peroxidase, polyphenol oxidase, and lipoxygenase inactivation have been studied over a broad range of temperatures, static pressures, and ultrasound amplitudes. A synergistic effect which can substantially reduce enzyme resistance and the heat treatment required for inactivation was observed in all cases. The peroxidase z value, estimated at 26 o C, was not changed by the combined treatment, but that of lipoxygenase increased from 4.2 o C (heat treatment) to 6.8 o C (combined treatment)


Village system planning is discussed with the experiment of Qian city in Hebei province as the case to illustrate if it is a need to have it as a company of urban system.Urban system has gained experience and built a mode to some extent while the village one is a newly established conception.It is still a problem debated whether village system be included in the urban system


Eric P. Pearson is the Sector Director of Development Programs for the Electronic Systems Sector of Northrop Grumman Corporation. After several years as an organizational Staff Manager and the Antenna Integrated Product Team lead for major radar programs he began the development of Internship, Co-op, New Graduate Engineering rotation and Early Career Leadership Training Programs. Eric carries a passion for assisting soon-to-be and recent university graduates as they develop their technical, professional and leadership skills through their early careers in industry.


Feedbacks between the terrestrial carbon cycle and the atmosphere have the potential to greatly modify expected rates of future climate change. This makes it all the more urgent to exploit all existing data for the purpose of accurate modelling of the underlying processes. Here we use a Bayesian random sampling method to constrain parameters of the Farquhar model of leaf photosynthesis and a model of leaf respiration against a comprehensive set of plant trait data at the leaf level. The resulting probability density function (PDF) of model parameters is contrasted with a PDF derived using a conventional "expert knowledge" approach. When running the Biosphere Energy Transfer Hydrology (BETHY) scheme with a 1000‐ member sub‐sample of each of the two PDFs for present climate and a climate scenario, we find that the use of plant trait data is able to reduce the uncertainty range of simulated net leaf assimilation (NLA) by more than a factor of two. Most of the remaining variability is caused by only four parameters, associated with the acclimation of photosynthesis to plant growth temperature and to how leaf stomata react to atmospheric CO2 concentration. We suggest that this method should be used extensively to parameterize Earth system models, given that data bases on plant traits are increasingly being made available to the modelling community.


But the very survival of your business depends on having a base of faithful and constant customers. So, how do you attract these elusive creatures to your business and, more importantly, how do you keep them coming back without having to lower your profits in providing spectacular and expensive feats of service? The Butterfly Customer: shows how to provide a predictable, consistent service experience for your customers that will build their trust and loyalty - and make you money; provides a proven process - the "3-D Audit" - to evaluate the consistency between what you promise to your customers and what you actually deliver; features examples of actual companies and what they are doing to capture customers' loyalty; and gives practical advice that any business can use, regardless of size or industry sector.


The operator spaces H k n , 1 < k < n, generalizing the row and column Hilbert spaces, and arising in the authors' previous study of contractively complemented subspaces of C*-algebras, are shown to be homogeneous and completely isometric to a space of creation operators on a subspace of the anti-symmetric Fock space. The completely bounded Banach-Mazur distance from H k n to a row or column space is explicitly calculated.


The launch of the new Faculty of Sport and Exercise Medicine jointly by the Royal College of Physicians of Ireland and the Royal College of Surgeons in Ireland on Tuesday 19 November 2002 should not go …


The environment and ecological aspects of economic development are becoming more and more important for Russia. Unfortunately, under the present conditions of political, social, and economic crisis, attention to ecological factors has declined. This is quüte understandable. The objectives of legislative and executive structures at various levels--as well as those of the absolute majority of the population-are determined today by the burning necessities of adaptation and bare survival, amid the breakdown of the Soviet Union, centrifugal tendencies in Russia and the consequences of the transition to a market economy. Hence, there are few incentives for environmental protection, whose results are not so imrnediately obvious as an empty stomach. This attitude is leading Russia into a blind alley, and to a bleak future for her social, political anca economic development. For a long time, information about the state of the environment in the former Soviet Union was considered a state secret. It was difficult to publish on the subject even in specialized scientific literature, not to mention critical articles in the mass media, which was a virtual impossibility. Many economic and industrial projects with adverse environmental effects, as well as serious ecological disasters, remained unknown to the public. Their investigation and discussion were banned. One example was the radiation accident in Kyshtym, the Urals, during the 1950s, which was comparable to the Chernobyl catastrophe as well as to what was perhaps the largest ecological disaster of the 20th century-the Aral Sea tragedy. The central planners practically did not take into account environmental implications. Information about the catastrophic state of the environment in the USSR became possible only a few years ago. Actually, the first document available to the general public was the "White Book" (the governmental report "On the State of the Environment in the Russiian Federation in 1991"). Prepared for the Congress of People's Deputies, which was to me.et at the end of 1992, this report was widely reprinted and commented on by the mass media. What everyone had suspected all along became a horrible reality: the country was on the brink of an environmental abyss. The word "ecocide" (ecological genocide) is gaining widespread and frequent use in Russia. Like the histo],ry of man has been said to be the history of wars, the history of the USSR could be described as the history of


Three types of devices that have been used in conjunction with marked crosswalks in an attempt to improve pedestrian safety were evaluated: an overhead crosswalk sign in Seattle, Washington; pedestrian safety cones (which read, "State Law: Yield to Pedestrians in Crosswalk in Your Half of Road") in New York State and in Portland, Oregon; and pedestrian-activated overhead signs (which read, "Stop for Pedestrians in Crosswalk") in Tucson, Arizona. The signs were used under varying traffic and roadway conditions. The effects of these three treatments on pedestrian and motorist behavior were evaluated. The variables of interest were whether pedestrians had the benefit of motorists yielding to them; whether pedestrians had to run, hesitate, or abort their crossing; and whether pedestrians crossed in the crosswalk. The New York cones and Seattle signs were effective in increasing the numbers of pedestrians who had the benefit of motorists yielding to them. At one location in Tucson, the overhead sign increased motorist yielding to pedestrians. The signs in Seattle and Tucson were effective in reducing the number of persons who had to run, hesitate, or abort their crossing. None of the treatments had a clear effect on whether people crossed in the crosswalk. By themselves, these devices cannot ensure that motorists will slow down and yield to pedestrians. It is essential to use these and other devices along with education and enforcement, but creation of friendlier pedestrian environments (e.g., by means of implementing geometric improvements) for the purpose of reducing vehicle speeds may be more important.


We compare InP and Si photonic (SiP) integration platforms for 400G coherent data center interconnects. Although power dissipation is roughly comparable, the InP solution drives tight integration of laser and modulator and better scaling to higher baud rates.


The aim of this study was to evaluate the effect of 10 % supplementation with commercial chicory fructans (I), commercial Agave tequilana fructans (ATC), experimental A. tequilana fructans (ATE), experimental A. salmiana fructans (AS), rice starch (RS), and a control diet (C) on Wistar rats, both healthy and carcinogen-induced to colorectal cancer. It was hypothesized that agave and chicory fructans have similar effects. The supplements evaluated in both experiments maintained the dry weight and length of rat femurs in both groups without producing significant changes. Only healthy rats supplemented with chicory and both A. tequilana fructans showed higher fecal nitrogen levels. The femur ash content in rats that were carcinogen-induced to develop colorectal cancer was significantly lower (p ≤ 0.05) than the content in healthy rats. Minerals in the femurs of both groups of rats were similar. The hypothesis of this work was rejected.


We report on 3D images, obtained with our ultracompact 100 beam photon counting lidar, of various types of terrain in Greenland and Antarctica and of calibrated forested areas.


Sharing language but not communicative patterns: Feedback in Sweden-Swedish and Finland-Swedish academic counselling interactionIn this article, we present a study of oral feedback (back-channels a ...


The management of employees with mental health problems in the workplace is an emerging organisational challenge for leaders and HR managers. Training programs on this topic are increasingly being implemented in organisations. However, this training is rarely built into leadership programs, and relevant skills and attitudes can fail to be sustainably integrated into organisational cultures. The aim of this study was to investigate the training needs of leaders. A survey of 379 leaders and 364 HR and learning and development professionals was undertaken. The majority of leaders surveyed had experienced a situation requiring management of mental health in the workplace and recognised the importance of workplace strategies. However, very few had participated in mental health training. Discrepancies between rated levels of importance and confidence on a range of relevant skills and knowledge areas were identified. These findings highlight for HR professionals the priorities for the design of leader-focused workplace mental health training. Such content prioritisations are critical to ensure engagement of time-poor leaders is maximised.


Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), has developed into a global health crisis. Understanding the risk factors for poor outcomes of COVID-19 is thus important for successful management and control of the pandemic. However, the progress and severity of the epidemic across different regions show great differentiations. We hypothesized the origination of these differences are based on location-dependent variations in underlying population-wide health factors. Disease prevalence or incidence data of states and counties of the United States were collected for a group of chronic diseases, including hypertension, diabetes, obesity, stroke, coronary heart disease, heart failure, physical inactivation, and common cancers (e.g., lung, colorectal, stomach, kidney and renal). Correlation and regression analysis identified the prevalence of heart failure as a significant positive factor for region-level COVID-19 mortality. Similarly, the incidence of gastric cancer and thyroid cancer were also identified as significant factors contributing to regional variation in COVID-19 mortality. To explore the implications of these results, we re-analyzed the RNA-seq data for stomach adenocarcinoma (STAD) and colon carcinoma (COAD) from The Cancer Genome Atlas (TCGA) project. We found that expression of genes in the immune response pathways were more severely disturbed in STAD than in COAD, implicating higher probability for STAD patients or individuals with precancerous chronic stomach diseases to develop cytokine storm once infected with COVID-19. Taken together, we conclude that location variations in particular chronic diseases and cancers contribute significantly to the regional variations in COVID-19 mortality.


The present invention makes it possible that when the operation of the entry / exit from the network / are implemented as an action for the table search results, increasing the action resource to be accommodated by reducing the action pattern required. As predetermined information entries in the table in the packet as the table is performed a search for whether the matching in the search key and, the action defined by the action corresponding to the matching search key is performed, the network packets of the exit information and the user information in the map are different from each other, if at least a is prepared in a plurality of stages the table is switched to the first and a second table, the first table is found for the input the first packet, the search key in the first table matching a, a in the first packet operation action associated with that corresponding to the search key in the first table is carried out to convert the first packet to a second packet, the second packet is supplied to the second table, for the second packet of claim 2 table is retrieved, the action associated with the operation corresponding to the second packet to the search key in the second table when the search key is matched in the two tables is performed to the second And it converts the packet into the third packet.


"Scientific theories are maps of the natural world." This metaphor is often used as part of a deflationary argument for a weak but relatively global version of scientific realism, a version that recognizes the place of conventions, goals, and contingencies in scientific representations, while maintaining that they are typically true in a clear and literal sense. By examining, in a naturalistic way, some relationships between maps and what they map, we question the scope and value of realist construals of maps-and by extension of scientific representations. Deflationary philosophy of science requires more variegated stances.


Aim: The purpose of the study is to determine the necessity of using a ureteral stent later to uncomplicated ureteroscopy in ureteral stones with intracorporeal lithotripsy. Methods: For ureteric stones 170 cases were planned for ureteroscopic lithotripsy at the Urology Department of Sahiwal Teaching hospital, Sahiwal and Abbasi Shaheed Hospital, Karachi for two-years duration from July 2019 to June 2021. 170 patients were encompassed in the analysis after stones fragmentation. The patients were divided randomly into 2 groups: the 1st group (80 patients with a stent) was inserted postoperatively with ureteral stents, while the second group had no stent (90 patients without a stent). Two weeks apart; stents were removed. Each group patients were evaluated for duration of surgery, success, postoperative pain, voiding irritating symptoms, stricture formation and hematuria. Results: Both groups of patients were similar in relation of sex, age and mean size of stones. The mean surgery duration was 40 minutes (15-55) in the stent group and 35 mints (20-45) for the stent-less group. Irritation symptoms during urination were observed in 33.7% in the group with stents and 26.7% in the group without the stent. 23(28.7%) patients in the group placed with stents and 13(14.4%) in the stentless group required two or more analgesics per day immediately after surgery. One patient in the stentless group required re-hospitalization for pain control. Hematuria developed in 11 patients (13.7%) and 9 patients (10%) in the stented and non-stented groups, correspondingly. The stricture formation and stone-free rate did not differ amongst the both groups. Conclusion: Ureteral stenting is not essential after uncomplicated ureteroscopy in the ureteral stone's treatment with intracorporeal shock wave lithotripsy. While placing the stent in the ureter does not provide any additional benefit, it is inconvenient for the patient in terms of cost and subsequent recovery. Keywords: Ureteral stent, Ureteroscopy, Ureteral calculus.


Covers medical and surgical pitfalls and problems affecting the genito-urinary system. Reviewed and updated, chapters are put into a clinical perspective. There are also new sections on management of impotence, continent urinary diversion, ESWL and non-operative management of BPH-Lange.


. - Suppose X is a smooth projective variety. The moduli space M (X) of rank one local systems on X has three different structures of complex algebraic group (Betti, de Rham, and Dolbeault). A subgroup which is algebraic for all three structures, we call a triple torus. We show that any closed subspace S of M (X) which is defined in a natural way, for example by looking at cohomology groups and related constructions, is a finite union of translates of triple tori by torsion points. This answers a conjecture of Beauville and Catanese. The proof that the translates are by torsion points rests on a result from transcendental number theory.


The frequency and cost of cyber-attacks continues to grow in commercial information systems. In power systems critical infrastructure, any level of breach may be unacceptable. Securing this infrastructure requires new approaches to communications networks which are not readily vulnerable to remote attack. Standard protocols like Ethernet and IP are difficult to secure. Within well-defined domains, SDN may provide mitigation for vulnerabilities which are otherwise intractable. Methodical approaches have been developed and implemented at a test site.


In the light of computational chemistry, based on morpholinium cation-based Ionic Liquid, their different types of physical, chemical, and biological properties is highlighted. The physical properties are evaluated through the Density Functional Theory (DFT) of Molecular Mechanics and also examine the chemical and biological properties. The difference between Highest Occupied Molecular Orbital (HOMO) and Lowest Unoccupied Molecular Orbital (LUMO) is starting from 11.19 to 4.00, which means that their chemical reactions change as soon as an anion change is done. Biological activity of predictions given by QSAR calculation is forecasted. Where the value of all the LogP that is available is positive, which indicates hydrophobic, on the other hand, PIC50 calculations are found that all the values below 5 are biologically active. To identify these molecules, computational data is used to determine the vibrational spectrum and electronic spectrum.


The study pro vides an investigation of a sample of Arabic subtitles on English movies and TV dramas in an attempt to identify and account for some patterns of "corruption" in these subtitles, to provide some suggestions for fixing such subtitling problems and to provide some guidelines for doing, and teaching, Arabic subtitling on English audiovisual texts. The investigation of the sample Arabic subtitles on the English movies - Big Daddy, Tempted, and Lizzie McGuire Movie - and TV dramas identifies specific patterns of problems: Literal translation, insensitivity to context, ungrammatical, unnatural or inaccurate translations, treatment of foul language and unnecessary formality. The discussion of the problems and the analysis thereof addresses some of the major issues in translating Arabic to English in general and in doing English-to-Arabic audiovisual translation (ATV) in particular.


This study aims to analyze; 1) the profile of informal sector workers in Jambi Province; 2) The development of informal sector employment in Jambi Province; 3). the effect of economic growth, population, and income per capita on informal sector employment. The data used microdata of National Labor Force Survey, Jambi Province 2015. The results showed; 1) Informal sector workers in Jambi Province 81.5 percent are in rural areas, dominated by male workers, mostly poorly educated, and work in agriculture; 2). During the period 2005-2015, the average growth of the informal sector was 1.3 percent per year, and 3) Simultaneously the economic growth, population, and income per capita had a significant effect on informal sector employment.Keywords: informal sector, economic growth, population, and income per capita


Abstract : During the past decade, scholars in Germany, Great Britain, and the Soviet Union have published a substantial amount of material dealing with the application of algorithms and algorithmic procedures to instruction. This paper reviews the most significant European concepts, describes what is being done in the USA, and identifies problems worthy of serious research endeavors. An algorithm is a list of unambiguous elementary instructions specifying a sequence of discriminations and operations which will yield the solution to any problem of a class. Algorithms may vary in the degree to which they are deterministic. Likewise, problems may vary in the degree to which they are amenable to solution by algorithms or algorithmic procedures. A concise taxonomy of algorithms based on these characteristics is presented. The applicability of algorithmic concepts to various types of problems is discussed and illustrated by means of concrete examples. (Author)


Objective:To investigate the current prevalence and distribution of mental disorders among people aged more than 15 in urban in Guilin.Methods:From July,2007 to December,2007,1260 subjects aged more than 15 were randomly selected for 6 Prefecture-level cities by stratified multi-stage cluster sampling method.All subjects were investigated by face to face interview.The Chinese version of Composite International Diagnostic Interview(CIDI3.0) provided by the Chinese Center for Disease Control and Prevention was used as the screening tool and the diagnoses were made with the 10th edition of international classification of Disease Criteria.Results: 1155 subjects were screened,the Completion rate was91.67‰.The general point prevalence was 29.44‰,and the general lifetime prevalence was 30.30‰.In order of the lifetime prevalence,the top 2 common specific disorders were schizophrenia(11.26‰) and affective disorder(7.79‰).The general lifetime prevalence in female(31.99‰) was higher than in male(28.52‰),but the result showed no significant difference(x2MH=0.029,P=0.864).The prevalence of schizophrenia has no statistically significant differences(P0.05) among age,educational level and marriage.The prevalence of affective disorder has also no statistically significant differences(P0.05) among age,educational level and marriage.Conclusions: Schizophrenia and affective disorder are the most common mental disorders in Guilin,and it is necessary to carry out targeted research in prevention and rehabilitation.


The present invention increases a method for producing them up and gellan gum, which has a biodegradability, as an active ingredient, and with the excellent biocompatibility and superior adhesion prevention of the adhesion preventing this adhesion agent composition. Adhesion preventing agent according to the present invention can prevent the adhesion phenomenon that is caused by surgery, infections and trauma.


In this study, investigations were carried out on strength properties such as compressive strength, split tensile strength of M25 grade concrete mixes with different replacement levels. Those mixes were the complete replacement of sand with quarry rock dust and marble sludge powder separately. Then the other mixes having sand as 40% constantly. Remaining 60% have replaced with varying the percentages of both Quarry rock dust and Marble sludge powder for each mix such as 20percent, 30percent, and 40percent with water cement ratio as 0.4, normal curing condition is adopted for 3, 7, and 28 days. The results of these investigations demonstrate the strength characteristics of various mix proportions adopted. Based on the result obtained, Mix-4 has higher compressive strength and Mix-2 has higher split tensile strength. Here Flexural behavior and shear behavior of reinforced concrete beam are evaluated for both control mix and design mix. The details of the investigations along with the result are presented in this report.


Dense aggregations of phytoplankton in layers or patches alter the optical and physical properties of the water column and result in significant hetero- geneity in trophic and demographic rates of local plank- ton populations. Determining the factors driving patch formation, persistence, intensity, and dissipation is key to understanding the ramifications of plankton patchi- ness in marine systems. Regression and multi-parametric statistical analyses were used to identify the physical and optical properties associated with 71 phytoplank- ton-rich layers (PRLs) identified from 158 CTD profiles collected between 2008 and 2010 in East Sound, Wash- ington, USA. Generalized additive models (GAMs) were used to explore water column properties associated with and characterizing PRLs. Patch presence was associated with increasing water column stability represented by the Brunt-Vaisala frequency (N 2 ), Thorpe scale (Lt), and turbulent energy dissipation rate (e). A predictive re- gression identified patch presence with 100% accuracy when log10(N 2 ) = �1 and 70% of the cases when log10(e) = �3. A GAM of passively measured variables, which did not include fluorescence, was able to model patch inten- sity with considerable agreement (R 2 = 0.58), and the fit was improved by including fluorescence (R 2 = 0.69). Flu- orescence alone was an insufficient predictor of PRLs, due in part to the influence of non-photochemical quenching (NPQ) in surface waters and the wide range of fluorescence intensities observed. The results show that a multi-parametric approach was necessary to char- acterize phytoplankton patches and that physical struc- ture, resulting in steep gradients in bio-optical proper- ties, hold greater predictive power than bio-optical properties alone. Integration of these analytical ap- proaches will aid theoretical studies of phytoplankton patchiness but also improve sampling strategies in the field that utilize autonomous, in situ instrumentation.


An 82-year-old male with a history of hypertension presented with resting dyspnea and orthopnea of 72 hours duration. At admission blood pressure was 145/75 mm Hg and respiratory rate was 30 beats/min. Jugular venous pressure was increased and heart sounds were diminished and arrhythmic. Pulmonary auscultation revealed absent breath sounds over the left lung base. Electrocardiogram showed atrial fibrillation at a mean rate of 120 beats/min, and low QRS voltages. Chest X-ray film revealed left pleural effusion and enlargement of the cardiac silhouette. Transthoracic echocardiography (Fig. 1) and contrast computed tomography (Fig. 2) disclosed a large pericardial effusion with incipient echocardiographic signs of cardiac tamponade, as well as a huge fusiform aneurysm of the ascending aorta with a maximum transverse aortic diameter of 105 mm; no evidence of aortic dissection was noted. Unfortunately, the patient experienced an episode of acute hemodynamic collapse that could not be reversed. Necropsy confirmed aortic rupture, and the etiology of the aortic aneurysm was found to be atherosclerotic. Few cases of ascending aortic aneurysms measuring more than 10 cm have been reported [1, 2]. Our case illustrates the unfortunate outcome of some of these cases. Rupture of an ascending aortic aneurysm into the pericardium may be rapidly fatal owing to acute cardiac tamponade; however, if the bleeding is contained, the patient may have a chance to survive; in such cases, emergency surgical intervention is mandatory; pericardiocentesis is controversial because it may precipitate recurrent hemorrhage and rapid death, particularly in the


PART I: TECHNOLOGY 1. Radio and Television Broadcasting - Leonard Shyles Broadcasting in America The Basics of Electromagnetic Radiation From Radio to Television Transmission The Expanded Video System Cyberinterview: Michael Young 2. Computers in Communication: Concepts and Application - Leonard Shyles The Language of Binary Code The Move Toward Machine Calculation Conceptual Foundations From Theory to Practice ASCII: Why 1 Is a Beautiful Number in the Computer Industry Capturing Sound with Binary Code Capturing Images Standard Computer Architecture Modern Computers Chip Manufacturing Cyberinterview: Dan Birenbaum 3. Sending Messages Across the Network - Leonard Shyles Connecting Users: Access From Analog to Digital Transmission Growth of Telecommunications Network Cellular Telephony Cyberinterview: Charles Ehlin PART II: MARKETS 4. Children in Cyberspace - Mark R. Banschick and Josepha S. Banschick The Child/Internet Interface Intellectual Development Internet and the Social World Identity Formation and the Internet 5. Social and Psychological Uses of the Internet - JoAnn Magdoff and Jeffrey B. Rubin Who Uses the Internet? When the Web Resembles the Real World Re-creating Identity What is the True Self? Online and Offline Emergence and Complexity Cyberinterview: Marvin Kane 6. Connected Learning in the Information Age - Thomas McCain and Leigh Maxwell The Infrastructure of Education The Unique Qualities of Digital Media Administrative Challenges Cyberinterview: Rick Marx 7. Adopting Instructional Technologies - Judy C. Pearson Brief Overview Assessing the Impact of Instructional Technologies The Promise of Instructional Technologies Challenges Facing Administrators PART III: POLICY 8. Law and Regulation, Part I: Individual Interests - Keith Lee and Janessa Light Freedom of Expression Constitutional Right to Privacy Copyrights Epilogue 9. Law and Regulation, Part II: Business Interests - Janessa Light and Katherine Neikirk Trademarks Jurisdiction Defamation Epilogue Appendix A: US Radio Spectrum Allocations and Uses


To define ICA positiveness and its clinical correlation in AITD, ICSA were checked in Graves' patients by indirect IF test using rat insulinoma (RINr) cells. Also Ig adherence to rat thyroid (FRTL5) and EB virus cloned human B lymphocytes that do not produce immunoglobulins were measured as the same method of ICSA with determination of organ specific antibodies in the sera. The incidence of ICSA in Graves' disease was 23.1 % (9/39) and the degree of the positiveness measured as % binding was roughly correlated to those of Ig adherence to FRTL5 and B cells. This ability to bind multiple organs of different species was not found to have any correlation with the titers of organ specific antibodies, but the incidence of organ specific antibody positiveness was much higher in the ICSA positive sera. Also there was a significant difference on the absorption pattern to FRTL5 and RINr cells between the sera of ICSA positive IDDM and Graves' patients, where absorption and % binding to FRTL5, cell in ICSA positive diabetic sera were significantly lower than those to RINr cells in ICSA positive Graves'.


In the state-parallel implementation of the Viterbi algorithm, one add-compare-select (ACS) unit is devoted to each state in the treillis. A systematic approach to partitioning, scheduling, and mapping N trellis states to P ACSs, where N>P, is presented here. The area saving of this architecture comes from the reduced number of ACSs and interconnection wires. The design of the ACS, path metric storage, and routing network is discussed in detail. The proposed architecture creates internal parallelism due to the ACS sharing, which can be exploited to increase the throughput rate by pipelining. Consequently, the architecture offers a favorable (smaller) area-time product, compared to the state-parallel implementation. >


titative evaluations of market potentials for new products, although it is noted that qualitative ratings and estimates from knowledgeable personnel are an important part of this procedure. Some interesting questions are posed by the author as an indication of the type of information which should be supplied at successive decision points before further developmental work is approved on pending new product proposals. One question concerns the value of additional information which can be supplied prior to making a decision, balancing the expected cost to be incurred in obtaining it against the probability that the decision will be changed as a result of obtaining the informa-


Reserves are typically estimated and re-validated throughout the life of a producing field. The accuracy of this estimation is based on the availability of relevant and current data from that reservoir or field and other factors. There are several methods for estimating reserves, but the choice of which method is to be applied is often based on the data available per time. However, these methods are known to be associated with varying degrees of uncertainties arising from quality of data, the assumptions adopted and the experience of the evaluator. The biggest uncertainty in reserve estimation lies in the inability of the commonly available methods to estimate and discount the huge volumes lost due to unauthorized production by third parties, through crude oil theft, illegal bunkering activities, and spills. This leads to the gross overestimation of reserves and the economic viability of an asset, especially in onshore and shallow offshore assets where such illegal activities are typical and rampant. This paper showcases an approach of estimating reserves, through the integration of multidisciplinary data, which enables the estimation and discounting of crude oil volumes lost due to illegal production from a reservoir.


This article will examine how a patient can be prepared for transport in a primary hospital, beyond the resuscitation protocols established by the 'early management of severe trauma' teaching.


Established wireless services continue to grow at healthy rates and new wireless services continue to emerge. The result is that there will be multiple networks offering connectivity. As applications grow on these services, subscribers will need cross functionality between these wireless networks. Additionally, as subscribers demand indoor coverage for these services, indoor environments could begin to look like outdoor environments with their multitude of systems and antennas. This paper will articulate several proposed architectures for in-building wireless services that can span the different frequencies, air standards and network interfaces to offer a seamless environment.


As cultural beings, our perceptions of and attitudes toward the environment are structured not just by our own upbringing and personality, but by the deep history of our ancestors' relationships with the harsh environments in which they managed to survive. This knowledge has been passed down to us, the land's fleeting occupants, from the preceding generations through the inheritance of both hardcoded genetic material and cultural traits, such as our norms and values. These act as a filter over our vision of the world around us, dictating how we receive and respond to the information with which we are constantly presented. Every interaction with the environment and each other is structured by this dual biological and cultural inheritance.


In our country,under the backdrop of rapid urbanization,urban construction and development should be consistent with the ecological environment,the protection of the physical environment of Humanities equilibrium.The core District of Yuhang innovation base is abundant with good ecological environment and human resources.With rapid urbanization,from the practices of urban design point of view,How can we keep the above three elements in harmonious with the other for the development in the future with a fair and reasonable manner,is this article and focus of our exploration.


Ectopic pregnancy is an important cause of maternal morbidity and mortality worldwide. To better understand the genetic risk factors underlying this pregnancy complication, we conduct a GWAS meta-analysis and identify two genome-wide significant loci on chromosomes 1 (rs4971091, p=5.32x10-9) and 10 (rs11598956, p=2.41x10-8). Follow-up analyses propose MUC1, an epithelial glycoprotein with an important role in barrier function, as the most likely candidate for the association on chromosome 1. We also characterise the phenotypic and genetic correlations with other phenotypes, identifying a genetic correlation with smoking and diseases of the (genito)urinary and gastrointestinal system, and phenotypic correlations with various reproductive health diagnoses, reflecting the previously known epidemiological associations.


The concept of Smarandache isotopy is introduced and its study is explored for Smarandache: groupoids, quasigroups and loops just like the study of isotopy theory was carried out for groupoids, quasigroups and loops. The exploration includes: Smarandache; isotopy and isomorphy classes, Smarandache $f,g$ principal isotopes and G-Smarandache loops.


The invention provides a pot supporting and stabilizing device and a method for lifting a container. The device consists of a stander, a carrying device, a rocker arm connecting device and a rocker arm rear platform, wherein the carrying device comprises a carrying hydro cylinder, a supporting claw, a carrying shaft and a carrying bearing; and the rocker arm connecting device comprises a rocker arm platform, a pot stabilizing hydro cylinder, a swing stem, a rocker arm hydro cylinder, a rocker arm shaft housing, an internal rocker arm bearing, an external rocker arm bearing, an internal pot stabilizing block and an external pot stabilizing block. When a cage does not reach an upper position and a lower position a mouth of a well for stopping the pot, the rocker arm platform is in a state of upwardly swinging and uplifting, and the supporting claw is in a pullback state; when the cage reaches the position of stopping the pot and is stopped, the carrying hydro cylinder elongates to push the supporting claw to carry the cage; according to the weight of the equipment going out and in the cage, whether the rocker arm hydro cylinder or the pot stabilizing hydro cylinder operates is selected, the rocker arm platform is fallen to the horizontal position to compress the upper surface of the cage chassis so as to stabilize the cage; after the equipment goes in and out the cage, the rocker arm hydro cylinder extends to push the swing stem to uplift the rocker arm platform, the carrying hydro cylinder contracts to pull back the supporting claw so that the cage conveniently runs up and down. The invention has simple structure, high stability for carrying the cage, high safety and high stability.


INTRODUCTION too rigid, it excludes extra-colonic cancers and it may not 6 Colorectal cancer (CRC) is amongst the common be applicable for small families . Alternatively, 7 cancers worlwide. The incidence of colo-rectal Amsterdam criteria II was defined: (1) atleast three carcinoma in Pakistan is similar to other Asian countries, relatives must have a cancer associated with HNPCC but much lower than in the developed countries. The risk (colorectal, endometrial, stomach, ovary, ureter or renal is equal in both sexes at present. However a 41 % rise in pelvis, brain, small bowel, hepatobiliary tract or skin incidence was noted in the males between 1995 to 1999, tumors), (2) one must be first degree relative of other two, 1 which may indicate a higher risk in the males in future . (3) atleast two successive generations must be affected, Various factors and mechanisms have been discovered (3) atleast one of relative should have diagnosed before 2,3 which play key role in the development of CRC . It has the age of 50, (5) familial adenomatous polyposis (FAP) been thought that one-third of CRC pateints have a should have been excluded in any relative with colorectal genetic background. Hereditary nonpolyposis colorectal cancer and (6) tumor should be verified whenever cancer (HNPCC) is a common autosomal dominant possible. colorectal disorder with special clinicopathological 4 The porportion of HNPCC varies by country, with rates features . In clinic, it is diagnosed by Amsterdam criteria 5 ranging from 1 to 10% among all colorectal cancer I: (1) three or more relatives with histologically confirmed 8 patients (median 2-5%) . Our previous studies colorectal cancer, one of whom is the first-degree to the mentioned that colorectal cancer patients under age 30 other two; (2) colorectal cancer affecting at least two represent more than 30% of total colorectal cancer in our generations; and (3) one or more colorectal cancer cases 9,10 diagnosed before the age of 50. Amsterdam criteria I is country . HNPCC HEREDITARY NONPOLYPOSIS COLORECTAL CANCER IN PAKISTAN


This research aims to see the influence of empowerment and interpersonal communication on improving organizational citizenship behavior. The influence seen is the partial influence and the simultaneous influence between the dependent variable and the independent variable. The research was conducted on 92 WJU Generation Y employees. The research is quantitative using two analysis methods, namely the descriptive method and the data analysis method using SMART PLS. To see the influence of the dependent variable on the independent variable, the t test and F test were used. The research results show that empowerment and interpersonal communication can influence the increase in employee organizational citizenship behavior both partially and simultaneously. Between these two influences, it is known that the influence of empowerment is higher than the influence of interpersonal communication. The aspects of interpersonal communication that need to be improved so that increasing organizational citizenship behavior has a stronger impact are the alturism aspect and the sportsmanship aspect.
 Keywords: Empowerment, Interpersonal Communication, Organizational citizenship behavior


Many experts prophesy incredible medical advances in the 21st century—an end to genetic diseases, a cure for cancer, prevention of Alzheimer's and heart disease, to name a few. It's clear that pharmaceutical products will play a critical role in fulfilling these medical promises, just as they have in the 20th century. That's the premise of Jurgen Drews's "In Quest of Tomorrow's Medicines." Here this former head of global research for Hoffmann-La Roche defines the role of research and technological advance in the discovery and development of therapeutic medicine. In elegant prose, he provides a careful construction of the history, present practice, and future vision of the pharmaceutical industry. More than two centuries of lessons show how sudden scientific insights have wrenched the fabric of the industry of the time, and Drews makes it clear that this process is happening again in today's giant pharmaceutical companies. Drews is still actively involved in drug discovery and development. ...


[Objective] To investigate the efficacy of Surfactan, N-CPAP and intravenous mucosolva in neonatal hyaline membrane disease (HMD). [Methods] 36 cases diagnosed as HMD were retrospectively analyzed: 14 cases with firm Sue treatment were as Ⅰ group, 8 cases with N-CPAP treatment were as Ⅱ group, and 14 cases with intravenous mucosolva treatment were as Ⅲ group. [Results] The skin color, percutaneous oxygen saturation and symptoms, signs, N-CPAP time and average hospital days of three groups of patients before and after treatment were compared. The anoxic symptom of Group I were rapidly improved, group Ⅱ showed the short time of NCPAP oxygen, and followed by group Ⅱ and group Ⅲ. There was significant difference between the three groups (P﹤0.001). Among 14 cases in GroupⅠ, 12 cases were cured, 2 cases died, cure rate of 86%. Ⅱ 8 cases of six cases were cured, 1 case discharged, and 1 died, and the cure rate was 75%. Among 14 patients of Group Ⅲ, 7 cases were cured, 1 cases discharged, six deaths, and the cure rate of 50%. [Conclusion] Surface active substances treatment showed aspects of fast, safe and effective in improving the lung function and clinical symptoms of preterm infants with transparent membrane pulmonary disease, and improving the children's survival, and shortening the rescue premature infants as well as reducing the oxygen retinopathy. N-CPAP is safe, comfortable, convenient and inexpensive in clinic application.


PURIFIED diphtheria and tetanus antitoxins, prepared from antitoxic horse sera by isolating the water-soluble globulins, are purer than the original sera in so far as they contain more antitoxin per g. of protein. Their higher degree of purity however does not exclude the fact that for a definite volume they often contain more protein than the original sera from which they were prepared. As the injection of concentrated protein solutions is not desirable, there are regulations fixing the maximum protein or total solid content of such purified antitoxins. For institutions concerned with the production of such antitoxins, the determination of total solids or total protein is therefore a matter of daily routine. The gravimetric methods for determining total solids and protein, and the Kjeldahl method, are well established but rather lengthy procedures. The nephelometric method for determining proteins [Kober, 1917] is quicker, but it seems not easy to obtain reproducible results. The present paper deals with the refractometric determination of the globulin content of concentrated antitoxins. The refractometric determination of serum-protein by Reiss [1913; 1915; 1924] differs from the method described here in that in natural sera the concentration of non-protein substances is unknown, and may in exceptional cases show great variations, so that from the refractive index alone the protein concentration can only be determined approximately. However, antitoxins, purified by a modification of Banzhaf's method of salt precipitation and heating, represent pseudoglobulin solutions free from albumin and non-protein fractions and containing known amounts of salt and preservative. The protein content of such solutions can be determined by a single refractometric reading.


Host cell proteins (HCPs) are among the process‐related impurities monitored during recombinant protein pharmaceutical process development. The challenges of HCP detection include (1) low levels of residual HCPs present in large excess of product protein, (2) the assay must measure a large number of different protein analytes, and (3) the population of HCP species may change during process development. Suitable methods for measuring process‐related impurities are needed to support process development, process validation, and control system testing. A multi‐analyte enzyme‐linked immunosorbent assay (ELISA) is the workhorse method for HCP testing due to its high throughput, sensitivity and selectivity. However, as the anti‐HCP antibodies, the critical reagents for HCP ELISA, do not comprehensively recognize all the HCP species, it is especially important to ensure that weak and non‐immunoreactive HCPs are not overlooked by the ELISA. In some cases limited amount of antibodies to HCP species or antigen excess causes dilution‐dependent non‐linearity with multi‐product HCP ELISA. In our experience, correct interpretation of assay data can lead to isolation and identification of co‐purifying HCP with the product in some cases. Moreover, even if the antibodies for a particular HCP are present in the reagent, the corresponding HCP may not be readily detected in the ELISA due to antibody/antigen binding conditions and availability of HCP epitopes. This report reviews the use of the HCP ELISA, discusses its limitations, and demonstrates the importance of orthogonal methods, including mass spectrometry, to complement the platform HCP ELISA for support of process development. In addition, risk and impact assessment for low‐level HCPs is also outlined, with consideration of clinical information. Biotechnol. Bioeng. 2014;111: 2367–2379. © 2014 Wiley Periodicals, Inc.


The opinions expressed herein are the views of the Consensus Panel members and do not reflect the official position of the U.S. Department of Health and Human Services (DHHS). No official support or endorsement of CSAT or DHHS for these opinions or for particular instruments or software that may be described in this document is intended or should be inferred. The guidelines in this document should not be considered substitutes for individualized patient care and treatment decisions.


During optimize the weights of Elman recurrent neural networks by genetic algorithm, if use simple genetic algorithm, two problems appear: constringency too early and the speed of search too slow in the anaphase. Aim at these problems, an improved Niche genetic algorithm is presented in this paper. Simulation results show that this algorithm can achieve perfect effect.


Brahman (n = 771) and F1 Brahman × Hereford (n = 56) calves born over 9 years (2002 to 2010) from 33 sires and 355 dams at the Texas AgriLife Research Center in Overton were utilized to evaluate the genetic and non-genetic factors influencing calf temperament. Calves were evaluated for pen score (PS), exit velocity (EV) and temperament score (TS) 28 d before weaning, at weaning, 28 d post-weaning, 56 d post-weaning, and as yearlings. Mixed models were used to determine non-genetic factors influencing PS, EV and TS at each sampling day and also as repeated records analyses. Contemporary group (calves of the same sex and weaned together) and dam age group were fixed effects, calf age at weaning and proportion Brahman were linear covariates, and sire and calf nested within sire were random effects. Exit velocity, PS and TS differed across contemporary groups (P < 0.05) and by day (P < 0.0001) but not by proportion Brahman (P = 0.63). Dam age group was significant for PS (P < 0.03) but not for TS (P = 0.07) or EV (P = 0.17). Solutions for calf age at weaning were 0.0048, 0.0033 and 0.0040 for PS, EV and TS, respectively (P < 0.02; average SE = 0.001). Table 1 presents means for temperament traits by day. Animal models were subsequently used to estimate heritability of PS, EV and TS at weaning: 0.48, 0.29 and 0.43, respectively (average SE = 0.08). From repeated records analyses, the proportion of phenotypic variance due to permanent environmental effects were 0.31, 0.43 and 0.25 (average SE = 0.02) and heritability estimates were 0.44, 0.28 and 0.41 (average SE = 0.07) for PS, EV and TS, respectively. These results suggest temperament is moderately to highly heritable and is influenced by contemporary group, dam age, calf age at weaning, and permanent environmental effects.


6-(Substituted methylene)-N-(aryl-alkylidene)-2,4-cyclohexadien-1-imines are suggested intermediates in a novel synthetic route to 2-arylquinolines based on the reaction of trifluoromethyl-substituted ketimines with strong bases


Gel immersion endoscopy (GIE) is a novel method to secure the visual field using gel with an appropriate viscosity, even during ongoing bleeding [1], and is effective in the narrow lumen of the gastrointestinal tract. Recently, GIE was reported to be useful for unexpected arterial bleeding during endoscopic submucosal dissection (ESD) [2]. However, the gel may be difficult to apply in the large lumen of the stomach. The pocket-creation method (PCM) is a new ESD strategy, which is characterized by entering the submucosal layer with a minimal mucosal incision and dissecting the submucosal layer completely under the lesion before the circumferential mucosal incision, as if a "pocket" is made [3]. In this narrow "pocket," GIE can be applied easily, even when there is massive arterial bleeding where water infusion alone cannot secure the endoscopic view (▶Fig. 1, ▶Fig. 2). A 78-year-old man was referred for endoscopic resection of a flat elevated 50-mm gastric tumor on the lesser curvature of the antrum. We performed ESD using PCM with a therapeutic-type endoscope (EG-L580RD; Fujifilm, Tokyo, Japan) and a small-caliber-tip transparent hood (DH15-GR; Fujifilm) (▶Video1). After incision of the mucosa on the proximal side of the tumor, the submucosal layer was dissected to make a pocket. However, a large vessel was injured accidentally during this procedure. We tried to achieve hemostasis with forceps, but the bleeding point could not be visualized because of a rapid collection of blood. Continuous water injection enabled transient visualization, but water and blood mixed immediately, leading to insufficient visualization. After continuous injection of gel (OS-1 JELLY; Otsuka Pharmaceutical Factory, Tokushima, Japan), we could identify the bleeding point. After the bleeding point has been grasped with forceps, the gel should be replaced with gas before applying electrocoagulation. Using this method, we achieved hemostasis. GIE simplifies hemostasis during ESD with PCM and can be a standard strategy throughout the gastrointestinal tract.


In the cation of the title compound, C10H13N2O+·I−, all non-H atoms, with the exception of the O atom, are essentially coplanar, with a maximum deviation of 0.04 (1) Å. In the crystal, the cations and anions are arranged in layers parallel to (100). The cations are connected to the anions via an O—H⋯I hydrogen bond and there are significant π–π stacking interactions between cation layers, with centroid–centroid distances in the range 3.606 (5)–3.630 (5) Å. A weak intramolecular C—H⋯O hydrogen bond is also observed. The crystal studied was an inversion twin with refined components of 0.52 (5) and 0.48 (5).


TRENDS in modern aeroplane design toward multi‐engined types super‐charged for high altitude operation have imposed new demands upon variable‐pitch airscrew equipment. To secure the best operating conditions with a minimum of attention from the pilot, constant speed control is essential. To meet the requirements of increased speed range, a wide operating range of blade angles is necessary. To prevent possible further damage to the engine and aeroplane due to "windmilling," in the event of failure of one of the power plants, and to secure a maximum of performance from the remaining power, it is highly desirable that the airscrew be capable of attaining blade angles of 85 to 90 deg. or of being "feathered." For maximum flexibility, the airscrew control should be independent of the engine. At all times, it is essential that the pilot should have ready means of selecting and controlling the type of operation desired.


A structure is called a normal tetrahedral structure if every atom of the structure has four nearest neighbors which are locatod at the vortices of a surrounding tetrahedron. If not all four comers of the surrounding tetrahedron are occupied with an atom, the structure is said to be a defect tetrahedral structure. Normal-tetrahedral structures are formed only if the average valenceelectron concentration per atom is four. Defect tetrahedral structures can be made to fit the valence-electron concentration rule if the number of structure defects, or the number of imused, tetrahedral orbitals, is considered. A scheme has been developed which allows one to calculate the compositions of all theoretically possible normal and defect tetrahedral structures. Some 200 tetrahedral-structure Compounds are known which all fit in the composition scheme. The system can be used as well to find the compositions of new tetrahedral-structure compoimds or to test reported compositions of tetrahedralstructure minerals for their correctness. It was found that it is possible to present the composition scheme not only analytically but also graphically in a master composition diagram. A plot of a Compound in a mtister composition diagram, regardless of the element combination, will show on first sight if the composition is right for a normal tetrahedral structure or a defect tetrahedral structure. In the latter cewe one can read from the diagram the number of structure defects. An average valence-electron concentration of foiir is a necessary but not sufficient condition for the formation of a tetrahedral structure. Other factors have to be considered, like the electronegativity difference A x and the average principal quantum mmiber of the valence shell of the participating atoms n. The influence of these factors can be conveniently studied in a so-called "/ixversus-n" diagram, first introduced for normal valence compoxmds by MOOSEB and PEAKSON. It is found that of all those compositions which have the correct average valence-electron concentration, only those which lie in a well defined region of the J r-versus-n diagram will crystallize with a tetrahedral structure.


A novel dual‐mode uniplanar square slot‐loop resonator, using an inset‐coupling mechanism with capacitive gaps is proposed. The mode splitting of the uniplanar resonator is described with respect to the perturbation size. A dual‐mode uniplanar filter using such a resonator is designed and fabricated with 5% bandwidth at the center frequency of 2.97 GHz for demonstration. The measured filter performance is presented. © 2004 Wiley Periodicals, Inc. Microwave Opt Technol Lett 41: 481–483, 2004; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/mop.20178


Diabetes mellitus-induced hyperglycemia is associated with a number of pathologies such as retinopathy, nephropathy, delayed wound healing and diabetic peripheral neuropathy (DPN). Approximately 50% of patients with diabetes mellitus will develop DPN, which is characterized by disrupted sensory and/or motor functioning, with treatment limited to pain management. Zebrafish (Danio Rerio) are an emerging animal model used to study a number of metabolic disorders, including diabetes. Diabetic retinopathy, nephropathy, and delayed wound healing have all been demonstrated in zebrafish. Recently, our lab has demonstrated that following the ablation of the insulin producing β-cells of the pancreas (and subsequent hyperglycemia), the peripheral nerves begin to show signs of dysregulation. Here, we take a different approach, taking advantage of the transdermal absorption abilities of zebrafish larvae to extend the period of hyperglycemia. Following 5 days of 60mM D-glucose treatment, we observed motor axon defasciculation, disturbances in perineurial glia sheath formation, decreased myelination of motor axons, and sensory neuron mislocalization. This study extends our understanding of the structural changes of the peripheral nerve following induction of hyperglycemia, and does so in an animal model capable of potential DPN drug discovery in the future.


Printed in Rome in 1632, Diego Collado's Ars grammaticae Iaponicae lingvae was the earliest grammar of Japanese ever to be printed in Europe. It is well known that this edition in Latin was preceded by a manuscript version in Spanish, a copy of which is kept at the British Library. At the end of the 19th century Ernest Satow had already drawn scholars' attention to another Spanish as well as to an Italian manuscript at the Museo Borgiano. Their later whereabouts were however deemed unknown for about a century. The "rediscovery" of these manuscripts, which are now in the possession of the Biblioteca Apostolica Vaticana, enables us to give some preliminary comments especially on the two Spanish manuscripts as well as on their relationship to each other and to the Latin edition.


The invention provides a movable pushing device for sliding launch of a large jacket. The movable pushing device is provided with a plurality of hydraulic jacks; the plurality of hydraulic jacks are respectively arranged on a plurality of slide rails; the front part and the rear part of each hydraulic jack are respectively provided with a fixing unit; and a pushing slide block is arranged in front of each fixing unit of the front part of each hydraulic jack. The pushing device can be flexibly and conveniently operated and can provide balance pushing forces; small space is occupied during construction, and the acting force can be accurately controlled, so that the occurrences of accidents is reduced and time and cost for installing offshore large modules are reduced; and on the premise of guaranteeing safety and reliability, the construction of an offshore oil platform and the construction progress of a project are accelerated and the project quality is improved.


Farmers know that cross-breeding presents great benefits, because hybrid vigour leads to a better weaner calf. But hybrid vigour, says the experts, leads to much more than only a better weaner calf. The secret lies in a well managed and structured cross-breeding programme, otherwise the herd might well end up looking like a fruit salad.


has not been evidence of recurring ear pain. Usually these cases are in children between the ages of 0 and 5 years who seem constantly to have a common cold. It becomes easier when the parents themselves suspect a hearing impairment in their child. The children with middle ear fluid who have often had episodes with ear pain have usually taken some type of antibiotic several times before they come to an otolaryngologist for the first time. The number of antibiotic treatments contributes to the picture of the degree of severity of the disease. The number of earlier intubations sheds light on it also.


Our aim is to overview and discuss some of the most popular approaches to the notion of a tolerance relation in algebraic structures with the special emphasis on lattices.


Leisure sports industry is a industry group made up of industries meeting with people's leisure needs by people's sports leisure consumption motivation with features of commercial ecosystem.It is a complex value network made up of core value chain and expansion value chain,finance chain and policy chain,complementary industry and substitution industry.A competition strategy choice of leisure sports industry ecosystem is put forward from the aspect of system and enterprise for valuable products and service to satisfy consumers' leisure sports demand.


Heath-Carter method was applied to study the somatotype of 409 aboriginal Gelao adult individuals(204 males;205 females) with ages ranging from 20 to 60 in Daozhen County of Guizhou.The results are:(1)The mean somatotype of males falled in Esto-Mesomorph category (1.7—4.8—2.5),while that of females was Endo-Mesomorph category (2.8—4.4—1.8); (2) Age rising up,the values of Endomorph increased with that of the Ectomorph decreasing.Somatotype obviously changed after 35 in females. (3) Except the 20~ group having obvious sexual difference in the somatotype,the rest of each group have highly significant difference.(4)Compared with the somatotypes of other groups,the Gelao have less fat with less-developed skeletal muscles and a slender figure.


A method for determining an internal combustion engine, the fuel injection amount of injectors (2) (1), which are fed from a common pressure line (3), in which fuel (P) under pressure is provided for injection, wherein a control unit (4) the present operating state of the internal combustion engine (1) determined corresponding injection quantity (MVE, MHE), and the respective injectors for the injection quantity (MVE, MHE) corresponding injection duration taking account of the fuel pressure (P) in the pressure line (3) opens, wherein during operation of the internal combustion engine is corrected with a time-offset partial injections per working cycle, the injection quantity (MHE) of the subsequent fuel injection with the fluctuation of the fuel pressure (P) in the pressure line (3) between the partial injections considered correction value (m), characterized in that as a correction value (m) the injection quantity (MHE) a Schwanku ngsbeiwert (m) as a function of a foreseen time interval (t


Introduction: Tremendous advance in mechanization and fastness of travel have been accompanied by steep increase in number and severity of fractures and those of tibial plateau are no exception. Knee being one of the major weight bearing joints of the body, fractures around it will be of paramount importance. This study is to analyze the functional outcome of CRIF of ORIF with or without bone grafting in tibial plateau fractures in adults. Methods: 30 cases of tibial plateau fractures treated by various modalities were studied from 1-6-11 to 30-07-13 at our institution and followed for a minimum of 9 months. Results: The selected patients evaluated thoroughly clinically and radiologically, after the relevant lab investigations were taken for surgery. The indicated fractures were treated as per the SCHATZKER'S types, accordingly with CRIF with percutaneous cannulated cancellous screws, ORIF with buttress plate with or without bone grafting. Immobilization of fractures continued for 3 weeks by POP slab. Early range of motion was then started. Weight bearing up to 6-8 weeks was not allowed. The full weight bearing deferred until 12 weeks or complete fracture union. Conclusion: Functional outcome is better in operatively treated tibial plateu fractures in adults, because it gives excellent anatomical reduction and rigid fixation to restore articular conguirity and early motion thereby preventing knee stiffiness.


Make use of the software of ANSYS to carry on an analysis towards using in the pressure vessels,The result of calculation indicate that ANSYS's strong abitity of calculation and imitation can satisfy the chemical engineering machine profession,it have vast applied foreground.


We report a case of complicated temporal lobe abscess following mastoidectomy. The patient complained of a headache after surgery, however, he was discharged as his symptom was considered to be a common postoperative headache. He revisited our due to a generalized tonicclonic seizure, and the CT and MRI findings suggested the diagnosis of temporal lobe abscess. The patient was successfully treated with antibiotics instead of surgical treatment. Although the cerebral abscess following mastoidectomy is extremely rare, it is necessary to pay attention to it. Particularly when the patient complains of a headache, it is important to consider the aspects of headache carefully. Bone defect in tegmen tympani and exposure of dura will increase the risk of cerebral abscess, therefore careful caution is required in the presence of lower dura mater.


Objective:To develop a high performance liquid chromatographic method with fluorimetric detection for the determination of labetalol in plasma.Methods:The plasma sample was treated with tert-Butyl Methl Ether extract.The HPLC method was performed on a column of Kromasil KR100-5C18(250mm×4.6mm,5μm)with the mobile phase of methanol-water-2.4mol L diethylamine phosporic acid(50:48:2),and the detective wavelength at Ex=302nm and Em=420nm.The retention time of labetalol and IS(proparnolol)were 5.5min and 8.4min respectively.Results:Labetalol was linear from 2.5ng mL to 160ng mL(r=0.9998).The extraction recovery of labetalol and IS was 81.28% and 88.68%.The limit of detection is 2.5ng mL.The inter-day and intro-day RSDs were 0.42%~7.72% respectively.Conclustion:This method is sensitive and can be used for TDM and pharmacokinetic studies of labetalol.


The present work is based on an analysis of a large statistical sample of meteor orbits collected in the Japanese shower catalogue (SonotaCo 2009, WGN, 37, 55) of 114280 video observed meteors. The shower meteor data were selected and analysed with the aim of determining the orbits' distribution in major meteor streams with heliocentric velocities close to the parabolic limit, in which the errors in the velocity determination correspond to large differences in the reciprocal semimajor axis, 1 =a . The contribution of the real dispersion of the semimajor axes, a , can be deduced from the high proportion of hyperbolic orbits in the analysed streams, where an excess over the parabolic value can be regarded as being entirely due to measurement errors. The orbital dispersion described by the median absolute deviation in terms of 1 =a was found to be ˙ 0.083 AU (cid:3) 1 for the Leonids and ˙ 0.080 AU (cid:3) 1 for the Orionids, and slightly smaller for the Perseid and Lyrid meteor streams ( ˙ 0.055 and ˙ 0.047 AU (cid:3) 1 ). The proximity of the parabolic limit caused a strong influence of observational effects; however, a significant contribution of the real dispersion is involved.


To attain the maximum intercept efficiency, the amplitude distribution along the rectenna's aperture should be significantly non-uniform. But the increase in the intercept efficiency results in a considerably large decrease in the rectification and collection efficiency. An effort to resolve the contradiction between the intercept efficiency and the decrease in the rectification and collection efficiency prompted an idea of designing a wireless power transmission (WPT) system with a uniform amplitude field distribution over the rectenna aperture. The aim of this work consists in checking the validity of this idea. Synthesis of the exciting field, ensuring the closest to the uniform amplitude distribution over the rectenna's aperture, is performed.


Average foams life, has been presented as criterion to evaluate the foaming behavior in mol-ten slag. Carbonate minerals as foamer, molten salt system of Na_2B_4O_7-CaO-MgO is foamed by the gas fromthe hest decompostion of the foamer in laborstory. The experimental results show that the particle size and fo-amer type have effects upon average foams life of slag, and these effects are dependent on the behavior of heatdecomposition of carbonate. Within a certain extent, the variation of concentration of CaO and MgO in moltenslag both varies the physical properties of melt, and directly influences the decomposition rate and of carbonateand the bubble size of gas from decompositions, so it plays important pole in foaming and foams stability ofslag.


Reflector assembly for concentration of Sunlight onto photovoltaic cell based on Cassegrainian optical system modified to increase allowable error angle between aim and line of sight to Sun. Widening of cone of acceptance reduces degradation of performance caused by surface-slope errors, misalignments between optical components, and non-fully-specular (i.e., partly diffuse) reflectance. Consequent relaxation of aiming and manufacturing tolerances reduces cost and number of rejects in manufacturing and simplify operation.


The purpose of this study is to analyze demands of education training about copyright for Infant and early childhood education institutions. This study investigated demands of education training about copyright for infant and early childhood education institutions targeting 248 directors and teachers. Using a questionnaire, research data was analyzed using the program spss. Demands of education training about copyright for infant and early childhood education institutions appeared differently depending on education institution type, position, education career, etc. copyright training topics include the highest demands for understanding of the copyright associated with the work of the early childhood education. Training contents had higher demands for using typeface(font) and video material. So these results reported that directors and teachers require copyright education relating to the work of Early childhood education. The results of this study suggest the implications for developing and implementing copyright training programs for Infant and Early childhood education institutions.


In order to select improved genotypes with potential for producing high-quality wines in a climate change scenario, asegregating F1 population with 151 progeny derived from a cross between Graciano x Tempranillo was studied for14 agronomic traits, 11 enological traits and 5 seed traits for three consecutive years. All traits presented transgressivesegregation and continuous variation. Significant correlations among traits were observed but most associations were weak.Seven groups of hybrids were distinguished based on ripening time, cluster weight, berry weight and anthocyanins content by cluster analysis; and fourteen genotypes were pre-selected for further research. In addition, the anthocyanin profilesof the hybrids and parents were determined during 2 growing seasons (2009 and2010)with HPLC-MS. Fifteen monoglucosideanthocyanins were detected with HPLC-MS, including two unidentified compounds. The concentration of 13 identified anthocyanins and the percentage of non acylated, acetyl and coumarylanthocyanins were analyzed to understand the inheritance of the anthocyanin profile in the population.Ratios between different anthocyanins were evaluated for their use as potential varietal markers. A genetic linkage map was constructed using Joinmap 3.0 software, following a pseudo-testcross strategy. Altogether271 simple sequence repeat (SSR) and 18071 SNP (Single Nucleotide Polymorphism) markers, and one CAPS marker were screened. Finally, a consensus map with a total of 1210 markers (183SSRs, 1 CAPs and 1026 SNPs) was assembled covering 1385.8 cM distributed into 19 linkage groups, with an average interval length of 1.2cM between markers.
Finally a QTL (Quantitative Traits Loci) analysis was carried out using MapQTL 6.0 software with the simple interval mapping (SIM) combined with permutations test and the non-parametric Kruskal-Wallis (KW) for agronomic, enological and seed traits.


Illicit drugs are involved in 7% of emergency department (ED) presentations, however the identification and measurement of blood concentrations is unavailable to the emergency physician [1]. Relying on clinical impressions can be inaccurate affecting further diagnostic evaluation and treatment in these patients. An approach based on the Western Australian Illicit Substance Evaluation (WISE) study developed at our hospital, overcomes this through the collection, storage and analysis of blood samples using Liquid Chromatography-Quadrupole-Mass Spectrometry [2]. If a clinician suspects that a patient has taken an illicit drug, then a blood sample can be collected. Knowledge of the causative agent in the clinical context may allow management to be tailored, particularly in life threatening ingestions and clusters (defined as aggregation of cases close in time and place) of poisoning. A cluster of patients with suspected 3, 4-methylenedioxymethamphetamine (MDMA) poisoning illustrates the value of blood testing to detect or exclude illicit drugs as a cause of the patient's presentation. A cluster of six patients presented with suspected illicit drug intoxication to the ED of Royal Perth Hospital over 4 h in 2019. Many patients exhibited agitated delirium, sweating, tachycardia, dilated pupils, and abnormal movements suggestive of sympathomimetic toxicity. All patients received symptomatic care for sympathomimetic toxicity including IV fluids and benzodiazepines. Blood samples were sent to WA ChemCentre Forensic Laboratories for analysis against a database of approximately 500 illicit and novel psychoactive compounds. Results were available within 29 h of sample receipt (Table 1). MDMA was detected in four patients, with median plasma MDMA concentrations 0.29mg/L (IQR, 0.10–0.57). In those patients all were discharged from hospital by 24 h. However one of these patients ( ) presented with status epilepticus requiring intubation and admission to ICU that was attributed to MDMA intoxication. This assumption was refuted at 29 h when no illicit drugs were detected in her blood analysis thus prompting ongoing investigations (MRI brain, EEG, lumbar puncture, vasculitic and autoimmune screens), looking for alternate causes for their seizure disorder. There is currently limited information relating MDMA plasma concentrations to clinical effects in recreational users. The Australian National Coronial Information System reports a median MDMA concentration of 0.45mg/L between 2001 and 2018 and was significantly higher amongst females than males (0.70 vs. 0.42mg/L). Deaths attributed solely to MDMA toxicity had higher blood MDMA concentration than deaths attributed to multiple drugs (1.20 vs. 0.43mg/L) [3]. The patients in this cluster had median plasma MDMA concentrations of 0.29mg/L. This cluster highlights that despite similar patient presentations in close proximity in location and time, the inference of these associations can lead to medical bias. Blood collection, storage and analysis helps refine clinical decisions and management. In the most severely unwell patient, the absence of illicit drugs on analysis changed the direction of clinical management. While results currently take 24 h, advances in analysis and wider availability of assays for illicit substances have the potential to improve the timeliness of clinical care and reduce clinical bias. This cluster also noted that plasma MDMA concentrations were at median levels as previously reported in coronial literature.


The design and development of engine surge control system,especially the parameters of heat disturbance when the fighter launches a missile,were discussed in this paper.Four heat disturbance parameters(inlet relative average temperature increment(δT);temperature rising rate(dT/dt);equivalent heat region angle(Φ_e);continuous time of heat disturbance(t_B)) were introduced and the criterion for optimal design of a engine surge control system is provided by means of tests and data analysis.A flight test with this engine surge control system has completed and it is shown that the method of design and development for engine surge control system introduced is successful.