One of the underlying mechanisms of multidrug resistance (MDR) is cellular over‐production of P‐glycoprotein (P‐gp), which acts as a drug efflux pump. P‐gp is encoded by a small group of related genes termed MDR; only MDR1 is known to confer drug resistance. To overcome P‐gp‐mediated drug resistance, we have developed two anti‐MDR1 hammerhead ribozymes driven by the β‐actin promoter. Upon transduction of the ribozymes into MDR cells, vincristine resistance was decreased. These two ribozymes were constructed, which showed different cleavage activities. In this study, to determine suitable target sites for the anti‐MDR1 ribozyme, the exon 1b–intron 1 boundary, the translation‐initiation site, the intron 1–exon 2 boundary and the exon 2–intron 2 boundary, codons 179 and 196 of the MDR1 gene were selected as candidates. To improve the ribozyme activity, a retroviral vector containing RNA polymerase III promoter was used. Stable retrovirus producer cells were generated by transfecting the retroviral vector plasmids carrying the ribozyme into the packaging cell line. Retroviral vector transduction of human leukemia cell lines expressing MDR1 was accomplished by co‐culturing these with virus producer cells. Stably transduced cells were selected by G418 and pooled to determine the efficacy of each ribozyme. These ribozyme‐transduced cells became vincristine‐sensitive concomitant with the decreases in MDR1 expression, P‐gp amount and drug efflux pump function. Among the ribozymes tested, the anti‐MDR1 ribozyme against the translation‐initiation site exhibited the strongest efficacy. This retrovirus‐mediated transfer of anti‐MDR1 ribozyme may be applicable to the treatment of MDR cells as a specific means to reverse resistance. Int. J. Cancer81:944–950, 1999. © 1999 Wiley‐Liss, Inc.


Findings: After using multiple linear regression, this research found that only the free cash flow has a significant and positive impact on dividend policy. Managerial ownership has a significant negative effect on dividend policy. Debt policy and firm size did not have a significant negative effect on dividend policy. Profitability did not have a significant positive effect on dividend policy. Dominant factor that affected dividend policy is the company's free cash flow.


Purpose: The COVID-19 pandemic has impacted the physical, mental, emotional and spiritual health of urban Indigenous Peoples. We sought to examine innovations and changes in service delivery by Indigenous service providers in the community who are addressing community needs based on an Indigenous worldview.
Basic Procedures: The research was a collaboration between an academic team, an Indigenous research associate, and an Indigenous oversight committee. Fifteen in-depth interviews were conducted with Indigenous service organizations, non-Indigenous organizations with Indigenous programming, Indigenous volunteer-based organizations and Indigenous volunteers. Participants were recruited based on having mandates that focussed on mental and emotional wellbeing, education, chronic health conditions, women and children and Indigenous cultural needs.
Major Findings: Health inequities for urban Indigenous Peoples were compounded during the pandemic. The lack of local infrastructure contributed to increased volunteerism to deliver and improve access to services. Service interruptions and access barriers triggered innovative programming and a strengths-based response with activities embedded on the land, braided with language, ceremony and culture. Unmet community service needs and capacity development priorities were identified.
Conclusions: Access to land, infrastructure and cultural programming is key to wholistic health for the urban Indigenous community. Despite continued inequities, the urban-based Indigenous response exemplifies the strengths-based approaches that helped to address pandemic impacts and demonstrated how Indigenous ways of knowing build strength and foster innovative program adaptations based on culture, ceremony and creating space for community.


Irradiation of a mixture of a hydrocarbon and carbon dioxide with high- energy electrons gives carboxylic acids. For instance, toluene is converted to phenylacetic acid. The radiation energy is used inefficiently (G = 0.01 - 0.1). Formic acid can be used in place of carbon dioxide to obtain carboxylic acids. Irradiation of a mixture of a hydrocarbon and hydrogen cyanide leads to nitriles. (auth)


The invention allows keys to increase reliability and ease of use it For this crepe conductive 3 and the retaining part 4 are the joining their common central rod 9. 7 h n. F ly-2-yl


A rigid skeleton during liquid phase sintering is the key to achieving high tolerances in liquid phase sintered compacts. The initial errors (due to inhomogeneities) induced during powder processing, powder mixing, powder compaction add up and this effects the sintering behavior of the material. This is usually observed as warpage, cracking or even compact shape distortion after sintering. Inhomogeneities were deliberately induced in a non-distorting 93W-Ni-Fe (7:3) alloy. Green compacts were formed using ethylenebis-stearamide as a pore-forming agent with the amount of polymer controlling the local porosity. Layers with varying amount of porosities were generated by using different amount of wax in each layer. The distortion profiles of the sintered samples were measured using a co-ordinate measuring machine. A green density inhomogeneity parameter was defined and the measured distortion parameter was correlated to the inhomogeneity parameter.


Characteristics of harmonic current generated by single-phase converter with L filter for distributed generator are studied. The variation of transient current in a carrier cycle is derived by the differential equation of the system in time domain. Then compared transient current and fundamental current generated by convertor with no grid, harmonic current under condition of different modulation ratio is analyzed. When and why harmonic current is the largest and smallest in a fundamental cycle is presented through the study of variation tracking capacity of transient current. The maximum and minimum TDD/ with a fixed carrier ratio is proposed. The current generated by the joint action of converter and grid voltage source is also analyzed to explain the relationship of variation tracking and harmonic currents. Simulation results in different operation mode verified the correctness of the proposed theoretical results.


Combining ability for seed yield and its component traits in sesame (Sesamum indicum L.) was studied using diallel mating design involved 37 test entries comprising of 28 hybrids developed from eight diverse parental lines and one standard check (G.TIL 4). The analysis of variance for combining ability revealed that mean square due to GCA and SCA were significant for all the characters except width of capsule for GCA indicated that both type of gene effects played a vital role in the inheritance of all these traits. The magnitude of GCA and SCA variances revealed that the SCA variances were higher than their respective GCA variances for all the characters which confirmed the preponderance of non-additive gene action for all the traits. The estimate of GCA effects indicated that the parents AT 377 and G.TIL 4 were found good general combiners for plant height, number of branches per plant, number of internodes per plant, length of capsule, number of capsules per plant, number of seeds per capsule, 1000-seed weight and seed yield per plant commonly. For the characters related to earliness viz., days to 50% flowering, AT 396 was found good combiner. The cross combinations viz., AT 377 x AT 396, AT 347 x G.TIL 4 and AT 376 x AT 377 were found to be good specific cross combination for seed yield per plant accompanied by high to moderate heterotic response.


The problem of testing the similarity of two normal populations is reconsidered, in this article, from a nonclassical point of view. We introduce a test statistic based on the maximum likelihood estimate of Weitzman's overlapping coefficient. Simulated critical points are provided for the proposed test for various sample sizes and significance levels. Statistical powers of the proposed test are computed via simulation studies and compared to those of the existing tests. Furthermore, Type-I error robustness of the proposed and the existing tests are studied via simulation studies when the underlying distributions are non-normal. Two data sets are analyzed for illustration purposes. Finally, the proposed test has been implemented to assess the bioequivalence of two drug formulations.


The method of manufacturing a glass substrate for a magnetic recording medium, the wear of the corner portion between the inner peripheral edge surface and / or the main surface chamfer surface of the glass substrate on which the chamfer surface formed on an outer peripheral end surface (main surface corner portion) is suppressed producing a glass substrate that is. The major surface 12 of the glass substrate 10 of the chamfer surface 16 on the end face of the glass substrate 10 is formed, a magnetic recording comprising polishing step of polishing with the polishing pad 24 to polishing liquid supply concave groove 31 is formed on the surface 24a the method of manufacturing a glass substrate for medium, the angle of the chamfer surface 16 with respect to a plane parallel to the thickness direction of the glass substrate 10 is formed in the inner side of the glass substrate 10 [theta] d, with respect to a plane parallel to the thickness direction of the polishing pad 24 when the groove side 31a has an angle theta] p, which forms an internal side of the polishing pad 24 Te, under the condition of 10 ° ≦ θp


Globalization is creating similar environments for younger consumers around the world. With younger individuals being socialized in more similar environments than their parents, the former should have more comparable values than the latter. The goal of the current study was to empirically test this argument.
154 consumers served as voluntary subjects (84 from the USA and 70 from Bangladesh). Questionnaires were administered to respondents for gathering the necessary data.
The respondents ranged in age from 19 to 80. Based on data gathered from 120 subjects across two countries, the results support growing similarities in values between younger consumers in comparison to older consumers. These results suggest that marketers might be able to adopt standardized marketing practices with younger individuals, whereas standardization might not have been an option with their parents.
JEL Classification Code: D46, F01, M31


The circulatory dynamics on the dorsal surface of the spinal cord were observed by serial fluorescein anglography. Fluorescein dye appeared in the posterior spinal artery and pial arterial plexus, although the direction of blood flow might be opposite and the time taken for fluorescein dye to enter the arteries was different for each. Fluorescein dye appeared in the veins after various periods, and the directions of flow of the dye were also variable and complicated. Laminar flow often was observed in veins of less than 200 µm in diameter. The regional circulation time was calculated to be 2.1 ± 0.4 seconds. There was no extravasation.


In recent decades, the United States Supreme Court has worked toward providing a clear standard dictating that a public school may not exclude a student organization from its limited public forum based on a group's expression of a religious viewpoint. The Supreme Court's decision in Christian Legal Society v. Martinez, though, may have significantly changed the tides for these organizations. This Comment will initially provide the background of relevant First Amendment freedoms in general, and then attend to those freedoms as applied to the rights of religious student organizations. Turning next to the Supreme Court's decision in Martinez, this Comment will discuss that opinion as well as its implications. By addressing these points, the Author seeks to bring to light the profound impact Martinez could have on the previously-existing and expanding trend of protecting the rights of religious student organizations.


In the context of large volume Big Divisor (nearly) SLagy D3/D7 μ-Split SUSY [1], after an explicit identification of first generation of SM leptons and quarks with fermionic superpartners of four Wilson line moduli, we discuss the identification of gravitino as a potential dark matter candidate by explicitly calculating the decay life times of gravitino (LSP) to be greater than age of universe and lifetimes of decays of the co-NLSPs (the first generation squark/slepton and a neutralino) to the LSP (the gravitino) to be very small to respect BBN constraints. Interested in non-thermal production mechanism of gravitino, we evaluate the relic abundance of gravitino LSP in terms of that of the co-NLSP's by evaluating their (co-)annihilation cross sections and hence show that the former satisfies the requirement for a potential Dark Matter candidate. We also show that it is possible to obtain a 125 GeV light Higgs in our setup. Keywords—Split Supersymmetry, Large Volume Swiss-Cheese Calabi-Yau's, Dark Matter, (N)LSP decays, relic abundance.


Occupancy and funding are crucial attributes of culture in predicting public housing transformation in Nigeria. The study investigates the implication of occupancy and funding as salient socio-economic factors of housing transformation. Questionnaire survey method was used to assess users' experience which was analysed using statistical analysis with structural equation model (SEM). The result indicated a good model fit of occupancy and funding as socio-economic predictors that motivates residents' housing adjustment decisions. Thus, the study recommends that socio-economic indices of occupancy and ease of funding future public housing adjustments can be considered by developers at the design stage.


This paperprovides a novel analytical platform for evaluating theessential second order statistical boundaries for fading in mobile communication for average fade duration (AFD) and levelcrossing rate (LCR) of Rayleigh, Rician and Nakagami fading channels. We derive new expressions for average LCR and AFD. We then model and computationally simulate the proposed method for Rayleigh, Rician and Nakagami channels and separately calculate the LCR and AFD for each channel by this approach. Simulated results obtained for all three channels show that the values of LCR and AFD calculated by using the proposed approach are much closer to actual simulated values than what conventional theoretical formulas deliver.


British. If, as some historians have suggested, the United States was in an increasingly difficult situation by the end of 1814, the British were too illinformed and to an even greater degree too anxious for peace to persevere with the conflict. A British attempt at a land offensive south from Montreal in 1814 had foundered in the waters of Lake Champlain. The Royal Navy had been able to impose a debilitating blockade, and (reinforced by the army) had launched a variety of attacks along the coasts. These raids had had mixed results. The brief capture of Washington and the costly defeat at New Orleans are the best known of these ventures. Both British and American experts continued to debate their efficacy for many years, and to examine how future operations of this kind could best be conducted or confronted.


dard operating procedures" and to classify all hospital jobs into three categories based on degree of exposure to blood, body fluids, or tissues.1 Although this is only a recommendation, the agency plans to enforce it through existing laws that "require safe and healthful working conditions," according to a recent publication.2 Hospitals can be cited and fined up to $10,000 if they fail to comply. Comment: OSHA, in effect, is setting minimum standards for infection control practice. The concept of handling all blood and body fluids the same way ("as though they were infectious") is not a new idea. The concern about human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) is new, but the idea of elevating our infection control practices to a higher level is not. The HIV epidemic merely magnifies the problems inherent in our current infection control practice. Until the AIDS problem, most health care workers adopted a somewhat laissez-faire attitude about disease transmission


In the present study, we investigate the fatigue behavior of Nickel Titanium (NiTi) microstents at 22 °C (room temperature) and 37 °C up to 30 × 106 load cycles. We briefly describe our test procedure, which applies displacement‐controlled pull–pull fatigue cycling between displacements corresponding to apparent strains of 5 and 7.5%. The response of the microstents to mechanical loading indicates cyclic softening during 30 × 104 cycles. Subsequently, the maximum load remains constant throughout the remainder of the test. We use transmission electron microscopy (TEM) to clarify the microstructural reasons for cyclic softening. A focused ion beam (FIB) technique is used to take out thin foil specimens from critical microstent locations. Our TEM results show that the dislocation density increases during cycling. We also find that microstructural regions with stabilized stress‐induced B19′ martensite can be detected.


The Proliferation Security Initiative was launched in 2003 by the Bush administration right after the So San incident. Its primary purpose is to interdict the spread of WMD and their delivery systems. Due to the provocative and challenging characteristics of the Initiative, which are inconsistent with conventional international law, there are some objections against the Initiative. This paper answers the highly topical questions regarding the Initiative in three parts. The first part addresses the origin and development of the Initiative. The second part critically analyzes the background of the Initiative such as the neoconservative ideology of the Bush administration and its world strategy, international terrorism, and the U.S. arms industry. The third part scrutinizes questions concerning the preemptive use of force for self-defense and the interdiction of foreign vessels on the territorial and high seas. The Initiative is also examined from a viewpoint of customary international law.


Liuxihe flood control and regulating project is one of the key projects of Guangzhou City.An introduction is made on the control of construction progress,quality and cost of project from the organization of supervision department,drafting of supervision policy and practice of supervision work during construction period of Liuxihe flood control and regulating project(second stage).Experience and lesson of supervision work are also summarized.


Purpose - This study proposes to examine regret arising from consumer decision-making contexts in cases of stock out situation. Consumer regret under sub-optimal and optimal conditions and its influence on subsequent behavioral intentions of brand switching is investigated. Further, the study examines the effect of regret on brand loyalty and switching behavior. Methodology- Data was collected from a convenient sample of 172 university students by using an online questionnaire circulated through social media platforms. Information about stock-out situation and sub-optimal condition is manipulated by a short excerpt in the questionnaire. Consumer responses in such a situation is measured by Likert type scales. Findings- Data analyses revealed that there is a significant amount of regret experienced by consumers in stock out situations and suboptimal conditions which might lead to brand switching. Conclusins- An enormous intent to switch brand was demonstrated. This denotes that when confronted with a comparable condition of purchasing a substitute brand during a stock out for the preferred brand, an individual may switch from the present vendor.


The book under review is about the marginal African borderlands and their consequences other than sad stories of death and misery. These areas apart from being the most turbulent areas of the world...


In the late nineteenth century Christian missionaries landed in a remote corner of IndiaBurma to seek converts in a "heathen" land, known as Chin Hills, now Chin State of Burma. The Christian mission was an extension of the American Baptist Mission, which had already been working in different parts of Burma and among different ethnic groups since the arrival of Adoniram Judson in 1813. This paper explores how the "incoming message" brought by the missionaries coped with a well-entrenched indigenous society and cosmology, and examines the role played by a contemporaneous indigenous socio-religious reform movement, spearheaded by Pau Cin Hau, in the conversion of the Zo (Chins) to Christianity. It argues that it is not historically correct to look at conversion only from the perspective of the "agents" without an in depth study of traditional belief and practices. In the case of the Zo, a careful analysis needs to be done because of the existence of an indigenous movement vis-à-vis the Christian mission.


The ubiquitous diffusion of Power Electronic Converters (PECs) in many fields of application including traction and energy conversion suggests the possibility of new and better integration of advanced power conversion and Information and Communication Technology (ICT) services. This work investigates the possible advancements in the use of optical communication links made of plastic optical fibers for control of PECs. The optical communication link connects the switching control to the converter control, following the line of separation between the expertise of power electronic and control engineers. Control wise, a PEC is a black box compatible with any off-board controller, now immune from the Electromagnetic Interference (EMI) produced by the power switches. The redundant optical link is ready for the high switching and sampling frequencies, made possible by relying on SiC power semiconductor devices (100+ kHz). Distributed control of multiple PEC units and advanced telemetry for diagnostics and prognostics are targeted. A proof-of-concept demonstrator is presented and tested. Moreover, the possible evolution towards a power electronic cloud with remote management and orchestration is described.


To reinforce the administration of the construction of electric projects,it discusses the aspects of broaden sources of income and reduce expenditure,to assure the electric project of building up has a high ratio of nature and price in the operation of the future markets,and make the efficiency and benefits maximum of the enterprise that related to the construction of electric projects.


Strain gauges made of nickel foil are devised for measuring the elastic surface stress of a specimen subjected to repeated loads. The nickel foil about 10μm thick composed of the crystal grains of 30μm in mean diameter is made by annealing the foil of nickel plating at 950°C for 60 s in a vacuum. Sticking the nickel foil on the surface of the specimen, the elastic stress is measured by observing slip-bands in the foil resulting from repeated strains. The calibration tests of the foil under rotating-bending are carried out at several test temperatures. The range of applicable temperatures of the gauge, and the relation between the appearance of slip-bands and the magnitude of cyclic stress are investigated. Using the "standard photographs" which show the relation between the density of slip-bands and the cyclic stress, the peak stresses in grooved shafts under bending are measured.


The paper presents the development of a MATLAB simulator for the indoor radio propagation models, used as a teaching aids. The software application is designed to allow the user to select the propagation models, characteristics of the building, transmitter and receiver systems, etc.


The invention discloses a direct current power supply device for an airplane dimming system. The direct current power supply device for the airplane dimming system comprises a power supply module and is characterized in that the output enable control site of the power supply is connected with a slow open control circuit. According to particular implementing examples of the direct current power supply device for the airplane dimming system, the power supply module is a high power adjustable power supply module and a voltage adjusting control site of the power supply module is connected with a voltage adjusting circuit. The direct current power supply device for the airplane dimming system has the advantages of adding the slow open control circuit to the control site of the power supply module, enabling the output of the power supply module to lag behind the set time corresponding to the input of the power supply module through setting inner parameter of the slow open control circuit, achieving power-on moments, outputting lighting and dimming voltage after the system working stably, guaranteeing a stable light intensity of a lighting device, avoiding glittering phenomenon and improving the whole lighting effects of an airplane cockpit.


Enterprise networks are large and complex, and their designs must be frequently altered to adapt to changing organizational needs. The process of redesigning and reconfiguring enterprise networks is ad-hoc and error-prone, and configuration errors could cause serious issues such as network outages. In this paper, we take a step towards systematic evolution of network designs in the context of virtual local area networks (VLANs). We focus on VLANs given their importance and prevalence, the frequent need to change VLAN designs, and the time-consuming and error-prone process of making changes. We present algorithms for common design tasks encountered in evolving VLANs such as deciding which VLAN a new host must be assigned to. Our algorithms trade off multiple criteria such as broadcast traffic costs, and costs associated with maintaining spanning trees for each VLAN in the network, while honoring correctness and feasibility constraints on the design. Our algorithms also enable automatic detection of network-wide dependencies which must be factored when reconfiguring VLANs. We evaluate our algorithms on longitudinal snapshots of configuration files of a large-scale operational campus network obtained over a two year period. Our results show that our algorithms can produce significantly better designs than current practice, while avoiding errors and minimizing human work. Our unique data-sets also enable us to characterize VLAN related change activity in real networks, an important contribution in its own right.


The More Leaps project provided leading languages teachers in Australia the opportunity to work with a suite of professional learning materials and with colleagues in a collaborative inquiry community, aimed at exploring models of mentoring and developing improved leadership skills. Each participant developed a mentoring inquiry project, and these were individually tailored to meet the needs of individuals in their particular professional contexts. The range of models developed is explored in this paper, with analysis of the variety of models, and the emphasis on collaborative inquiry, as engaged reflexive praxis. The models provide illuminating insights into potential for all languages teachers to work with colleagues in collaborative and complementary ways, to improve individual practice and the leadership skills of the profession, and to support sustainable outcomes for long-term engagement in languages education in Australia.


This study on the hydrocarbon source rocks identification of LT-1 well in a Tertiary rift basin, northern Kenya, which had oil and gas shows was based on the organic matter quantity, quality, and the thermal maturation generation capability of the organic matter disseminated in the analysed rock samples. The organic matter contents were determined directly from laboratory analyses of the source rock samples with the help of seismic and gamma-ray profiles, total organic carbon (TOC wt%), maturity indices (HI and PI), temperature maximum (Tmax °C), porosities and other sedimentological parameters. This study involved a series of analytical geochemistry and petro-physical studies in ascertaining a number of effective source rock samples from the well cores which were then analysed in terms of TOC, PI, HI, S2, S1 and Tmax to determine oil/gas prone samples (resource areas) and distinguish them from strata with very high organic matter content. The samples with very high TOC were identified for possible source rock characterisations of the lithology pertaining to the well in terms of potential source-reservoir-seals associations. The Rock-Eval pyrolysis data were useful in assessing and evaluating the type of organic matter, thermal maturity, and the generation capability of source rocks for hydrocarbon exploration rationale. The analyses revealed that some strata within the sampled well data have high hydrocarbon generation potential with the existence of commercial hydrocarbon production. In conclusion, after an in-depth comparison and study of organic carbon content, hydrogen and production indices, type of organic matter content and maturity of organic matter, we confirmed that the studied resource areas are favourably considered for medium- to large-size hydrocarbon discoveries.


Post kala-azar dermal leishmaniasis, generally develops 6 months 10 years after apparent successful cure from visceral leishmaniasis. Rarely, it shows the feature of perineurial infiltration. This causes diagnostic confusion with tuberculoid leprosy, especially in countries like India, where leprosy is endemic.


Objective. To evaluate and compare the utility of commonly used outcome measures for assessing disease exacerbation or flare in patients with rheumatoid arthritis (RA). Methods. Data from the Dutch Potential Optimalisation of (Expediency) and Effectiveness of Tumor necrosis factor-α blockers (POET) study, in which 462 patients discontinued their tumor necrosis factor-α inhibitor, were used. The ability of different measures to discriminate between those with and without physician-reported flare or medication escalation at the 3-month visit (T2) was evaluated by calculating effect size (ES) statistics. Responsiveness to increased disease activity was compared between measures by standardizing change scores (SCS) from baseline to the 3-month visit. Finally, the incremental validity of individual outcome measures beyond the Simplified Disease Activity Score was evaluated using logistic regression analysis. Results. The SCS were greater for disease activity indices than for any of the individual measures. The 28-joint Disease Activity Score, Clinical Disease Activity Index, and Simplified Disease Activity Index performed similarly. Pain and physician's (PGA) and patient's global assessment (PtGA) of disease activity were the most responsive individual measures. Similar results were obtained for discriminative ability, with greatest ES for disease activity indices followed by pain, PGA, and PtGA. Pain was the only measure to demonstrate incremental validity beyond SDAI in predicting 3-month flare status. Conclusion. These results support the use of composite disease activity indices, patient-reported pain and disease activity, and physician-reported disease activity for measuring disease exacerbation or identifying flares of RA. Physical function, acute-phase response, and the auxiliary measures fatigue, participation, and emotional well-being performed poorly. (J Rheumatol First Release May 15 2017; doi:10.3899/jrheum.160915) Key Indexing Terms: RHEUMATOID ARTHRITIS TUMOR NECROSIS FACTOR INHIBITORS DISEASE ACTIVITY REMISSION From the Arthritis Center Twente, Department of Psychology, Health and Technology, University of Twente; Arthritis Center Twente, Department of Rheumatology and Clinical Immunology, Medical Spectrum Twente, Enschede; Department of Rheumatology, VU University Medical Center and Reade Medical Center, Amsterdam; Department of Rheumatology, University Medical Center Utrecht, Utrecht; Department of Rheumatology, Rijnstate Medical Center, Arnhem; Department of Rheumatology, Viecuri Medical Center, Venlo, the Netherlands; Department of Rheumatology, University Hospital Leuven, Leuven, Belgium. M.A. Oude Voshaar, PhD, Arthritis Center Twente, Department of Psychology, Health and Technology, University of Twente; M. Ghiti Moghadam, MD, Arthritis Center Twente, Department of Psychology, Health and Technology, University of Twente, and Department of Rheumatology, University Hospital Leuven, and Arthritis Center Twente, Department of Rheumatology and Clinical Immunology, Medical Spectrum Twente; H.E. Vonkeman, MD, PhD, Arthritis Center Twente, Department of Psychology, Health and Technology, University of Twente, and Arthritis Center Twente, Department of Rheumatology and Clinical Immunology, Medical Spectrum Twente; P.M. ten Klooster, PhD, Arthritis Center Twente, Department of Psychology, Health and Technology, University of Twente; D. van Schaardenburg, MD, PhD, Department of Rheumatology, VU University Medical Center and Reade Medical Center; J. Tekstra, MD, PhD, Department of Rheumatology, University Medical Center Utrecht; H. Visser, MD, PhD, Department of Rheumatology, Rijnstate Medical Center; M.A. van de Laar, MD, PhD, Arthritis Center Twente, Department of Psychology, Health and Technology, University of Twente, and Arthritis Center Twente, Department of Rheumatology and Clinical Immunology, Medical Spectrum Twente; T.L. Jansen, MD, PhD, Department of Rheumatology, Viecuri Medical Center. Address correspondence to Dr. M. Ghiti Moghadam, University Hospital Leuven, Department of Rheumatology, Herestraat 49, 3000 Leuven, Belgium. E-mail: email@example.com Accepted for publication April 7, 2017. Disease activity cannot be directly measured in rheumatoid arthritis (RA) because of the absence of a gold standard measure of the inflammatory process of the disease. Consequently, numerous standardized measures of various symptoms and signs of the disease and measures of global disease effect have been proposed and validated over time to assess beneficial effects of treatment. Early clinical trials in this field were characterized by many different outcome Rheumatology The Journal of on May 16, 2017 Published by www.jrheum.org Downloaded from measures and results were frequently difficult to compare1. To address this, a set of 7 outcome domains was recommended independently by the American College of Rheumatology (ACR) and the World Health Organiza tion/International League against Rheumatism2,3. Other efforts to standardize outcomes across studies have led to the development and validation of several composite disease activity indices. Each of these combines a number of the endorsed outcomes to produce an overall disease activity score4,5,6. Responsiveness and discriminative ability are key properties of such measures and the performance of commonly used disease activity indices, as well as individual core set measures in detecting treatment effects and discriminating between different levels of achieved therapeutic response, have been extensively described in previous studies7,8,9,10,11,12,13,14. While these previous studies have provided a great deal of insight into which of the commonly applied instruments are most suitable for measuring treatment benefits in RA, not much is known about their performance when assessing exacerbation of disease activity or flares. This is of importance, however, because the occurrence of flares or disease worsening are increasingly adopted as endpoints of clinical trials15. Moreover, there is a need for instruments that can be used to monitor disease exacerbation in clinical practice16. It has been proposed by the Outcome Measures in Rheumatology flare working group that RA flare represents worsening of disease activity that would, if persistent, in most cases lead to initiation or change of therapy, and a flare represents a cluster of symptoms of sufficient duration and intensity as to require initiation, change, or increase in therapy17. Moreover, an extended set of outcomes for the assessment of flare was endorsed, which includes several besides the 7 core outcomes, and is intended to comprehensively cover the experience from the patient's perspec tive18,19. However, a factor to consider in addition to the relevance of outcome domains, according to experts and patients, is that the assessment of flares or disease worsening should proceed using measurement instruments that are optimally valid and reliable for this purpose to minimize flare status misclassifications (i.e., false-positives and falsenegatives) and nonoptimal sensitivity to change because of random and systematic measurement errors. In our present study, we compared the relative efficiency of a series of clinical and patient-reported measures using data from the Dutch Potential Optimalisation of (Expediency) and Effectiveness of Tumor necrosis factor-α blockers (POET) study to identify measurement instruments and outcome domains that most reliably assess disease exacerbation. The primary objective was to compare the performance of commonly used disease activity measures and indices, as well as recently endorsed patient-reported outcome (PRO) domains in assessing disease activity worsening. A secondary objective was to evaluate the incremental validity of individual outcomes over the traditional disease activity indices. MATERIALS AND METHODS POET study. POET was an open-label pragmatic randomized controlled trial conducted at 47 rheumatology departments in the Netherlands. To be eligible for the study, patients had to be 18 years of age or older, meet the 1987-revised ACR criteria for the classification of RA20, have been treated for at least 1 year with concomitant tumor necrosis factor-α inhibitor (TNFi) and conventional synthetic disease-modifying antirheumatic drugs (DMARD), and be in remission or stable low disease activity for at least 6 months. Remission or stable low disease activity were defined as either a 28-joint Disease Activity Score (DAS28)21 < 3.2 measured at least twice or the rheumatologist's clinical impression of remission or stable low disease activity in combination with at least 1 C-reactive protein (CRP) level < 10 mg/l in the 6 months prior to inclusion. There were no exclusion criteria. Study inclusion took place from March 2012 to March 2014. The study was approved by the Institutional Ethical Review Boards of all participating hospitals (grant/award number 40-00506-98-12001). Written informed consent was obtained from each patient upon study entry. The study was conducted in adherence to the Good Clinical Practice guidelines and with regulatory requirements consistent with the Declaration of Helsinki. The study is registered in the Netherlands Trial Register (number NTR3112). Measurements. Baseline characteristics included age, sex, disease duration, medication use, and rheumatoid factor and anticyclic citrullinated peptide antibody status. Patients were evaluated at baseline and at least once every 3 months thereafter up to 1 year by the attending rheumatologist and rheumatology nurse in accordance with current Dutch treatment guidelines for RA. Clinical measurements, which are part of standard rheumatology care, were performed at every visit and included the tender joint count (TJC) in 28 joints, the swollen joint count (SJC) in 28 joints, the erythrocyte sedimentation rate (ESR), CRP, and the physician's (PGA) and patient's global assessment (PtGA) on a 0–100


To the Editor.— The question of whether to do routine cholesterol screening in children is one that is being hotly debated across the country. 1 I wish to make reference to an epiphenomenon that my practice group of pediatricians sees every day. We do routine cholesterol screening for children as young as 3 years. If the cholesterol level is higher than 4.70 mmol/L (180 mg/dL), a letter and suggested dietary changes are sent to the parents and another appointment is suggested, after the child follows the diet plan for about 2 months. We follow up lipid or cholesterol levels as indicated. Regardless of the cholesterol level, we have found that, by focusing on it, we have improved the diets of our patients enormously. The impetus for this improvement, I feel, is not our letter and the enclosed diet, but rather the parents' concern over their family's cholesterol levels, a concern


A fully integrated 2.4 GHz low-power frequency source including a 1.2 GHz voltage-controlled oscillator (VCO) and a current-reused frequency multiplier is fabricated in 0.18-mum CMOS process. The proposed frequency source tunes from 2.22 GHz to 2.45 GHz by changing control bias from 0 V to 0.7V, and achieves a phase noise of -115.83 dBc/Hz at 1 MHz offset from a 2.2 GHz carrier frequency while drawing only 840 muA bias current (490 muA for a 1.2 GHz VCO and 350 muA for the frequency multiplier) from the low supply voltage of 0.7 V


A 16-channel optical power equalizer has been fabricated and tested in a WDM link. BER of a 10 Gbps data channel is evaluated for the equalizer located in the middle and at the link end.


A silicon field emission electron source consisting of a cathode and a grid electrode has been fabricated by laser micromachining. The cathode features 21×21 tips on an area of 4×4 mm2, With a self-aligning MEMS technology for the aperture grid, a high electron transmission (99 %) was achieved. Onset voltages of 50…70 V were observed for an emission current of 1 nA. A stable emission current of 1 mA ± 1.3 % at an extraction voltage of 250 V was observed during a 30-min operation.


In this paper,a new pattern math model for high DC current comparator based on magnetic modulator has been researched At the same time,the mechanism for studying the mathematical model has been explained clearly and particularly its profound effect of the stability on the whole control system has also been analysed The result of the simulation of sample machine based on theory of this paper has been shown with particular illuminations


The invention relates to a sensor (29) for outputting a first sensor signal (40) in response to a first angular position (30) of a first shaft (9) of a first electric motor (4) and a second sensor signal (43) (in response to a second angular position 30 ) of a second shaft (9) of a second electric motor (4), comprising: - a first sensor (39) for detecting a fixed position with the first shaft (9) excited first sensor field (38) and to output the first sensor signal (40) as a function of the sensed first field transducer (38) - a second sensor (42) for detecting a fixed position with the second shaft (9) excited second transducer array (41) and to output the second sensor signal (43) as a function of the sensed second field encoder (41), and - a circuit carrier (33), on which the first sensor (39) and the second sensor (42) are jointly arranged directed in different Sensi erections.


The invention discloses an acid liquor absorbing device. The acid liquor absorbing device comprises a box body. A separating plate is arranged at the upper end inside the box body. The box body is provided with a feed pipe, and the feed pipe penetrates through the separating plate and extends to the inner bottom of the box body. A reducer pipe is arranged on the upper portion of the feed pipe, and a drainage pipe is communicated with the lower end of the reducer pipe and connected with a sulfuric acid outlet pipe of a reaction still. The feed pipe returns to the lower end of the box body and is connected with the box body. A water pump is arranged between the lower end of the feed pipe and the box body and is fixedly installed on the box body through a fixing base. The acid liquor absorbing device overcomes the shortcomings in the prior art, and is simple in design and reasonable in structure. The box body is sealed, alkaline aqueous solutions are stored at the lower end inside the box body, and the box body is provided with the drainage pipe connected with the reaction still. Sulfuric acid smoke is guided into the alkaline aqueous solutions at the lower end inside the box body for reaction processing, is processed effectively and does not pollute environment.


The paper introduced the main processes in the sinking by freezing method,such as lifting and transporting,walling and supporting,drilling and blasting.The new sinking equipment and machinery matching technology can provides valuable reference for the similar engineering works.


The Algarve Basin corresponds to the southernmost geological province of mainland Portugal. It has an E-W strike and is represented onshore from Cap São Vicente to the Guadiana River on the Portuguese-Spanish border. More than 3000 m of essentially marine sediments accumulated during Mesozoic-Cenozoic times in the Algarve Basin. The Sagres region, is the reference area for the Mesozoic fill of the Western sub-basin, where Middle Jurassic strata outcrop in the cliffs at Mareta and Cilheta beaches. The Mareta beach represents an important reference section for the Middle Jurassic of the Algarve Basin. The exposed composite section is a 140 m thick succession, which consists of calcarenites at the base that grade upwards into marls and marly limestones. This section is assigned to the late Bajocian at the base and to Callovian at the The coastal exposure at Cilheta beach a 40 m thick succession of marly limestones, the Callovian


This article is based on same-named course work and appears as first part of upcoming research of Ancient Greek Philosophy. The research aim to be a reactivator of social ideas by the way of adopt antique mode of thinking. New method of working at material, trying to represent well-known text in an unusual perspective shows an urgency of this article. Metaphysical poem of Parmenides is taken as a material, so the author prevalently uses a text from the poem and looks at the structure, keywords such as The Truth, necessity, The Fate and Alethea, and a use of them. In the article a correlation between The Truth and necessity, Alethea and The Truth in Parmenides philosophy is explained for the first time. The author pays great attention to Parmenides, so the research has a primary focus on understanding the poem as a Parmenides' creature. The article has a short biographical background of Parmenides. In this article, the author tries to motivate readers to reflect on it instead of obtruding any defined answers


We have grown the uranium compound URhIn5 with the tetragonal HoCoGa5-type by the In self-flux method. In contrast to the nonmagnetic ground state of the isoelectronic analog URhGa5, URhIn5 is an antiferromagnet with antiferromagnetic transition temperature TN=98 K. The moderately large electronic specific heat coefficient γ=50 mJ/K2mol demonstrates the contribution of 5f electrons to the conduction band. On the other hand, magnetic susceptibility in the paramagnetic state roughly follows a Curie-Weiss law with a paramagnetic effective moment corresponding to a localized uranium ion. The crossover from localized to itinerant character at low temperature may occur around the characteristic temperature 150 K where the magnetic susceptibility and electrical resistivity show a marked anomaly. © 2013 American Physical Society.


Psycholinguistic investigations (Cutler, 1976; Cutler and Foss, 1977) have proposed that accents direct the listener's attention to the words carrymg the accents. This would make sense if, as linguistic investigations have proposed, accents mark words which convey important information in a given context, and deaccentuation (that is, not accenting a word that may be accented for syntactic reasons) marks information that is recoverable from the context (Halliday, 1967; Chafe, 1974). Accentuation and deaccentuation might Signal to the listener how to distribute processing efforts in an efficient way; for instance, deaccentuation might tell him not to spend much effort on doing a precise analysis of the speech signal, since the interpretation is already available on the basis of the preceding context (Nooteboom and Terken, 1982; Terken, in preparation). If the distinction between presence and absence of accent is a functional one, we should be able to measure the extent to which the presence or absence of accents affects the listener's comprehension of the incoming information. More specifically, we may ask what the effect of appropriate application of accentuation rules is, that is, whether the listener's comprehension is seriously disrupted if a word which should be accented is not accented or vice versa. For the clearly structured material used in the present experiment we will use the following straightforward wie: if an expression has been mentioned in the preceding utterance in the same syntactic function, it need not be accented. Deviation from this rule defines 'inappropriate' accentuation.


Summary: The adsorption of aqueous phospholipid dispersions containing dipalmitoyl phosphatidylcholine (DPPC) is investigated at 35–37°C as a function of dispersion preparation technique. Systems studied in terms of surface pressure-time (π-t) adsorption behavior were pure DPPC, 9:1 DPPC:dipalmitoyl phosphatidylethanolamine, 7:3 DPPC:egg phosphatidylglycerol (PG), and lipids extracted from cow lung lavage. The results show that π-t characteristics can differ significantly depending on the technique by which the DPPC-containing mixtures are initially dispersed in 0.15 M NaCl solution. Examples of path dependence include the fact that DPPC, which will not adsorb at T = 35°C when placed in powdered crystals on the subphase surface, exhibits measurable π-t changes after subphase dispersion by sonication or by mechanical vortexing. For 7:3 DPPC:PG, dispersion by sonication on ice or by mechanical vortexing gives faster adsorption than dispersion by sonication without temperature control. The effect of heating to T = 45°C, which is greater than the gel to liquid crystal transition temperature of DPPC (Tc = 41 °C), is found to be particularly detrimental to the adsorption of 7:3 DPPC:PG. Of the phospholipid mixtures studied, extracted cow lung lipids exhibited by far the greatest adsorption capability and also showed less path dependence than 7:3 DPPC:PG. Similarly, in terms of dispersion techniques investigated, sonication on ice tended to give the most rapid adsorption for a given phospholipid mixture.Speculation: Treatment of neonatal Respiratory Distress Syndrome by exogenous surfactant replacement with well-defined mixtures of synthetic phospholipids is an attractive potential alternative to the use of multicomponent lung extracts. However, the existence of a variety of possible metastable solution states for phospholipid mixtures requires that adsorption properties be characterized for each mixture as a function of dispersion technique. It appears probable that synthetic phospholipid mixtures of identical composition and apparent bulk concentration might give variable therapeutic results for different dispersion methods.


The future technology requirements for magnetic fusion have been identified from an assessment of the conceptual design studies that have been performed. A summary of worldwide conceptual design effort is presented. The relative maturity of the various confinement concepts and the intensity and continuity of the design efforts are taken into account in identifying future technology requirements. A major conclusion of this study is that there is a high degree of commonality among the technology requirements identified for the various confinement concepts.


The revolutionary idea of asymmetric cryptography brings a fundamental change to our modern communication system. However, advances in quantum computers endanger the security of many asymmetric cryptosystems based on the hardness of factoring and discrete logarithm, while the complexity of the quantum algorithm makes it hard to implement in many applications. In this respect, novel asymmetric cryptosystems based on matrices over residue rings are in practice. In this article, a novel approach is introduced. Despite the matrix algebra M(k,ℤn), the matrix algebra M(k,Rn′), Rn′ = ℤ2[w]⟨wn−1⟩ as the chain ring is considered. In this technique, instead of exponentiation, the inner product automorphisms the use for key generation. The chain ring provides computational complexity to its algorithm, which improves the strength of the cryptosystem. However, the residue ring endangers the security of the original cryptosystem, while it is hard to break using Rn′. The structure of the chain ring deals with the binary field ℤ2, which simplifies its calculation and makes it capable of efficient execution in various applications.


THE tradition of this treatise in the Greek MSS. is very imperfect and in spite of Thomas Mangey's many brilliant conjectures (which I add in brackets) the text remains full of faults and lacunae. The following emendations are based upon the old Armenian version, printed at Venice in 1892. In this version the treatise begins only with § 5 ( = Mangey's ed. vol. 2, p. 254, 45) of the Greek treatise, giving in place of the words TO ak\a ra irtpl TO 6vo~iao~nrjpiov the fresh title $lXwvo<s TO K.T.\.


High-power laser-diode arrays, which are made of stacks of individual or multistripe laser diodes, or in some cases vertical-cavity surfaceemitting lasers (VCSELs), can put out watts to kilowatts of optical power for uses such as laser pumping, industrial heating, illumination, or as the input for fiber-optic direct-diode laser devices for materials processing or for medicine. Laser diodes typically have much higher electrical-to-optical (wall-plug) efficiencies than other types of lasers; in fact, they are some of the most-efficient light emitters known. The d i sadvantage of laser-diode arrays is their rela t i v e l y low beam quality— there are no sing le -mode kilowatts-level laser-diode sources in our near future. However, there are many applications that do not require a single-mode beam; in addition, laser manufacturers are constantly refining beamcombining techniques to produce ever-brighter high-power laser-diode sources.


In today's image communication system security of images is essential. It is necessary to protect confidential image data from unauthorized users. To detect and find unauthorized users is a challenging task. Different researchers proposed different techniques for securing image transmission. In this paper comparative study of these existing techniques has been presented also present types of images and different techniques of image processing with steps used to process an image.


Making recourse to Virginia Woolf's "Professions for Women" (1931), I have studied the manner in which F.D. Bridges criticizes the patriarchal representations of Victorian women in her Journal of a Lady's Travels Round the World (1883). In her text, she not only accounts for her experiences of travel in foreign countries but also inserts a discourse that lies counter to male definitions of women's roles as "household angels," confined in the domestic space and deprived of power. With the strength she demonstrates through her experiences of travel, she criticizes the fact that women are considered to be 'the weaker sex.' She also cultivates a quest for knowledge so as to carve her place in the 'public sphere' of knowledge and power and to criticize the practice of representing women as uneducated and ignorant. Last but not least, she highlights the degraded condition of the foreign women in an attempt to call for a universal enfranchisement of women abroad and in her country. All the three elements allow Bridges to fight against the "phantom" of the "angel in the house," which, according to Woolf, needed to be "killed" in order for a woman to impose her authorship.


Production of soy-sauce from amino acid liquid was attempted by utilizing hydrolyzate of soybean hull. The soybean hull was hydrolyzed with cellulase extracted from Trichoderma (No. 1), and amounts of total nitrogen and sugars solubilyed were determined. The composition of sugars and amino acids in the solution was also examined. 1) When soybean hull was treated with0.5% enzyme solution for 48 hours, about 40% of cellulose was dissolved and saccharified. And when 1% enzyme solution was used for 48 hours, about 60% of cellulose was dissolved and saccharified. About 40% of total nitrogen in soybean hull can be extracted by treating with 0.5% enzyme solution for 24 hours. 2) The presence of rhamnose, xylose, arabinose, glucose, cellobiose, and dextrin was recognized in a solution obtained by treating soybean hull koji with cellulase. 3) Leucine, isoleucine, alanine, hydroxyproline, arginine, lysine, and cystine were found in a solution obtained by treating soybean hull koji with cellulase. 4) Soybean hull koji and wheat bran were mixed(1 : 1), and digested with cellulase. Then, resulted solution was added to amino acid liquid at a rate 30% of the latter, and the mixture was fermented, and aged to give soy-sauce.


Microwave transistor stability is a real preoccupation of MMICs designers. In this paper, it is shown that the classical electrical lumped model is inappropriate to the FET stability study. A non linear finger-distributed modeling technique, based on an electromagnetic deem bedding, is presented. The derived model exhibits a very interesting capability to predict the electrical behavior of arbitrary shaped transistor. It also brings a real improvement in the FET analysis study.


According to the designing program procedures of dry-type transformers, and aimed at different demands of actual production, a dry-type transformer optimization design software system was designed by own, the software applied object-oriented programming designing method, reasonably setted up target functions and controlling conditions, thereafter calculating time was greatly saved.


Because of the special characteristics of aero-engine precision-forging blade edge, the edge profile shape errors are easily caused by using conventional processing methods. The purpose of this research is to improve real-R profile shape errors and also exploring the belt grinding mechanism for the high-strength materials. Firstly, the grinding characteristics and process planning to the blade real-R edge are analysed. And then, the methodology of EBG with CBN belt is illustrated, at the same time, the control equation for EBG is established. Finally, the method of EBG with CBN belt is analysed by the experiment investigated to the aero-engine precision-forging blade, comparing to the method of hand. The experimental results show that the real-R profile shape errors ≤ ± 0.07 mm, and the real-R shape smoothing, profile clear and the inter sectional surface smooth transition. It is verified that the method of EBG is better than the conventional method.


In 1984 twenty-nine commercial catfish producers in Tennessee reported 460 acres of ponds, 179,575 pounds of catfish produced and aggregate sales of $204,188. About 60 percent of the acreage was in West Tennessee. The average annual yield was 598 pounds per pond acre. About half of the producers produced both market catfish and fingerlings. Nearly half processed some or all of the food fish they produced. Fifty-three percent of total catfish production was sold live through five principal markets and forty-seven percent was sold in processed form. Principal market outlets included restaurants (some producer owned), direct-retail sales, live-fish haulers, and fee fishing. Producers indicated intentions to expand production substantially in 1986. *Graduate Research Assistant and Professor, Department of Agricultural Economics and Rural Sociology, University of Tennessee, Knoxville.


An abdominal aortic aneurysm (AAA) is a localized dilatation of the abdominal aorta resulting from degenerative cardiovascular disease. Such aneurysmal arteries pose few problems for many patients and are simply monitored and managed conservatively within the community. However, the ruptured abdominal aortic aneurysm is a time-critical medical emergency requiring timely surgical intervention in order to offer any chance of survival. Even when recognized early, 90% of patients will suffer an out-of-hospital cardiac arrest before arriving at the emergency department and of those who reach theatre, only 40% will survive. This article aims to increase the paramedic practitioner's knowledge and understanding of AAA through a holistic discussion of the prehospital recognition and early management. Particular emphasis will be placed on fluid replacement therapy and analgesia with specific reference to the issues associated with aggressive fluid resuscitation, and the potential benefits elicited through the use o...


Natural fibers are usually selected as filler because it is readily available and environmentally friendly, inexpensive, non-toxic, biodegradable and still have good characteristics for a variety of uses. In this study, four types of natural fiber have been used which; coconut shell, coconut fiber, corn cob, and pineapple skin, as fillers in thermoplastic polyurethane (TPU). The mixing process conducted through melt mixing techniques. The percentage of TPU/natural fibers are 95/5, 90/10 and 85/15. Higher fiber loading will increase the thermal stability and it also depends on the type of fiber itself. Swelling testing is also having been done to prove the absorbency ability by natural fiber composites in cooking oil and engine oil. The pineapple fiber absorbed a large amount of both oil compared to others.


Differential diagnosis for anemia late after allogeneic stem cell transplantation is broad. In this report, we describe a case of severe anemia secondary to pure red cell aplasia associated with human parvovirus B19 infection over 8 years after allogeneic bone marrow transplantation. Characteristics of parvovirus B19 infection and the immunosuppressed state after allogeneic stem cell transplantation are reviewed. Am. J. Hematol. 75:142–145, 2004. © 2004 Wiley‐Liss, Inc.


The deep-sea hydrological data, observed by the R / V"Xiangyanghong 16" in the central part of the tropical North Pacific Ocean (178° -165° W, 7° -13° N)during the period from Jan.11 to March 12 of 1 986, was analysed This analysis shows that the bottom water in the area flows from SW to NE, and this conclusion is consistent with the results obtained by Knauss (1 962)and Mantyla (1 975).It also shows that the influence of bottom topography on distribution of the deep -see hydrological elements are very apparent.


Background:
 Isotretinoin or 13-cis-retinoic acid (RA) is one of the most effective and widely used drug for the treatment of severe acne vulgaris. Despite deemed safe, no definite consensus has been reached on the cardiovascular risk of RA derivatives. We describe the first case of concomitant dilated cardiomyopathy (DCM) and renal infarction after 5 months of isotretinoin use in a previously healthy 18-years old man.

 Case Summary:
 An18-years-old man, with history of acne vulgaris, presented in August 2021 to our emergency department because of left iliac fossa pain and effort dyspnea. Computed tomography scan revealed left renal infarction and echocardiogram demonstrated global left ventricular (LV) dilatation with severely reduced LV-ejection fraction (LVEF: 29%). Coronary artery disease, autoimmune, infective, or heritable causes of DCM were ruled out. Cardiac magnetic resonance evidenced LV circumferential mid-wall late gadolinium enhancement and ECG monitoring revealed several non-sustained ventricular tachycardia episodes. Thus, Bisoprolol, Sacubitril/Valsartan, and Eplerenone were started and up titrated until maximum tolerated doses, with only poor LVEF improvement.

 Conclusion:
 Our case aims to raise awareness on rare life-threatening cardiovascular events associated with isotretinoin use for the treatment of severe acne in young patients. To the best of our knowledge, this is the first described case of renal thromboembolism and DCM requiring S-ICD implantation and cardiac transplant program listing occurring in the course of isotretinoin treatment.


During the pyrometallurgical treatment of the nickel-bearing laterite in the plant of G.M.M. S.A. LARCO, slag is produced after treatment in electric-arc furnace (EAF) that contains 0.10 to 0.20 % Ni. Taking into account the great quantity of slag produced per year, the recovery of nickel from the EAF slag will add benefits to the entire process. The target of the current work is to investigate the possibility of nickel recovery from EAF slag by magnetic separation. To meet the target, the effect of the following parameters was studied: grain size, magnetic field intensity, thickness of slag layer, moisture content, and re-grinding of the coarser slag particles. The results show that it is possible to obtain a magnetic product with nickel grade close to that of the primary raw material or even better, with sufficient nickel recovery.


The linear friction welding(LFW) experiment of TC4 alloy was carried out with homemade XMH-160 LFW machine.The curve of the friction power during linear friction welding of TC4 alloy was examined.The evolution characteristics of the friction power were analyzed and the formation mechanism of LFW TC4 was discussed according to the curves of the interfacial temperature and the shear strength.


The chemical reaction between a SiO molecular beam and a tungsten carbide surface is investigated by Auger electron spectroscopy (AES) and flash desorption mass spectrometry (FDMS). For SiO adsorbed on a carburized tungsten surface. AES shows that the silicon peaks at 64, 78, and 92 eV dominate. (The 92-eV peak is characteristic of elemental silicon, the 64- and 78-eV peaks are characteristic of higher oxidation states of silicon.) FDMS shows that there are two desorption peaks for mass 28. The low temperature peak is identified as CO (T/sub m/ approx. 1100 K, ..delta..W approx. 37 K, ..beta.. = 30.3 K s/sup -1/), which is unlike the flash desorption spectrum of CO from a polycrystalline clean W surface. Desorption from this state is described by a first-order process, but the activation energy increases with increasing coverage. This is interpreted as due to complex (CO + SiO) formation on the surface, and is confirmed by a separate coadsorption experiment. The other peak at higher temperature is identified as Si (T/sub m/ = 2020 K, ..delta..W = 155 K, ..beta.. = 30.3 K s/sup -1/), and these data indicate a simple first-order desorption process with E/sub d/ = 123 kcal mol/sup -1/ andmore » ..nu.. = 1.2 x 10/sup 13/ s/sup -1/. If the surface temperature is increased to 1500 K, AES shows only a 92-eV peak for silicon and its peak-to-peak height is comparable to that for a pure silicon crystal. Thus, it is concluded that silicon monoxide molecules were reduced by the tungsten carbide surface to elemental silicon.« less


{delta}{sup 13}C of organic carbon (OC) in soils and paleosols integrates the relative contribution of C{sub 3} and C{sub 4} plants to the soil OC pool. Geographic distribution and relative productivity of C{sub 4} species are both correlated strongly with temperature. {delta}{sup 13}C of paleosol OC should reflect long-term vegetation dynamics and past climatic variation. To understand vegetation and climate dynamics in the Great Plains during the late Quaternary, {delta}{sup 13}C of OC (n=51) in a stacked sequence of 8 paleosols and one modern soil in central Texas was measured. Three distinct periods of low C{sub 4} productivity ({delta}{sup 13}C = -25 to -21 {per_thousand}) occurred between 15,000-8,000 YBP. These events coincided precisely with 3 well-documented episodes of glacial meltwater flux into the Gulf of Mexico (220 km from study area) via the Mississippi River, indicating strong coupling between marine and adjacent continental ecosystems. The effects of glacial meltwater in the Gulf ceased around 8,000 YBP; after this time, relative C{sub 4} productivity was strongly influenced by orbital forcing mechanisms. Holocene altithermal periods were characterized by high relative C{sub 4} productivity at {approx}5,000 YBP ({delta}{sup 13}C = -18.5 {per_thousand}) and {approx}2,000 YBP ({delta}{sup 13}C = -16.7 {per_thousand}). This late Quaternarymore » {delta}{sup 13}C record of relative C{sub 4} productivity is highly correlated with previous climatic reconstructions for this region based on other methods, indicating that {delta}{sup 13}C of paleosol OC may be a useful proxy for paleotemperature in the Great Plains. Furthermore, large shifts in relative C{sub 3}-C{sub 4} productivity during the late Quaternary documented here and elsewhere may have implications for modeling carbon and hydrologic cycles at regional and global scales during this time interval.« less


The India-Bangladesh borderland serves as a vital crossroads, witnessing the convergence of diverse cultures, trade, and historical ties. The people of Bangladeshi borders seem that India has been our trusted friend since the emergence of our country. However, amidst this dynamic landscape, the border areas of Bangladesh bear witness to the anguish and suffering endured by its inhabitants. The experiences and perspectives of the tortured people residing in the border areas of Bangladesh, specifically focus on the impact of the India-Bangladesh border control operations led by the Border Security Force (BSF). Sometimes innocent people at the Bangladeshi border are being tortured by the BSF when they are trying to ensure their state security from any unwanted anomalies in the adjacent India-Bangladesh border. This study contributes to a better understanding of the complex dynamics at play in the India-Bangladesh border region and calls for attention to the plight of the innocent tortured people residing there.


The creative fashion industry is one of the sources of economic strength in great demand by businessman and consumers, such as MSMEs. The purpose of this study was to examine the effect of consumer knowledge on purchase intention in MSMEs sustainable fashion products with trust as a mediator variable. The research method will use quantitative research. The samples obtained were 257 consumers of Indonesian MSMEs fast fashion products and used the Qualtrics electronic questionnaire. This research data is from perception data for sustainable fashion knowledge variables, trust, and purchase intention in MSMEs sustainable fashion products. The data were processed using SPSS to test the validity, reliability, regression analysis, and mediation test using JASP. The results obtained are that consumers who know sustainable fashion will make these consumers more confident in sustainable fashion MSMEs products and ultimately increase consumer purchase intention in MSMEs sustainable fashion products. So, it is very important for MSMEs engaged in the sustainable fashion business to educate consumers about the meaning of sustainable fashion and the practice of MSMEs in a sustainable fashion.


Magneto-optic Kerr spectra in the photon energy range from 1 to 5 ev have been measured for NdGd/Fe, PrGd/Fe, TbGd/Fe and NdGd/FeCo multilayers, The multilayers exhibit Kerr rotation becoming larger with increasing photon energy. The spectra of the magneto-optical figure of merit have been also estimated for the multilayers considering the Kerr ellipticity as well as the Kerr rotation. The multilayers containing Nd and Pr exhibit higher figure of merit than conventional TbFeCo amorphous films.


This study examines the impact of foreign direct investment in agricultural productivity on food security in sub-Saharan Africa covering the period 2010-2020. The data were obtained from World Bank World Development Indicators, United Nations Food and Agricultural Organization and United Nations Conference on Trade and Development. The technique used for data analysis is System Generalized Method of Moment. The results of Arrelano-Bond tests show no autocorrelation. The estimated GMM-SYS results show that foreign direct investment in agriculture is positive and statistically significant in influencing food security variables including food consumption score (with the coefficient of 0.042) and dietary energy consumption (with the coefficient of 0.317). The control variables like crop production, food exports, age dependency and rural population are significant determinants of food consumption score. Also, GDP per capita, crop production, age dependency and rural population are significant factors influencing dietary energy consumption in Sub-Saharan Africa. Based on the findings of the study, there is need for regional governments to ensure tenure reforms by formalization of customary rights to enhance tenure security for a more equitable access to land. It is also essential that proper monitoring and impact assessment systems are developed to ensure transparency of the processes associated with agricultural investments. Furthermore, countries with currently high foreign direct investment transaction costs or that have a generally less conducive investment environment can improve agriculture by eliminating these obstacles.


Abstract This paper addresses a path following problem for mobile manipulators of ( nh, h ) type. The desired task was decomposed into two independent parts: the end-effector of the manipulator has to follow a path described relative to the platform and the platform has to follow a path lying on the plane. The Serret–Frenet parametrization was used to describe the non-holonomic system relative to the desired path. The proposed control strategy consists of two parts, kinematic controller and dynamic controller, because of the presence of nonholonomic constraints.


The American Society of Gene and Cell Therapy (ASGCT)'s annual meeting is the most relevant conference focused on gene and cell therapy, bringing together more than 3,400 professionals including scientists, physicians and patient advocates Due to the global COVID-19 infection pandemic, the 23rd Annual Meeting, due to be held in Boston, was held virtually, following the same schedule as planned Recorded oral and poster sessions were made available to share the ongoing research in this area


International tourism service trade is a significant part of international trade, at the same time, tourism is a potential growth industry. International tourism service trade of our country has made grate contributions to international service trade and economic growth. This paper analyses the competitiveness of international tourism service trade among nine other tourism services trade powers and our country, according to the export market share index, TC index and RCA index. The analysis shows that our tourism service trade has certain competitiveness, but still has distance with advanced countries. In order to improve the international competition of our tourism service trade, we should take effective policy measures further.


In order to provide scientific basis for the quantity control and comprehensive utilization of highland barley, δ-vitamin E, γ- vitamin E , α- vitamin E contents in 16 cultivars of highland barley from Qinghai and highland barley samples from different 10 areas of Tibet were determined by HPLC. The chromatographic column, mobile phase, column temperature, flow rate and detection wavelength were Symmetry C18 column (4.6 mm × 250 mm, 5 μm), methanol-water at the volume ratio of 98: 2, 25 ℃, 1 ml/min and 295 nm, respectively. The results indicated that all the collected highland barley in Tibetan plateau contain vitamin E,and the total content is between 0.3 mg/100g and 0.8 mg/100 g, especially the average content of total vitamin E in highland barley from Tibet is higher about 10% than that from Qinghai.


The article proposes to conceive newspieces on mental disorders published in weekly magazines as advertisements aimed at stimulating the consumption of medication, in particular of antidepressants. It then examines the linkages
between consumption and contemporary subjectivities by analyzing two main rhetorical strategies by which individuals may come to conceive of themselves as possibly ill and thus as a potential consumer of medication. The first one separates suffering and morality, thus erasing the
stigma associated to mental disorders; the second one inquires how quizzes published in these newspieces may enhance the sense of uncertainty in individuals regarding one's allegedly normal mental states.

Keywords
Media. Consumption. Subjectivity. Mental Disorder.
Antidepressant.


This paper discusses fouling of a twisted tube heat exchanger under different conditions of fluid velocity and heat input. The fluid velocity was varied from 0.5 to 2.0 m/s, whereas the heat input to the heat exchanger was varied from 200 to 800 W. The experimental results show that for low fluid velocity of 0.5 m/s, the fouling resistance showed noticeable variation with respect to heat input, whereas for high velocity ranges, that is, 1.0–2 m/s, the variation in fouling resistance is less. The fouling in twisted tube steadily increases with time for different values of heat input from 1000 min onward for fluid velocity in the range from 1.0 to 2.0 m/s. It is also observed that fouling resistance curves overlap for various values of heat input. During the initial 1000 min of the test duration, the maximum fouling in a twisted tube heat exchanger decreases with increase in fluid velocity from 1.0 to 2.0 m/s. This behavior of the fouling rate can be attributed to the fact that at higher fluid velocity, flow becomes turbulent, and this in turn flushes the fouling particles. The time-series correlations for the fouling resistance are found to be logarithmic in nature.


An equation governing the evolution of a Hele-Shaw free boundary flow in the presence of an arbitrary external potential – generalised Hele-Shaw flow – is derived in terms of the Schwarz function g(z, t) of the free boundary. This generalises the well-known equation ∂g/∂t = 2∂w/∂z, where w is the complex potential, which has been successfully employed in constructing many exact solutions in the absence of external potentials. The new equation is used to re-derive some known explicit solutions for equilibrium and time-dependent free boundary flows in the presence of external potentials, including those with singular potential fields, uniform gravity and centrifugal forces. Some new solutions are also constructed that variously describe equilibrium flows with higher order hydrodynamic singularities in the presence of electric point sources and an unsteady solution describing bubbles under the combined influence of strain and centrifugal potential.


A studying abroad is a course of learning through joining between two countries and cultures. And students studying abroad should accustom themselves to it's culture, language, living styles and so on. But they recognize that the original idea of studying abroad belong to their individual and national profits with their studying abroad. In the result of situation studying abroad, they experience on the stress of antagonistic relationships such as relation between assimilation and dissimilation, and between dependence and independence. And students can be called 'marginal man' who should experience on the hard learning courses of circulation between maladjustment and adjustment, or adjustment and maladjustment with experiencing on the special situation that the compulsive conformity and self conscious alienation between two cultures. I think that Joseph Joo(朱耀燮, 1902~1972)´s 『A Price of First Love(첫사랑값)』(1925~27), Kwangsoo Lee(李光洙, 1892~1950)´s 『Letters in Blood(血書)』(1924) need to be taken notice for the studying. These works include not only self-presentations of intellectuals who had studied in Japan, China, and Korea before and after the 3.1 Movement but also characters who had been suffered and agonized between the modern nationalism and the private consciousness. 『A Price of First Love』 is an incomplete frame medium-lenth story which recollects main character 'M' through his diary in which M gives up his Chinese female lover and comes back to his country but finally suicides by himself. 『Letters in Blood'』 is a short novel that a main character, 'I' refuse a Japanese woman's courtship and recollects the woman's death. These two novels pretty well show the mental agony of intellectuals who suffer from the problems on "how to live" in the real colonial lives decorated with cultural politics after the 3.1 Movement.


High Z exploding foil targets are used in many soft x-ray laser schemes. The foils are typically irradiated with a long ('1 ns) optical laser pulse that burns through the foil to produce a large hot plasma with long density scale lengths suitable as an amplifier. While it is expanding, and before the plasma conditions are suitable for stimulated emission, a large fraction of the heating laser energy is lost through radiation and conduction. We report the results of experiments attempting to increase the efficiency of exploding foil amplifiers through the following procedure. A laser beam ('1 2 W/cm2) is used to heat the foil sufficiently to expand it to approximately 200 pm. A high intensity (''1 5 W/cm2) short pulse (1 0 ps) laser beam is then used to raise the plasma to the desired temperature and ion state. Temporally resolved x-ray spectra from Yb foils are presented.


Background Immobility in intensive care units (ICU) increases the rate of muscle weakness, delirium and skin breakdown. Early rehabilitation (ER) has been shown to be safe and feasible within adult ICU, whilst improving physical and psychological wellbeing. ER is less common across paediatric ICU. The aim of this service evaluation was to describe ER practices on CICU and benchmark against international standards. Method A retrospective case-note review captured ER practices from April - September 2018. Primary outcomes were the type and frequency of ER implemented. Inclusion criteria included new patients intubated and ventilated >72 hours. Results Data were collected for 69 children (54% female). Ages ranged from one day to 14 years 8 months; mean age 11 months. 84% were surgical admissions and 64% of the cohort remained ventilated for >5 days. ER commenced on day one for 100% of patients (position changes). By day six, 39% of infants were out for cuddles and 2% sat on the edge of the bed. Of all the recorded ER episodes, 95% were completed by nurses. PICU Up! was the international benchmark, a direct comparison was made on day three of admission. Position changes were received by 100% of our cohort, compared to 47% in PICU Up!. On day three 46% of the PICU UP! cohort completed transfers and 27% ambulation, compared to our 0%. Conclusions This service evaluation highlights that ER is being implemented from day one on CICU and incorporates a multidisciplinary approach. However implementation of higher level ER is delayed. Benchmarking demonstrated a disparity between the types of ER completed. Direct comparison is difficult due to variations in demographics; our cohort was younger, ventilated for longer and predominantly surgical. Future plans include formalising ER to safely implement across GOSH ICU and once established to re-audit practice.


Quasi-steady-state, rf-driven currents with roughly-equal30 A x cm/sup -2/ (J/sub p/ = 1.2 kA, qroughly-equal2.2) were generated in the Alfven heating mode in a P-0 stellarator. The transfer of particles and of plasma energy along the minor radius decreases as a result of propagation of the wave in the direction of diamagnetic electron drift.


roidal anti-inflammatory agents and tetracyclines have been related to psoriasis (15). In our patient, apart from pegylated INF use, we were unable to determine any of those endogenous or exogenous factors. Our patient had quiescent psoriasis until the onset of pegylated IFN administration. Until now, only two cases with psoriasis aggravated or provoked during pegylated INF treatment had been reported (16,17). In those cases, pegylated INF treatment was stopped due to extensive psoriatic cutaneous reactions. In the literature, in most of the cases with psoriatic activation after conventional INF administration, INF was also discontinued (5,6,14). The severe psoriatic reaction in a patient with viral hepatitis on INF treatment presents a complex therapeutic predicament. Naturally, oral anti-psoriatics are contraindicated in cases with psoriasis and viral hepatitis. However, topical corticosteroid and ultraviolet treatment in these cases poses no risk to the liver. In our case, we used UVB treatment as early as possible when the first signs of psoriasis developed. Three months of this treatment was successful and though we continued pegylated INF treatment, psoriasis remained in remission in this case. We believe that topical ultraviolet treatment should be administered as soon as possible in cases with early signs of psoriasis exacerbation. It is debatable as to whether prophylactic UVB therapy should be initiated as a reasonable strategy in these cases. We know that not all patients develop IFN-a-induced exacerbation of psoriasis, which probably reflects the heterogeneity of the condition (18). However, it is impossible to draw firm conclusions on ultraviolet prophylaxis in INF-treated cases with a previous history of psoriasis based on the present literature knowledge. It appears that induction of psoriasis exacerbation is another important side effect of pegylated IFN therapy. We suggest that psoriasis patients requiring pegylated IFN therapy for chronic active hepatitis should be treated carefully, with an early administration of UVB after the first signs of psoriasis exacerbation. Psoriatic lesions can thus be controlled and it may not be necessary to discontinue INF treatment. We need prospective studies to suggest prophylactic ultraviolet therapy in viral hepatitis cases considered for INF treatment who have a previous history of psoriasis.


Routine diagnostic studies can locate the source of gastrointestinal bleeding in the vast majority of persons. In approximately 5 percent of persons, however, the source remains obscure despite sophisticated studies. Our inability to localize the source of bleeding in these individuals illustrates the limits of available diagnostic technology. In an elderly patient who requires repeated diagnostic studies, attendant morbidity can be a limiting factor in the aggressive pursuit of the source of bleeding. In this paper, we discuss the usefulness of empiric hormonal therapy for the frail elderly patient who would be a poor surgical candidate or who could not tolerate repeated invasive procedures. Obscure intestinal bleeding is known to remit spontaneously. In the individual patient, therefore, it is not possible to ascribe the cessation of bleeding to oral hormonal treatment. Because randomized, controlled studies have not addressed this question, clinicians caring for a frail older person bleeding from an obscure lesion should consider empiric hormonal therapy as a reasonable treatment option.


Bilateral lesions of the nucleus locus coeruleus in rats deplete the cerebral cortex of norepinephrine and significantly diminish the rate of increase of running for food reward in a simple L-shaped runway. As assessed in this situation, learning was absent in those rats with the most complete ablations of the locus coeruleus, although these rats showed normal weight gain and normal motor and exploratory activity.


Background Preformed metal crowns (PMCs), as an effective technique recommended for the enduring restoration of primary molar defects, have not been widely implemented in China as well as that in Western countries. This study is aimed at assessing the knowledge on the clinical use of the PMC technique and its effective factors among dentists in Chengdu, China. Thus, the present study is aimed at providing the best available evidence on clinical decision-making to manage dental caries in children and the overall benefits. Methods The self-designed questionnaire in this study consisted of two main sections, including the sociodemographic characteristics of the respondents and their perception and use of PMCs. The anonymous questionnaire was distributed among 1000 dentists practicing in Chengdu via SO JUMP. Results The response rate was 45%. Most respondents (69.6%) did not use PMCs. Academic qualification, working specialty, and professional experience were associated with dentists' use of PMCs. The lack of knowledge about the PMC technique was the main obstacle to the dental practitioners' use of PMCs (41.7%). The lack of understanding of the rationale behind PMCs was the main reason for parents' acceptance of PMC restorations (43.6%). Attending continuing education programs was the main approach to learning the PMC restorative technique (59.1%). Conclusions The clinical use of PMCs was not very popular in Chengdu city. To promote this restorative technique, knowledge and practical training should be incorporated into routine courses of undergraduate dental education.