Primary data on the organic geochemistry of the Tetori Group provide basic information about depositional environments and thermal maturation of organic matter through two geological sections in the Hokuriku region, central Japan. The thermal maturity of organic matter was evaluated by the methylphenanthrene index‐1. The maturity progressively increases stratigraphically down through the Izumi section in Fukui Prefecture. The estimated vitrinite reflectance equivalent is <1.35% near the top of the section, gradually increasing to >2.0% near the base. The thermal maturation process can account for stratigraphic changes in abundance of PAHs through this section. However, the occasional occurrence of coronene in the middle of the Izumi section is attributed to possible paleo‐wildfires that supplied more coronene to the depositional site. The stratigraphic distribution of PAHs through the Tateyama section, Toyama Prefecture, also can be explained by the same scenario as envisaged for the Izumi section, but weathering and/or other secondary factors may have partly modified primary signals for this section. Polycyclic aromatic sulfur compounds were observed in nearly all samples from both sections, even in samples for which a freshwater paleoenvironment is surmised. Most plausibly, some reduced sulfur was re‐oxidized to elemental sulfur, which persisted in the sediments and may have contributed to the formation of aromatic sulfur compounds. Hence, polycyclic aromatic sulfur compounds do not provide an index to separate marine environments from the freshwater settings for the Tetori Group.


Perioperative nursing roles continue to change rapidly as we enter the 21st century. The need for good leadership skills, expert clinical skills, creative management and ongoing education and research, continues to grow in many surgical departments. Perioperative nursing roles are evolving in response to healthcare reforms, technological developments, patient demands and changing opportunities for advanced nursing practice. The aim of this study was to investigate the attitudes of a group of operating room nurses and nurse anaesthetists towards perioperative conversation. A questionnaire, which included a specific attitude scale, was constructed and used in the collection of data. The informants were 86 operating room nurses and nurse anaesthetists. The results showed that the nurses had a positive attitude towards perioperative conversation. There were significant differences in attitudes related to age, gender, educational level, category of profession and working hours. Reliability, measured using the Cronbach's alpha coefficient for the attitude scale, was 0.96. The validity of the scale was high.


Pituitary adenylate cyclase-activating polypeptide (PACAP) is a naturally occurring peptide found in the central nervous system that plays a role in somatosensory processing and activation of protein kinase A (PKA) and protein kinase C (PKC). Because activation of PKA or PKC results in reactivation of HSV-1 from latently infected embryonic neuronal cells, PACAP was used to evaluate HSV-1 activation from quiescently infected (QIF)-PC12 cells. Our studies demonstrate that physiologically relevant concentrations of PACAP38 and PACAP27 induce HSV-1 activation from QIF-PC12 cell cultures in a


The United States National Academy of Engineering produced its seminal work, The Engineer of 2020 – Visions of Engineering in the New Century, to prepare industrial, governmental, and academic institutions for the future of engineering. The authors of the report state, "Emphasis on the creative process will allow more effective leadership in the development and application of next-generation technologies to problems of the future." In 2011, 2012, and 2013, engineering undergraduates from Valparaiso University participated in a four-day off-site extracurricular fieldtrip focused on creativity, innovation, teamwork, and leading the creative process. The course was taught by members of the engineering faculty and included on-location sessions and tours led by employees and cast members from an external training organization. Preand postcourse surveys identify a significant improvement in the students' understanding of the roles of leadership, communication, and teamwork in the creative process. In an attempt to determine how much the students benefitted from the fieldtrips, a full class dedicated to the creative process was taught along with the trip in 2014. Quantitatively, students who participated in only the fieldtrips showed improvements similar to those who also participated in the full class. However, additional qualitative results indicate that students who participated in the full course with a fieldtrip experience had higher levels of confidence and affinity for the program.


This paper proposes a computational model for the calculation and visualization of bone mineral density from images of conventional X-rays. The initial idea is to get a range of values related to the processing and segmentation of medical images and apply them as input values in a interval
fuzzy system, shaped specifically to accommodate this need. This proposal is part of a larger project called Project M-IPE (Medical Information Processing Environment), whose main objective is to provide processing and simulation of dynamic aspects based on medical information.


research, 'digital religion' most certainly "does not simply refer to religion as it is performed and articulated online, but points to how digital media and media spaces are shaping and being shaped by religious practice" (Campbell 2013, 1). For instance, actor-centred studies on digital religion have become more and more popular and now extend beyond the research of institutionalised religious authorities. Overall, the present volume is nevertheless a welcome addition to the expanding field of digital religion, as the contributors discuss the increasing complexities of digital religion in global contexts.


Part of a series which presents desktop references to a full range of social, political and economic information, specific to 150 nations, this volume provides information on Japan, including geography, language, education, climate, foreign trade, health care and much more.


Proof-oriented programming is a paradigm where programs are designed and developed along with mathematical proofs of their correctness and security. In recent years, proof-oriented programming has reached a point where not only several high-assurance software components have been developed using it, but these components have also been deployed in production systems. In this talk, I will provide an overview of this paradigm in the context of F*, a proof-oriented programming language developed at Microsoft Research. I will briefly discuss several critical software components, developed from scratch in F*. These components are already deployed in production systems such as Windows Hyper-V, the Linux kernel, Firefox, and mbedTLS. As a complementary methodology for retrofitting strong, formal guarantees on existing legacy services, I will present the Zeta framework. Zeta works by running a small, proven correct monitor in a trusted execution environment validating responses from the service. The key idea is that we only need to develop the monitor using proof-oriented programming once-and-for-all, while the large legacy service remains untrusted. I will illustrate Zeta by sketching an example of how we can make a concurrent, high-performance, key-value store "zero trust" and argue that this step incurs modest software engineering effort and modest runtime overheads.


In the U.S. the 12 great freight routes, which bear 90 percent of the business of the 535 surviving railroads, are all profitable these days. They make up a $27.5 billion industry that nets $1.95 billion and can easily absorb the $200 million damage from the Midwest flood that inundated 500 miles of track and caused 1,000 trains to be rerouted. Emerging from a century and a half of wild venture, corruption and the suffocating hand of government, they are a gathering economic force, destined to get stronger in a transport picture dotted with troubled ships, planes and trucks.


This study was carried out at the Muar River Estuary, Johore, Malaysia. Water samples, sediment and biota that are Crassostrea iredalei, Perna viridis and Anadara granosa were collected during monsoon season in November 2005. All the samples were analyzed for the mercury concentration by using cold vapor atomic absorption spectrophotometer (CV-AAS). The temperature was between 28.70°C to 29.83°C, salinity at 12.78-29.96 ppt, dissolved oxygen at 5.0-6.83mg/L and pH at 6.71-7.93. The report of water samples show that the dissolved mercury in water samples was between 0.271µg L-1 and 0.8261tg L-1 while the total mercury in sediment was between 0.560-3.513µg g-1 dry weights. For biological sample, the average concentration of mercury in Crassostrea irredelei was 1.854 ± 1.012 µg g -1 . Perna viridis was 0.366 ± 1.125 µg g-1 and Anadara granosa was 1.178 ± 1.182 µg g-1 . The water at Muar River Estuary is still in safety level of mercury but biota especially Crassostrea irredelei and Anadara granosa are not safe to be taken due to the total mercury concentration was exceeding (WHO) level of 0.5 µg g-1 .


In English grammar, the sentences of passive voice can be turn into active voice in grammatical requirements, and the process are usually to be done by exchanging the places of what are the subjects in the passive voice with that of the objects in the active voice. However, it is not an arbitrary rule due to different verbs and objects.


This article presents a further test for market segmentation between the real estate market and the capital markets. We use rescaled range analysis developed in the fractal geometry literature to test for nonlinear trends in the returns series for different asset classes. We make three major conclusions: (1) the stock market displays tendencies consistent with a random walk, (2) portfolios of mortgage and equity REIT returns display tendencies consistent with a random walk and, (3) conditional upon the methods used, segmentation does not exist between different real estate markets and between the real estate and stock markets.


Decoding algorithms with reliability information are of considerable interest in error control coding. Such information when available and when properly used increases the error correcting capability of the decoder. We find decoding algorithms that use soft decision with optimal error correcting capability for fixed constraints on decoder complexity.<<ETX>>


........................................................................................................................................ iv Chapter I: Introduction and overview ........................................................................................ 1 Background – Manufacturing in Asia ......................................................................................... 2 Setting ......................................................................................................................................... 6 Purpose Molding Project Management .................................................................................... 9 Problem Statement .................................................................................................................... 11 My Role .................................................................................................................................... 11 Summary ................................................................................................................................... 11 Chapter II: Leadership and Organizational analysis .............................................................. 12 Leadership ................................................................................................................................. 12 Organizational Characteristic.................................................................................................... 16 Ethics and Accountability ......................................................................................................... 17 SPELIT analysis........................................................................................................................ 17 Social analysis .................................................................................................................. 17 Political analysis. .............................................................................................................. 18 Economic analysis. ........................................................................................................... 19 Legal analysis. .................................................................................................................. 20 Intercultural analysis. ....................................................................................................... 20 Technological analysis...................................................................................................... 21 Chapter III: Change Management ............................................................................................ 22 Lean six sigma (LSS) ................................................................................................................ 22 Dual operating system and Kotter's 8 accelerators ................................................................... 24 Accelerator 1: Create a sense of urgency ......................................................................... 27 Accelerator 2: Build a guiding coalition .......................................................................... 28 Accelerator 3: Form strategic vision and initiative .......................................................... 30 Accelerator 4: Enlist volunteer army ................................................................................ 30 Accelerator 5: Enable action by removing barriers ......................................................... 31 Accelerator 6: Generate short-term wins ......................................................................... 32 Accelerator 7: Sustain acceleration .................................................................................. 32 Accelerator 8: Institute change ......................................................................................... 33 NETWORKING FOR SUCCESS 34 Further implications .................................................................................................................. 34 Evaluation ................................................................................................................................. 34 Chapter IV: Conclusion ............................................................................................................. 35 References .................................................................................................................................... 36 Appendix A – FCL Chairman C Cultural Map Profile ............................................................. 40 Appendix B – GLOBE Country Clusters.................................................................................. 42 Appendix C – Polar Graph of Confucian Asia, South Asia, and Anglo cluster cultural dimensions ................................................................................................................................ 43 Appendix D – Leadership Dimension for Confucian Asia, South Asia and Anglo culture clusters ...................................................................................................................................... 44 Appendix E – GLOBE Leadership Dimension desirability ranking profile of Confucian Asia, South Asia, and Anglo clusters ................................................................................................. 45 Appendix F – Kotter's Dual Operating System ........................................................................ 46 Appendix G – Key Characteristics of the dual operating system ............................................. 47 Appendix H – TurnItIn (TII) Originality Report ...................................................................... 48 Appendix I – EDOL Courses taken .......................................................................................... 49 NETWORKING FOR SUCCESS 34


SUMMARY This article provides a critical review of recent active life expectancy literature, describing trends of special interest to women. We review findings from leading perspectives used to study life expectancy and active life expectancy, including gender, racial and socioeconomic differences, disease-specific effects, and biodemography. We examine three competing theories of population health that frame active life expectancy research—compression of morbidity, expansion of morbidity, and dynamic equilibrium—concluding there is support for both the compression of morbidity and dynamic equilibrium theories. Policy implications for women include a greater understanding of the role of education and racial and ethnic diversity in active life trends, and an increased public policy emphasis on prevention and treatment of chronic disease, together with adoption of more healthy lifestyles.


Health plays a key role to maintain human welfare, improves economic conditions, helps in social development, and sustains life. Therefore, the WHO member countries have planned to target their health sectors financing to ensure that all people have the accessibility to free or economical health services at their region. Many countries in the world (developed, developing) are introducing health sectors reform in varying steps and system. Recently, the developing countries in Asia (Philippines, South Korea, Malaysia, and Thailand) and Africa (Nigeria, Tanzania, and Uganda) have initiated the health sectors reform. The main goal of health sector reform system is to improve the effectiveness of the health care system. Furthermore, the health care system effectiveness is possible by improving the quality of service (technical), and to generate new resources (human, financial, material) for the health care system (Islam, 2002). The Devolution Plan (2001) guide and provides an opportunity to the health care system to justify the health requirements of the population. Pakistan is a developing country and needs reform in the health care system. For this purpose, Pakistan has shown little basic improvement in the health care system. Unfortunately, Pakistan is facing the worse economic situation which leads to poor health care reform, and is far away from the Millennium Develop Goal (MDGs) of 2015. This report will focus on brief summary of the Pakistan and Iran health care delivery system and its organization environment (goal, expectation, resources, technology), authority, power, and status structure, decision making process, primary problems, challenges, and strategies to improve our health sector.


An apparatus for processing a frame of data for transmission comprises: a demodulator flag generator (2) for appending a flag indicative of a forthcoming frame of data using a supplemental channel; a CRC generator (4) for generating and appending to said frame of data a check bit sequence generated in accordance with said frame of data and a predetermined CRC format; a tail bit generator (6) for appending a 8 bit tail of predetermined value to said frame; an encoder (8) for encoding said frame in accordance with a predetermined encoder format; and an interleaver (10) for reordering encoded symbols. The apparatus is suitable for transmitting high speed digital data in a spread spectrum communications system. There is described a method for processing the data for transmission in a 1.2288 Mcps band and in a 3.6268 Mcps band. In addition, there is described a method for transmitting forward link and reverse link data of both rate set 1 digital data and rate set 2 digital data. Rate set 1 digital data comprises variable rate data at rates defined as MUX Option 1 in the IS-95 standard. Rate set 2 digital data comprises variable rate data at rates defined as MUX Option 2 in the appendix to the IS-95 standard. There are also described methods of transmitting the data for applications using packet switched technology and circuit switched technology.


He's variational iteration method (VIM) is used for solving space and time fractional telegraph equations. Numerical examples are presented in this paper. The obtained results show that VIM is effective and convenient.


Abstract Survival strategies of 34 species of lichens from a range of substrata, climates and growth forms were examined using the triangular ordination procedure of Grime. Triangular ordination is apparently an appropriate technique to apply to lichens, all available data falling within a triangle except for two foliicolous species which are probably partial leaf parasites. Statistically significant relationships between survival strategy and growth form, mode of asexual reproduction, substratum preference, family affiliation, and diversity of secondary chemical biosynthetic pathways have been demonstrated.


Taking such factors into consideration,as the scale benefit,resource endowments,the impetus to economic growth employment promotion and the recycling economy,the further strategic value of the various industries is rediscovered from the sequence change of the six leading industries,especially with the concept of circular economy to analysis.


In recent years,the social and economic development and human activities have produced complex and profound influence on the river and lake relation of middle and lower Yangtze River. The new situation and problems under the influence, such as operation of cascade reservoirs with Three Gorges Project as backbone one,operation of Three Gorges Reservoir in flood season,utilization of sandbar,shoal and shoreline and water and sediment resources,were analyzed. The principles and direction of river and lake regulation in middle and lower Yangtze River under changing environment,utilization of sandbar,shoal and shoreline and river management are discussed. It can provide technical support for river and lake regulation,river management and the optimal regulation of the Three Gorges Project.


Aim. To study the features of lipid-lowering therapy with rosuvastatin in high and very high cardiovascular risk patients in real outpatient practice. Material and methods. Patients ≥30 years, visited internists or cardiologists of district outpatient clinics in the period from October 2013 to July 2014 were included into the study. Each patient fill in questionnaire. Determination of total cholesterol (TC) level was performed without special preparation of the patient using a portable photometric blood analyzer. Doctors prescribed rosuvastatin therapy when indicated, in accordance with the Guidelines, choosing the dose on their own. Repeated TC level was determined after 1 month. Results. TC level was initially determined in 10547 patients. Rosuvastatin treatment was recommended for all patients. Repeated TC level determination was performed in 7897 patients in an average after 33 days. Baseline TC level in them was 6.37±0.89 mmol/l, and after 1 month while taking rosuvastatin – 4.89±0.81 mmol/l (p<0.001). The change of TC level was -22% (p<0.001). The average prescribed dose of rosuvastatin was 11.88±5.1 mg per day. The most often (62.8%) rosuvastatin was prescribed in a dose of 10 mg per day, in 27.3% of patients – 20 mg per day, in 9.2% – 5 mg per day, and only 0.5% of patients took it in the maximal dose. Conclusion. In real clinical practice, rosuvastatin for treatment of patients with high or very high cardiovascular risk is often prescribed in moderate doses and rarely in the maximum dose despite the proven lipid-lowering effect.


An adequate understanding of the characteristics and operation of labor markets in Argentina also requires an adequate understanding of the development strategies followed by the country and their consequences for growth performance. It is argued here that the long-run stagnation of the Argentine economy is the expected outcome of a development strategy based on an import substitution model. This strategy has led to a distortion of relative prices which resulted in a production structure strongly biased towards the domestic market, i.e. resulted in a very large anti-export bias. This gave rise to an impediment to sustained growth which originates in a conflict between the production structure of the economy and the performance of the foreign trade sector; it has been called 'the trade balance/domestic growth trade-off'. Evidence analyzed in this paper strongly suggests that there can be no income policy independent of economic conditions in the labor and goods markets and the foreign sector.


paper presents the chemical analysis of copper-alloy metal- work from three early first century sites in the Galilee area of modern Israel together with their interpretation and discussion. The analyses were by Inductively Coupled Plasma Atomic Emission Spectrometry (ICP-AES). Interesting compositional differences were found between those artefacts from Jewish sites and those from a pagan site which mirror differences already identified in the material culture assemblages. Brass, an alloy with strongly Roman associations, was found to be an alloy only present in the pagan assemblage, whereas traditional tin-bronze dominates the assemblages from Jewish sites. It is suggested that, during this very polarized period, the populations of the Galilee declared their cultural affiliations through the manipulation of the materials they used as well as the objects they manufactured and traded. Parallels offering explanations for this phenomenon were found in other material culture studies and the reasons for these 'choices' are investigated. Introductionadoption of brass and the mastery of the necessary tech- nology needed to produce it, is one of the many changes and developments in material culture that accompany the expan- sion of Roman influence in Western Europe (Bayley 1998: 19; Dungworth 1997). During the first century BC and pre-con- quest years of the first century AD, the local tribal elites in those areas peripheral to the Roman provinces were keen to acquire Mediterranean luxury items - prestige goods - to reinforce their status at home (Millet 1990; Collis 1984: 158- 180). As a consequence of this, the non-ferrous metallurgy of first century Britain and North-West Europe in general is marked by a gradual increase in the use of brass and the pres- ence of significant trace levels of zinc in copper alloy artefacts (Bayley 1998; Dungworth 1996). A recent study of the material culture of the towns and cities of the Galilee region of Northern Israel has shown a quite dif- ferent trend during the same period - the early years of the first century running up to the Great Revolt of AD 66 (Berlin 2002). Here it appears that the increasing antagonism towards the Romans by the Jewish population (as recorded in the writ- ings of Flavius Josephus) is reflected in material culture by the increasing exclusion of objects with clear Roman associations in assemblages from Jewish settlements. Given the close asso- ciation of brass with Roman material culture and its gradual appearance in the indigenous metalwork of peripheral peo- ples noted above, it was felt of value to ascertain whether the same phenomenon occurred in Palestine. If it did not, then copper alloy metalwork was probably subject to the same strictures as the other aspects of material culture identified by Berlin.


A novel computational method based on full-wave analysis of stripline planar structures in multilayer dielectric media is presented in this paper. The method is based on the electric-field integral-equation solved with the matrix equation by using Galerkin method.So network parameters (i.e.,scattering or admittance matrices) to describe the circuit's performance can be obtained easily. The accuracy of the proposed modeling method is examined thoroughly with extensive numerical tests and the results are compared with these generated by Momentum simulators for a LTCC band pass filter. The need for complex time and memory consuming numerical calculations is minimized and the calculation becomes more efficient.


A 4-year-old Caucasian girl was admitted with a 4-day history of fever, diarrhea and vomiting, and 12-hs of oliguria. Her past medical history was negative for any renal disease. On admission, she had a temperature of 39.5oC and blood pressure of 93/48 mm Hg. Physical examination was normal. Investigations showed leukocytosis with 88% neutrophils and anemia (hemoglobin level of 8.7 g/ dL), elevated serum creatinine (3.84 mg/dL) and urea nitrogen (BUN) (164 mg/dL), estimated glomerular filtration rate (GFR) of 15.7 mL/min/1.73m2 and metabolic acidosis. Erythrocyte sedimentation rate was 61 mm at the end 1-hr and C-reactive protein was 22.5 mg/dL. Urinalysis showed 3+ proteinuria, hematuria with dysmorphic erythrocytes and red cells casts. Blood levels of electrolytes were normal. Urine, blood, stool and throat swab cultures were negative for pathogenic bacteria or fungi. Serum C3 and C4 complement levels, antistreptolysin O titer and autoantibodies were normal.


Study of the ionization gauge with carbon nanotube cathode for carbon nanotube (CNT) field emission cathode, a high gate electrode voltage, as high as several hundred volts, is required to generate high emission field current. However, high gate potentials could affect the electric field distribution in the ionization space significantly, and the electron energies endowed by gate potential are relatively high for the gas ionization. Both of them have negative impacts on the ionizatio Simulation n probability. In this work, the structure of the ionization gauge with CNT cathode was optimized from the simulation study. The results show that electron trajectory in the ionization space vary with the change of the voltage ratio between the anode and the gate (Vgrid/Vgate). For extractor gauge, the longest effective electron trajectory could be achieved when the ratio of Vgrid/Vgate reaches 1.6. The sensitivity decreases with increasing the anode potential, which is due to the drop of the ionization probability caused by the high anode potential. Accordingly, a new cathode structure is proposed with adding a suppressor electrode between the gate and the anode. The suppressor electrode is help to decrease the electron energy, leading the increase of the sensitivity. This design provides a new approach to extend the measurement lower limit for CNT field emission based ionization gauge.


Objective Detection of cell-free fetal mRNA in maternal plasma by real-time quantitative flouorescence polymerase chain reaction(QF-PCR) and on the basis of it's amount to discuss the feasibility as a new prenatal screening indicator of Down'S syndrome. Methods Peripheral blood samples (n=26) were collected from pregnant women attending the International Peace Maternity and Child Health Hospital,School of Medicine,Shanghai Jiaotong University from May 2007 to August 2008.Cel1-free fetal mRNA in maternal plasma was isolated from 26 samples in the midtrimester(15~26W)pregnancy.Samples consisted of 9 women carrying trisomy 21 fetuses(group B),4 carrying aneuploid fetuses(group C),and 13 carrying normal fetuses(group A).QF-PCR was used to detect HPL,β-HCG,TFPI2,DSCR4,LOC90625 gene markers of the placental origin and 18sRNA gene of the mothers and the fetuses. Results All abnormal high concentrations of cell-free fetal mRNA but TFPI2 were found in a proportion of women carrying trisomy 21 fetuses and aneuploid fetuses(P0.01).Conclusion Cell-free fetal mRNA in maternal plasma is a potential prenatal screening maker for trisomy 21.


We obtain the functional relations for the eigenvalues of the transfer matrix of the sl(3) chiral Potts model for q2 = −1. For the homogeneous model in both directions a solution of these functional relations can be written in terms of roots of Bethe ansatz-like equations. In addition, a direct nested Bethe ansatz has also been developed for this case. On leave of absence from Institute for High Energy Physics, Protvino, 142284, Russia, E-mail: email@example.com E-mail: firstname.lastname@example.com


In view of the problems occurred during underground application of Mattill self-advancing tail device, some structures of it is improved in order to satisfy the requirements for underground operation.


In this paper, we propose a dipole and loop combined antenna structure for switchable radiation beam patterns. This antenna is designed to generate a switchable antenna radiation pattern for wireless communication device. The frequency bandwidth defined by S11<-10 dB is from approximately 1.8 – 2 GHz with maximum gain of 3.35dBi. Maximum beam direction can be steered by changing switch on/off configurations with maximum tilted beam of 90 degree in Eplane


VMS deposits in the Greater Antilles are described throughout the Dominican
Republic and Cuba, genetically linked to two main episodes of the island-arc
tectonic and magmatic evolution: 1) bimodal mafic type deposits, formed
during the earliest stages of island-arc volcanism and 2) mafic (Cyprus) type,
formed in mature back-arc basins (Nelson et al., 2011). Bimodal-mafic
VMS deposits are in the main hosted in tholeiitic volcanic rocks of Early Cretaceous age of the Maimon and Amina Formations in Cordillera Central of the Dominican Republic and in Los Pasos Formation and Purial Complex in central and eastern Cuba respectively.
Mild though decided trend toward Sb enrichment in tennantite from stratiform
ores in the San Fernando and Antonio deposits with respect to Cerro de Maimon parallel lower values of Se and As and higher contents in the more incompatibles Sb, Te and Bi in galena. These nuances in ore geochemistry support a slightly more primitive setting of formation of VMS mineralization in the Maimon Formation denoted by the lithogeochemistry of the hosting volcanic units.


The current ageing of the world's population is probably the most profound demographic change in the history of humankind. It is a pervasive and truly global phenomenon, without precedent or parallel, largely irreversible, and with the young populations of the past unlikely to occur again. Indeed, at the world level, the number of older persons will exceed the number of children by 2047, which has already occurred in many developed regions. The profundity of this demographic change will impact on economic growth, labor markets, pensions, health care, housing, migration, politics, and of course consumption (United Nations 2007). If the second half of the 20th century focused on the young, the 21st century will have to focus on the mature.Despite the growing importance of the 50 population and its perception as an attractive market segment, older consumers are still routinely neglected by many marketing and advertising practitioners (Niemela-Nyrhinen 2007; Simcock and Sudbury 2006; Uncles and Lee 2006) and what is known about their consumer behavior still lags far behind what is known about other important segments (Williams et al. 2010; Yoon et al. 2005). This is particularly true of research conducted outside the USA, where there is a marked lack of a coherent body of knowledge pertaining to senior consumers which can guide international marketing decisions.Self-perceived or cognitive age has emerged as a key variable in studying older people and their consumer behavior (Psychology & Marketing 2001; Wilkes 1992). The relatively sparse number of studies that have investigated this type of age identity in cross-national settings have concluded that cognitive age is "culture-free" (cf. also Barak 2009; Van Auken and Barry 2009; Van Auken, Barry, and Bagozzi 2006). Using data from an empirical study in four different countries, we challenge this view of cognitive age as culture free and thus aim to make a contribution to knowledge on older consumers on an international scale.


In the process of replacing a corroding 2.4-meter diameter corrugated metal culvert, the utility contractor determined that the culvert paralleled a high voltage electrical ductbank for a distance of approximately 91.5 meters. The invert of the culvert was on the order of 9.2 to 10.7 meters below and as close as 4.1 meters away from the ductbank. The goal of the instrumentation program developed and described in this paper was to minimize the risks assumed by the owner, design engineer and contractor in pursuing this project by: 1) enabling all parties involved to know the actual movements along the ductbank as they occurred so that construction could be stopped if excessive displacements were observed, thus ensuring protection of the ductbank; and, 2) providing the design engineer with data that would enable back-analysis resulting in reasonable estimates of material properties that could be used for predicting the displacements that might be expected during the next and successive stages of construction. This process was developed with the intention that additional lateral support and soil improvement strategies would be decided upon during the excavation process.


The measurement of radiant energy by the photographic plate has given an enormous advantage to the spectroscopy.It can simultaneously and permanently reccrd a wide region of wave length with an unexcelled power of discrimination and this characteristic is a indispensable factor for the quantitative spectrographic analysis which requires the determination of intensity ratio of several spectral lines based on the simultaneity of emission source.In spite of these excellent characteristics, however, owing to its property of reciprocity failure, the spectrochemical analyst frequently has to reinvestigate about the photometry in order to establish their applicability for his work.To avoid such troubles the authors have contrived a new quantitative method which maked good use of this failure. And from the standpoint of variation for analytical substances and of less time-consuming, the authors have attempted an another method using a two-stepped filter.The outline of these theories and prccedures is reported here.


140 The International Neonatal Immunotherapy Study (INIS). A Randomised Placebo Controlled Trial of Intravenous Immunoglobulin Therapy for Infants with Clinical Sepsis


Missed canals pose a potential risk in the treatment of teeth with anatomical variations, even when multi-angled radiographs have been used. Incomplete mechanical and chemical debridement of the root canal system can lead to treatment failure. Therefore, clinicians must have adequate knowledge of normal root canal systems as well as any possible variations in order to prevent any failure during or after the treatment of teeth with anatomical variations. Any case report of such rare variations would add to this critically required body of knowledge. The current case report presents the diagnosis and endodontic treatment of a maxillary first premolar with one root and three canals (one palatal and two buccal canals, all buccolingually positioned, bifurcating in the apical region), which was different from premolars with 3 canals reported up to now. This configuration describes an unusual root canal system for the maxillary first premolar and does not fit into any of the well-known root canal classification systems


Objective
To investigate the prognosis factors of patients with non-functional pancreatic neuroendocrine carcinoma (NF-PanNEC).

Methods
The patients with NF-PanNEC confirmed by pathology from 2004 to 2015 were collected from the Surveillance, Epidemiology, and End Results (SEER) database of the American National Cancer Institute. The MatchIt package in the R software was used to perform propensity-matching analysis of surgery, radiotherapy and chemotherapy. The Kaplan-Meier method was used to calculate the cumulative survival rate, and the significant difference was evaluated by the log-rank test. Then the Cox multivariate regression analysis was applied to evaluate the prognostic factors of NF-PanNEC patients.

Results
A total of 2 603 NF-PanNEC patients were included in the analysis. Univariate analysis showed that the age of diagnosis (χ2=123.8, P<0.001), gender (χ2=7.3, P=0.007), marital status (χ2=26.7, P<0.001), primary site of tumor (χ2=47.8, P<0.001), degree of tumor differentiation (χ2=628.7, P<0.001), American Joint Committee on Cancer (AJCC) stage (χ2=811.7, P<0.001), T stage (χ2=425.9, P<0.001), N stage (χ2=272.3, P<0.001), M stage (χ2=779.8, P<0.001), surgery (χ2=962.6, P<0.001), chemotherapy (χ2=21.9, P<0.001) were associated with the prognosis of NF-PanNEC patients. No correlation was observed between radiotherapy and the prognosis of NF-PanNEC patients (χ2=0.1, P=0.750). Multivariate Cox regression analysis showed that older diagnostic age (≥74 years old vs. ≤56 years old, HR=2.20, 95%CI: 1.84-2.62, P<0.001), male (male vs. female, HR=1.14, 95%CI为1.01~1.29, P=0.035), single or divorced or widowed (single or divorced vs. married, HR=1.26, 95%CI: 1.10-1.45, P=0.001; widowed vs. married, HR=1.29, 95%CI: 1.04-1.61, P=0.022), head of pancreas (tail of pancreas vs. head of pancreas, HR=0.85, 95%CI: 0.73-0.99, P=0.033), poor differentiation (grade Ⅳ vs. grade Ⅰ, HR=3.75, 95%CI: 2.70-5.20, P<0.001), late AJCC stage (stage Ⅳ vs. stage Ⅰ, HR=5.72, 95%CI: 4.23-7.73, P<0.001), no surgery treatment (yes vs. no, HR=0.37, 95%CI: 0.30-0.44, P<0.001) were significant prognostic risk factors for NF-PanNEC patients, and chemotherapy was not independent prognostic factor (yes vs. no, HR=1.00, 95%CI: 0.88-1.13, P=0.958).

Conclusion
The older diagnostic age, single or divorced or windowed, head of pancreas, poor differentiation, late AJCC stage and no surgery treatment are significant prognostic risk factors for NF-PanNEC patients. Radiotherapy and chemotherapy may not improve the prognosis of NF-PanNEC patients.

Key words:
Pancreatic neoplasms; Carcinoma, neuroendocrine; Prognosis; SEER program


In order to foster creative talents and set up modern creative teaching ideas, the relations of between teaching purposes must be dealt with correctly and paid attention to comprehensive practice of students.


The invention provides a coiling shaft which is applied to a coiling device of a safety belt. The coiling shaft comprises a core shaft which is provided with a through hole along a central axis and is used for winding a braiding belt, and two end covers which are separately and respectively arranged at two ends of the core shaft; the end covers are respectively in a flat cylinder shape; outer teeth which are matched with tooth shapes of inner teeth on the side wall of a frame of the coiling device are uniformly arranged along the periphery of each end cover and the center of the end cover, facing the inner end face of the core shaft, is provided with a central concave hole with inner teeth; the tooth shapes of the inner teeth of the central concave hole are matched with the tooth shapes of outer teeth at one end part of a torsion bar; and inner teeth which are matched with the outer teeth of the middle part of the torsion bar are arranged at the middle section position of a through hole at the central axis of the core shaft. The coiling shaft can contain the torsion bar with a shorter length so that the torsion bar is not easy to bend and deform; and the whole stress condition is simplified and is safer and more stable. The invention further provides the end cover for the coiling shaft, a safety belt coiling device using the coiling shaft and a safety belt assembly using the coiling shaft.


In the midst of restrictions issue on the use of fossil fuels, the world began to move towards the use of renewable fuels. One such fuel is hydrogen. Hydrogen itself could synthesized from fermentation method. Complex phenomenon will be difficult to be analyzed simultaneously and comprehensively when using conventional techniques. Optimation would be important since yield hydrogen from fermentation method was very small. Cause of few obstacles such as comprehensive phenomenon data not exsted mades this process very difficult to optimize. Simulation of hydrogen fermentation based on CFD would be one of the solution to retrieve phenomenon data comprehensively


This investigation set out to estimate exercise intensity and blood lactate corresponding to the maximal lactate steady state (MLaSS) and also examined the relationship between performance at the MLaSS with performance at fixed blood lactate reference values of 2.5 and 4.0 mmol•1−1. Cardiopulmonary responses at peak treadmill exercise and blood lactate reference values were measured in 10 boys and 8 girls ages 13-14 years. The 2.5 mmol•11 reference value represented 84±7% peak VO2 in boys and 82±6% peak VO2 in girls. Corresponding values at the 4.0 mmol•1−1 level were 93±6% and 90±5% peak VO2. MLaSS occurred at 77±7% peak VO2 in boys and 76±7% peak VO2 in girls. Blood lactate at the MLaSS was 2.1±0.5 mmol•l−1 in boys and 2.3±0.6 mmol•l−1 in girls. Cardiopulmonary and heart rate responses at the MLaSS were not significantly different from corresponding responses at the 2.5 mmol•l−1 reference value. In contrast, cardiopulmonary responses at the 4.0 mmol•l−1 reference level were significantly higher than tho...


The H/D exchange reaction between CH4 and D2 was carried out over Rh/active-carbon catalysts, which
 were prepared from RhCl3 and Rh(NO3)3. In the case of the catalysts prepared from RhCl3, Rh species were homogeneously dispersed on the support from external surface to the inside of pores. Metallic particles of Rh
 were found to be the predominant species on the catalysts prepared from Rh(NO3)3 in the low Rh-loading region of 2 wt.%. The reaction rate per unit gram of catalyst and the
 product distribution in methane reflected well the Rh-dispersion on the catalysts. The catalysts which contained the highly dispersed Rh species as predominant species were found to be more active for the H/D exchange reaction than the catalysts with relatively large metal particles of Rh. On the former, the ratio of CH3D/CD4
 was observed to be much higher than that on the latter.


The past three decades have witnessed the publication of an ever-improving flow of scholarly works on Muslim Separatism in India and the emergence of Pakistan. Nevertheless, Farzana Shaikh's study fills an important gap in historical understanding of these developments. While the roles of colonial policy and pragmatic interests have already been described in authoritative studies by Peter Hardy, Ayesha Jalal and Francis Robinson in his early works, Dr. Shaikh examines the way in which ideas influenced Indo-Muslim politics between 1860 and the Partition of India in 1947. What emerges from the book is the importance of Muslim ideas of political consensus and legitimacy in underpinning the development of a separatist political platform. Values drawn from Mughal history and the Islamic faith ultimately determined in the minds of Muslims the proper end of politics. At the heart of it all, was the Muslims' awareness that they constituted a ' charismatic community in the service of a higher end'. From this there flowed two important assumptions which directed political practice. Firstly, there was the belief that righteousness rather than the ' law of numbers' qualified the Muslims for power. This had its outgrowth in the 'pragmatic' demand for political weightage. Secondly, there was the belief that a predominantly non-Muslim organization like the Congress could not legitimately represent the Muslim community. Hence the demand that the Muslim League be accorded the status of the Sole Spokesman of Indian Muslims, a demand which many previous writers have narrowly construed as nothing more than a bid for power. Farzana Shaikh shows clearly how this Islamically derived view of politics came into growing conflict with the liberal-democratic understanding as the British increasingly extended the measure of political representation in India. Muslim adherence to the Islamic tradition led inexorably to Partition. This radical revision will undoubtedly provoke much thought. The widely held view that Muslim Separatism was inspired primarily by administrative definitions of Indian society must now be questioned. It will also now be more difficult to dismiss the Two Nation theory of Partition as mere polemic. Farzana Shaikh has undoubtedly provided a useful service to scholarship by effectively demonstrating that ideas rooted in Islamic tradition powerfully GIOVANNI STARY: Epengesdnge der Sibe-Mandschuren. (Asiatische Forschungen, Bd. 106.) [v], 166 pp. + errata et corrigenda slip. Wiesbaden: Otto Harrassowitz, 1988.


The study of Content-based instruction (CBI) and its application in College English in China has been one of the most talked about issue over the recent years due to the reform in College English. The paper discussed the theory of CBI and its application in China first, and then explored the reform and curriculum planning in recent four decades. After a survey carried out in Southwest University of China, a new curriculum planning based on CBI was introduced, particularly from the perspective of Six-T's Approach.


A high-precision rainfall measurement scheme is presented by using pressure gauge instead of the traditional siphon rain gauge or tipping bucket rain gauge.The intelligent and wireless technology on the rainfall measurement is realized by taking Atmega128 as the core,in control of CC2420 RF transceiver.The traffic meteorological station needs a strict requirement of realtime and accuracy in rainfall measurement,as a network node in wireless sensor network of the automatic meteorological station. The system has features on flexible networking,low power consumption,high precision and high reliability.


SUBTITLE: MEET A HANDS-ON GUY WHO WASN'T CONTENT TO TAKE CARE OF JUST HIS OWN FLEET. HIS CONTRIBUTIONS TO OTHER FLEETS' WELFARE AND TO THE INDUSTRY AS A WHOLE ARE WELL DOCUMENTED. MAYBE HE'S EVEN HELPED YOUR FLEET. READ ON TO SEE WHY OREN SUMMER IS BOTH A CHAMPION AND THIS YEAR'S CAREER LEADERSHIP AWARD RECIPIENT.


Time-delay is a natural phenomenon that is present in most physical systems and engineering applications, thus, delay systems have been an active area of research in control engineering for more than 60 years. Observer design is one of the most important subject that has been dealt with, this is due to the importance of observers in control engineering systems not only when sensing is not sufficient but also when a sensing reliability is needed. In this work, the main goal was to design observers for different classes of nonlinear delayed systems with an arbitrary large delay, using different approaches. In the first part, the problem of observer design is addressed for a class of triangular nonlinear systems with not necessarily small delay and sampled output measurements. Another major difficulty with this class of systems is the fact that the state matrix is dependent on the un-delayed output signal which is not accessible to measurement. A new chain observer, composed of sub-observers in series, is designed to compensate for output sampling and arbitrary large delays.In the second part of this work, another kind of triangular nonlinear delayed systems was considered, where this time the delay was considered as a first order hyperbolic partial differential equation. The inverse backstepping transformation was invoked and a chain observer was developed to ensure its effectiveness in case of large delays. Finally, a new observer was designed for a class of nonlinear parabolic partial differential equations under point measurements, in the case of large delays. The observer was composed of several chained sub-observers. Each sub-observer compensates a fraction of the global delay. The stability analyses of the error systems were based on different Lyapunov-Krasovskii functionals. Also different mathematical tools have been used in order to prove the results. Simulation results were presented to confirm the accuracy of the theoretical results


Summary A new Boundary Element Method for numerical simulation of strong discontinuity in solids is presented. Different scales can be recognized by an appropriate decomposition of the displacement field of solids exhibiting strong discontinuities. In a multiple scale framework, the components related to the strain concentration zone define the 'fine scale' and represent the effect of the microstructural behavior. The 'coarse scale' is achieved by removing the 'fine scale' from the total solution. The basic idea of the proposed formulation consists of obtaining the governing equations only in terms of the 'coarse scale', but preserving the 'fine scale' information. The corresponding non-linear BEM integral equations are similar to those of standard collocation approach with initial strain field applied over the domain. This similarity leads to a numerical procedure to treat discontinuities without hipersingular equations and sub-region techniques. Only small changes are required in the standard non-linear boundary element codes to make possible strong discontinuity simulations. Some representative analyses of elasto-plastic solids are performed to access the performance of the proposed formulation.


The Clitoria ternatea, Solanum nigrumand Aloe vera leaves were extracted serially by the solvents of increa s- ing polarity (petroleum ether, chloroform and ethano l) were tested for their free radical scavenging activity against DPPH. The petroleum ether extracts of Clitoria ternatea, Solanum nigrum and Aloe vera leaves were the most effective scavenging of DPPH. These plant extracts were also analyzed for the activ ities of selected enzymic antioxidants such as catalase, polyphenol oxidase and the non -enzymic antioxidants were ascorbic acid and total phenols. The results showed the leaves of Solanum nigrumpossess higher levels of antio xidants.


This paper is aimed at to increase the enrollment and awareness about National Service Scheme (NSS), among the hotel management colleges of Pune. Six colleges participated with various age groups volunteers and gender. Different types of benefits from NSS are discussed and explained in this paper which helps the volunteers to develop their personality. Author has covered the awareness about NSS, whether they enroll for it or not. What are the different qualities have imbibed through NSS. Whether all colleges must go for NSS or not Questionnaire technique has been followed to collect the data from the hotel management students of Pune City. Maximum volunteers are enroll and aware about it. They have emphasized on compulsion of NSS in colleges. This paper would help the colleges and institutions about the importance of NSS and its benefits to the students.


This is the inaugural address of Lord Robert Mair, who became 153rd president of the Institution of Civil Engineers on 7 November 2017.


This study examined Saudi Arabia teachers' perceptions of obstacles to educational rehabilitation for students with intellectual disability (ID). An online survey was completed by 84 special education teachers of students with ID. Results show statistically significant differences in these teachers' perspectives on the obstacles based on the grade levels they taught; there were no differences based on the other demographic variables studied (i.e., gender, level of education, and teaching experience). Moreover, the results show no statistically significant differences in teachers' perspectives on obstacles to educational rehabilitation related to demographic characteristics of gender, level of education, teaching experience, and grade level, compared to their views on other obstacles such as those related to (a) the tools used in educational rehabilitation, (b) school administration and equipment, and (c) students with ID. Also, there were no statistically significant effects of multiple demographic factors on teachers' perspectives on overall obstacles.


Abstract
 This chapter focuses on the origin, geographical distribution, morphological, physiological and phenological characteristics, cultivation history, breeding, vegetative propagation methods and molecular genetics and genomics of coconuts (Cocos nucifera). The importance of developing various genetic manipulation methods for the genetic improvement of coconut germplasm is also discussed.


The problem of large deformations often occurs in geotechnical engineering. Numerical modeling of such issues is usually complex and tricky. The chosen solution has to implicate soil-soil and soil-structure interactions. In this paper, a review of the most popular numerical methods for large deformation problems is presented. The Coupled Eulerian-Lagrangian (CEL) method, the Arbitrary Lagrangian-Eulerian (ALE) method, the Smoothed Particle Hydrodynamics (SPH) method, the Particle Finite Element Method (PFEM) and the Material Point Method (MPM) are described. The basic concepts and features of these methods are shown. Also a comparison of these methods in terms of geotechnical engineering is made.


In this chapter I attempt to correct the previously-discussed data set that showed extreme energy variations (Chapter 2) and largely non-reciprocal behavior (Chapter 4) so that the data become more reciprocal. In Chapter 3 I defined the problem theoretically and gave a numerical analysis of the solution structure by treating it as a generalized inverse problem. In this chapter I apply it to a small synthetic transverse isotropic (TI) data set that is based on the Marmousi structural model and show that the equalization gives results as theory would predict. When I apply it to the nine-component data, the equalization improves data symmetry for strong coherent events. 6.1 The optimization problem In chapter 3 I described the solution structure to the problem of finding the symmetric data in an optimal way. In this chapter I set up a least-squares optimization problem in which I minimize the difference between data and its reciprocal counterpart. Analysis of the solution structure of the problem shows that none of the eigenvectors has a pure spatial DC component. Thus, the absolute radiation pattern at source and receiver locations cannot be determined. However, relative changes should be resolved within a cable length. This relativity requires one to specify a reference with respect to which the prediction error or matching filters are computed. In the optimization I equalize to the average of the reciprocal trace pairs. Thus, source and receiver behavior influence the estimation-100


The investigations of mining tailings containing sulfide-bearing wastes (Urschi and Djukov Log, Kemerovo region) using electrical resistivity tomography and geochemical methods are presented in the article. The direction of groundwater and surface drainage stream from the tailings are predicted by means of geophysical methods with verification by geochemical sampling of the contrast geo-electric zones.


In Connecticut v. Teal' the Supreme Court issued a ruling of major importance to the way the law defines employment dis crimination. By a five-to-four vote, the Court resisted an effort to curb the principle that for more than a decade had been the cornerstone of equal employment opportunity. In doing so, the Court, for the present, left apparently intact the protection Title VII of the Civil Rights Act of 19642 has been deemed to afford individuals injured by employment practices that more heavily burden one group than another. Yet, the narrowness of the mar gin by which the Court reached its decision, in conjunction with the Court's failure to resolve a significant related issue, raises a question about the future of that protection. -


Advances in the design of chimeric antigen receptors (CARs) have improved the anti-tumor efficacy of redirected T cells. However, functional heterogeneity of CAR T cells and their restriction by polymorphic HLA molecules limit their therapeutic potential and are associated with toxicity, especially in allogeneic settings. We proposed that CAR expression in Vα24-invariant NKT cells (NKTs) can build upon the natural antitumor properties of these cells while their restriction by monomorphic CD1d limits toxicity. Primary human NKTs were engineered to express a CAR against the GD2 ganglioside, which is highly expressed by neuroblastoma. We compared CAR constructs that encoded the CD3ζ chain alone, with CD28, 4-1BB, or CD28 and 4-1BB co-stimulatory endodomains. CAR expression rendered NKTs highly cytotoxic against neuroblastoma cells without affecting their TCR-induced proliferation and CD1d-dependent killing of M2-polarized macrophages. We observed a striking Th1-like polarization of NKTs by 4-1BB-containing CARs in vitro and in mice. Expression of both CD28 and 4-1BB endodomains in the CAR maximized persistence of NKTs in NSG mice with neuroblastoma xenografts. These NKTs, expressing CAR with two co-stimulatory endodomains localized to the tumor site more effectively than T cells with the same CAR (p Citation Format: Andras Heczey, Daofeng Liu, Gengwen Tian, Ekaterina Marinova, Xiuhua Gao, Linjie Guo, John Hicks, Gianpietro Dotti, Leonid Metelitsa. Invariant NKT cells as a platform for cancer immunotherapy with chimeric antigen receptors. [abstract]. In: Proceedings of the AACR Special Conference: Tumor Immunology and Immunotherapy: A New Chapter; December 1-4, 2014; Orlando, FL. Philadelphia (PA): AACR; Cancer Immunol Res 2015;3(10 Suppl):Abstract nr B08.


Using newly available workstation technology, a clinical workstation has been developed that manages the flow of medical information from many sources. A consequence of this technology has been the development of a hybrid, medical information architecture that complements the distributed nature of electronic information in most large medical institutions. This hybrid information architecture emphasizes the use of the relational database paradigm for management, accounting, quality assurance, and epidemiology, but incorporates the hierarchical database paradigm into the medical record itself. By incorpora:ing the hierarchical database paradigm into the medical record, speed of access to a single patient's information is increased, network traffic is reduced, and portability of the medical record is enhanced without losing the flexibility of the relational database del.


Objectives: Antibacterial substances added to different toothpastes that are presented to the market with the claim of showing antibacterial effect are aimed at preventing periodontal diseases and tooth decay by controlling pathogen formation in the bacterial plaque. The aim of this in vitro study is to evaluate toothpastes with different contents for their antimicrobial activity against Streptococcus Mutans.


Background Greater knowledge of the behavior of rheumatoid arthritis in his response to biological therapy and the need to improve the resource efficiency of national health systems has led in recent years to implement optimization strategies with the treatments most overburdened financially to social security systems. Objectives The aim of this study is to describe what the status of such optimization and clinical conditions that takes place in a hospital serving the healthcare demands of nearly one million inhabitants. Methods All patients with a diagnosis of RA (ACR/EULAR 2010), served in the Clinical Management HUVR in Seville, during the period January 2008 to May 2014 and received at least one dose of etanercept with indication sheet in Spain. Design: Observational, longitudinal, retrospective and analytical study. Patients and methods: Five rheumatologists, after defining the project and the variables to obtain reviewed the medical records of patients and collected them in a database designed exprofeso sociodemographic variables, RA and clinics. As part of clinical management, to achieve remission defined as =1 =1 and swollen joint painful joint sustained for at least two consecutive visits, was decided to reduce the biological dose. Statistical analysis: descriptive, univariate tests according to the distribution of variables an Results Results: 130 patients were included, excluded 4 (3%) by incomplete data for analysis. The median age (p25-p75) of the 126 (97%) patients was 55.9 (47-65), 79% female, 72% FR +, 49% received etanercept as first biological and the rest as second or third 44% were treated with concomitant MTX and 28% with low doses of corticosteroids. The duration of RA was 10.9 (6.9 to 20) years. Remission was found and it was possible to reduce the dose of etanercept in 92 (73%) cases. Of these, only 1 (0.8) discontinued treatment due to persistence of remission and the majority (48%) received doses of 25 mg of etanercept every 7 days. The main characteristics of the two groups of patients are shown in the table. In multivariate analysis that shorter duration of RA greater chance of remission (OR 0.98 95% CI 0.97 to 1.001) and smoking as a factor of no remission (OR 2.54 95% CI 1,1 5 found, 8), but the predictive capabilities of the models were low (11%). Conclusion: In patients with RA treated in routine clinical practice and appropriate response to etanercept, remission is possible and reduces the dose of biological two-thirds of patients with RA, although the definitive discontinuation is rare. In multivariate analysis that shorter duration of RA greater chance of remission (OR 0.98 95% CI 0.97 to 1.001) and smoking as a factor of no remission (OR 2.54 95% CI 1,1 5 found, 8), but the predictive capabilities of the models were low (11%). Conclusions In patients with RA treated in routine clinical practice and appropriate response to etanercept, remission is possible and reduces the dose of biological two-thirds of patients with RA, although the definitive discontinuation is rare. Disclosure of Interest None declared


Higher education programs need to be evaluated and reviewed quantitatively and qualitatively. The sensitivity and importance of the role of graduate nursing and midwifery graduates of the researcher has been to review the present review with the aim of identifying the problems in this field in view of achieving the high goals in this regard. In this overview, internal and external databases such as pubmed, scopus, SID, magiran, SCI, medlib were used to access internal resources. Published articles were searched and data were analyzed using meta-analyzing method. In the initial search with the keywords of nursing and midwifery, higher education in nursing and meta-analysis and their equivalent in English, a total of 135 studies were found. In the final review, titles and. abstracts were 13 articles related to the main subject of this study and were selected for review. The findings were discussed in terms of syllabus related to the curriculum, faculty, students and faculty politics. Knowledge of nursing and midwifery graduates in need of review and reform based on the needs of the community. This requires the underlying pathology of course, examine gaps and needs in the health system, given the problems of clinical and health care system of the country.


One source of clutter for active sonar in shallow water is backscatter from the rough ocean bottom. Backscatter may often be dominated by Bragg scale roughness. Bathymetry measurements are not generally made at sufficient resolution to determine the Bragg scale roughness distribution directly. We examine the distribution of ocean bottom slopes and determine power law relationships. These relationships can be used to define fractals which allow extrapolations of bathymetry to finer scale. The fine‐scale bathymetry is then related to the distributions of sonar clutter. The generalized gamma distribution is particularly useful to describe clutter. The upper tail of this distribution approaches a power law related to the power laws in the bathymetry. [This work is sponsored by the Office of Naval Research (ONR).]


Abstract : This report presents and analyzes a solid-state device concept for compact, dc-driven, room-temperature generation of coherent THz radiation. The advent of low-dimensional high-electron-mobility devices (HEMT) suggests that a micro-scale, solid-state analog of vacuum tube electron-beam microwave sources may be feasible.


Numerous studies on marine parasites are devoted to surveys,
used of parasites as biological tags (MacKenzie 2002) and
parasite community ecology (Holmes 1990, Rohde et al. 1995,
1998). Very few papers are directly concerned with population
dynamics (Lo et al. 1998) and hence metapopulation theory. In
this section theoretical arguments are summarised that
emphasise that parasites of marine fish do show dynamic
behaviour that should be analysed in the framework of
metapopulation theory. The patterns of distribution and
abundance of fish parasites (at least ectoparasites) are
explained by epidemiological and statistical models in
accordance to the theory. The most important point is the lack
of interaction between ectoparasite species exploiting the same
patchy resource (i.e. the fish host). Patterns of
epidemiological and community structure suggest that each
metapopulation of parasite behaves independently. This point is
also in accordance with the theoretical prediction of Dobson
and Roberts (1994) who concluded that interactions between
parasites and their hosts are more important in determining
community structure than direct interactions between parasite
species. Hence, spatial aggregation, and demographic
characteristics of both host and parasite are the crucial
mechanisms permitting increases in diversity in parasite
communities. However, several questions remain unresolved,
mostly because of the lack of long-term studies of fish
parasite population dynamics. The most crucial question is
linked to the habitat specificity both at the level of the
whole resource (i.e. the host species) and at the level of the
microhabitat within a local patch (i.e. individual host). For
example, species coexistence of congeneric monogeneans is
generally explained by pre-reproductive isolation in order to
prevent hybridisation (Rohde and Hobbs 1986, Simkova et al.
2002b). This necessitates the use of genetics for the analyses
of metapopulation biology among and within host species, which
would help to demonstrate the very necessary point that
extinction and recolonisation of populations may occur, leading
to a better understanding of how parasite communities are
established.


An unusual occurrence of a hexanchid shark, Notidanodon, was discovered below a skeleton of Mosasaurus missouriensis along the shores of the Missouri River in central South Dakota. Both vertebrate fossils were derived from the lower DeGrey Formation of the Pierre Shale Group above the Crow Creek Member. The shark tooth was found slightly below the skeleton and so cannot be considered directly associated with the mosasaur; however, hexanchid shark teeth have been found associated with marine reptiles elsewhere. Therefore, the tooth may have been shed during scavenging of the mosasaur carcass. The tooth represents a rare occurrence of a cow shark from the Cretaceous portion of the North American Western Interior Seaway. Because hexanchids normally prefer deeper water, the occurrence is somewhat surprising in the middle of the former seaway in the shallow marine waters of the DeGrey Formation, although hexanchids are known to range into shallower waters.


This paper describes the authors' initial investigation into on-line trajectory planning for autonomous robotic excavation. A dynamic model for arm/environment interaction is proposed. Excavation trajectories are generated using a trapezoidal velocity profile under the maximum force/torque constraints. A scheme for real-time identification of dynamic arm/environment interaction parameters is implemented with a first-order algorithm of Saridis-Stein stochastic approximation. The result of a simulation study is presented to illustrate the proposed trajectory planning approach.<<ETX>>


This article estimates several integral inequalities involving (h−m)-convexity via the quantum calculus, through which Important integral inequalities including Simpson-like, midpoint-like, averaged midpoint-trapezoid-like and trapezoid-like are extended. We generalized some quantum integral inequalities for q-differentiable (h−m)-convexity. Our results could serve as the refinement and the unification of some classical results existing in the literature by taking the limit q→1−.


The Southeast portion of the Sul-Rio-Grandense Shield is a large area that, although some published works and geological maps, little has been detailed. Several areas require detailed studies, since some units are less than a kilometer long. In this context, the Septos do Embasamento unit occurs as old remnants in the Pinheiro Machado Granite-Gneissic Complex, composed by the metamafic and metaultramafic studied rocks, western of Arroio Grande city, RS. Three previous studies in detail and semi-detail scale were conducted in the region that covers the studied area, but none of them refers to the metamafic-metaultramafic rocks studied in this project. Through petrographic and petrological investigations performed in this work using optical microscopy, scanning electron microscopy and X-ray diffraction, in both units the epidote amphibolite facies paragenesis were found, represented by metamafic ortho-amphibolite rocks composed mainly of hornblende, plagioclase and epidote, as well as metaultramafic rocks represented by peridotites, showing chromite and relicts of olivine with the predominance of secondary minerals such as serpentine and talc. This association of rocks is adjacent to an elongated granitic body called Figueirinha Granite, possibly the responsible for the formation of hydrothermalites found in the region (muscovitites and tourmalinites) and also the responsible for the epidote-amphibolite facies metasomatism of ultramafic bodies with generation of steatites, tremolitites and chloritites. In addition, the studied rocks are inserted in a ductile shear zone of E-W and NE-SW preferential directions known as Arroio Grande Shear Zone, responsible for the formation of mylonites and intense alteration in the lithologies found in this area. The Arroio Grande metamafic-metaultramafic rocks were interpreted as ophiolites, fragments of an ancient obducted ocean floor interspersed with crustal rocks in the closure event of a paleo-ocean by the collision between Kalahari and Rio de La Plata Cratons. These events in the Dom Feliciano Belt represent the final stages of the Gondwana paleocontinent amalgamation, in the Neoproterozoic.


The upcoming E12-14-009 [1] experiment at Jefferson Lab will determine the ratio of the electric form factors for the A=3 mirror nuclei 3 He and 3 H. The measurement will use a 1.1 GeV electron beam, a special collimator plate to allow for simultaneous optics measurements, and the low-activity tritium target being prepared for Jefferson Lab. By observing the dependence of the form factor ratio as a function of Q 2 over 0.05–0.09 GeV2 , the dependence of the radii extraction on the shape of the form factors is minimized. As a result, we anticipate the uncertainty of the extracted charge radii difference to be 0.03 fm, a reduction of 70% from the current measurement. Using precise measurements of the 3 He charge radius from isotopic shift or μ He measurements [2–4], we can deduce the absolute 3 H charge radius. The results will provide a direct comparison to recent calculations of the charge radii.


During September (spring) 1984 a medusa bloom of the freshwater jellyfish  Limnocnida tanganyicae  (Gunther, 1893) was observed in Lake Lisikili bordering on the Zambezi River in the eastern Caprivi. All examined medusas were found to be infested by numerous specimens of a previously unknown trichodinid peritrich. A taxonomic description of this new species,  Trichodina zambeziensis  sp.n. is provided.


There is a close relationship between leptin and insulin.Leptin plays an important role in the genesis and development of insulin resistance,and the disorder of its effects contributes to insulin resistance.Leptin regulates many intracellular signaling pathways mediated by insulin and there exists potential for "cross-talk" between intra-cellular signaling in response to these hormones.By improving the peripheral function of leptin,exercise can enhance leptin's function in administrating the body mass in the hypothalamus.Leptin and exercise can both stimulate AMP-Activated Protein Kinase (AMPK) activated,increase the amount of AMPK in muscle cells,help lower insulin resistance and enhance the intake of sugar (glucose) by muscle.


Objective To observe the effect of pure puerarin and pueraria crude extract on H446 cell proliferation, and explore its mechanism. Methods H446 cells grew in different concentrations of SP and CP, cell growth inhibition was detected by MTT assay.Cell cycle and apoptosis were detected by flow cytometry.Bcl-2 and Bax protein were detected by immunohistochemistry. Results The CP for 72 h 50% inhibitory concentration (IC50) was 435 μg/ml, for SP was 1 403 μg/ml、 435 μg/ml on H446 for 72 h,the apoptosis rate induced by CP and SP were respectively 14.71% and 2.61%, the percentages of G0/G1 phase cell numbers were respectively 79.20% and 72.20%, those of G2/M phase were respectively 8.94% and 10.50%, there was significant difference compared with control group(P0.05). Compared with the control group the Bcl-2 protein expression was lower, Bax expression is increased, P0.05. The expression proportion of Bax/Bcl-2 was higher than control group. Conclusions SP and CP inhibit H446 tumor cell proliferation. SP and CP can induce apoptosis, which may be related to block the cell cycle in the G0/G1 phase, up Bax Expression, lower Bcl-2 expression.


There is a difficult technology problem of high-pressure differential multi-layer separate injection, which had given birth to after using the technology of water injection in the process of oil extraction, the electrical control type water distributor has been designed for the solving of this difficult technology problem. The dynamic characteristics for the executive body of electrical control water type distributor had been studied based on the technology of virtual prototyping and the theories of multi-rigid-body kinematics and modal analysis. The three-dimensional model and dynamics model had been established firstly using UG software, then the kinematics analysis and modal analysis of its key components had been simulated using ADAMS software, its kinematics discipline and natural frequencies and vibration modes have been simulated at last. Therefore, the simulation results provide theory data for its structural optimization design.


Abstract : For 1971 and 1972, 202 distinct, energetic particle enhancements have been identified. Solar and geomagnetic circumstances prior to each of these proton increases have been evaluated. For 93 of the particle enhancements, confident flare or geomagnetic associations could be established. These events included 27 relatively high energy (19-80 or 60 MEV or PCA) proton enhancements. An additional 17 high energy increases were observed, but assured solar or geomagnetic associations could not be established. Tabulations have been prepared of solar and geomagnetic circumstances prior to all events with assured flare or geomagnetic associations and/or high energy proton detection. The tabulations of this report provide solar and geomagnetic data for approximately 50% of the identified energetic particle events in 1971 and 1972. The remaining events included only those with lower particle energies and the less confident solar or geophysical associations. (Author)


Background: Medication management is a complex process which involves different phases including prescribing, transcribing, ordering, dispensing, supplying, administering, and storing. This study aimed to assess the medication adherence and its barriers among the residents in long-term care facilities to identify residents who are at risk for medication-related problem and resident`s beliefs toward medication. Methods: A prospective cross-sectional study was conducted in 24 long-term care facilities in Malaysia. The Chi-square test was performed to see any association between the adherence level and medication beliefs. Results: A total number of 185 residents were interviewed and majority of the residents were identified as highly adherent to their medication. There was a significant association found between duration of disease and medication adherence (P = 0.002). With regards to their belief toward medication, most of the residents had weak necessity scores (mean = 16.85, standard deviation [SD] = ±3.41) and strong concern scores (mean = 13.91. SD = ±2.684). There was a significant association between medication beliefs and medication adherence (P = 0.007), and a high number of residents were identified as at high risk for medication-related problems. Conclusion: Residents′ risk for medication-related problems and their overall well-being should be emphasized and related actions should be taken to rectify the problems.


In Reply.— Drs Rosenstein and Langbaum raise an extremely important and valid issue regarding the implementation of newborn screening procedures without prior evaluation of test sensitivity, specificity, and availability of effective therapeutic interventions. In our article entitled "Genetic Services in the United States: 1979-1980" (1982;248:1733), we were not advocating at present the screening of newborns for CF, but we were using this disease as an example of one for which new technological development could increase the need for genetic services during pregnancy or shortly after delivery. New screening technologies should be evaluated not only before routine screening programs are established in a population, but also periodically after they have been in use. The necessity of ongoing evaluation has been illustrated recently with phenylketonuria screening programs. Issues such as timing of specimen collection, biologic variability, and necessity of routine follow-up screening are currently being addressed—almost 20 years after screening was instituted


Road scene understanding is one of the important modules in the field of autonomous driving. It can provide more information about roads and play an important role in building high-precision maps and real-time planning. Among them, semantic segmentation can assign category information to each pixel of image, which is the most commonly used method in automatic driving scene understanding. However, most commonly used semantic segmentation algorithms cannot achieve a good balance between speed and precision. In this paper, a road scene segmentation model based on dilated convolutional neural network is constructed. The model consists of a front-end module and a context module. The front-end module is an improved structure of VGG-16 fused dilated convolution, and the context module is a cascade of dilated convolution layers with different expansion coefficients, which is trained by a two-stage training method. The network proposed in this paper can run in real time and ensure the accuracy to meet the requirements of practical applications, and has been verified and analyzed on Cityscapes data set.


The widespread use of a local variety of English, Singapore Colloquial English, or Singlish, has become somewhat of a controversial issue in Singapore especially in the eyes of the Singapore government. For example, in 2002 the Singapore government launched The 'Speak Good English Movement' (SGEM) with the objective of promoting the use of Standard English among Singaporeans. Furthermore, Singapore's newspapers have recently suggested that the responsibility for halting the deterioration (perceived or real) of the standards of English rests with Singapore's English language teachers. The case study presented in this paper offers one lens from which to view a policy-to-practice connection by outlining the impact of language policy on the beliefs and classroom practices of three primary school teachers concerning the use of Singlish in their classrooms. The results confirm those of previous studies that teachers' reactions to language policy is not a straightforward process and as such it is important to understand the role teachers play in the enactment of language policy.


Both visible and inferred, these curatorial hands and fingers serve to connect the audience to the object in a more haptic and engaged manner that is currently possible via a digital manuscript viewer. The manuscripts are no longer disembodied by the digital skin they wear but are enlivened by the hands that manipulate them for the Instagram audience. By using theorizations of the aura of the original object/image by Barthes,36 the reproduction of the object by Benjamin,37 and the sensory connections between object and audience by Brollo38 respectively, I here argue that Instagram provides users with a digital "hands-on" experience of medieval manuscripts, one that offers a significantly different encounter and experience than that of a digital manuscript viewer or in a traditional physical exhibition. Just as Kim argues the medieval manuscript is better understood as a mise-en-système than a mise-en-page —that is, a site of interaction, recreation, and reinterpretation—so we might better understand the digital manuscript presented via Instagram, as a site for engagement, exploration and, crucially, touch . 39 Thus, though the platform has visual content at its focus, its communicative offerings are not simply ocularcentric; it is digitally haptic.


After the embankmentis reinforced,the seepage controlwalls are builtin it.The seepage field is necessary to be calculated in order to study whether the seepage control wall will lead to the change of the groundwater and the influence on people's life.The impact of setting the impervious body in the embankmenton the seepage field of the flood storage polders is calculated and analyzed by using 3-D seepage FEM. Firstly, based on the analysis of regional geological structure and hydrogeology conditions, a finite element model is created, and the calculation scheme is determined. Then, the regional seepage field sunder see page control measures and without prevention facilities are calculated separately in connection with the flood period, normal period and dry season.On this basis, the seepage field and seepage flow changes are compared and analyzed.Finally,The conclusions are obtained asfollows:In addition to the local positions of the embankment, the seepage control facilities have little impact on the groundwater distribution in the embankment; In the flood period,the impervious body hasobviou seffecton disaster preventing;In the normal period,the wate rlevel outside the lake drops,whenwater is needed inside the embankment, the influence of impervious body on the seepage flow inside the embankment is decreased.When falling to a certain level, the effect is disappeared. In the dry season, the impervious body has the benefits to inhibit the leakage inside the embankment.


Forms and Concepts is the first comprehensive study of the central role of concepts and concept acquisition in the Platonic tradition. It sets up a stimulating dialogue between Plato s innatist approach and Aristotle s much more empirical response. The primary aim is to analyze and assess the strategies with which Platonists responded to Aristotle s (and Alexander of Aphrodisias ) rival theory. The monograph culminates in a careful reconstruction of the elaborate attempt undertaken by the Neoplatonist Proclus (6th century AD) to devise a systematic Platonic theory of concept acquisition.


ABSTRACT : The title The Analysis of Main Character in the Novel Problem at Pollensa Bay by Agatha Christie by using Humanistic Approach is given because of interest to the story itself. This interest stimulates the writer to explore the main character of story, and also the role of the main character to setting and to plot of the story. In order to analyze a characters personality, the reader needs to understand the technique of characterization, which is the process by which an author creates a character. This approach can create the characteristic of dialog, action, and description. I choose novel Problem at Pollensa Bay by Agatha Christie because the writer is interested in one of the inside this novel which is Hercule Poirot. Hercule Poirot is private detective who is very clever, smart, and passionate to investigate crimes . In this novel, Hercule Poirot plays two different kinds of stories. The are The Second Gong and Yellow Iris. In The Second Gong Hercule also play as a private detective. He handle the crimes of Lytcham Close. Lytcham Close is the well known owner of the old house in England. He was killed by his secretary, named Geoffrey Keene just because of money. And in the Yellow Iris He solves the case of a woman named Iris, a wife of Barton Russell who died because her husband put some cyanide inside her alcohol drink. Just because of Legacy. In this research the writer uses the Humanistic Approach and the writer will connect it to the psychology because this novel is about a private detective who is clever, smart, and very passionate and very sympathetic with his clients without payment at all. With this characteristic, so the writer uses the Humanistic Approach. I hope this research will be useful for the readers and the reader can take many messages from it. Because every person can do something bad because of money or treasure, and this evil deed can then kill him or her


This study examines parametric modeling of NIR reflectivity spectra for dyed fabrics, which provides for both their inverse and direct modeling. The dye considered for prototype analysis is triarylamine dye. The fabrics considered are camouflage textiles characterized by color variations. The results of this study provide validation of the constructed parametric models, within reasonable error tolerances for practical applications, including NIR spectral characteristics in camouflage textiles, for purposes of simulating NIR spectra corresponding to various dye concentrations in host fabrics, and potentially to mixtures of dyes.


This study deals with teachers' questions in promoting students' thinking skill. The objectives of this study were to reveal the types of questions based on taxonomy that teachers used in classroom communicative practices and how the teachers employed strategies to stimulate students' responses towards the teachers' questions. A descriptive qualitative design was used in this study. The data was collected by observing two teachers in two classes of grade twelve. The findings of this study showed that the teachers used all of questions types. The type of teachers' questions which were commonly used by the two teachers is Productive Questions. The cognitive domain which can be achieved from productive categories is creating level. Teacher A mostly used evaluative question. The cognitive domain which can be achieved from evaluative category is evaluating level. While, Teacher B mostly used productive questions. The cognitive domain which can be achieved from productive category is creating level. Furthermore, the less questions appearing is Empirical Question. So, the researcher can conclude that teachers' questions can promote higher order questions instead of lower order questions. In addition, the two teachers used some strategies to stimulate students' responses towards the teachers' questions. Teacher A used rephrasing strategy, simplification strategy, decomposition strategy, and probing strategy, while Teacher B used rephrasing strategy, repetition strategy, and decomposition strategy.Keywords : Teachers Questions, Cognitive Domain, Question Strategy


Here we find large lower bounds for a certain family of algorithms, and prove that such bounds are limited only by natural computability arguments.


It is expected that livestock numbers will have to double in the next 50 years to meet increasing demand for animal protein world-wide. However, if farming practices continue as they are, then environmental impacts from livestock farming on our land, water and air will also double. To avoid the doubling of these environmental impacts, we have 2 main options: we can either modify farming practices to reduce the environmental impacts, or increase the productivity of existing farm animals so that livestock numbers do not need to double. Over my career, I have endeavoured to carve out two productive lines of research:1) infectious diseases epidemiology of cattle; and 2) ecosystem health epidemiology, along with the interactions between these two lines. Improving productivity through infectious disease control would have direct economic benefits to farmers, and environmental sustainability would have long-term indirect benefits to farmers. This presentation will provide a smattering of some of the research projects that I have been involved in across Canada and in Kenya in these 2 lines of research.


An engine and a method of adjusting the compression pressure inside the cylinder of the engine, which regulates pressure in the cylinder of the engine based on the power requirements. Changing the compression ratio of the cylinder is adjusted by using the adjusting means (19). Adjusting means (19) the lifting piston (1) to a desired distance from the combustion chamber at a position from the head is changed to the connecting rod (2) by the adjusting wheel (4) the eccentric (3). Adjusting means for measuring the volume of air entering the cylinder and the compression ratio is adjusted appropriately. Speed adjustment means are also contemplated to increase or decrease the compression pressure as appropriate.


The invention relates to grinding wheels and other abrasive products bonded with phenolic resin. One object of the invention is to provide phenolic resin bonded grinding wheels of greater strength. An other object of the invention is to provide phenolic resin bonded grinding wheels of greater strength when sub jected to moisture. Another object of the invention is to provide organic bonded grinding wheels which are more durable, having slower rate of wear in grinding and at the same time maintaining their good cutting action. Another object of the invention is to provide phenolic resin bonded grinding wheels which are resistant to de terioration by water. Another object of the invention is to provide phenolic resin bonded grinding wheels which are resistant to deterioration by coolants and grinding fluids. Another object of the invention is to provide phenolic resin bonded grinding wheels which are more stable and less affected by changes in atmospheric conditions. An other object of the invention is to provide phenolic resin bonded grinding wheels which are resistant to deteriora tion by water, coolants, and other grinding fluids thereby providing phenolic resin wheels whose performance will remain unchanged throughout the useful life of the wheel. Another object is to provide wheels capable of being operated with greater safety against breakage, partic ularly in the wet condition. Another object is to provide wheels which are operable at higher speeds giving faster rates of stock removal with equal or better safety, partic ularly in the wet condition. Another object is to obtain greater strength of adhe sion between phenolic resin and abrasive grains in abra sive products particularly in the wet condition. Another object is to provide phenolic resin bonded grinding wheels , which perform uniformly from one wheel to another, and from one batch of wheels to another batch of wheels. Other objects will be in part obvious or in part point ed out hereinafter. In accordance with the invention, we coat abrasive with silane or hydrolyzed silane so as to deposit a uniform coating on the surface of all grains and then allow the silane or hydrolyzed silane to further react to form silox anes. We, then make grinding wheels and other bond ed abrasive products therefrom using phenolic resin bond ing material. Such wheels show far greater resistance to deterioration by water than do phenolic resin bond led grinding wheels heretofore known. In this invention the silane is defined as


Introduction: Type 2 diabetes mellitus is a major public health problem worldwide and accompanied by
enduring vascular complications, which leads to morbidity and mortality. Inflammation play major role in
the pathogenesis of type 2 diabetes mellitus. High sensitivity C-reactive protein is an acute phase protein
synthesized by the liver and has been revealed as sensitive, systemic inflammatory marker. Oxidative
stress, low grade systemic inflammation contributes to insulin resistance and is linked to the characteristics
of metabolic syndrome and type 2 diabetes mellitus.
Objectives: The present study was to evaluate hs - CRP, malondialdehyde (MDA) levels in type 2 diabetic
patients compare with healthy controls and correlate these levels with glycated hemoglobin (HbA1C) and
insulin resistance
Materials and Methods: Fifty type 2 diabetic patients with age group of 35 to 45 years were selected for
this study and 50 age matched healthy subjects were selected as controls. Ser um hs- CRP and insulin was
assessed by ELISA, malondialdehyde (MDA) was assessed by Thiobarbituric Acid Reactive Substances
(TBARS) method and other routine investigations were carried out by standardized protocols with ERBA
EM-360 fully automated analyzer.
Results: The mean serum hs - CRP and MDA levels were significantly increa sed in type 2 diabetic patients
com pared with healthy controls. Hs-CRP and MDA levels w ere shown significant positive correlation
with glyc osylated hemoglobin (HbA1C), insulin resistance, triglycerides and negative correlation with
HDL cholesterol.
Conclusion: Elevated hs - CRP, MDA levels are potentially important diagnostic markers for the
assessment of endothelial dysfunction in type 2 diabetic patients. Tight blood glucose control, regular
monitoring of hs-CRP, MDA levels within normal range might be useful for reduction of vascular
complications in type 2 diabetic patients.

Keywords: Type 2 diabetes mellitus (T2DM), High sensitivity C- reactive protein (hs-CRP),


If your patient is planning a trip
to a foreign country, this practical advice can help her make the visit both safe and enjoyable.