In biomedicine, causal inference often relies on the counterfactual framework, which requires that treatment assignment is independent of the outcome, known as strong ignorability. Observational data typically does not satisfy this assumption, but can be manipulated so that strong ignorability is upheld. One such manipulation is weighting. However, many weighting methods estimates can be unstable. This research proposes a generative adversarial network (GAN)-based model called the Counterfactual χ-GAN (cGAN) to learn stable, feature-balancing weights. cGAN utilizes a unique generator which balances two objective functions; the first encourages coverage over units, and the second identifies the weights and enforces strong ignorability. BACKGROUND. Observational data is a potentially very valuable source from which to generate causal knowledge, but it suffers from complexities such as poor quality, irregular sampling, and biases that undermine its use in causal estimation. (1,2) Methods to correct for these biases would permit for new avenues of causal inquiries to supplement experimentation. The calculation of unbiased causal estimates from this imperfect data source is often framed as the identification of a natural experiment. Natural experiments are a type of observational study in which researchers do not have the ability to assign the treatment, but treatments are nonetheless assigned nearly randomly. This is analogous to enforcing the assumption of strong ignorability, which is often employed under the Rubin model of counterfactual inference. (3) This assumption states a unit's assignment to a treatment is independent of that unit's potential outcomes, and that treatment assignment is, therefore, ignorable. The identification of the natural experiment often focuses on manipulating the non-randomized, observational data such that the assumption of strong ignorability is upheld. Popular manipulations which support counterfactual inference and the approximation of natural experiments include (i) matching, in which treatment units are paired with similar comparator units based on the pre-treatment covariates (3–6); and (ii) weighting, in which units are disproportionally considered so that the weighted expectation of covariates are similar across arms (7–9). Both manipulations result in pseudo-populations in which covariates are equivalent between arms (covariate-balance) and the unconditional form of strong ignorability is upheld. Under a matching procedure, units may go unpaired, which is inefficient and may introduce new bias. (10,11) Weighting is a more efficient method for identifying a natural experiment. However, under many weighting techniques, downstream estimates may be unstable. This research proposes the Counterfactual χ-GAN (cGAN), a variation on a generative adversarial network (GAN) that learns stable covariate-balancing weights for two or more treatment and comparator arms. The neural networks that underlie GANs may be both powerful and flexible enough to balance the rich covariates and relationships that lead to the unconditional form of strong ignorability. We demonstrate the effectiveness of cGAN in achieving covariate balance relative to state-of-the-art methods in simulation, in which the ground truth is known, and with real-world medical data the Observational Health Data Sciences and Informatics (OHDSI) instance of a large, academic medical center THE MODEL. Traditional-GANs simplify the often-troublesome task of modeling a generative distribution by pitting two neural networks – one discriminator and one generator -against each other in a zero-sum game to minimize the objective function of Jensen-Shannon divergence between the training data and the generative distribution. Assuming that units for which strong ignorability is upheld arise from a single generative distribution, we may draw upon the traditional-GAN's training process to model the distribution of strong ignorability (the shared distribution) and – as a byproduct -aid in the learning of covariate-balancing weights to support natural experimentation. Like the traditional-GAN, the cGAN has a generator, which parameterizes the target distribution. However, unlike the traditional-GAN, there is a discriminator for each treatment group, and each treatment group is parameterized by weights. Also unlike the traditional-GAN, our model minimizes the χ-divergence, which we show produces minimal variance importance sampling estimates. The cGAN balances two objective functions; the first identifies a target distribution that minimizes the importance sampling variance and encourages coverage, and the second identifies the importance sampling weights and enforces the unconditional form of strong ignorability. METHODS. To evaluate the cGAN when the ground truth is known, we applied the model on simulated data of two populations. Each population was comprised of two subpopulations. Each subpopulation contained 5 covariates, drawn from a randomly generated multivariate normal distribution with a normal-Wishart prior distribution. Population 1 was composed of 250 samples from both subpopulation A and subpopulation B; and Population 2 was composed of 250 samples from both subpopulation A and subpopulation C. Because our simulation deliberately constructs populations from a shared subpopulation distribution (A); we would expect points generated from this subpopulation to have higher weights, as they should contribute more to the shared distribution, than units from either subpopulation B or subpopulation C. We additionally applied the cGAN to two experiments using real-world clinical data from NewYorkPresbyterian Hospital's OHDSI instance. For both experiments, cohorts of comparator drugs were created using the OHDSI's ATLAS tool. The first experiment compares sitagliptin and glimepiride in elderly patients with Type II Diabetes Mellitus; and the second experiment compares atorvastatin and pravastatin in patients with a history of Acute Coronary Syndromes. We evaluate the ability of the cGAN to improve covariate balance by comparing the Absolute Standardized Difference of Means (ASDM) between the treatment and comparator cohorts under different weighting methods. The ASDM is a popular method of assessing cohort similarity, with a lower metric corresponding to improved covariate balance. The ASDM is presented for (i) the unweighted cohorts, and cohorts weighted according to (ii) the cGAN, (iii) inverse propensity scores (IPW), and (iv) clipped-IPW. RESULTS. Results of the simulation demonstrate that points from the overlapping subpopulation A are both captured by the generator and assigned higher weights. This is confirmed upon an inspection of the average weights of data points per subpopulation. Average weights from Subpopulations 1A and 2A are substantially higher (0.0023 and 0.0023, respectively) than those from Subpopulations 1B and 2C (0.0017 and 0.0017, respectively). Experimentation shows similarly promising results. The sitagliptin versus glimepiride experiment show that the cGAN improved mean ASDM from the unweighted data and outperformed clipped-IPW (unweighted = 0.0949; IPW = 0.0196; Clipped IPW= 0.0600; and cGAN= 0.0334). Similar results are seen in the atorvastatin versus pravastatin trial, (unweighted = 0.1017; IPW = 0.0150; Clipped IPW= 0.0319; and cGAN= 0.0251). In both experiments, IPW weighting only marginally improved covariate balance over cGAN, which may be attributable to nonoptimal parameter tuning in our model. DISCUSSION. These results suggest that cGAN is an effective method of learning covariate balancing weights to support counterfactual inference. The cGAN may provide an alternative means to causal inference from observational data. If all potentially confounding variables are assumed to be observed and included as covariates, the performance of the model suggests that average treatment effects borne from cGAN-weighted cohorts would be less biased than those estimates generated from other weighting methods. The cGAN may, therefore, increase the confidence of claims and permit the identification of effective interventions and improve outcomes. Furthermore, the ability to determine and evaluate causal relationships from observational data may support solutions to many critical issues. Questions of causal inference are broadly applicable to domains in which there is actionable uncertainty, and may therefore benefit a wide audience. This research is enriched by the use of OHDSI tools. Our experimental cohorts are defined using the OHDSI common data model, which will allow other institutions to apply the cGAN experiments presented above to their own data. Collecting results from various institutions will aid in our understanding of the generalizability of causal claims produced by cGAN.


According to one embodiment, a radio frequency (RF) circuit comprises a plurality of series-connected RF switch cells which have a load path and a control node and a control node coupled to the switch driver. The plurality of series-connected RF switch cells each comprising a switching transistor and a gate resistor having a having a gate of the switching transistor and a first end coupled to the control node coupled to second end. The switch driver comprises a variable output impedance that varies with a voltage of the control node.


Excerpt Although the induction of acute respiratory failure in patients with chronic obstructive lung disease and CO2retention by morphine or barbituates is well-known, few data are available on th...


A plethora of measurements are available to characterise scoliosis, but a mismatch remains between cosmesis, radiological parameters and patient functional outcomes. Better assessment of cosmesis, through quantitative techniques, may help address this mismatch. We propose a new method of quantifying external scoliotic deformity, by assessing rotation in transverse slices across the length of the torso, using 3D photography.

Patterns of segmental rotations across the spine were seen to be highly individual, and changes were observed after surgery. Along the length of the spine, pre-operatively, the range of rotations within individuals varied from 10.4° (Individual minimum 0.4° to maximum 10.8°) to 21.8° (Individual minimum of -5.2° to maximum of 16.6°). Post-operatively, this decreased, with individual rotational ranges as low as 2.6°, and individual decreases of up to 10.2° in total range. With further development, this technique has the potential to provide a useful quantitative and qualitative tool for assessing external deformity and surgical correction, possibly providing a non-irradiating diagnostic and monitoring tool to augment clinical imaging.


This study examines the process of internationalization of the SME enterprise in the footwear and manufacturing cluster of Bogota. The method used is systematic review of the literature (SRL), which identifies key components, and is now even more necessary given the external dynamics of bilateral and multilateral treaties and agreements. It includes a specific analysis of the sector in Bogota and, through its findings, seeks to reclaim the productive processes and skilled labor force in homogeneous conditions of support.


Full‐length protein disulfide isomerase (UfPDI) cDNA was cloned from the intertidal macroalga Ulva lactuca Linnaeus. Modulation of UfPDI expression by stresses and polyamines (PA) was studied. UfPDI transcription and enzyme activity were increased by hypersalinity (90) or high light illumination (1,200 μmol photons · m−2 · s−1), decreased by the addition of 100 μM CuSO4. An exposure to a salinity of 90 decreased PA contents. Treating with PA biosynthetic inhibitors, D‐arginine (D‐Arg) or α‐methyl ornithine (α‐MO), led to a further decrease and also inhibited UfPDI expression and recovery of the growth rate. These results suggest that PAs are required to activate UfPDI expression with hypersalinity, even PA contents are decreased at a salinity of 90. The induction of UfPDI expression by hypersalinity of 90 and tolerance to hypersalinity could be enhanced if internal PA contents rise. Sung et al. (2011b) showed that PA contents could be increased by pretreating with putrescine (Put, 1 mM), spermidine (Spd, 1 mM), or spermine (Spm, 1 mM) at a salinity of 30. Therefore, PA pretreatment effect on UfPDI expression was examined. Pretreatment with Spd and Spm, but not with Put, enhanced UfPDI expression after transferred to a salinity of 90 and restored the growth rate. In conclusion, induction of UfPDI expression by Spd or Spm before exposure to hypersaline conditions and continuous up‐regulation after hypersalinity exposure are required for the acquisition of hypersalinity tolerance in the intertidal green macroalga U. lactuca.


Carinosella gen. n. is described (by monotypy) from Maasai land in Africa with one new species Carinosella maasaiorum sp. n. The genus belongs to stridulating eurychoroid Adelostomini and is related to the genus Symphochora Koch, 1952. (© 2010 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim)


A pediatric and an adult database, with 550 and 443 samples respectively, are used to test the efficiency of the AED analysis algorithm originally developed for adult rhythms. Statistical analysis of the four significant parameters that define the shock-noshock classification algorithm has been performed. Following parameters are considered: Pulse Rate (PR), Waveform Power Ratio (WPR), and two morphological parameters, Baseline Content (BC) and Probability Distribution Width (PDW). The specificity of the classification algorithm is measured and compared to the AHA goals. The result for pediatric Sinus Normal rhythms is 100% specificity, and 78.95% for other nonshockable rhythms. The likelihood of an AED to inappropriately shock pediatric rhythms is thus analyzed.


Background The risk of thromboembolism and bleeding before initiation of oral anticoagulant (OAC) in atrial fibrillation patients is estimated by CHA2DS2-VASc and HAS-BLED scoring system, respectively. Patients' socioeconomic status (SES) could influence these risks, but its impact on the two risk scores' predictive performance with respect to clinical events remains unknown. Our objective was to determine if patient SES defined by area deprivation index (ADI), in conjunction with CHA2DS2-VASc and HAS-BLED scores, could guide oral anticoagulation therapy. Methods and findings The study cohort included newly diagnosed patients with AF who were treated with warfarin. The cohort was stratified by the time in therapeutic range of INR (TTR), ADI, CHA2DS2-VASc, and HAS-BLED risk scores. TTR and ischemic and bleeding events during the first year of therapy were compared across subpopulations. Among 7274 patients, those living in the two most deprived quintiles (ADI ≥60%) had a significantly higher risk of ischemic events and those in the most deprived quintile (ADI≥80%) had a significantly increased risk of bleeding events. ADI significantly improved the predictive performance of CHA2DS2-VASc but not HAS-BLED risk scores. Conclusion ADI can predict increased risk for ischemic and bleeding events in the first year of warfarin therapy in patients with incident AF.


TRIAN PRASTIAWAN,"The Study of Rice on Peatlands in Mulyaguna Village Teluk Gelam District Ogan Komering Ilir Regency" (Guided by SUTARMO ISKANDAR DAN HARNIATUN ISWARINI)
This study aims to find out 1) How agribisuness of rice on peatlands in mulyaguna village,Teluk Gelam District, Ogan Komering Ilir Regency and 2) How much is the income of rice farmers on peatlands in Mulyaguna Village, Teluk Gelam District, Ogan Komering Ilir Regency. This research was conducted in the Village of Mulyaguna, Teluk Gelam District, Ogan Komering Ilir Regency in June to September 2019. The research method use was a case study. The sampling method is simple random sampling, where there are as many as 120 farmers who cultivate rice on peatlands and then take 19% of the populations to be respondents so that respondents are obtained as many as 22 sample farmers. Data collection method use oin this study are observation and interview directly to respondents, in aaddition to be type of data collected are primary data and secondary data. furthemore, data processing and analysis in this research are editing, coding, and tabulating. Analysis of the data used is descriptive qualitative adn qualitative descriptive. Furthemore, to find out how much indcome on rice farming on peatlands in Mulyaguna Village, Teluk Gelam District, Ogan Komering Ilir Regency uses the formula. Based on the result of the study that 1) Agribusiness of rice on peatlands in Mulyaguna Village, Teluk Gelam District, Ogan Komering Ilir Regency consist of production system procurement subsystem, farming subsystem and marketing subsystem. 2) Income obtained by rice farmers in the peatlands in Mulyaguna Village, Teluk Gelam District, Ogan Komering Ilir Regency is with an average harvest of unhusked rice production of 1602 Kg/Mt and rice rice produced an average of 651Kg/Mt with an average revenue obtained of Rp 3.638.345 Lg/Mt an average production cost of Rp 1.285.106 Lg/Mt, so as to get income from rice farming on peatlands an average of Rp 2.353.239 Lg/Mt.


ABSTRACT The gut contents analysis of obscure puffer (Takifugu obscurus) and ocellated puffer (T. ocellatus) during the spawning migration period revealed that animal material was the main food item and vascular plant material was the secondary. The high rates of non-empty guts during spawning period suggest that spawning migration did not affect the feeding of these two fishes.


The RF cavity is used to establish electrical field for the particle acceleration in the cyclotron,the stability of the RF cavity affects the RF system directly.A RF cavity with high quality can reduce thepower consumption of the RF system and make the cooling system simple.A good design is the first step towards RF cavity with high quality.The installation and commissioning are the next important process to achieve an excellent performance.The height of the


In the given article the three main research approaches to the Informative Regulating Texts in French are described. They are cultural linguistic approach, sociolinguistic approach and functional-pragmatic approach. Special attention is given to the functional-pragmatic approach in which two aspects are identified: the communication oriented aspect providing the description of communicative strategies and tactics of regulation and the textual aspect.


The paper deals with selected topics and problem areas of x-ray tubes, particularly those with rotating anodes, as they relate to CT scanner requirements. Only the main limiting factors will be treated, such as "rotor ripple", heat problems, off-focus x-rays, and high voltage stability. Some basic considerations are given to super large x-ray source assemblies for ultra fast scanners. Because of the extent of x-ray tube physics and engineering, the discussion had to be kept short.


In this paper a number of known limit theorems for the classical allocation problem, including the local limit theorem, are generalized to a family of conditional distributions related to a random equiprobable allocation of particles into cells of two-dimensional tables.


In this paper,we mainly studied the urban logistics real-time distribution system,worked on its optimization,then in the case of Xi'an,proposed the solution of the urban logistics real-time distribution system,and designed the functional modules for the realization of the plan.


Abstract Pseudomonas corrugata Scarlett et al. 1978 is identified as the cause of tomato pith necrosis of glasshouse and field-grown tomato (Lycopersicon lycopersicum (L.) Karst ex Farw.). This is the first record of the pathogen in New Zealand.


This paper proposes a methodology to valuate mental damage in a flood disaster with CVM and covariance structure models. The mental damage which the victims receive in a flood disaster is essentially unobservable. Hence, the set of mental damage are expressed as quantitative variables in the form of structural concepts, which are used as explanatory variables of victims' utility function in order to measure their mental damage. The structural concepts of mental damage are regarded as outputs of the psychological production structure of stresses, which is modeled by a covariance structure model. The applicability of the methodology presented in this paper is investigated by an application example.


Recent developments in surface nuclear magnetic resonance (NMR) data transmit schemes, called steady-state measurements, involve acquisition of the NMR signal during a train of closely spaced identical pulses, and show great promise to enhance the measurement's signal-to-noise ratio. The steady-state signal displays a complex dependence on a range of experimental parameters, such as the strength of the individual pulse and the separation between the pulses, as well as subsurface parameters, including the relaxation times controlling the time-dependence of the NMR signals. It is imperative to understand the role that each of these parameters plays in controlling the depth of origin for steady-state signals so as to enable an optimization of a suite of measurements consisting to the fewest possible measurements delivering satisfactory resolution. A range of synthetic studies are conducted to gain insights into controls on steady-state signals' depths of origin. Relaxation times, duty cycle, pulse train timing are all observed to play strong controls on the signal's depth, in addition to the pulse duration and current strength. Discussion of whether high-duty cycle steady-state sequences may enhance depth penetration is given, along with the presentation of a field data set composed on a non-traditional depth sounding approach, where repetition times are varied to encode depth sensitivity.


In this case study the nature of record keeping for two different kinds of research in Physics, experiment and theory, is used to assess the potential value of keeping electronic instead of paper records. We find that, although there is already a range of positive aspects to electronic record keeping, the software currently available is not yet able to fulfill all of the requirements of a lab book and may be inappropriate in novel working environments. Given the rate at which the relevant hardware and software is developing and the option for researchers to try current note taking software for free, we suggest waiting at least another year and assessing the latest options before investing in support for electronic record keeping.


244 Background: Neoadjuvant cisplatin-based chemotherapy benefits patients with bladder cancer, particularly in the 30% with pathologic complete response (pCR) at cystectomy. Many patients with bladder cancer are not candidates for cisplatin. Taxane-based regimens have activity in urothelial cancer. ABI-007 is an albumin-bound paclitaxel with increased activity and decreased toxicity compared to standard paclitaxel preparations.

METHODS
Eligible pts have T2-4,N0,M0 or Tany,N1- 3,M0 bladder cancer with ECOG PS 0-1, and adequate marrow (granulocyte count > 1,500/mm3, platelet > 100,000/mm3, and hemoglobin > 9.0 g/dl), hepatic (transaminases < 2.5 X upper limit of normal, alkaline phosphatase < 2.5 X upper limit of normal, and bilirubin < 1.5 mg/dl) and renal function (serum creatinine < 2.0 mg/dl and/or creatinine clearance > 40 ml/min). Pts are treated with intravenous ABI-007 260 mg/m2 and carboplatin (target area under the curve=5) on day 1 with gemcitabine 800 mg/m2 on days 1 and 8, followed by radical cystectomy after three cycles of therapy. The primary study endpoint is the proportion of patients with pCR at cystectomy.

RESULTS
27 patients have been enrolled. By clinical staging, 20 had T2 disease, 5 had T3, 2 had T4, and 2 had nodal enlargement. All are evaluable for toxicity with 22 evaluable for response (exclusions-3 for change in dose schedule, 1 each for refusal of cystectomy and withdrawal from study). 25/27 patients received all three cycles (78 total cycles) with doses reduced in 26 cycles for toxicity. All patients had transient grade 3-4 neutropenia and 17 received filgrastim, but only two had febrile neutropenia. Six pts had pCR with an additional 5 having residual carcinoma in situ (CIS) and 1 with T1 disease at cystectomy. 54% of evaluable patients had no muscle invasive disease at cystectomy.

CONCLUSIONS
Neoajuvant ACG is active in bladder cancer with pCR rate nearing 30% and nearly as many patients with CIS but no residual invasive disease. Marrow toxicity is significant but manageable. [Table: see text].


Four phosphatidyl ethanolamine polyphosphates were prepared by polycondensation of β-chloroethyl dichlorophosphate and pentaerythritol di-fatty acid esters in benzene,and then by aminatlon with ammonia. Liposomes were prepared with these amphiphilicpolymers according to REV method. All materials could form large unilamellar vesicles (LUV)detected by polarized optical microscope and electron microscope. Encapsulation efficienciesof liposome (Ⅱa-Ⅱd) to 5-fluorouracil and release rate of liposome were determined.


The present study looks at the problems involved in preparing a programme of
martial arts training for blind and partially sighted people and represents part
of a project carried out by the Partnership for Improving Access to the Labour
Market for the Blind, whose activities are carried out within the framework of
Theme A: "Facilitating access and return to the labour market for those who have
difficulty in being integrated or reintegrated into a labour market which must
be open to all". Theme A is part of the EQUAL Community Initiative Programme
for Poland 2004-2006, an operational programme co-financed by the European
Social Fund. The project is administered by the Foundation Institute for Regional
Development in Krakow. The martial arts programme was devised by Andrzej
Szuszkiewicz, and the brain child behind the idea was his assistant, Bartlomiej
Maleta.
The aim of the martial arts programme devised under the Partnership project is to
make visually impaired people more active, feel more secure outside the home,
encourage them to overcome their own weaknesses, promote perseverance
and tenacity as well as a sense of order and discipline, learn how to overcome
stress and, as a consequence, achieve self-improvement. These goals, which are
undoubtedly the effects of martial arts training geared towards self-defence,
have helped significantly increase the independence of project participants and
made them more attractive on the employment market..


On the first chapter, antecedents and research important results are presented for an institutional benefit which was analyzed. Besides, this research defined its action guidelines through general and specific objectives, including its justification.
All information about public relationship and corporate image were analyzed on the second chapter. It clearly defines its features and guidelines about communication labor. Besides, it makes a brief review about STAR as an educational institution. It got a wide perspective around a communication plan. Finally, there is a close analysis about public relationship influence over the institutional bachelorship.
The methodological process is represented on the third chapter. There were some tools applied on it such as: surveys and direct observation; all of them were used in order to collect data, to analyze information and then, to get conclusions and recommendations on the fourth chapter.
Finally, a communication plan proposal is presented on the fifth chapter, which aims to satisfy communicational needs at the institution, since finding a disease is not the cure itself, rather it is to find possible solutions. Consequently, that is the worthy value of a social communicator in a society.


To detect infinitesimal amount of microbubbles is becoming more important with development of functional microbubbles and nanobubbles. Microbubbles modified with targeting ligands have a potential in early diagnosis by ultrasound because the targeted-bubble has both a selective property for accumulation in diseased area and a high degree of echogenicity[1]. And the in vivo bubble cavitation application, such as sonoporation and drug delivery, is a promising method with combination of targeting microbubbles[2]. However, conventional ultrasonic imaging methods, such as Bmode and ultrasound color Doppler method, need a large amount of contrast agents for imaging because they do not have enough sensitivity for microbubbles when only very small amount of microbubbles exists in ROI. In order to detect infinitesimal amount of microbubbles, we proposed a novel visualization of bubble cavitation signal (BCS) induced by high intensity US irradiation. In this method, high intensity US (h-US) is irradiated to microbubble with a fixed time delay after introducing an imaging US (i-US) and BCS is detected by power Doppler imaging unit.


The major aim of the current investigations is to study the magnetohydrodynamic effects on heat and mass transfer phenomena in third-grade fluid past an inclined exponentially stretching sheet fixed in a porous medium with Darcy–Forchheimer law influence. The constitutive equations compatible for heat and mass transportation in third-grade fluid in terms of partial differential equations are modeled. These partial differential equations are then converted to ordinary differential equations by using suitable similarity variables formulation. The transformed flow model is solved by using MATLAB built-in numerical solver bvp4c. Effects of pertinent parameters on physical properties that are velocity field, temperature field and mass concentration along with skin friction coefficient, Nusselt number and Sherwood number are demonstrated in graphs and tables. The impact of dimensionless numbers on the physical properties is analyzed and discussed with a physical view point at angle  α=π/6 (inclined sheet). It is seen that as the third-grade fluid parameter (0.1≤β≤11) is increased, the velocity profile increases, but the temperature field and mass concentration are decreased. It is observed that as the permeability parameter (1≤K*≤11) is raised, the velocity distribution decreases and mass concentration increases. It is concluded from the results that owing to an increase in the local inertial coefficient (0.1≤Fr≤5), the velocity profile reduces but an increment in mass concentration is noted. It is concluded that by increasing values of magnetic field parameter (0.1≤M≤10) the velocity field is delineated and temperature field is elevated exactly according to the physics of magnetic field parameters. The present results are compared with already published results and it is observed that there is good agreement between them. This good agreement ensures the validation of accuracy of the results.


We present a mathematic model for making contact stresses least using boundary element method(BEM) as analysis tools and CVM01 as optimization technique. Then the optimal shape of contact line along tooth width direction is obtained for optimizing the helical gear shape. The results and method may be used in profile modification of involute gear drive.


To address the basic problem of teaching fundamentals of control theory, a one-credit-hour control laboratory is proposed. The three-lecture-hour introductory control course is replaced with a four-hour lecture-lab course. This proposed lab is simple and inexpensive enough that any electrical engineering department with any shrinking budget, with the help of NSF matching fund, can afford to have it. The experiments are designed to make students better engineer practitioners, to convince students that theory indeed makes sense, to finally make control course an interesting subject. The control lab can help to bring examples ranging from bungee jumping to missile tracking in the classroom.


A good reputation is one of the main factors for successful performance, but its implementation is still being questioned in various agencies or organizations in Indonesia. This qualitative study aims to analyze and evaluate the success of the reputation restoration strategy for Mitra Sejati Hospital in Medan after the baby are swapped. This research involved two key informants (public relations and supervisors) who handled the case. The collected data were analyzed using the Miles and Huberman analysis techniques. The results of this study informed that Mitra Sejati Medan Hospital was quite slow in providing an initial response, so that the case was spread through the media. Furthermore, the hospital then used three stages, namely mortification, compensation, and collective action. Following up on the findings in this study, the reputation management of Mitra Sejati Medan Hospital must be further optimized through various training and special learning resources.


In order to improve the accuracy of structured light measurement, this paper proposes a color surface structured light three-dimensional reconstruction method based on DB sequence. In the encoding stage, according to the principle that the greater the Euclidean distance between two points in the RGB space model, the greater the color difference, the color of adjacent stripes in the stripe pattern is constrained; in the decoding stage, in order to eliminate the influence of ambient light on the edge color of the stripes, Based on the threshold method, an improved algorithm is proposed. First, the color of the main area of the stripe is corrected by setting the RGB three-channel threshold. For the point where noise is generated by the crosstalk on the stripe boundary, a single-channel threshold and the other two-channel color are proposed. The method of co-constraining the size of the components. The experimental results show that for the measurement of achromatic objects, this method has high measurement accuracy and can be used for actual measurement.


We examined two Japanese patients with hypochondroplasia (HCH) whether they had mutations in the gene (FGFR3) encoding the fibroblast growth factor receptor 3 using polymerase chain reaction (PCR) coupled with direct sequencing. In both of our patients, a C→A transversion was detected in nucleotide 1659, predicting a substitution of asparagine for lysine at position 540 of the mature protein which corresponds a part of the tyrosine kinase 1 (TK1) domain. Our results suggest that a common mutation specific for HCH in the TK1 domain of FGFR3 exists among Japanese patients with HCH.


A contract between the Federal Republic of Nigeria and petitioner Dutch corporation for the purchase of cement by Nigeria provided that Nigeria was to establish a confirmed letter of credit for the purchase price. Subsequently, petitioner sued respondent bank, an instrumentality of Nigeria, in Federal District Court, alleging that certain actions by respondent constituted an anticipatory breach of the letter of credit. Petitioner alleged jurisdiction under the provision of the Foreign Sovereign Immunities Act of 1976 (Act), 28 U. S. C. § 1330(a), granting federal district courts jurisdiction without regard to the amount in controversy of "any nonjury civil action against a foreign state . . . as to any claim for relief in personam with respect to which the foreign state is not entitled to immunity either under sections 1605-1607 of this title or under any applicable international agreement." The District Court, while holding that the Act permitted actions by foreign plaintiffs, dismissed the action on the ground that none of the exceptions to sovereign immunity specified in the Act applied. The Court of Appeals affirmed but on the ground that the Act exceeded the scope of Art. Ill of the Constitution, which provides, in part, that the judicial power of the United States shall extend to "all Cases arising under [the] Constitution, the Laws of the United States, and Treaties made . . . under their authority," and to "Controversies. . . between a State, or the Citizens thereof, and foreign States, Citizens, or Subjects." The court held that neither the Diversity Clause nor the "Arising Under" Clause of Art. Ill is broad enough to support jurisdiction over actions by foreign plaintiffs against foreign sovereigns.


This article aims to debate some recent questions related to the development of the field of design through the contributions from the social sciences, specailly from a field called Design Anthropology. We'll iniciate the debate with the inflexion that the field of Design made to open up and interact with other scieces, other than exact sciences. Then, we'll clear up some definitions and main questions that are taken within the field of Design Anthropology. Finally, we'll show the developpment of the resarch projetcs that are lead by members of Laboratório de Design e Antropologia (LaDA) from Escola Superior de Desenho Industrial (ESDI) of Universidade Estadual do Rio de Janeiro (UERJ).


Simple Summary Lung cancer is a serious burden worldwide. The growth of lung tumors depends on vessel density and intratumoral copper concentration. Copper chelating agents can reduce copper content in tumor tissue, resulting in lower vessel density and lower tumor weight. PSP-2, a very potent copper chelator, was tested on lung tumor grafts that were on-planted on the chorioallantoic membrane of the chicken embryo. We found a lower vessel density and a lower tumor weight under PSP-2 application compared to the controls. Thus, PSP-2 could be a potential therapeutic agent to treat lung cancer in the future. Abstract Human lung cancer ranks among the most frequently treated cancers worldwide. As copper appears critical to angiogenesis and tumor growth, selective removal of copper represents a promising strategy to restrict tumor growth. To this end, we explored the activity of the novel high-affinity membrane-permeant Cu(I) chelator PSP-2 featuring a low-zeptomolar dissociation constant. Using H460 human lung cancer cells, we generated small tumors on the chorioallantoic membrane of the chicken embryo (CAM assay) and studied the effects of topical PSP-2 application on their weight and vessel density after one week. We observed a significant angiosuppression along with a marked decrease in tumor weight under PSP-2 application compared to controls. Moreover, PSP-2 exposure resulted in lower ki67+ cell numbers at a low dose but increased cell count under a high dose. Moreover, HIF-1α+ cells were significantly reduced with low-dose PSP-2 exposure compared to high-dose and control. The total copper content was considerably lower in PSP-2 treated tumors, although statistically not significant. Altogether, PSP-2 shows promising potential as an anti-cancer drug. Nevertheless, further animal experiments and application to different tumor types are mandatory to support these initial findings, paving the way toward clinical trials.


In the structure design of gear chamber casing,strengthen rigidity and reducing weight were contrary.As an advanced dynamic and optimizing design method,the Finite Element modal analysis could make reasonable mass distribution of structure. In this paper, the modal character for ZH1105 engine casing of gear chamber was analyzed by the Finite Element modal analysis. At first, it introduced the fundamental theory of modal analysis. Secondly, it established 3 dimensional model of casing of gear chamber by I Deas software, and obtained the 10 ranks parameters and model of vibration. It provided the modified scheme for gear chamber design, and compared with the former in model analysis. The result indicated that the modified scheme improves the structure vibration characteristic obviously.


Objective To select the optimal preparation process of optimum the extraction condition of baicalain from Qinguidihuang Oral Liquid. Methods Orthogonal test to determine baicalin content of the study objectives,optimum the extraction of baicalain was selected as the content index.Results Influencing factors :solid-liquid ratio Solution containing methanol Decoction time decoction frequency.The money benefits the best mixture Extraction Process :tenfold increase in the volume of water decoction twice,each 60 minutes,filtration,after adding suitable concentration of ethanol,alcohol made with a capacity of 65% to 70%,placed 24 hours after filtration,recovery of ethanol.Conclusion This optimum preparing procedures are rational and the extraction rate of active compenents is good.


The trend in learning has drastically changed with the advent of information technology and its allied tools. As far as the students are concerned, updating on the latest trends in their domain is essential to have a cutting edge in this ever-changing world. For medical students, this is the need of the hour as they have to deal with challenging situations involving human lives throughout their career. Hence, a deep survey to check the length of usage of ICT skills and its tools by the medical students was conducted. The paper elaborates the types of mobile devices, types of apps, time spent on apps, the commonly used apps to access electronic resources, type of medicalapps and advantages in using these apps by 1150 medical students sampled based on the method of stratified random sampling technique. These sample students belong to 16 medical colleges that have been functioning for at least 25 years in Karnataka. The methodology used was a questionnaire to elicit data from all sample students. Wherever necessary, interview and observation methods also were used. The analysis showed that 'smartphone' is used by the majority of the sample population. Regarding the type of apps used by medical students, it was found that 100% of them use 'Medical-related apps' and among the apps, 'MedCalc' is the most sought-after. 99.4% of the total students sampled opined that they were 'looking for medical information.'


Numerical simulations employing an algebraic volume-of-fluid methodology are used to study the air entrainment characteristics of a water jet plunging into a quiescent water pool at angles ranging from θ = 10° to θ = 90° measured from the horizontal. Our previous study of shallow angled jets [S. S. Deshpande, M. F. Trujillo, X. Wu, and G. L. Chahine, "Computational and experimental characterization of a liquid jet plunging into a quiescent pool at shallow inclination," Int. J. Heat Fluid Flow 34, 1–14 (2012)]10.1016/j.ijheatfluidflow.2012.01.011 revealed the existence of a clearly discernible frequency of ingestion of large air cavities. This is in contrast with chaotic entrainment of small air pockets reported in the literature in case of steeper or vertically plunging jets. In the present work, the differences are addressed by first quantifying the cavity size and entrained air volumes for different impingement angles. The results support the expected trend – reduction in cavity size (D43) as θ is incre...


Sustainability and project managers leadership competencies both are the topics which have been undertaken for research by countless studies and authors. Therefore, this study aims at investigating the effects and consequences of the project sustainability on the construction sector project success through the moderating role of Project managers leadership competencies. Due to the deadly disease - COVID-19, there was no other option to collect the data so the online survey method has been used, from the construction companies having the project-based status throughout in Pakistan having sample size four hundred i.e. n = 327. Moreover "Random Sampling Technique" & "Smartpls version three - 3" was used for the analyzation of our collected data. The overall results showed that the assumptions made are satisfied and the triple bottom-line aspects of sustainability have a major influence over the projects in Pakistan.


In the medium of 0.25 mol/L H2SO4,PO43-reacts with MoO42-to produce phosphomolybdate heteropoly acid,which can combine cationic dye-quinine to form an associated complex.The complex exhibits a sensitive resonance light-scattering(RLS) peak at 398.0 nm.There is good linear relationship between the RLS intensity and the concentration of phosphorous in the range of 1~200 μg/L.The detection limit(3σ) for phosphorous is 0.5 μg/L.Based on this,a new RLS method for determination of micro amounts of phosphorous has been established.The proposed method is convenient,sensitive and selective.


Abstract : The difference frequency generation (DFG) signal from a two electronic level system with vibrational modes coupled to a Brownian oscillator bath was computed. Simulations of two-dimensional DFG signals illustrated how the ground and excited electronic state resonances may be distinguished. Factorial moments of photon counting statistics from a single molecule coupled to a quantum bath were expressed in terms of multipoint quantum correlation functions and represented by double-sided Feynman diagrams. The results of stochastic models of spectral diffusion where the bath dynamics were independent of the state of the system were recovered and the moments described. Closed expressions for tunneling currents in molecular junctions were derived in electron-phonon coupling. The Keldysh-Schwinger formalism was recast in terms of density matrices in Liouville space. The current was related to the decay of coherences in Fock space between many-body molecular states. Effects of hydrogen-bond forming and breaking kinetics on the linear and coherent third-order infrared spectra were described by Markovian fluctuations and simulated using stochastic Liouville equations. Slow and fast frequency fluctuations were distinguished and described. Recursive relations were developed for computing the multipoint correlation functions of a particle undergoing a biased continuous-time random walk (CTRW) in an external potential. Comparison of the CTRW with the Brownian harmonic oscillator model illustrated how higher-order correlation functions may be used to distinguish between dynamical models that have the same two-point correlation function.


Student group is part of the system and its educational psychology should know because every student to adapt to the university teaching career, his professional development as a specialist is in the student group, the value of which is difficult to overestimate. The most important task of improving the work of the curator is to assist students in the organization of such events that would profoundly aware of, understand, feel and absorb the traditions of the Academy, its value orientation, the relationships and norms that traditionally form the basis of relations and interactions in the school and for beyond.


Microstructural and magnetic characterizations of YBa2Cu3O7−δ nanowire fabric-like samples were performed. Fabric-like ceramic superconductors are nanoporous materials and can be applied, e.g., in magnetic shielding, since the porous morphology makes them extremely light-weight and effectively to be cooled. The samples were produced by the solution blow spinning (SBS) technique, starting from a sol-gel solution of the precursor materials in polyvinyl-alcohol. The morphology of the samples was characterized by scanning electron microscopy, transmission electron microscopy, and x-ray diffraction with the aim to analyze the possible current paths. The magnetic hysteresis loops revealed typical polycrystalline behavior, and field-cooling in various small applied fields shows the presence of the paramagnetic Meissner effect (PME), but in a distinctly different way as compared to melt-texured Bi2Sr2CaCu2O8+δ or Nb.


ABSTRACT Eighty four, sunflower hybrids were developed by crossing 14 cytoplasmic male sterile male lines and 6 testers in a line x tester fashion during Spring 2000. The hybrids and parents were evaluated during Spring 2001. Highly significant differences existed among genotypes, parents and parents vs crosses indicating the presence of heterosis for recorded traits. The highest heterosis and heterobeltiosis for days to flower initiation was showed by crosses ORI-6 x RL-69 and ORI-6 x RL-77, respectively in the required direction. The cross combination ORI-20 x RL-77 exhibited maximum increase over mid and better parent for flowering period. The maximum decrease over mid and better parent for days to maturity was showed by the crosses ORI-20 x RL-27 and ORI-6 x RL-46, respectively. The hybrid ORI-20 x RL-77 showed highest positive heterosis and heterobeltiosis values for plant height. The highest positive heterosis over mid and better parent for seed yield was showed by the cross ORI-3 x RL-77.


It is difficult to confine the historiographical world of Le Roy Ladurie in a certain histoiographical trend, because his territory has moved away from the socio-economic history through the anthropological history to the cultural history. We had better understand his historical thinking by way of the conception of the total history. The Peasants of Languedoc, his doctoral thesis, is an adventure of the total history, and his following works are its complement. In other words, his thesis is a seedbed where are sown the anthropological history, the lecture of the history in the literature, and an idea of "the civilizing process" dear to Elias. That is the reason why his historiographical world is esteemed to be "open", and we can consider him as witness of the contemporary historiography. For all the transition, his anthropological or cultural works are not floating, but based on the solid foundation of the socio-economic history and the quantitative history. This fact serves as a lesson. The cultural history and the microhistory which are in vogue actually will give us only a superficial interest unless they are associated with the socio-economic history, the political and institutional history. This kind of history is no other than the "partial" history. But, as Lucien Febvre said, isn't the history in principe the total history? The cultural history or the microhistory which is far from the total history is not qualified to be called as history. Emmanuel Le Roy Ladurie is also an witness of this prosecution.


Speech recognition software technology provides people with limited hand mobility or visual impairments the opportunity to work with computers through an alternative approach. However, when it comes to programming, voice recognition systems leave much to be desired. To tackle this problem, we have developed a generic vocabulary and grammar to help a user to program by voice in any C-based language. With the purpose of validating the aforementioned vocabulary and grammar, receiving feedback from the programming community and determining future features for enhancement, we administered a survey and distributed it among faculty members and advanced computer science and engineering students. Our objective is to create an assistive technology tool that will serve the community with limited hand mobility or visual impairments yet will be accepted and embraced as the spoken programming language and model of choice for implementation.


Opportunistic Network (OppNet) is the next step in the Mobile Ad hoc Networks family with tremendous and updated features that make it second to none in the domain of Network Technology. The main advantage of OppNet is its capability of storing messages to be communicated at intermediate nodes up to the moment of successful communication without any time limit. This quality of OppNet makes it unique among other Network Techniques. From the past few years, it has attracted a huge number of researchers to get involve and innovate it further. it has various applications in real life ranging from smart city to Inter-Planetary Communication. itt has a large number of routing protocols developed by researchers' time-to-time as their research contribution towards shaping OppNet better than its current versions. Many such attempts have been proved as benchmarks globally. Due to this huge popularity and research scope, young researchers are also getting attracted to OppNet, but, there is no such platform that delivers a basic somehow of OppNet to date. To partially fulfill this space, This paper is intended to familiarize basic knowledge of OppNet covering its introduction, applications, routing protocols, Challenges, and future aspects. It is believed that this paper will be beneficial to the novice researchers to gain basic knowledge of OppNet.


Objectives The purpose of this observational cohort study was to observe outcomes in geriatric (aged ≥65 years) and nongeriatric (<65 years) patients after employing a diabetes resource nurse (DRN) case manager in a suburban 12-physician family practice. Study design Data were collected by retrospective chart review of 106 patients enrolled in the diabetes care project who completed at least 6 months of the project between March 1999 and January 2001. Population Patients were recruited by either referral from their primary physician or invitation from the DRN. Outcomes measured Utilizing measures from the American Diabetes Association and the Diabetes Quality Improvement Project, comprehensive protocols were developed for implementation of process measures and management of glucose by the DRN. Active management protocols were not put in place for hypertension, lipids, or depression, but appropriate clinical measures were taken during patient visits. Data were collected at baseline, 6 months, and 12 months. Results Improvements in process measures were seen for geriatric and nongeriatric patients: 77% of patients had foot exams, 100% had ≥2 blood pressure measurements, 92% had eye exams, and 99% had lipid profiles. Both groups had improvement in hemoglobin A1c levels (means 7.2% to 6.6% for geriatric patients and 8.9% to 6.8% for nongeriatric patients). The number of hypoglycemia incidents decreased in both groups. Depression scores improved in the nongeriatric group. Conclusions Results appear to corroborate a growing body of evidence supporting nurse intervention protocols as a way to improve diabetes care. A randomized controlled trial is planned to examine the effectiveness of the DRN.


Many flowers, bred for stunning blossoms and long vase life, have all but lost their scent. Now plant biologists hope to bring back petal perfume by using modern genomics and classic biochemistry to master the molecular details of floral scent.


The paper discusses the definition of the so-called Transitional Generation,its meaning,characteristics and limitations,and analyses the writing styles of its representative poets.


Three-dimensional (3D) geometric reconstruction and characterization of the human body from bidimensional (2D) images has been a major research topic in Computer Vision. However, it is still a complex problem to solve, when automation, speed and precision are required. Volumetric based methods are a recent and successful solution for 3D structures reconstruction from images. In this work, using an uncalibrated turntable image sequence, acquired with a single off-the-shelf CCD camera, a 3D geometric model of the structure in cause is built. Our main goal is the reconstruction of 3D shapes of external anatomical structures from images, with good precision and photorealistic appearance. Teresa C. S. Azevedo, Joao M. R. S. Tavares and Mario A. P. Vaz


An extractor for removing inaccessible broken key portions from keyways of tumbler locks wherein the extractor tool consists of a pair of thin elongated elements capable of being inserted into the lock on opposite sides of the broken key end portion and wherein twisting of the elements grips the broken key end to permit extraction from the lock. Extraction is aided by a pliers-like spreader tool having thin jaws inserted into the lock keyway for retracting lock tumblers, the dust shutter door and buzzer electric switches to prevent such items from interfering with the key extraction.


There are many biochemistry role of nucleotides in animal and human,nucleotides can be de novo synthesis in body.Dietary nucleotides have beneficial effects upon function of immune system,digestive gut growth and development,hepatic function and lipid metabolism in animal.The endogenous nucleotides supply may in sufficient for animal in periods of rapid growth,immune challenge,and certain disease states.Nucleotides and nucleic acid are safe additive,it may be have the effect of increasing growth and improving meat quality in animal.As a new feed additive,it has a good prospect.


In this paper, two NAND-type PHINES flash memory architectures (1 bit/cell and physically 2 bit/cell) are proposed for mass storage applications. PHINES nitride trapping storage flash memory features high storage density, low power operation, good reliability, simple process, and high programming throughput. Fifteen-nm generation is feasible for future flash memory technology


In clause attempt to define a place of region Indochina in geopolitic plans of the USSR and the USA after the termination of the second world war is undertaken, to track process of formation of their geopolitic strategy concerning Southeast Asia. Not entering into sphere of direct interests of the USSR and the USA in second half 40th, индокитайский region, nevertheless, in the beginning of 50th XX century, becomes object of possible expansion of own geopolitic and ideological influence of "superstates" in region.


Solid solutions of CuInSe2-ZnSe have recently shown promising potential as a photovoltaic material. In this work we investigate the CuInSe2-ZnSe and CuGaSe2-ZnSe systems for high Voc photovoltaic applications. It was found that the highest Voc (~740 mV) was achieved when the In/(In+Ga) ratio in the precursor was 0.13, i.e. very Ga-rich composition. Selenization conditions of CuZnGaIn metallic precursors were studied by changing reactive annealing parameters: temperature, dwelling time, temperature ramp and quantity of elemental Se. The optimal selenization parameters obtained in this study were: 550 °C, 30min, 20 °C/min and 50 mg of Se.


Poverty reduction has been a prominent and critical goal of Haiti's main international donors, yet they have directed little economic aid to rural areas where a large segment of Haiti's poor live and work. Instead, donors have focused on re-establishing a vibrant urban-based manufacturing sector. While sidestepping agriculture is not a new trend, this paper argues that the policy set employed by donors since 2004 – a conflict and development approach that stresses vulnerability to crime and political instability – has served to reinforce the country's historical bias against rural development. While the 2010 earthquake has provided the impetus to decentralise economic activity, it is too soon to know if and how the rural poor will benefit, particularly given continued security-related concerns associated with the capital region.


This paper proposes a method of heterogeneous similarity calculations for time series data comparison and its score integration for evaluating semantic similarity of human posture feature between two persons as trainee and trainer. In this method, a set of posture feature data obtained from videos of body motion of a person with superior posture and a person who want to have superior posture are used as input data. The similarity degrees between the data are calculated by multiple calculation methods using the shape and the frequency features as waves on the time-series data. A superior body motion is defined as a suitable posture from the viewpoints of mechanics, work efficiency, and aesthetics. The posture feature data consists of coordinate information of joints extracted using MediaPipe [1]. DTW (Dynamic Time Warping) [4], [5] to compare the shape feature and FFT (Fast Fourier Transform) [6] to compare the frequency feature are adopted in this time. In addition, the scores of two or more similarity measures are integrated after normalization. In the experiments, we confirmed the effectiveness and feasibility of the proposed method on flexion and extension exercises. As an application of the proposed method, we assume to be personal training at home or in the office in order to realize healthy society.


In this paper we introduced a new method to optimally select the time window for a single-trial classification problem in BCI system. As a hybrid-BCI, we combine EEG and NIRS signals to improve the performance of BCI system. Since there's a coupled relationship between EEG and NIRS, we try to define the activation state of subject's brain according to the changes of hemoglobin. We therefore defined the maximum point of HbO changes to be the time when the brain was fully activated. Then we chose the EEG data according to this critical time point with a 3 s window, which is almost within 6-9s according to the NIRS signal. With this selected time window, there is a significantly improvement of decoding accuracy from 69% to 79% compared to the original time window (1-12 s).


Background and Objective: Synergistic combinations of antimicrobial agents with different mechanisms of action are successful approaches for combating bacterial infections. This study aimed to evaluate the synergistic effect of 1-methyl ester-nigericin (1) and methyl 5-(hydroxymethyl) furan-2-carboxylate (2) against Proteus spp., isolates. Materials and Methods: The synergistic antimicrobial activity of the compounds was tested by the checkerboard method and time-kill curves. To estimate the interaction between the compounds, the Fractional Inhibitory Concentration Index (FICI) of the combination was calculated. The cytotoxic activity of the compounds in combination was determined by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay on LLC-MK2 cell lines. The reduction percentage of biofilms was obtained using the colourimetric method. Results: The MIC values for compounds 1 and 2 against test bacteria ranged from 39.06-78.12 μg mL1 and from 78.12-156.25 μg mL1, respectively. The MIC was reduced to 1-8th as a result of the combination of compounds 1 and 2. After 4-24 hrs of treatment with ½ MIC of compounds 1 and 2, the killing rate (in CFU mL1) increased to a greater degree than observed with either test compound alone. The combination of compounds 1 and 2 showed a synergistic effect with FICI of 0.50 and 0.28. The synergistic combination of compounds 1 and 2 was effective on the biofilm reduction of Proteus vulgaris NP16 (85.72%) and NP47 (89.14%). Conclusion: This study recommends compounds 1 and 2 in combination as a potential alternative treatment agent for Proteus spp. infections.


To observe the clinical efficacy of "Liver-Clearing Granule" in the treatment of chronic hepatitis C,127 cases in treatment group were treated by the Granule and another 40 cases in control group were treated by interferon,with six-month course and one-year survey.Results:After six-month treatment in treatment group,most symptoms disappeared and the score of symptoms fell obviously;the restoration rates of ALT and AST were 60% and 52.9% respectively;the contents of ALT and AST dropped and decreased with treatment time;no relapse happened.The survey one year after final treatment showed that the restoration rate of liver functions was 88%;HA and CIV reduced remarkably;the negative-transforming rate of HCV RNA was 30.7%;the contents of hepatitis virus reduced in 61.1% of cases.It is revealed that the Granule is fairly effective to protect the liver and fight viruses.


The basis of this investigation is to characterize growth property differences in normal versus virally transformed cells. Using a temperature-sensitive mutant of Rous sarcoma virus, the cells' transformation state is regulated by the growth temperature; at 33°C the cells are transformed, while at 39°C the cells have normal characteristics. The morphology of NRK cells is elongated and fibroblastic; when transformed the cells are rounded. Normal cells grow to a monolayer and stop, while transformed cells grow to saturation densities greater than just a monolayer amount. Transformed cells can form foci when grown in mixture with normal cells. Normal cells must be in contact with the culture vessel in order to grow, but transformed cells lack anchorage dependence for growth.


The authors make use of the acoustoelastic method to measure some basic parameters of the metal materials, so that various kinds of damage variables can be derived from the angle of macro and mesoscopic analysis. The authors have also found that not only the connections between the defects and non liner characteristics of the material can be established on the basis of consistent definition of damage variables, but also the quantitative calculation can be made. The experimental results have shown that the damage variables will increase with the increase of the plastic strains, and the value of the damage variable described with the basic body strain and the cave volume rate is the most sensitive. In addition, the differences among the damage variables are explained and analyzed in the theory of Continum Physics.


The Ostracod formation in the Awali brownfield is an extremely challenging layer to develop because the tight carbonate rock is interbedded with shaly streaks and the presence of a nearby water-bearing zone. Although the Ostracod formation has been in development since 1960, oil recovery has not yet reached 5% because past stimulation attempts experienced rapid production decline. The current project incorporated aggressive fracture design coupled with a unique height growth control (HGC) workflow, improving the development of Ostracod reserves.
 The HGC technology is a combination of an engineering workflow supported by geomechanical modeling and an advanced simulator of in-situ kinetics and materials transport to model the placement of a customized, impermeable mixture of particles that will restrict fracture growth. The optimized treatment design included injections of the HGC mixture prior to the main fracturing treatment. This injection was done with a nonviscous fluid to improve settling to create an artificial barrier. High-resolution temperature logging was used before the main treatment to calibrate and optimize the pumping schedule, and fracture geometry was measured independently with an acoustic scanning tool after the stimulation.
 The high clay content within the Ostracod layers creates a significant challenge for successful stimulation. The high clay content prevents successful acid fracturing and leads to severe embedment with conventional proppant fracturing designs. We introduced a new approach to stimulate this formation with an aggressive tip-screenout design incorporating a large volume of 12/20-mesh proppant to obtain greater fracture width and conductivity, resulting in a significant and sustained oil production gain. The carefully designed HGC technique was efficient in avoiding fracture breakthrough into the nearby water zone, enabling treatments of up to 450,000 lbm to be successfully contained above a 20-ft-thick shaly barrier with small horizontal stress contrast. Independent measurements proved that the fracture height was successfully contained. Wells treated with this optimized workflow produced up to 22,000 bbl of oil within first 8 months with negligible water cut, which significantly exceeded all previous stimulation results in the field. This trial campaign in vertical wells proved that the combination of aggressive, large fracture designs with the HGC method could help unlock the Ostracod's potential.
 The applied height growth control technique was modified with additional injections and improved by advanced modeling that only recently became available. These contributed to a significant increase of treatment volume, making the jobs placed in the Ostracod some of the world's largest utilizing HGC techniques. The experience gained in this project can be of a paramount value to any project dealing with hydraulic fracturing near water formation with insufficient or uncertain stress barriers.


Today, we can say that the Lisbon Treaty is the most important document in the European Union (EU). It is the newest treaty, the most up to date, and it dictates how European institutions work. However, previous treaties should not be considered as less important. If we think about the evolution of the EU and how it came into existence, it could be said that every treaty shares credit for what happened. Yet, certain treaties have had more impact on European integration than others. The Treaty on European Union (TEU), signed in Maastricht, was one of the most important agreements in the EU's history. Indeed, not only did it reform the structure of the European Community (EC) through the establishment of a political union, and strengthen economic integration with the creation of the Economic and Monetary Union (EMU), but it also enabled the stabilisation of political tensions within Europe at the end of the Cold War, and integrated a unified Germany into the EU. As a result of this treaty the EC could not be called as such anymore, and from that point on it had to be referred to as the European Union. With the Maastricht Treaty, the EC took a step forward in European integration and in uniting its member states. Nonetheless, even if governments were very enthusiastic about it, public opinion was very much concerned about where this integration would eventually lead, thus making the ratification of the treaty more difficult. This essay will focus first on what the TEU actually says, and on the major innovations of the treaty. Then, it will study the effects it had on, as well as the reaction of the member states and will determine why the ratification process was so long. Finally, we will try to understand why the treaty was so important for the EC, and what the catalysts were that brought together the member states to agree upon the Maastricht Treaty.


Summary

The purpose of this paper is to attempt to show that present day paraprofessional drug milieu treatment facilities are extended drug subcultures and are not fully rehabilitating addicts.

Research tends to indicate that Synanon House of California may offer its residents a protective society and a program which is not conducive to complete rehabilitation. It was also noted that ex-addicts may become part of Synanon's ex-addict social system and that the ex-addict may become emotionally dependent upon Synanon. Also, numerous clinical impressions and observations made by the writer during a graduate field work placement were noted. It was suggested that professional ex-addicts may be part of an extended drug subculture. Maintenance of the extended subculture and some of the inter- and inter personal dynamics which appear to be operating at a para-professional drug rehabilitation facility were discussed.

Lastly, modifications of present day drug programs were suggested to facilitate rehabilitation. Generally, the recommendations centred around getting community people into the facility and getting residents out of the facility.


We the paper by al. [1], that aimed at evaluating the impact of preoperative treatment with anti-TNF agents (infliximab and adalim-umab) on the length of resected bowel and at identifying risk factors for postoperative morbidity in patients undergoing ileocolic resection for Crohn's disease (CD). A total of 184 patients were included in this observational study of a prospective cohort: 66 (35.9%) patients received anti-TNF agents within 8 weeks before surgery. The mean length of the resected bowel was 10 cm shorter in those patients who had received preoperative anti-TNF therapy than those who had undergone ileocolic resection without preoperative treatment with anti-TNF ( P < 0.001). The multivariate analysis showed that preoperative anti-TNF therapy was associated with a shorter length of the resected bowel. Systemic ste-roids, but not anti-TNF agents, were independent risk factors for overall complications and intra-abdominal sepsis, thus confirming the current evidence available in the literature. This study brings some new interesting insights to the scientific community that handles with CD in the biologics era. During the last few decades,


: Literature has always been important in forming both personal and cultural identities. Literature reflects the complexity of human identity via the representation of individuals' experiences, cultural origins, and personal development. By exposing readers to a variety of viewpoints and tales, they help readers get a greater knowledge of their own sense of self. This article will examine the significant influence of literature on the development of identity at the individual and cultural levels. We learn how characters' journeys operate as a mirror for readers, exposing the complexity of identity and its ever-changing nature, through examining the storylines of various literary works. Readers can see characters overcoming obstacles, considering social norms, and growing as people via these stories. Readers are prompted to consider their own personal development and the transformational potential of life events as a result of this investigation, which builds a greater awareness of the fluidity of identity. Readers are given a richer knowledge of the complexity of identity and its ongoing growth through the various viewpoints and travels portrayed in literature.


Long before anyone else, John A. Wheeler saw a role for information theory in tackling the still-unresolved foundational questions of quantum mechanics. To pursue this grand vision, Wheeler exhorts us to begin building a structure of concrete technical results. We offer one such example here in honor of Wheeler's eighty-third birthday. A quantum communication channel is defined by the action of sending one of n possible messages, with prior probabi l i t i es~~, . . . ,p,, to a specified receiver in the form of one of n distinct (possibly mixed) density operators b l , . . . , f i n on an N-dimensional Hilbert space. The message states P I , together with their probabilities p,, constitute the message ensemble. At the end of the transmission, the receiver can perform any generalized quantum measurement described by a positive-operatorvalued measure (POVM) in an attempt to discern which message was actually sent. The fundamental question of quantum communication theory' is this: Which measurements maximize the Shannon mutual information about the actual message and just how much information is that maximal amount I,,,? Previous results on I,,, include an upper bound due to Holevo," a lower bound recently exhibited by Jozsa, Robb, and Wootters? and the classification of a few examples where I,,, can be calculated e x a ~ t l y . ~ ~ Of the two bounds, both are uniquely distinguished in the sense that they are the best bounds expressible solely in terms of the total density operator fi = Cp&, whenever all the fit are pure states. For this reason, however, both bounds are fairly loose for many message ensembles. Here, we derive ensemble-dependent bounds (an upper bound for the general channel and a lower bound for the binary channel) by way of reexamining and simplifying Holevo's original derivation. The quantum communication problem' is made precise through a formalization of the most general measurements allowed by quantum theory, the POVM.y A POVM is a set of nonnegative, Hermitian operators &, which are complete in the sense that z & , = 1 = (N-dimensional unit operator). The subscript b indexes the possible outcomes of the measurement; the conditions on the E b are just those necessary and sufficient for the quantity tr(bkh) to be a valid probability distribution.


The telemetry and aerospace communities require communications equipment providing various modulation and demodulation formats. One format, with application in Space Ground Link Subsystems (SGLS), utilizes a Ternary (tri-tone) Frequency Shift-Keyed (FSK) signal Amplitude Modulated (AM) by a triangle waveform. Historically, SGLS equipment has operated with a fixed tri-tone frequency set (e.g., 65 kHz, 76 kHz and 95 kHz). The need for additional transmission channels and increased bandwidth efficiency creates the requirement for equipment with the flexibility to generate and receive varied and higher frequency tone sets. Combining analog and digital techniques, GDP Space Systems has developed the FDT001. It is an FSK/AM detector which recovers a bit rate clock at one of four selectable bit rates and reproduces ternary FSK modulation data over a widely tunable range of tone frequencies. The tuning range is expanded by using two methods of digital frequency discrimination. The following paper describes the design of the FDT001.


Many on‐farm‐processed products frequently command a premium price, characterised as they are by unique sensory properties and image. Examines the nature of consumer judgements about product quality for farmhouse Cheddar cheeses based on utilities derived from the product attributes, and the trade‐off against price. Determines key Cheddar cheese attributes through in‐depth interviews with specialist cheese consumers and employs conjoint analysis to estimate the utilities associated with these attributes based on a wider choice‐experiment survey of farmhouse Cheddar consumers. A "price sensitivity meter" technique was used to establish acceptable price ranges as perceived by the latter group. Results from market simulations suggest that the consumer price sensitivity for farmhouse cheese is likely to be low. The analysis also revealed that those attributes associated with the traditional characteristics of farmhouse Cheddar have the highest utilities and that any characteristics similar to industrial Cheddar were largely unattractive to the consumers of farmhouse cheese.


Background: The phenomenon of flow diversion in high grade internal carotid artery (ICA) stenosis and secondary head and facial pain from increased regional flow in the external carotid artery (ECA) system remains under-recognized and unreported. We examine this phenomenon in a large study population of Asymptomatic Carotid Atherosclerosis Study Methods: We utilized the Asymptomatic Carotid Atherosclerosis Study (ACAS) data to explore the relationship between ICA stenosis and headache. In ACAS, eligible patients with carotid stenosis ≥ 60 % were randomized to endarterectomy or medical management and risk of stroke or stroke & death over 5 years was observed. Information on headache and its characteristics was collected at the baseline visit and comprised questions inquiring self-reported history of headache, including characteristics of migraine, and physician diagnosis of headache. Carotid stenosis was evaluated by doppler ultrasound (as Results: In this study (n= 1662), patients with stenosis (measured by Doppler) of 60% or higher in the right ICA or left ICA, self-reported headache within the past year was reported in 424, and physician diagnosed headache in only 68 patients. Significant relationship was noted between physician diagnosis of headache and right ICA (χ2=10.3, df=4, p 0.036), and left ICA (χ2=15.6, df=4, p=0.004) stenosis categories. Self-reported history was associated with left ICA stenosis (χ2=26.6, df=4, p Conclusion: Recognition of flow-diversion into the ECA as a possible mechanism for headaches may help in further understanding of ICA disease, its progression, and the effects of carotid revascularization on quality of life. Headache as a likely surrogate marker of carotid stenosis with flow-diversion warrants more research, and may be critical in the early identification of significant ICA stenosis and prevention of TIA or stroke.


The article presents a study of the pragmatic particles like in English and liksom in Norwegian. Both like and liksom are particles whose frequency has increased remarkably in informal spoken language, in particular among adolescents, during the past decades. Both are stigmatised, yet they have developed and continue to develop new functions and meanings that are not in accordance with traditional grammar. In this article, it is suggested that the two particles are used in similar ways to mark the speaker's epistemic stance towards the content or form of an utterance. On the basis of previous studies, a model is proposed in which both like and liksom are assigned three main pragmatic functions: (1) like/liksom indicating a discrepancy between the speaker's thought and the content of an utterance, (2) like/liksom indicating a discrepancy between the speaker's thought and the form of an utterance, and (3) like/liksom used in connection with attributed utterances/direct quotations to indicate a discrepancy between what is reported and what was 'really' said or thought. These three functions are all used to express a similar kind of speaker attitude or epistemic commitment, namely that the speaker takes a certain distance from the utterance or part of it. In addition, there is highlighting of the element focussed by like/liksom as well as loosening of the meaning of this element. Considering their social stigma, the particles may also function on a higher meta-level to signal social and stylistic phenomena such as informality, solidarity and in-group identity.


The life history of Arilus cristatus (L.) was studied in southern Illinois from March 1997 to November 1998. The bug also was reared in the laboratory at 26 0.5C under a 16:8 (L:D) photoperiod. This univoltine species overwintered as eggs. First instars were found from early May to late June, second instars from mid-May to early June, third instars from late May to early July, fourth instars from early June to mid-July, fifth instars from early June to mid-August, and adults from early July to late November. In the laboratory, the five nymphal stadia averaged 15.64, 14.04, 15.17, 20.53, and 28.61 d, respectively. Also, the incubation periods of two egg clusters oviposited by two field-collected females were 60 and 61 d.


The public policy regarding public infrastructure licensing in Chile since the nineties does not merely correspond to the influence of foreign models. It is better characterized by singularities whose origin lies in the history of Chilean roads and the relation between the public and private sectors.   These singularities are explained by the beliefs and norms regarding the role of the State in the country's development, and about infrastructure as key to that development. The latter does not imply that foreign influence was completely absent, but explains that its design and implementation differ in certain areas, such as regulation, from the "good practices" promoted by some international organizations.


Zhang Zai, an important founder of Confucian School of idealist philosophy of the Song and Ming dynasties, played a key role in reestablishing human ethics in neo-confucianism when he unconsciously developed his theory of human makings into ethics.


General thermodynamic dependences were derived for the simultaneous chemisorption of two substances on the uniformly inhomogeneous surface. In terms of these dependences and on the basis of thermodynamic data available in the literature, the potential-pH diagram was calculated for the Pt-S-H 2 O system at 25 °C on considering the sulfur and hydrogen chemisorption.


---------------------------------------------------------------ABSTRACT-------------------------------------------------------This study examined the effect of Suggestion Scheme a form of Employee Voice and Workers Commitment. Using Cross Sectional Survey design, a sample size of 357 workers from the banks in the South-South zone of Nigeria was used as respondents. We found that suggestion scheme had a significant positive effect on employees' continuance and normative commitment but no significant effect on employee's affective commitment. This result suggests that when organizations utilize suggestion scheme as a form of employee voice, workers will be morally obliged to remain with the organization and will stay because they would not want to lose their investment.


A series of investigations is described in which changes in mammary tissue content of monovalent ions are measured following treatment with prolactin. These effects of prolactin are compared with the effects of ouabain and prolactin together. In vitro experiments were carried out using slices of lactating mammary gland from rabbits, held in continuously gassed (95% O2:5% CO2) Krebs bicarbonate buffer for 1 h in the presence or absence of prolactin (43.5 nM [lμg/ml], ouabain (0.1 mM) or both. In the presence of prolactin [Na+] decreased and [K+] increased in the whole slices, and also when calculated as intracellular ion concentrations. Ouabain had the reverse effect; ouabain and prolactin together also had the reverse effect to prolactin alone. The tissue slices were sensitive to prolactin concentrations as low as 2.2 nM (50 ng/ml) in the incubation medium. The decreased [Na+] in the tissue slices showed a significant dose/response relationship up to a prolactin concentration of 6.5 nM, above which no fur...


plying, complex, complicated, fluid, and infinite lines of flight and possibilities of identities and becomings" (p. 51) that engenders a "pedagogy of the imaginary" to address "the multicultural, multinational, multilingual, multiethnic" (p. 28) nature of Blackness. In Chapter 2, "Wallahi, ils sont tous des racistes: Striated Racialization and the Rhizomatic Process of Becoming Black," Ibrahim "sets a stage for discussions of the racial climate of/in the schools" (p. 27) through his critical narrations of "a Black teacher who experienced one of the most violent symbolic utterance and anger" (p. 27) to illustrate "crucial moments" in the process of joining in the African diaspora by becoming Black for immigrant and refugee groups of Frenchand English-speaking continental African youths living in Southwestern and Northeastern Ontario, Canada. In Chapter 3, "Si tu allais faire un sondage, ça vien souvent de l'orientation ou des personnels: Teachers, Curriculum, and Pedagogy," Ibrahim addresses "questions of pedagogy, the lack of Black teachers, and the absence of Black people from history books" (p. 27). An Interlude, a powerful poem on "Homeless Urban Dreams" composed by Reenah L. Golden, interrupts and weaves chapters of the book together. There are two sections in Chapter 4, "Oh, I got It, It Gives Me Great Pleasure! Hip-Hop Culture and Language, Post/Coloniality, and the Imaginary." The first section focuses on "the historical memories of language learning, students' relation to and emotion investment in language, and diverse language learning sites such as Black popular culture—Hip-Hop and Rap." The second section illuminates how Africans and Africa are "imagined" in popular "cultural representation and separatist culture" (p. 27) and how such "cultural zones are demarcated through cultural practices, languages, and religions" (p. 28) and impact on sense of belonging of immigrant and refugee groups of Frenchand Englishspeaking continental African youths. In Chapter 5, "Peace and One Love! A Rhizomatic Third Space: Race, Language, Culture, and the Politics of Identity," Ibrahim visualizes the shapes and forms of "the rhizomatic third space" where "racial, gender, and sexual identities are manifested through linguistic and cultural performances" (p. 28). In the Conclusion, "What's the Dillio? Toward a New 'Ticklish Subject': Pedagogy of the Imaginary as Integrative Antiracism," Ibrahim illuminates "the need to rethink the intersection of displacement, culture, language, identity, and Blackness" (p. 28). He proposes "black popular culture as a curriculum site" to "centralize and engage marginalized subjects, their voices, and their ways of being, becoming, and learning" (p. 211). He calls for a "pedagogy of the imaginary" (p. 209), "an integrative antiracism pedagogy of struggle" (p. 212), to question and decolonize "the unidimensional, colonized imaginary of Blackness" (p. 28), to represent rhizomatically "the multicultural, multinational, multilingual, multiethnic" (p. 28) nature of Blackness "with full agency and subjectivity" (p. 212), and to cultivate "pedagogy of hope and radical love" (p. 213) for all, in an increasingly diversified, complicated, and rhizomatized world. To order a copy of The Rhizome of Blackness: A Critical Ethnography of Hip-Hop Culture, Language, Identity, and the Politics of Becoming, contact Peter Lang, 29 Broadway, 18th Floor, New York, NY 10006< USA. Website: http://www.peterlang.com


Assignment of porcine insulin-like growth factor-binding protein-4 (IGFBP4) to SSC12 by fluorescence in situ hybridization and radiation hybrid mapping W. Wenjun*, Z. Yonghui*, Z. Yunhai* and L. Ning* *State Key Laboratory for Agrobiotechnology, China Agricultural University, Beijing 100094, China. Division of Food Science and Technology, Jiangxi Agricultural University, Nanchang, Jiangxi 330045, China


Specificity and challenges of organization of students' self-study system in the modern environment when teaching foreign languages are examined. The necessity of upbringing the personality of a modern specialist having both linguistic and information and communication competences, capable of self-development is substantiated. The integrity of a self-study system on the basis of methodically well-organized informational and educational environment is granted as an important condition of its effectiveness.


The present invention relates to an image display system, apparatus and method. First, based on the mark recognition result left real space images calculated, the outer imaging section (left) with respect to the relative position and the relative posture mark, and token-based recognition result the right real space image is calculated, the outside shooting section (right), the relative position and relative posture marks, to determine the spacing between the left virtual shot device means and the right virtual shot. After determining the interval between the left and right virtual image capturing device virtual capture device, based on the determined intervals to determine position and orientation of the left virtual shot means and the right virtual imaging apparatus, so that left shooting position and orientation of the virtual device and right virtual image capturing device position and orientation of an ideal relationship.


The pharmaceutical industry operates both as an important business sector and a vital contributor to the delivery of health services worldwide. In 2012, the total world market for pharmaceutical products amounted to nearly US$1 trillion (see Table 1). Although global in scope, some 60 percent of sales were in North America and Europe, which comprise only 15 percent of the world's population. The industry plays an important economic role in many countries by contributing to national income and employing hundreds of thousands of educated workers. Studies in the United States and Germany have found that for each direct employee, the pharmaceutical industry also generates between 1.6 and 3.5 jobs in supporting industries [7, 9]. While Germany long boasted of its role as the "world's apothecary," firms in Switzerland, France, the United Kingdom, and the United States also have underwritten decades of research into new medicines and brought several thousand new medicines to market since the late 19th century [1]. However, since the early 2000s, a steady decline in global prescription drug sales has accompanied an international deterioration in the underlying conditions critical to pharmaceutical in novation [6]. Troubles can be found also in a declining number of new chemical or biological medicines approved for markets despite a steady rise in research spending [8]. Policy discussions in some countries reveal a shift against industry arguments that high profit margins on current drug sales are necessary to finance research into future pharmaceuticals. Countries across the OECD instead are looking for ways to reduce health spending and national pharmaceutical budgets have been held constant or even reduced. Policies including reference pricing and demands that the industry demonstrate the cost effectiveness of its products are now widespread, especially in Europe [4]. Articles in this special issue of Pharmaceuticals Policy and Law analyse factors governing the legal and competitive environment for the pharmaceutical sector. Key issues are explored across the full pharmaceutical value chain, including drug discovery, development, authorization, and marketing. The articles demonstrate widespread, typically longstanding, tensions between policies that on the one hand


The deaf and dumb peoples mostly communicate with normal people through the standard nonverbal American gesture. But the sign languages are difficult to recognize and understandable by the common people. The existing computerized sign recognition methodologies suffer from the sign object classification. The false-positive test result reduces the prediction accuracy or increases the training overhead. The proposed approach named Improved Haar Feature (IHF) locate the skeleton of the hand pose and recognize the sign by the Angle Support Vector (ASV). The skeleton is estimated by the series of cyclic connected points of the box model. The object's centroid is estimated, and the cut-vertex is defined through the support vector. The number of vertices and the distance between the point-pin are also considered for region mapping. The number of segregation classes will differ based on the nature of the sign skeleton. The angle of the centroid and the connection points are examined to extract the right feature. The custom gesture is trained using the deep convolutional neural network models. The proposed methodology will observe the hand sign and produce an optimal output in the form of verbal speech or text. The algorithm produces a good prediction accuracy of 96.2 percent.


3. Promoting positive personality growth and development. We must plan systematically to alleviate large variety of mental health problems. Thus we can bring about the readjustment of the patient so that he or she will become more comfortable in her social emotions, thoughts, attitudes an social relationships. Therefore training and research for Mental Health professional is crucial as it would ensure that every person develop, strengthen and retain capability to perform his job well. In this context we need to understand that a large number of individuals suffer from mental illnesses and in need of treatment and support. But the capacity of the existing mental health services to support mentally il l and caregivers is lagging behind the demand for services. Compared to the past, the outcomes for individuals with mental illnesses have improved, but much needs to be done to meet current needs. Strategic initiatives to meet this challenge include improving care systems as well as imp!oving modalities of care diagnostic, therapeutic and preventive. Ultimately, new modalities of care will be required to ensure a more effective and efficient mental health care system. opportunity for improvement through research has never been 1 greater. Research tools are increasingly applicable to a wide range of mental health problems as also rapid advances in understanding behaviour and its alternative promise to spawn creative and effective clinical insights. On the other hand there is also a growing concern that the number of new young Psychiatrists have been falling short of meeting the need and the opportunities to advance the field.


Daytime urinary incontinence is a major health care problem occurring in 15 and 5% of 4-year-old and 9.5-year-old children, respectively (1, 2). Continence comes from an intrinsic interaction between anatomical and functional factors. Ascertaining the cause of incontinence remains a challenging task and is often derived from a complex of features. A few principal causes are urge in overactive bladders, voiding postponement, dysfunctional voiding, an underactive bladder, and stress incontinence. Mostly no structural, neurogenic, or other organic cause can be found in children with daytime urinary incontinence. Bladder neck competence is an important factor in achieving continence. The following basic outlet functions are known: closure during urine storage with increased closure during exercise or bladder filling (the guarding reflex), sustained opening when voiding, and transient opening for males when ejaculating (3, 4).

Standardization of terms as well as diagnostic and therapeutic abilities have been improved by the efforts done by dedicated institutions (5). Essentially non-invasive screening is standardized consisting of history-taking, clinical examination, urinalysis, uroflowmetry, ultrasound (US) (including post-void residual volume), voiding, and stool diary and pressure-flow studies (1, 6, 7). Initial management requires basic diagnostic tests. Treatment is mostly conservative and empiric (lifestyle interventions, physiotherapy, and pharmacotherapy). More elaborate assessment is required when primary therapy fails, diagnosis is unclear, or symptoms and signs are complex/severe (8). More (and novel) diagnostic tools to pinpoint the reason for incontinence need to be evaluated. After all, only the right diagnosis can lead to appropriate therapy or even surgery.

Ultrasound can be a valuable and patient friendly additive to physical examination. Already, it is the primary imaging tool in children with urological problems. Physical examination can be stressful especially for the pediatric population. US is well tolerated, not expensive, widely available, not invasive, and needs no radiation (9). Nowadays, a portable handheld pocket US machine is available. Transperineal US provides accurate visualization, both static and dynamic. It provides anatomical and even functional information. Imaging the bladder neck is superior to transabdominal US due to the bony pubic landmark as a reference point (10). Also it seems better than cystoscopy since it provides an overview of the bladder neck and surrounding tissue instead of the rather limited internal view. Furthermore, US requires no anesthesia, making the situation more physiological enabling dynamic testing.

This article focuses on US imaging of the lower urinary tract for patients with daytime incontinence. It provides practical guidance on how to perform transabdominal and transperineal US. We combine current insights from the literature with our clinical practice. We like to promote the use of US for physicians specialized in urinary incontinence.