When Jerry Bentley's article on the Blake dealings of A. S. W. Rosenbach appeared posthumously in the winter 2017–18 issue of the journal, I assumed that it was his last work to be published. I should have known better. Boondoggles are his tales of a lifetime's travels, a memoir begun with the editing assistance of his daughters and completed by them after his death. That Sarah and Julia brought the project to fruition is appropriate, as the stories revolve around family and derive from the many letters that Jerry wrote to family and friends. His pride in and love for them shine through, as they do for his wife, Beth, who presides throughout as a benevolent facilitator of all things: "For fifty-nine years Beth managed my life firmly and inconspicuously. Hurricanes, revolutions, poverty, respectability—nothing fazed her. Beth could always manage" (6).


Introduction: It is essential not to ignore that the world is continuously changing.
Hence, it is vital that organisations also alter, and adopt new ways to manage this
constant evolving environment in order not to fall behind competition. One way to
achieve this is by executing efficient product development (PD) projects. However,
there are studies today showing that a third of all PD projects performed nowadays
fail.
Aim: This research aims to explore how an MNC could increase the efficiency of
their product development process through enhancing the project management
activities. For this purpose, the research identifies the factors, and their attached
issues, that constitute the knowledge areas within project management. Further, the
research will also examine how these potential issues could be solved.
Theory: There are three main theoretical frameworks used in this study: Project
Management, Organisational Efficiency, and Product Development. Further, the
purpose of these is to create the foundation for the discussion of the findings
generated in this research.
Method: The method used to perform this investigation is a case study executed at a
Swedish MNC. Moreover, a qualitative approach was adopted and the data were
collected mainly by conducting semi-structured interviews with case company
employees.
Results: The study disclosed that there are several issues connected to the project
management practices. For example, the MNC has poor communication methods, the
projects spend too much time on the process of bargain for resources from the line
organisation, the top management strategies are not as well-defined as they need to be,
which creates poorly defined project scopes and changes to the project scope. Besides,
the MNC also spends a lot of time on their local request process.
Conclusion: The main problem areas in a product development process with regards
to project management are: Communication, Scope, Time, and Human Resource.
Nevertheless, the study also reveals that there are methods on how to deal with these
issues. One solution could be to implement a lean mindset into product development
project management activities.


Leena Bajracharya 1 Sachit Kumar Bhandari Shankha Narayan Twyana 3 1Department of Cornea, Tilganga Institute of Ophthalmology, Kathmandu, Province No. 3, Nepal; 2Tilganga Institute of Ophthalmology, Kathmandu, Province No. 3, Nepal; 3Nepal Eye Bank, Tilganga Institute of Ophthalmology, Kathmandu, Province No. 3, Nepal Purpose: Corneal problems is one of the major causes of blindness in developing countries like Nepal. This study intended to analyze donor and tissue profile of Nepal Eye Bank (NEB). Material and Methods: This was a cross-sectional descriptive type study. Data of corneal tissues collected by NEB from January 2015 to December 2016 were used in the study. Data collected were demographic profile, cause of death, type of corneal donation (whether voluntary or motivated), quality and utilization of tissues. A comparison was made between voluntary and motivated donors. Results: 1244 corneal tissues were retrieved from 639 donors. Mean age of donors was 49.4 years. 57.7% of the donors were male. There were almost equal number of donor deaths due to cardiovascular disease, 27.2%, and respiratory disease, 26.7%, followed by hanging, 17.8%. Majority of donors were motivated (n = 561, 87.7%). Mean death to preservation time was 5.79 hours (hrs). Of the harvested corneas, 1040 (83.6.%) were suitable for transplant with a mean endothelial cell count of 2850 ± 520 cells/mm; 16.4% were of poor tissue quality and 2.7% were seropositive. 76.2% of total tissues were of optical quality. Utilization rate of transplantable tissues was 97%. Tissues from motivated donors were significantly "younger" (p=0.0001), had better endothelial count (p=0.0001), and were of better quality (p=0.026) than those from voluntary donors. Conclusion: Motivated eye donation is a major and effective source of cornea collection in the eye bank under study with "younger" and better quality corneas compared to voluntary donors.


The issue of stress associated with higher education and its impact on markers of student health is explored in three experiments looking at blood pressure levels in college students. All participants were full‐time undergraduate students of psychology. In Experiment 1, academic fear of failure, assessed using psychometric testing, was found to be associated with depressed blood pressure responses among students who performed a stressful task on a computer. In Experiment 2, students were found to exhibit higher blood pressure before end‐of‐semester examinations than afterwards. In Experiment 3, students of relatively high academic ability were found to have demonstrated increased levels of pre‐examination blood pressure responses to stress. Overall, the three experiments suggest ways in which the stressfulness of student life may have adverse consequences for student health and, moreover, ways in which the stressfulness of student life can be further explored. Factors such as fear of failure, impending examinations and academic ability must be taken into account when considering stress‐related health consequences on campus.


The paper by E.A.T. Merks et al. (see ibid., vol. 18, p. 19-32, 1992) "Language design for program manipulation" identifies design principles for a procedural or object-oriented language whose programs will be easier to manipulate. However, it neglects to relate these design principles to existing, broader, design principles, and in some instances omits good examples of languages meeting their criteria. The author relates the new principles to more fundamental design principles, and provides the needed examples of languages meeting their criteria. Together these additions can better help designers of new programming languages that are amenable to manipulation. >


In this report the epidemiologic aspects of epilepsy in Arab countries are systematically reviewed. MEDLINE and Embase were searched, and six papers were identified: one incidence report from Qatar and five prevalence reports (two from Sudan, and one from each of Libya, Tunisia, and Saudi Arabia). An incidence of 174 per 100,000 persons in 2001 was reported in a hospital‐based study from Qatar. Prevalence ranged between 0.9/1,000 in Sudan and 6.5/1,000 in Saudi Arabia, with a median of 2.3/1,000. An approximate 724,500 people with epilepsy live in the Arab world. All the studies report higher prevalence in males, which was statistically significant in the Saudi study. The prevalence is approximately 2‐fold higher in children and young adults, compared to the rates in middle age. Two studies showed a high prevalence in individuals older than 60 years of age. Primary generalized seizures are reported in 28–97% of cases, partial seizures in 3–43.8%, and unclassified seizures in 18–51%. Idiopathic epilepsy represents 73.5–82.6% of cases. Early childhood brain damage such as in cerebral palsy and mental retardation represented a major cause of symptomatic epilepsy, whereas infection was the main cause in Sudan. The epidemiologic data from Arab states are lacking, especially from populous countries like Egypt, Algeria, and Syria. Well‐designed studies are needed to accurately determine the burden of epilepsy in the Arab world.


This articles explores the ways in which Elizabeth Gaskell negotiates with issues of class and gender in her novella "Cousin Phillis." It first focuses on the representations of male scientists in the tale and the ways in which Gaskell disguises the class divisions between them and evades confronting the question of their social agency as scientists. The article then moves on to look at the ways in which Gaskell transfers the pain of social and scientific change onto the romantic plot and, in particular, onto the character of Phillis herself. A detailed account of Gaskell9s description of Phillis9s somatic symptoms throughout the narrative is then used to argue that by making Phillis the index of change, Gaskell both avoids confronting the complex class issues that her novella raises and simultaneously produces a radical critique of the ways in which the female subject is repressed and controlled by a masculine scientific culture. The article concludes that it is possible to read "Cousin Phillis" as indicative of Gaskell9s own troubled response to rapid social change and to the iniquitous divisions between classes and sexes that, she seems to suggest, can be numbered among its results.


Objective: High affective reactivity to pain (i.e., increased negative affect in response to pain) can have an adverse impact on the well-being of individuals with chronic pain. The present study examined the role of momentary and average positive affect and trait mindfulness in protecting against affective reactivity to chronic migraine–related pain. Methods: The sample included 61 adults with chronic migraine. Following the experience sampling method, participants completed smartphone-based assessments of momentary pain intensity (PI), positive affect (PA), and negative affect (NA) at nine random moments a day for 7 consecutive days. The Five-Facet Mindfulness Questionnaire was used to assess two dimensions of mindfulness: nonjudging and nonreactivity. Results: Momentary PA inversely predicted the strength of the concurrent but not the time-lagged associations between PI and NA. Average PA predicted neither the strength of the concurrent nor the time-lagged associations between PI and NA. Furthermore, the concurrent associations between PI and NA were weaker in individuals who reported higher "nonjudging" while "nonreactivity" did not significantly moderate these associations. Conclusions: Results provide partial support for the dynamic model of affect in the context of chronic migraine. State PA seems to play a larger role in momentary affective reactivity to chronic migraine–related pain than trait PA. Results also suggest that the ability to take a nonjudgmental stance toward negative experiences may lower momentary affective reactivity to pain. These factors seem promising targets for interventions aimed at improving the well-being of individuals with chronic migraine.


Background Good nutritional care is a fundamental element of the management of individuals with Huntington's disease and all patients with Huntington's disease will, at some time, need dietary intervention because of the sequelae of the disease, yet there are no European nutritional guidelines. Aim The aim was to develop nutritional guidelines to facilitate optimal nutritional screening, assessment and management of individuals throughout all stages of HD, with the aim of improving the standard of nutritional care delivered and to ensure the nutritional management of individuals with HD is based on sound evidence and current best clinical practice. Methods Literature was systematically searched in an attempt to ensure that the recommendations are based on sound evidence. Where evidence is lacking, specific guidance is based on consensus expert dietetic opinion of the European Huntington's Disease Network Standards of Care (SoC) Dietitians group which brought together expert Dietitians from across Europe. Outcome The SoC guidelines highlight the fundamental nutritional issues for individuals with HD; nutritional screening, assessment and care planning; nutrition and function; nutrition and oral health; the multidisciplinary approach to nutritional treatment; the nutritional challenges resulting from the impact of the behavioural aspects of the disease and the importance of respecting autonomy when delivering nutritional care. Key recommendations within the guidelines include the use of validated nutritional screening fit for purpose, early referrals for a preventative approach to weight management and comprehensive nutritional assessment with appropriate management and timely reviews. Adequate education and training (in communication, feeding techniques, long term tube feeding) for those involved in the nutritional care of individuals with HD is advocated. Conclusions Nutritional screening together with the delivery of good nutritional care is fundamental to the care of an individual with HD. For clinicians involved in HD management these SoC nutritional guidelines will offer an invaluable insight into the role of the Dietitian and guidance on the nutritional assessment and management of the individual with HD. The provision of nutritional care varies widely between countries. Implementation of these nutritional guidelines across Europe should improve the quality of nutritional care delivered to individuals with Huntington's disease.


OBJECTIVE
The objective of the study was to determine the prevalence of ocular surface disease (OSD) symptoms and the possible existence of differences between peri- and postmenopausal women, based on the result of the Ocular Surface Disease Index (OSDI).

METHODS
A transversal observational study based on the results of an e-mail survey between October 2018 and January 2019 involving 1,947 women. The study was performed on a group of peri- and postmenopausal women aged between 45 and 79 years. The personal data in the survey included age, menopause status, age at menopause, prediagnosis of dry eye, undergoing dry eye treatment, and the OSDI questionnaire. Student's t test and Chi squared test were used to compare means or percentages between results on the survey and peri- and postmenopausal women. Finally, a univariate logistic regression was carried out to estimate the prevalence of OSD. The OSDI score is assessed on a scale of 0 to 100.

RESULTS
The mean age of the entire sample was 54.2 ± 6.8 years, with a mean age at menopause of 49.45 ± 4.02 years. The mean OSDI score was 29.2 ± 19.4, considered as moderate dry eye. The global prevalence of OSD symptoms was 64% (1,247/1,947), which increased significantly in postmenopausal women, being 66.8% (820/1,228) (P = 0.001). The probability of OSD symptoms prevalence increases with age (odds ratio: 1.02; 95% CI [1.01-1.03]). The greater the age at menopause, the lower the probability of OSD symptoms prevalence (odds ratio: 0.96 95% CI [0.93-0.99]).

CONCLUSIONS
Sixty-four percent of the pre- and postmenopausal women studied had OSD symptoms. There was a correlation between OSD symptoms and age, postmenopause, and earlier age at menopause, which was associated with an increased prevalence. : Video Summary:http://links.lww.com/MENO/A603.


The effect of statins occur in several stages: 1) inhibition in hepatocytes of synthesis of functionally specific pool of spirit cholesterol, polar mono-layer of lipoproteins of very low density; 2) activation of hydrolysis of triglycerides in lipoproteins of very low density, formation of apoE/B-100-ligand and absorption of lipoproteins of very low density by insulin-depended cells; 3) decreasing of content of and spirit cholesterol-lipoproteins of very low density in blood plasma; 4) activation of hydrolysis of triglycerides in lipoproteins of low density, formation of apoB-100-ligand and absorption of lipoproteins of low density by insulin-independent cells; 5) decreasing of level of and increasing of content of lipoproteins of high density. During first weeks of effect of statins occurs decreasing of concentration of triglycerides and unesterified spirit cholesterol-lipoproteins of very low density in blood plasma. Then, slower and more durational decreasing of level of spirit cholesterol-lipoproteins of low density occurs. The value of spirit cholesterol-lipoproteins of low density is primarily determined by content of palmitic saturated fatty acid in food, its endogenous synthesis from glucose and concentration of palmitic triglycerides and lipoproteins of very low density of the same name in blood plasma. The effect of preparations is biologically valid and corresponds to alternative hypolipidemic preparations. All these preparations have an effect following a common algorithm: they activate, using different mechanisms, receptor absorption of lipoproteins of very low density or lipoproteins of low density by cells. The level of spirit cholesterol-lipoproteins of low density in full measure depends on content of triglycerides in blood. The concentration of spirit cholesterol in blood plasma has a reliable diagnostic significance only under physiological content of triglycerides. The main criterion of diagnostic and control of hypolipidemic therapy biologically is content of triglycerides. The comprehension of differences in effect of hypolipidemic preparations within framework of common algorithm permits rationally combine them under treatment of both primary inheritable phenotypes of glucolipoproteins and secondary symptomatic types of glucolipoproteins under obligatory observation of strict dietary treatment.


The main focus of this thesis was to investigate the influence of solidity on the performance, swirl characteristics, wake length and blade deflection of a Horizontal Axis Tidal Turbine (HATT) using the simulation software package Ansys. An existing laboratory scale prototype HATT was modified to improve upon previously gathered experimental data and provide further confidence of the validity of the numerical models. The solidity was varied by altering the number of blades in the numerical models.
The work presented in this thesis shows that, for this blade profile, increasing the solidity increases the peak Cθ and peak Cp and reduces the λ at which these occur. Ct was found to be approximately the same at peak Cp, which was assumed to be the normal operating condition. At λ above peak Cp, near freewheeling, Ct continued to increase for the 2 bladed turbine, remained approximately constant for the 3 bladed turbine and decreased for the 4 bladed turbine, due to the change in pitch angle required to maintain optimum power. This indicates that higher solidity rotors would have to withstand lower loads in the event of a failure. In addition, the thrust per blade was shown to increase with reducing number of blades.
The swirl characteristics in the wake were found to agree with swirl theory and the swirl was found to increase with solidity whilst being weak or very weak in each case. Swirl number was found to be dependent on solidity only up to distances of 10 diameters downstream.
At higher turbulent intensities, the wake recovery was only influenced by solidity up to 15 diameters downstream of the HATT but at low turbulence intensities the wake length increased with solidity indicating that low solidity rotors may offer higher overall array efficiencies in areas of low turbulent intensity.
Blade deflection was shown to increase with a reduction in the number of blades, due to the increased thrust per blade. The power output of the 3 bladed turbine was shown to decrease by 0.4% with a deflection of 0.12 m. However, the power output of the 2 and 4 bladed turbines was found to increase with deflections as it was subsequently found that the pitch settings found in a previous study were not fully optimised for a rigid blade. At deflections above 0.20 m the power output of the 4 bladed turbine was found to decrease. It is expected that the power output of the 2 bladed turbine would eventually decrease with further deflections but no decrease was found for the maximum deflection considered, of 0.35m.
This thesis therefore shows that the optimum number of blades may vary from site to site and even from one location within an array to another. It also shows that blade deflection will alter the power output and that blades could be designed so as to reach their optimum setting at a given blade deflection.


Hyperlipidaemia refers to an increased concentration of lipids in the blood. Hyperlipidaemia is common in dogs and has recently emerged as an important clinical condition that requires a systematic diagnostic approach and appropriate treatment. Hyperlipidaemia can be either primary or secondary to other diseases. Secondary hyperlipidaemia is the most common form in dogs, and it can be a result of endocrine disorders, pancreatitis, cholestasis, protein-losing nephropathy, obesity, as well as other conditions and the use of certain drugs. Primary hyperlipidaemia is less common in the general canine population but it can be very common within certain breeds. Hypertriglyceridaemia of Miniature Schnauzers is the most common form of primary hyperlipidaemia in dogs but other breeds are also affected. Possible complications of hyperlipidaemia in dogs include pancreatitis, liver disease, atherosclerosis, ocular disease and seizures. Management of primary hyperlipidaemia in dogs is achieved by administration of ultra low-fat diets with or without the administration of lipid lowering drugs such as omega-3 fatty acids, fibrates, niacin and statins.


It is essential for fish to respond appropriately when faced with a threatening situation. Accordingly, fish are able to reduce predation risk through learning. In addition to privately learned experiences, fish can acquire social information about a threat by observing the response of conspecifics and use such public information to adapt future behavior through learning. It is unclear if social learning can also influence the behavioral response of fish when faced with human-induced threats in the form of angling. Using an experimental approach in the laboratory, we examined the influence of private (i.e., direct experience of hooking) and social information on angling vulnerability in Common Carp Cyprinus carpio—a species regularly exposed to catch-and-release angling. Compared with control groups, individuals with direct or social experience of catch-and-release angling expressed significantly elevated hook avoidance behavior during a short-term vulnerability assessment hours after a catch-and-release experience. In the medium-term vulnerability assessment, conducted within days after the threat event, fish with direct hooking experience continued to exhibit decreased angling vulnerability, whereas the social experience of catch and release did not consistently reduce angling vulnerability compared with controls. Yet, in a subsequent trial within days after the threat exposure, we found that fish with direct hooking experience and fish with only social hooking experience were both more cautious towards bait (corn) in the presence of a sham rig (i.e., a hookless rig with bait) than when only exposed to bait without a rig. Collectively, these results indicated that the combined influence of direct and social experience of catch-and-release angling induced a hook avoidance behavior in Common Carp. The extent to which the phenomenon of social hook avoidance learning exists in other recreationally targeted fish species and in the wild deserves further attention because of the potential to affect catch rates and population-level catchability.


Background: Rituximab is a chimeric anti-CD20 human/mouse monoclonal antibody. As its usage has increased, there have been growing concerns about rituximab-related infusion-related reactions (IRRs). Objective: The aim of this study is to verify the clinical features and risk factors of IRRs by rituximab, and to help establish clinical guidelines for their prevention. Methods: We reviewed electronic medical records of all the adult patients who were prescribed rituximab from January 2005 to July 2010 for B cell malignancy at Seoul National University Hospital. Results: A total of 389 cases of IRRs by rituximab (12.5% of a total of 3,104 infusions) were identified in 281 patients (49.4% of a total of 568 patients). IRRs most frequently occurred during the first infusion (40.5%) and abruptly decreased in subsequent infusions to rates of 3-8% (p < 0.001). The incidence of IRRs in patients premedicated with corticosteroid for their first infusion was significantly lower when compared to patients not pretreated with corticosteroid prior to rituximab infusion (8.3 vs. 41.2%, p = 0.017). Conclusion: Almost half of all patients in the study experienced IRRs at least once during their scheduled rituximab treatment. Premedication with corticosteroid can be recommended in patients with high risk of IRR in the first infusion.


The incredible feats of athleticism demonstrated by humans are made possible in part by a vast repertoire of general-purpose motor skills, acquired through years of practice and experience. These skills not only enable humans to perform complex tasks, but also provide powerful priors for guiding their behaviors when learning new tasks. This is in stark contrast to what is common practice in physics-based character animation, where control policies are most typically trained from scratch for each task. In this work, we present a large-scale data-driven framework for learning versatile and reusable skill embeddings for physically simulated characters. Our approach combines techniques from adversarial imitation learning and unsupervised reinforcement learning to develop skill embeddings that produce life-like behaviors, while also providing an easy to control representation for use on new downstream tasks. Our models can be trained using large datasets of unstructured motion clips, without requiring any task-specific annotation or segmentation of the motion data. By leveraging a massively parallel GPU-based simulator, we are able to train skill embeddings using over a decade of simulated experiences, enabling our model to learn a rich and versatile repertoire of skills. We show that a single pre-trained model can be effectively applied to perform a diverse set of new tasks. Our system also allows users to specify tasks through simple reward functions, and the skill embedding then enables the character to automatically synthesize complex and naturalistic strategies in order to achieve the task objectives.


The use of Web Clusters that implement Quality of Service has gained much attention in recent years. In this paper we propose an adaptive algorithm for a Web Switch that estimates the best configuration of the Web cluster attending to the throughput of servers. The slotted time used by the system is adaptive to the burstiness factor of client requests arriving to the Web Cluster. The web switch model is based on the estimation of the throughput that servers would have in the next future to dynamically balance the workload. In order to reduce the checking time, estimations are computed in a variable slot scheduling. Simulation results are confronted with other algorithms and show that the algorithm proposed performs significantly better in terms of latency time for priority users.


A 109Cd K x-ray fluorescence (XRF) system using a point source in a back-scatter geometry is described. The suitability of plaster-of-Paris phantoms as targets for intercalibration standards was evaluated. When the phantom concentrations were measured by inductively-coupled-plasma mass spectrometry (ICPMs), the calculated phantom concentrations underestimated true concentrations by an average of 15%. Since calculated values are used to calibrate the K XRF system, in vivo bone-lead concentrations may be similarly underestimated. The difference between calculated and measured concentration is attributable to impurities in the plaster of Paris (e.g. calcium carbonate). The ICPMS-measured concentrations were used to calibrate the K XRF system. The same phantoms were also measured as 'unknowns' by a bone-lead measurement system (Abiomed, Danvers, MA, USA). The commercial system overestimated the lowest-concentration phantoms and underestimated the phantoms with concentrations above 15 microg Pb/g plaster of Paris. The commercial system and our system were compared by measurement of the new phantoms in air and in water. The K XRF system exhibited better precision in both situations. On the basis of this work, we recommend that plaster-of-Paris phantoms used to calibrate K XRF measurement systems be analysed first by ICPMS or another valid analytical technique.


Alexander Henry Rhind (1833–63) was one of the earliest exponents of scientific techniques and methodology in archaeological excavations, but the last in-depth survey of his life and career in the field was published in the year after his death. He undertook fieldwork in Scotland before travelling to Egypt for health reasons. There, he applied for a permit to excavate and some of his subsequent acquisitions and finds are among the finest in the collections of the British Museum and National Museums Scotland. He advocated for proper recognition and protection of monuments, in Britain and abroad, and implemented publication standards and excavation and recording methods followed by others. He may be called the first educated archaeologist to work in Egypt and publish his finds, and he left bequests to ensure the continuation of his work and to assist the work of others, such as the establishment of the prestigious annual Rhind Lecture Series. Some of his Scottish fieldwork and publications are relatively well known to scholars in this area, but he is also known to Egyptologists for artefacts such as the Rhind Mathematical Papyrus and his seminal volume Thebes: Its Tombs and Their Tenants. This paper revisits his life, with emphasis on his work beyond Scotland and his impact on the study of ancient Egypt.


Open Source Information (OSI) and Open Source Intelligence (OSINT) are attracting enormous interest from the business, military and political intelligence communities. OSI and OSINT offer the prospect of delivering valuable intelligence, from so‐called open sources such as newspapers, experts, and online databases. While OSI and OSINT may offer considerable potential when employed to produce information on foreign countries, they are totally dependent on the researchers' and analysts' understanding of the target country's history, politics and society. A research project on the BAM (Baikal‐Amur Mainline) Railway in eastern Siberia provides a practical example of OSI. The project involved researching a book on the BAM (Baikal‐Amur Mainline) Railway in eastern Siberia using OSI alone as it was impossible to visit the region. The 3,084km BAM traverses an almost unpopulated region which had been virtually closed to Westerners since it became a major gulag zone in the 1930s. Once the book's research was underway, it became clear that much of the English language published material was ill‐informed and contradictory. After the collapse of the Soviet Union and the relaxation of travel restrictions, it was possible to validate the information gathered. This led to a number of surprising findings about the accuracy and comprehensiveness of the material collected outside Russia.


Aim: To compare the effect of de-worming alone and de-worming plus iron supplementation on the haemoglobin (Hb) of primary school children.
Materials and methods: An intervention study involving 502 primary school children aged 5-15 years was carried out between May to August, 2003. The study group comprised 253 children who were de-wormed using Levamisole hydrochloride as single dose and also given ferrous sulphate twice a week for 3 months. The control group was 249 children who were only de-wormed using Levamisole hydrochloride. Pre- and post-intervention Hb estimation of each child were obtained and results of study and control groups compared. Hb of less than 12g/dl was taken as anaemia.
Results: There were no significant differences in the sex (P=0.65) and age (P=0.18) distributions of study and control groups. Pre-intervention, there was no significant difference in the level of anaemia among the school children (P=0.54). Post-intervention, the level of anaemia dropped more significantly in study than control group (P=0.00).
Conclusion: Though de-worming will improve the Hb level better result will be achieved by including twice a week iron supplementation especially as a short term preventive/curative measure for mild to moderate anaemia in school children.

 Keywords : Haemoglobin; anaemia; de-worming; iron supplementation; children Journal of College of Medicine Vol. 12 (1) 2007: pp.25-29


This paper documents a balloon-borne experiment vis-a-vis the observation of the radiance and polarization ratio of sunlight scattered by the stratospheric aerosol at near-infrared wavelengths. Described are the results and preliminary analysis of the first flight, on 15 Dec. 1983, at an altitude of 20 km. The observations, particularly the polarization features, are consistent with single scattering calculations for spherical particles with a mean radius of ~0.3 μm and with a refractive index of 1.45 at 0.85 μm; thus, the presence of sulfuric acid aerosol is corroborated.


Background Congenital Heart Disease (CHD) is the commonest group of congenital malformations and affects 7-8 per 1000 live born newborns. Nevertheless, it is estimated that more than 50% of babies with undiagnosed CHD are not detected by routine neonatal cardiac examination. Aim To find the incidence of CHD in newborns and to determine the accuracy of pulse oximetry for detecting clinically unrecognized critical congenital heart disease (CCHD) in the newborns. Methods Pulse oximetry was performed on clinically normal newborns within 4 hours of first day of life. Inclusion criteria: All newborns who were admitted in postnatal ward & Neonatal Intensive care unit (NICU). Exclusion criteria: babies and neonates with a prenatal diagnosis of duct dependent circulation. If oxygen saturation (SpO2) was below 90%, then echocardiography was performed. Results During the study period, 4926 live born neonates were examined. Nine out of 12 neonates with SpO2<90% had CCHD. Four neonates had tetralogy of Fallot (TOF), two had tricuspid atresia, two had transposition of great arteries (TGA) and one had truncus arteriosus. The incidence of CHD was 33.49 per 1000 live births and CCHD was 1.82 per 1000. A pulse oximetry cut-off value of below 90% for detecting CCHD showed 90% sensitivity, 99.94% specificity, 75% positive predictive value (PPV) and 99.98% negative predictive value (NPV). Conclusion Pulse oximetry is safe, feasible and noninvasive and also used to screen for CCHD. It is the nice method to detect the CHD along with the physical examination of neonates by medical personal.


A variety of non-neoplastic and neoplastic conditions involve the nasal cavity and paranasal sinuses which are commonly encountered in clinical practice. The nose and paranasal sinuses are exposed to a variety of infections, chemically irritating, antigenically stimulating, traumatic and undoubtedly many other influences and consequences of these multifaceted deleterious exposures result in the formation of tumour-like and truly neoplastic conditions. To study histopathological pattern of sinonasal lesions and association of Human Papilloma Virus (HPV) with sinonasal papillomas and squamous cell carcinomas. The present study was a hospital based observational study conducted over a period of three years from January, 2010 to January, 2013 in the Department of Pathology, Government Medical College, Srinagar which included 181 cases of non-neoplastic and neoplastic lesions of nasal cavity and paranasal sinuses followed by study of association of HPV with sinonasal papillomas and squamous cell carcinomas by polymerase chain reaction (PCR). Out of total 181 cases, 114 were non-neoplastic and 67 were neoplastic. Out of 67 neoplastic lesions, 46 were benign and 21 were malignant. Nasal polyp was most common among non neoplastic lesions. Inverted sinonasal papilloma was most common benign lesion and squamous cell carcinoma was most common malignant lesion seen. Out of a total of 181 sinonasal lesions 101 (55.8%) were present in males and 80 (44.2%) were present in females with male to female ratio being 1.26:1. The age range of patients with sinonasal lesions varied from 5-75 years with a mean age being 34.67 (SD±16.58) years. HPV positivity was seen in 4 (13.33%) out of 30 cases of inverted papillomas, 3 out of 6 (50%) exophytic papillomas tested positive for HPV. Out of 9 squamous cell carcinomas HPV positivity was seen in 2 (22.2%) cases. Categorizing the sinonasal lesions according to histopathological features into various types helps us to know the clinical presentation, clinical outcome and prognosis of the disease. Also low risk HPV types 6 and 11 show an association with sinonasal papillomas and oncogenic HPV types 16 and 18 with squamous cell carcinomas.


This paper develops a structural equilibrium model with intertemporal macroeconomic risk, incorporating the fact that firms are heterogeneous in their asset composition. Compared with firms that are mainly composed of invested assets, firms with growth options have higher costs of debt because they are more volatile and have a greater tendency to default during recession when marginal utility is high and recovery rates are low. Our model matches empirical facts regarding credit spreads, default probabilities, leverage ratios, equity premiums, and investment clustering. Importantly, it also makes predictions about the cross section of all these features.


We introduce an innovative formulation for simple linear tetrahedral elements non‐sensitive to volumetric locking. Tetrahedral meshes enable to deal with high deformation by using efficient and robust adaptive meshers—while standard explicit formulations based on linear hexahedral elements with reduced integration and hourglassing stabilization cannot be coupled with efficient remeshing procedures. The principle of this anti‐locking modification is to impose the volumetric constraints at each node instead of at each integration point, as been done in the averaged nodal pressure formulation proposed by Bonet in 1998. However, the modification made here is material independent: the strain tensor is directly modified before any stress or pressure calculus. The formulation is extended to incompressible elasticity and von Mises incompressible isotropic inelasticity (elastic–visco‐plasticity). An infinitesimal strain formulation has been chosen in order to obtain a very simple and thus computational time saving algorithm. This choice can be easily justified taking into account the value of the critical time step in explicit simulations, especially for metal‐forming processes. Standard elastic and inelastic benchmarks issued from the literature validate qualitatively and quantitatively this promising formulation for quasi‐incompressible deformations cases. Copyright © 2009 John Wiley & Sons, Ltd.


Background and Objectives Little is known about respiratory syncytial virus (RSV) infection in patients with leukemia. The aim of this study was to determine the characteristics, and the outcome of RSV infection with or without therapy with aerosolized ribavirin in leukemia patients. Design and Methods We reviewed the records of 52 leukemia patients with RSV infection seen at our institution between October 2000 and March 2005. Results The median age of the patients was 47 years (range, 1–83 years). Most patients were male (65%) and had acute leukemia (65%); 46% had received salvage chemotherapy and 62% corticosteroids before RSV infection. Compared to the 25 patients with upper respiratory tract infection (URI), the 27 patients with pneumonia had a higher median APACHE II score at the time of the first assessment at the hospital for respiratory symptoms (11 vs 16), and a higher rate of corticosteroid treatment in the month preceding the infection (48% vs 74%) (all p ≤0.05). Twenty-four (46%) patients received aerosolized ribavirin. Patients who presented with URI and were treated with ribavirin were less likely than non-treated patients to develop pneumonia (68% vs 96%, p<0.01) and possibly die of pneumonia (6% vs 36%, p=0.1). Multiple logistic regression analysis identified high APACHE II score and lack of ribavirin treatment as independent predictors of progression to pneumonia (p=0.01). Five patients (10%) died within 30 days of RSV infection; all had pneumonia. Interpretation and Conclusions RSV infection is associated with significant morbidity and mortality in leukemia patients; treatment with aerosolized ribavirin at the stage of URI may prevent pneumonia in some subsets of patients.


To make machine learning (ML) sustainable and apt to run on the diverse devices where relevant data is, it is essential to compress ML models as needed, while still meeting the required learning quality and time performance. However, how much and when an ML model should be compressed, and where its training should be executed, are hard decisions to make, as they depend on the model itself, the resources of the available nodes, and the data such nodes own. Existing studies focus on each of those aspects individually, however, they do not account for how such decisions can be made jointly and adapted to one another. In this work, we model the network system focusing on the training of DNNs, formalize the above multi-dimensional problem, and, given its NP-hardness, formulate an approximate dynamic programming problem that we solve through the PACT algorithmic framework. Importantly, PACT leverages a time-expanded graph representing the learning process, and a data-driven and theoretical approach for the prediction of the loss evolution to be expected as a consequence of training decisions. We prove that PACT's solutions can get as close to the optimum as desired, at the cost of an increased time complexity, and that, in any case, such complexity is polynomial. Numerical results also show that, even under the most disadvantageous settings, PACT outperforms state-of-the-art alternatives and closely matches the optimal energy cost.


Seed collected from Acacia hybrid trees yields highly variable and poorly performing offspring and are not commonly used in regeneration. The present study described the encapsulation of Acacia hybrid shoots and axillary buds in the calcium alginate gel. The aim of the study was to evaluate the germination of the buds in vitro on the medium with different concentrations of plant growth regulator and; the performance of the germination under light and darkness. For encapsulation purposes, 3% sodium alginate (w/v) in the Murashige and Skoog (MS) free of calcium salt solution solvent were tested. While for complexation, 100 mM calcium chloride solutions (CaCl2.2H2O) were prepared in liquid MS medium. The encapsulated explants or the beads were cultured into the following media: Modified basal MS supplemented with 6-benzylaminopurine (BAP) ranging from 0 to 2.5 mg/L BAP. High germination rate (100%) was observed within five to eight days in all medium tested. Analysis of variance showed no significant difference in the ability of the synthetic seeds to germinate. This showed that the regeneration of shoots is possible by using basal MS only. It was observed that synthetic seeds needed sucrose more than plant growth regulator for its germination. They were also showing good regeneration and development under light condition.


The Joint Commission on Accreditation of Healthcare Organizations introduced the ORYX initiative in February 1997 to integrate outcomes and performance measurement into the Joint Commission on Accreditation of Healthcare Organizations survey process. A survey was mailed to laboratories accredited by the Joint Commission to assess performance measurement system participation, the results of which will be available in the first quarter of 1998. This article discusses the requirements of the initiative as well as some of the problems that have been encountered.


A set of N independent Gaussian linear time invariant systems is observed by M sensors whose task is to provide the best possible steady-state causal minimum mean square estimate of the state of the systems, in addition to minimizing a steady-state measurement cost. The sensors can switch between systems instantaneously, and there are additional resource constraints, for example on the number of sensors which can observe a given system simultaneously. We first derive a tractable relaxation of the problem, which provides a bound on the achievable performance. This bound can be computed by solving a convex program involving linear matrix inequalities. Exploiting the additional structure of the sites evolving independently, we can decompose this program into coupled smaller dimensional problems. In the scalar case with identical sensors, we give an analytical expression for an index policy proposed in a more general context by Whittle. In the general case, we develop open-loop periodic switching policies whose performance matches the bound arbitrarily closely.


It was shown that the nonlinear relaxation of a model system confined to the Berendsen's thermostat is determined by an attractor regime. The latter does not correspond generally to the true thermodynamic state of the system. Therefore, the use of the Berendsen's thermostat for molecular dynamics simulations, even in the case of large protein molecules at trajectory lengths of more than 10 ns, can lead to wrong conclusions. Our results agree with the concept of slow dynamics for macroscopic systems considered within the framework of the topological approach to stochastic dynamics.


Using two hexagonal samples of ice, polycrystalline and single-crystalline, the electrical treeing has been investigated under an applied impulse voltage. The crystallinity and temperature of the ice play an important role in the events of the treeing. In the single-crystalline ice, the tree in the samples at -25 /spl deg/C always progressed along the basal plane of the ice crystal, but at -196 /spl deg/C, it progressed along the c-axis. These distinctive patterns of the tree progression were attributed to the crystal axis dependence on the electrical conductivity and the relative permittivity at each temperature. The current accompanying the trees were detected by means of an electro-optic coupling with light emitting diodes and photodiodes. After the large current pulses which occur just after voltage application, small intermittent current pulses were visible in the wave tail of the applied voltage. These intermittent pulses appear to generate by the movement of accumulated charges after the formation of tree channels. The electrical breakdown strength of ice at -25 C was large for the electric field parallel to the c-axis of the single-crystalline ice.


BACKGROUND
frequency compression.

AIM
to evaluate the index of speech recognition (IPRF) using frequency compression in three different ratios.

METHODS
monosyllabic words were recorded using an algorithm of frequency compression in three ratios: 1:1, 2:1, 3:1, generating three lists of words. Eighteen listeners accomplished the IPRF using the modified words. They were subdivided in two groups, considering familiarity with the speech material: group of audiologists (F) and group of patients (P).

RESULTS
a statistically significant decrease in accuracy was observed when using frequency compression. Group F presented a better performance than Group P in all of the applied ratio frequency compression ratios.

CONCLUSION
Frequency compression hinders speech recognition; as the compression ratio increases, so does the level of difficulty. Familiarity with the words facilitates recognition in any hearing condition.


Serotonin (5-HT) transporter (5-HTT) plays a key role in the control of 5-HT neuronal activity by reuptaking extracellular 5-HT from the synapse cleft. We have previously demonstrated that 5-HTT mRNA expression levels and its uptake activity in the mouse midbrain are significantly higher in the dark phase than those in the light phase. However, the molecular mechanisms of time-dependent expression of 5-HTT have not been clarified. In this study, expression of 5-HTT mRNA in the mouse midbrain showed a significant 24-h rhythm and was higher in the dark phase. Although such an oscillation was eliminated by a Clock gene mutation, CLOCK and BMAL1 did not activate 5-HTT transcription in the luciferase reporter assay. Activating transcription factor-4 (ATF4), a member of the ATF/cAMP response element (CRE)-binding protein family, is a component responsible for sustaining circadian oscillations of CRE-mediated gene expression. ATF4 significantly activated 5-HTT transcription in vitro and time dependently bound to the CRE site in the 5-HTT promoter in the mouse midbrain. In addition, mutation of the Clock gene disrupted temporal binding of ATF4 to the CRE site in the 5-HTT promoter. These results indicated that the circuit of circadian-basis molecular regulation between the clockwork system and mouse 5-HTT gene was connected by the ATF4 signaling pathway.


The need for inspections and audit is seen as key in providing safe and efficient services (cite Ofsted, CQC?) However, negative ratings in inspections also significantly impact organisations and their staff. (Stats and cite include workforce transitions) There is little existing research on these particular themes and it appears to be an underdeveloped area of research and practice. In response we developed a workshop that would provide the opportunity to further explore these impacts. Working with mixed group of early career managers from health and social work backgrounds undertaking level 7 qualifications in leadership and management, we developed an experiential workshop to enable staff to explore these issues in some depth. Working with Visiting Professor Karen Norman, the course leaders discussed common themes in relation to our own and others' experiences of audit, inspection and crises across the professions we represent. We noted

that this was an area that received little attention in current teaching and in particular the emotional aspect of managing the self and staff within this context was mainly ignored. Using case scenarios we asked groups of students to develop their own organisational structures and then introduced crisis events, drawing on existing literature and research, including findings from the relevant inspection agencies. Students responded in a number of different ways. Similarities in the manager's experiences and responses were consistently noted In this workshop teaching staff and students will describe our findings and replicate some of the elements of the processes involved with the audience.


We discuss issues surrounding the visualisation of the polarisation properties of light stored in the pixels of an image. In order to facilitate comparisons between the work of different researchers, and in order to aid the development and debugging of polarisation-capable rendering systems, we propose a set of four standardised, easily comprehensible visualisations. These cover all aspects of polarisation that are relevant for rendering research, but also for optical design tasks. However, the so-called luminance scaled overlay form of the proposed visualisations is conceivably also useful and instructive to a wider, non-technical audience, and can be used for educational purposes.


The aetiology and frequency of Phytophthora spp. in discoloured xylem tissue beneath phloem lesions was investigated in a range of broadleaved trees infected with P. ramorum, P. kernoviae, P. cambivora, P. citricola and other species. Isolation was attempted from the inner surface of 81 sterilized discoloured wood panels (6 × 4 cm) from 53 trees. Discolouration mostly extended 1–5 mm into the xylem (75%), but incursions of 6–10 mm (10%) and 10–25 mm (15%) were frequent. Of the wood panels, 81% yielded Phytophthora spp. In 66 cases, both a wood panel and an overlying phloem panel were sampled. In 56% of these, a Phytophthora sp. was isolated from both the wood and the phloem panel. In 23% the Phytophthora sp. was isolated from the wood panel only and in 8% from the phloem panel only. Small 'island' phloem lesions, often in linear arrays adjacent to main lesions, were a common feature of Fagus sylvatica and Quercus spp. trees infected with P. ramorum or P. kernoviae. Island lesions were often connected by underlying strips or intermittent pits of discoloured xylem in line with the wood grain. Phytophthora ramorum, P. kernoviae and other Phytophthora spp. were successfully isolated from these connecting xylem features with P. ramorum and P. kernoviae also recovered from discoloured tissue 5–25 mm below exposed xylem surfaces 24–27 months after the overlying phloem was removed. These results show that these pathogens commonly occupy xylem beneath phloem lesions; that they can perennate in xylem tissue; that they can spread in xylem tissue ahead of phloem lesions; and indicate that they may initiate new phloem lesions in this way. Such colonization must lead to at least local xylem dysfunction. It is recommended that, if xylem discoloration is present, isolation of the Phytophthora sp. should be attempted from the xylem as well as the bark; also, that removal of infected outer sapwood should be undertaken during excision of bleeding lesions for disease control and in protocols aimed at preventing national or international spread of these tree stem pathogens.


As communication networks are growing at a fast pace, the need for more scalable approaches to operate such networks is pressing. Decentralization and locality are key concepts to provide scalability. Existing models for which local algorithms are designed fail to model an important aspect of many modern communication networks such as software-defined networks: the possibility to precompute distributed network state. We take this as an opportunity to study the fundamental question of how and to what extent local algorithms can benefit from preprocessing. In particular, we show that preprocessing allows for significant speedups of various networking problems. A main benefit is the precomputation of structural primitives, where purely distributed algorithms have to start from scratch. Maybe surprisingly, we also show that there are strict limitations on how much preprocessing can help in different scenarios. To this end, we provide approximation bounds for the maximum independent set problem—which however show that our obtained speedups are asymptotically optimal. Even though we show that physical link failures in general hinder the power of preprocessing, we can still facilitate the precomputation of symmetry breaking processes to bypass various runtime barriers. We believe that our model and results are of interest beyond the scope of this paper and apply to other dynamic networks as well.


A loss of bone mineral density has been reported1`S in premenopausal women with systemic lupus erythematosus (SLE), but its pathogenesis is uncertain.4 Studies on the sequential changes in bone mass in these patients are scarce.35 Recently, we studied 74 premenopausal women with SLE without any complications or treatment (except for glucocorticoids) that could interfere with bone mineral density.2 We excluded nine osteoporotic patients according the established World Health Organisation criteria,6 because they were on treatment for low bone density. We repeated the measurement of bone mass after 18 months in 25 consecutive patients, all of whom had continued on glucocorticoid treatment during this period. Bone mineral density was measured in the lumbar spine (L2-L4) and femoral neck (FN) by dual energy x ray absorptiometry (DXA), using a densitometer (Hologic QDR 1000). Measurement of the bone mineral content, calibrating with the Hologic X-calibre QDR-1 anthropomorphic spine phantom of the known mineral content, was accurate to 0.5%. The precision measurement was better than 0.01 g cm-2 (coefficient of variation = 1.0% at bone mineral density 1.0 g cm-2). Disease activity was assessed with the University College Hospital/Middlesex SLE scoring system,7 by a numerical score graded from 1 to 4 (inactive to severely active disease). The results were expressed as the mean (SD). For all conventional analyses we used the SPSS/PC software package. A t test was used and the correlations were calculated by linear regression analysis. Results were considered significant at P < 0.05. At the time of the first densitometry, the mean age was 31.7 (6.8) years, and disease duration was 91 (64) months. After 18 months there was no significant decrease in bone mineral density, despite glucocorticoid treatment (table), in either the lumbar spine or the femoral neck. No fractures were found. Serum calcium, phosphorus, creatinine, and alkaline phosphatase, and 24 hour urine calcium and phosphorus did not change during this period. Using linear regression, there was no correlation between bone mineral density or changes in bone mineral density and the prednisone dose (cumulative and baseline). We found no correlation between disease duration or mean disease activity grade and bone mineral density. No other correlations with bone mineral density were found. This study shows that in premenopausal SLE patients lumbar and femoral bone min-


Under Delaware law, a securities issuance in which all existing investors may participate pro rata (a "rights offer") is often seen as treating insiders and outsiders equally, making it difficult for nonparticipating outsiders to prevail on a claim that insiders sold themselves cheap securities. I show that insiders can use rights offers to sell themselves cheap securities, even if outsiders are sophisticated and well-capitalized. My analysis suggests courts applying Delaware law should more aggressively probe rights offers for substantive fairness. I conclude by describing red flags indicating a heightened risk of expropriation.


When the export-led growth model is combined with the Okun's law, it is naturally predicted that export expansion, as one the key components of economic growth, improves the general employment level by creating new job opportunities in the overall economy. For testing the validity of this hypothesized linkage, the existing studies have focused on emerging industrial economies (EIEs) that have been recording considerable achievements towards the export-led growth strategy especially during the past two decades but recently experiencing persistently high unemployment challenge. Nevertheless, the extant literature has not paid enough attention to this paradoxical observation which can be attributed to the paradigm of the export-led jobless growth. Therefore, this paper tests the validity of the export-led jobless growth phenomenon for EIEs in the case of six important exporters of manufactures that are leading in their regions: China (East Asia), Poland (Europe), Mexico (South America), India (South Asia), South Africa (Africa), and Turkey (Europe and Middle East). Consequently, three models (general growth model, unemployment model and, export-led jobless growth model) are estimated separately utilizing an annual panel data set which covers a 26-year period spanning from 1991 to 2016. Results reveal an inconclusive evidence for the export-led jobless growth phenomenon that export does not have any significant impact on growth but it is positively and significantly associated with unemployment whilst economic growth tends to lower the unemployment. Based on the jobless export findings the study discusses several initiatives for policy-makers and future research.


A sensitive and highly specific nested PCR (nPCR) protocol was developed for the specific detection of Fusarium oxysporum DNA in clinical specimens. The diagnostic value of F. oxysporum-specific DNA and (1-->3)-beta-D-glucan (BDG) detection was subsequently evaluated in serum and bronchoalveolar lavage (BAL) specimens of mice infected intravenously with F. oxysporum conidia. Mice were sacrificed in groups of six daily up to day 8 and then on days 11 and 14. The F. oxysporum-specific DNA and BDG in serum and BAL specimens were detected using nPCR and a Fungitell kit, respectively. Cultures of lung homogenate of all of the infected animals yielded F. oxysporum and the fungus was also observed in KOH/Calcofluor mounts of 67 % of the tissues. The BDG (cut-off value 80 pg ml(-1)) and nPCR sensitivity in BAL and serum specimens was 15 and 98 %, and 92 and 75 %, respectively. Combined detection of F. oxysporum DNA and BDG in serum enhanced the sensitivity to 98 %. However, the kinetics of the two markers were slightly different. Whilst BDG positivity in serum remained high throughout the infection period, nPCR positivity declined slowly. The data obtained in this study suggest that combined detection of BDG and DNA in serum offers a sensitive and specific diagnostic approach for invasive Fusarium infection.


Pearl millet (Pennisetum glaucum) is a drought-tolerant cereal commonly grown for grain and fodder in arid areas throughout the world. Senegalese millet fields are infested with Helicotylenchus. The native evergreen woody shrub Piliostigma reticulatum is widely distributed in sub-Saharan Africa. Its coppiced residues are used by small farmers as mulch in crop fields. The shrub's nematicidal effect on the spiral nematode Helicotylenchus dihystera was evaluated in a pearl millet pot experiment. The abundance of nematodes decreased by 64% after application of either leaf powder or a pulverized mixing of leaves and stems, suggesting the use of aboveground materials of P. reticulatum as a potential nematicide. The results show promise for use of a local resource by subsistence farmers in the Sahel. Further research is needed on application to fully develop this approach as a biopesticide.


The article is an attempt at sketching the main problems ofMichal Wikowski's prose. In his novels, the author often returned to the history of People's Republic of Poland (PRL), as a country governed in 1944–1989 by the Communist authorities, dependent on the USSR. He analysed the experiences of the past in his own way. His narratives, as well as those of other members of the youngest generation of writers, confirmed the common belief that the past should be described in a different manner, because PRL still seems to be an incomplete object of common or even national discourse. Differences of Witkowski's vision of the last decades result also, or possibly to a larger extent, from his method of using irony and nostalgia – both separately and in a particular conjuction. The success of Witkowski's attempts depends on the critical awareness of ideological and especially social assumptions, as well as on the ability to identify the crucial questions, i.e. the mental stances and their material conditions, whose common and totalising character strongly influenced (consciously or, more often, subconsciously) choices or decisions of the people living then and there.


A three-year consortium project, with members of Science Applications International Corp., University of Colorado at Boulder, Harvard University, Multimax Inc., Geophysical Institute of Israel, Western Services, and University of California at San Diego, was initiated in 2000 to improve locations and reduce uncertainties in the Middle East, North Africa, Europe, and Western Eurasia. The consortium developed high-resolution three-dimensional models of the Earth's mantle to generate accurate travel-time predictions for regional and teleseismic P phases. Since the approach was purely model-based, a large set of high-quality reference events was needed to validate the model predictions. The consortium has spent considerable effort to collect, vet, and validate reference events located with 5-km accuracy or better by local networks and "promoted" reference events located with an accuracy of 7 km or better by application of multiple-event location techniques. Consortium members built an extensive network of contacts to solicit candidate reference events from local, regional, and national network operators. Strict methodologies were developed to identify candidate reference events in earthquake bulletins, and to validate and quality control the selected candidate reference events. The outcome of the consortium effort was a quality-controlled reference event list with nearly 2000 events and over 200,000 arrivals. The Reference Event List is provided as an electronic supplement to this article.

Online material : Reference event database.

Manuscript received 23 June 2003.


Citrullus colocynthis and Citrullus vulgaris both look alike and belong to the genus Citrullus except that Citrullus colocynthis has thick black ring round its circumference. However, they are among the underutilized seeds of the World. Citrullus colocynthis and Citrullus vulgaris seed flours were analyzed for their amino acid and proximate compositions which was further subjected to statistical analysis to determine the correlation between the proximate compositions of the two species. The seeds show significant difference in fat and protein contents, but they are both good sources of fats and protein with values (56.00 and 49.59) % f at and (24.37 and 32.96)% protein contents for Citrullus colocynthis and Citrullus vulgaris respectively. However, they are closely related in fibre (1.91 and 2.00)%, moisture (3.08 and 2.75)% and ash contents (3.15 and 3.53)% respectively. The percentage essential amino acids of the seeds are also closely related: Citrullus colocynthis (52.73) and Citrullus vulgaris (50.86). The biological values of Citrullus colocynthis and Citrullus vulgaris are significantly different (12.83 and 26.35) with Protein efficiency ratios that are closely related (2.71 and 2.58) respectively.


This essay describes the life of the outstanding Soviet scientist A. A. Fridman (1888–1925), known in the western literature as Friedmann, in connection with the centenary of his birth. The main stages in the life of Fridman are discussed in chronological order, beginning with his years at high school and university. Archive files are used in an account of the first steps of Fridman's scientific activity dealing with the problems in mathematical physics and aerodynamics. His participation in the First World War (1914–1917) is then described, followed by his professorship in Perm' University (1818–1920) and finally by the last very fruitful part of his life in Petrograd (1920–1925) where he taught at leading higher educational establishments and worked at the Main Geophysical Laboratory of which he became Director during the last year of his life. Particular attention is given to Fridman's work on relativistic cosmology (1922–1925) and dispute on the subject between Fridman and Einstein in connection with Fridman's theory of an expanding universe. The full bibliography of Fridman's work (73 items) is included.


A forward error correction (FEC) strategy and a medium access control (MAC) protocol that are thoroughly tailored to complement and support a high-speed asymmetric physical layer design based on equalization and precoding is presented and fully discussed. Both proposals exhibit a high degree of adaptability and flexibility, which allows for increased data throughput while providing a wide range of quality-of-service requirements. Fast link layer adaptation is made possible through the joint design of link and physical layers. The adaptive FEC algorithm is based on the use of variable-rate trellis coded modulation with fast channel estimation, while the MAC protocol employs a centralized, dynamic slot allocation technique. The overall system design is shown to achieve high spectral efficiency, while minimizing energy consumption at the portable unit.


[1] We report δO and minor element (Mg/Ca, Sr/Ca) data acquired by high-resolution, in situ secondary ion mass spectrometry (SIMS) from planktic foraminiferal shells and 100–500 μm sized diagenetic crystallites recovered from a deep-sea record (ODP Site 865) of the Paleocene-Eocene thermal maximum (PETM). The δO of crystallites (~1.2‰ Pee Dee Belemnite (PDB)) is ~4.8‰ higher than that of planktic foraminiferal calcite ( 3.6‰ PDB), while crystallite Mg/Ca and Sr/Ca ratios are slightly higher and substantially lower than in planktic foraminiferal calcite, respectively. The focused stratigraphic distribution of the crystallites signals an association with PETM conditions; hence, we attribute their formation to early diagenesis initially sourced by seafloor dissolution (burndown) ensued by reprecipitation at higher carbonate saturation. TheMg/Ca ratios of the crystallites are an order of magnitude lower than those predicted by inorganic precipitation experiments, whichmay reflect a degree of inheritance from "donor" phases of biogenic calcite that underwent solution in the sediment column. In addition, SIMS δO and electron microprobe Mg/Ca analyses that were taken within a planktic foraminiferal shell yield parallel increases along traverses that coincide with muricae blades on the chamber wall. The parallel δO and Mg/Ca increases indicate a diagenetic origin for the blades, but their δO value ( 0.5‰ PDB) is lower than that of crystallites suggesting that these two phases of diagenetic carbonate formed at different times. Finally, we posit that elevated levels of early diagenesis acted in concert with sediment mixing and carbonate dissolution to attenuate the δO decrease signaling PETM warming in "wholeshell" records published for Site 865. Citation: Kozdon, R., D. C. Kelly, K. Kitajima, A. Strickland, J. H. Fournelle, and J. W. Valley (2013), In situ δO and Mg/Ca analyses of diagenetic and planktic foraminiferal calcite preserved in a deep-sea record of the Paleocene-Eocene thermal maximum, Paleoceanography, 28, 517–528, doi:10.1002/palo.20048.


High quality BaTiO3 powders that were synthesized with hydrothermal and solid state methods are characterized with respect to surface chemistry. Different characterization techniques are used to obtain a physical picture for the BaTiO3 powders with respect to different synthesis routes and thermal histories. X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR), thermogravimetric analysis (TGA), and X-ray photoelectron spectroscopy (XPS) are used to understand the BaTiO3 powders after heat and humidity treatments. Formation of amorphous and crystalline BaCO3 in local heterogeneous regions depletes the surrounding surface of Ba ions to create larger areas that are Ti-rich. BaCO3 formation and adventitious carbon adsorption occur extremely quickly on the surface of crushed single-crystal BaTiO3 powder, but for manufactured powders, the degree of carbonate formation and the impact on surface stoichiometry varies with thermal history.


Background: Drinking is largely viewed as a socialized behavior; however, our understanding of factors associated with levels of risky drinking is limited in cultures where underage drinking is relatively unacceptable. Purpose: The aims of this study were to define the different levels associated with risky drinking and to examine the factors that are associated with these levels. Methods: We used data from the Child and Adolescent Behavior in Long-Term Evolution project. Of the 2184 students who participated in the 2006 Child & Adolescent Behavior in Long-Term Evolution survey, 1591 self-reported prior use of alcohol and had complete questionnaire data that could be used in secondary data analysis. The main study variables that were used in this study to assess levels of risky drinking included frequency of drinking, amount of drinking, and frequency of intoxication. We used ordinal logistic regression to analyze the relationships between levels of risky drinking and associated factors. Results: In the study sample, 9.55% were classified with high-risk drinking behavior, 22.51% were classified with medium-risk drinking behavior, and 67.94% were classified with low-risk drinking behavior. Having a mother or peers who used alcohol, being encouraged to consume alcohol by older adults or peers, high alcohol availability, high positive alcohol expectancies, low negative alcohol expectancies, and low alcohol refusal efficacy were all associated with higher levels of risky drinking. Conclusions/Implications for Practice: Decreasing the availability of alcohol, developing appropriate alcohol expectancies, and increasing alcohol refusal skills may help decrease the development of high-risk drinking behavior in adolescents. Our study furthers the understanding of underage alcohol use in societies with low alcohol consumption.


Background The pathogens from Fusarium species can cause Fusarium root rot (RR) and other diseases in plant species including sugar beet (Beta vulgaris L.), and they have a strong negative impact on sugar beet yield and quality. Methods A total of 22 sugar beet breeding lines were evaluated for the symptoms of RR after inoculation with Fusarium oxysporum Sch., isolate No. 5, and growth in a field trial. Two candidate genes for RR resistance, BvSP2 and BvSE2, encoding chitinases Class IV and III, respectively, were previously identified in sugar beet, and used for genotyping using modern Amplifluor-like single nucleotide polymorphism (SNP) genotyping approach. The qPCR expression analysis was used to verify responses of the candidate genes for RR infections. Results A strong association of two SNP markers for BvSP2 and BvSE2 with resistance to RR in sugar beet was found in our study. Very high BvSP2 expression (100-fold compared to Controls) was observed in three RR resistant accessions (2182, 2236 and KWS2320) 14 days after inoculation which returned to the control level on Day 18. RR sensitive breeding line 2210 showed a delay in mRNA level, reaching maximal expression of BvSP2 18 days after inoculation. The gene BvSE2, showed a strong expression level in leaf samples from the infected field trial only in the breeding line 2236, which showed symptoms of RR, and this may be a response to other strains of F. oxysporum.


This work investigates some aspects of the dynamics of non-invertible quasi-periodic circle maps, from the point of view of rotation numbers and their structure in parameter space.Circle maps and quasi-periodically forced circle maps have been widely used asa model for a broad range of physical phenomena. From the mathematical point of view they have also received considerable attention because of the many interesting features they exhibit.The system used is given by the maps: x_n = [ x_n-1 + a + b/(2pi) sin( 2pi x_n-1) + c sin( 2pi theta_n-1) ] mod 1, and, theta_n = theta_n-1 + omega.Where a, b and c are real constants. In addition, b and omega are restricted, respectively, to values larger than one and irrational.A fundamental part of this thesis consists of numerical approximations of rotation intervals using and adapting of the work of Boyland (1986) to the quasi-periodic case.Particular emphasis was given to the case of large coupling strength in quasi-periodicforcing.Examination of the computed rotation numbers for the large coupling case, together with previous claims suggesting that for large coupling strength the b-term could be neglected (see Ding (1989)), led to the formulation of an ergodic argument which is statistically supported. This argument indicates that, for this case, the qualitative behavior of rotation number depends linearly on a. It is also shown that the length of the rotation interval, when the transition from a trivial rotation interval (invertible case) to a non-trivial rotation interval occurs, it develops locally as a universal unfolding.A different map, piecewise monotone, and structurally similar to the maps defined to calculate the edges of rotation intervals in Boyland (1986), is studied to illustrate how the rotation number grows. The edges of rotation intervals are analytically calculated and matched with numerical observations.


Background Although the wide use of human albumin(HA), the risks and benefits of its use in clinical practice remains not conclusive. Since Surgery is the specialty that most uses HA in our hospital, it is relevant to analyse how it is used and what are the outcomes. Purpose Evaluation of concordance of HA prescription on a surgery department(SD) with hospital general recommendations. Materials and methods Retrospective study of six month prescription of HA from January-June 2010. Review of patient's medical record to collect prescription data from the SD. Evaluated data: number of vials (10g) prescribed and administered; plasma albumin value before treatment (ABT) and after; prescribed daily dose; treatment duration prescribed and administered; daily cost/patient and global costs; percentage of prescriptions with ABT<2.5 g/dl and percentage of prescriptions with ABT≥2.5 g/dl; justification for use. Descriptive statistics (mean±SD). Results During six months 329 prescriptions were made to 226 patients: Number of vials prescribed: 3121 and administered: 2705 with global cost 68.950,45€; Plasma albumin before treatment: 2.4±0.5 g/dl(1.2-5.4) and after: 3.0±0.5 g/dl(1.9-5.2); Prescribed daily dose: 27.7±6.3 g (10-60); Treatment duration- prescribed: 4.0±1.0 days (1-10) and administered: 3.0±1.2 days (1-10); Daily cost/patient: 70.6±16.1€(25.5€-152.9€); Percentage of prescriptions with ABT<2.5g/dl: 56.8%; Percentage of prescriptions with ABT≥2.5 g/dl: 41.3% – 1135 administered vials with a cost of 28.931,15€; Justification for use: hypoalbuminaemia: 57.3%, postoperative hypoalbuminaemia: 12.4%, pathology of gastrointestinal tract: 7.0% and others: 23.3%. A percentage of 13.3 HA are not administered and return to pharmacy department. Conclusions The authors found 41.3% of prescription profile not in accordance with hospital general recommendations – HA administration only if the ABT<2.5g/dl. The results of this pilot study, lead us to conclude that, to better support prescription, plasma albumin ought to be measured before and after treatment, and that, systematic drug utilisation review programs, should be started to assure a better cost/effectiveness ratio.


Chapter I.—GENERAL OBSERVATIONS ON THE DISTRICT Introduction The district, which we purpose to describe in the following memoir, comprehends the several coal-fields which lie near the estuary of the Severn and the Bristol Channel, including parts of the adjacent counties of Gloucester, Somerset, Monmouth and Glamorgan. These coal-fields, though apparently distinct and insulated, are yet connected together by resting on a common base of old red sandstone. They all appear to have been formed by similar agency, and at the same era; to have been subject at a later period to the same revolutions; and, lastly, to have been covered partially by similar overlying deposits. The many particulars, therefore, which they supply in illustration of one another, and their contiguous geographical position, have induced us to collect into one Memoir the materials that we have obtained concerning them. Of the great coal-field of South Wales, however, the most extensive of those within our district, we have reserved a full and detailed account for a separate communication; and have here restricted ourselves to such a general description of its eastern limits only, as may serve to point out its connexion with the other coal-basins adjoining. The district to be examined is of the highest interest to the scientific geologist, as serving to establish the relations of some of the most remarkable British rocks; it is of importance to the practical miner, from its numerous strata of coal and iron-ore, so opportunely associated together, and from the limestone-beds which border on


Drawing on couple-focused prevention intervention models that target family level processes, we used complier average causal effect (CACE) estimates to determine whether relationship skills education moderated the association between fathers' depressive symptoms assessed when their children were 15-months-old and again when their children were 36-months-old. The sample consisted of low-income Hispanic American, European American, and African American fathers (N = 2,540) from the Building Strong Families Study. Fathers from 8 sites across the United States were randomly assigned to either a treatment group who were offered relationship skills education or a control group. Paternal age and family residential stability predicted fathers' utilization of intervention services. Relationship skills education moderated the association between depressive symptoms at 15 months and depressive symptoms at 36 months. The impact of dosage of relationship skills education on depressive symptoms was inconsistent and dependent on percentage of receipt of relationship skills education classes. Data are interpreted in the context of the efficacy of intervention programs for tempering depressive symptoms in low-income fathers with young children.


The primary purpose of this paper was to investigate the concept of "repeatable good performance" in professional cricketers. The manuscript reports the findings and triangulation of 3 separate studies using different participants within the same population. Participants' responses were subjected to either an inductive content analysis (study 1), the repertory grid technique (study 2), or a cultural consensus analysis (study 3) as means of data analyses. The triangulation of results suggested that both batters and bowlers in cricket reported similar core element antecedents before repeatable good performance occurred. The core antecedents were confirmed as: total self-confidence; optimal arousal levels; motivation and focus; and total mental preparation which included imagery, pre-match routines, and goal setting. These findings experimentally confirm the need for professional cricketers to use a repertoire of mental skills that have previously only been suggested via anecdotal evidence. The results may prove beneficial for cricketers, coaches, and sport psychology practitioners in their pursuit of consistent good performance. Future research will be required to establish repeatable good performance as a viable construct across different athletic populations or within other sports.


Objective: To establish the normal limits of FHR and reliability of fetal heart anatomy evaluation during obstetric scan at 12 to 16 + 6 weeks of gestation. Material and methods: Analysis of transabdominal ultrasound scans performed in 343 pregnant women at 12 to 16 + 6 weeks of gestation. 2D, M-mode and Doppler techniques were used. Gestational week was established on the basis of CRL, BPD, HC, AC and FL measurements. Demographic factors, obstetrical history and follow up of pregnancies were collected. All data were statistically reviewed (Chi test, Student T test, Mc Person correlation). Results: Maternal age varied between 18 and 44 years (mean 32.7 ± 6) and paternal age: 22–62 years (mean 35.4 ± 7). There were 56% primigravidas, 18% women had a history of two or more deliveries and 14% had one or more abortions. FHR varied between 127 and 185 bpm (mean 151 ± 9). The statistically significant difference was found between FHR at 12 weeks (mean 160 ± 8) and following gestational weeks (149–155 bpm). The r – correlation ratio between FHR and gestational week was −0.41 (ns), maternal age – r = 0.40 (ns), paternal age r = 0.28 (ns) and nuchal translucency r = −0.11 (ns). The ultrasound visualization of four chamber view was possible from 12 weeks (72%) to 14 weeks – full evaluation of fetal heart structures could be done in about half of patients then (54%). The ratio between fetal heart area and fetal chest area varied from 0.22 to 0.29. There was no significant correlation between that ratio and gestational week. Conclusions: Fetal heart rate at 12 to 16 weeks was irrespective of the duration of gestation. Parents' age and nuchal translucency did not have influence on the fetal heart rate. It is possible to evaluate fetal heart anatomy as early as at 12 to 16 weeks. The fetal heart size is then smaller than later in pregnancy.


Liquid desiccant dehumidification is an effective method of removing moisture from the air for air conditioning in built environments. The dehumidifier is a critical component where coupled heat and mass transfer between the desiccant solution and the air occurs. Understanding the dynamic characteristics of the dehumidifier is essential to develop controllers and operation strategies for the liquid desiccant hybrid air-conditioning systems. This article presents an experimental study of the dynamic heat and mass transfer characteristics of a counter-flow packed-type liquid desiccant dehumidifier. Experiments were carried out to investigate the dynamic responses of the outlet air and desiccant solution to various changing inlet conditions. In addition, the influences of typical configuration and operation parameters on the dynamic dehumidification process were analyzed. The results indicate that the settling time of the dynamic process decreases with the air and solution flow rates while increases with the packing height. The experimental results also show that the outlet air humidity ratio stabilizes sooner than the outlet air temperature during the dynamic process. The time constants of the heat and mass transfer processes were obtained, which are valuable to controller design.


In order to investigate the microstructure evolution of materials, loading and unloading experiments with specimens deformed at different strains are required. In this paper, momentum traps were introduced for rendering the conventional Split Hopkinson Tension Bar suitable for loading-unloading experiment. The new technique allows a specimen to be loaded to a preset strain for post-test characterization. This technique was applied to study the dynamic mechanical properties of pure titanium. The results show that: 1) the twinning density of titanium increases rapidly as the strain increases. 2) The strength and ductility of titanium exhibited on the adiabatic curve are much smaller then those exhibited on the isothermal curve, which may be caused by the adiabatic heat generated during the transient deformation process.


The contents of this thesis examine British management of the sterling area between 1950 and 1958, covering the period between the devaluation of sterling in 1949 and the establishment of sterling convertibility in 1958. The main body of the thesis is comprised of five chapters which analyze different aspects of the sterling area system during this period. Long term lending from the UK to the overseas sterling area is examined with the conclusion that these capital flows were not a major drain on the British economy. The mechanics of movements in British short term liabilities to the rest of the sterling area are described and their effects on the British foreign exchange reserves is found to be positive or neutral for most of the period although the basis for this erodes as the decade draws to a close. The trade pattern of the sterling area members is analyzed and the changing policies to coordinate the trade of the area are described. The possibility that the existence of the sterling area inhibited the freedom of policy choices faced by the British authorities is explored with the conclusion that the major opportunities for a new direction in British external economic policy were abandoned for reasons other than the sterling area system. Finally, some possible alternatives to the sterling area system are analyzed and the thesis concludes that these were not plausible alternatives given the historical context in which economic policy decisions were made. The general conclusion of the thesis is that the sterling area system as it functioned in the 1950s was not the major burden or destabilizing factor for the British economy that contemporary observers and some current research have suggested.


Background/Context Charter school policy has evolved into a major component of the current education reform movement in the United States. As of 2012, all but nine U.S. states allowed charter schools, and in one of those nine, Washington State, charter school legislation was passed by popular vote in November 2012. There is a substantial, if contested, research base focusing on charter school effectiveness, particularly related to test score achievement, as well as an equally contested literature base on charter school enrollment selectivity, student expulsions, and increased segregation in charter school populations. Purpose The purpose of this study is to analyze the network of relations of policy actors surrounding the statewide campaign to pass the charter school Initiative 1240 in Washington State in order to better understand how wealthy individuals and their associated philanthropic organizations influence educational policy. Research Design Making use of available tax records, public election information, individual and organizational websites, and institutional and foundation databases, this study uses simple directed graphing techniques from social network analysis to analyze the complex relationships and affiliations of policy actors relative to the campaign to pass charter school Initiative 1240 in the state of Washington. Conclusions/Recommendations This study concludes that, compared to the average voter in Washington, an elite group of wealthy individuals, either directly through individual donations or indirectly through their affiliated philanthropic organizations, wielded disproportionate influence over the outcome of the charter school initiative in the state, thereby raising serious concerns about the democratic underpinnings of an education policy that impacts all of the children in Washington State. This study also concludes that elite individuals make use of local nonprofit organizations as a mechanism to advance their education policy agenda by funding those nonprofits through the philanthropic organizations affiliated with those same wealthy elites. In light of these conclusions, the authors recommend that a mechanism for more democratic accountability be developed relative to education policy campaigns, initiatives, and legislation.


Background: Progressive multifocal leukoencephalopathy (PML) is the main safety concern for dimethyl fumarate (DMF) treatment in persons with multiple sclerosis (pwMS). Risk stratification under DMF is currently based on age above 50 years and prolonged lymphopenia below 500 cells/μL. Objective: To report a case of PML under DMF without severe lymphopenia or immunosenescence. Methods: Case report. Results: A 39-year-old female pwMS developed DMF-associated oligosymptomatic PML. The patient had not experienced any repeated lymphocyte counts below 800 cells/μL and was 15 years younger than previously described cases. Conclusion: Despite risk stratification, vigilance for PML is advised in all pwMS under DMF. Severe CD8-lymphopenia is a common feature of all published DMF-associated cases.


OBJECTIVES
Considering the enormous advantages of minimally invasive surgery, attempts to introduce less invasive trans-abdominal incisions might represent an alternative to classic gynecologic surgery. The aim of this study is to assess the feasibility and clinical outcome of minilaparotomy in patients operated due to benign gynecological diseases and to analyze selected parameters with regard to the abdominal wall incision size.

DESIGN
In this retrospective study, we have described our experience with 26 patients, undergoing minilaparotomy for benign adnexal or uterine diseases.

MATERIAL AND METHODS
26 patients with benign uterine or adnexal diseases, hospitalized from November 2003 until March 2006 at the Department of Surgical and Endoscopic Gynecology at the Polish Mother's Memorial Hospital--Research Institute in Lódź, had undergone successful surgical treatment by means of minilaparotomy. The following procedures were included in the analysis: myomectomy (17 patients), ovarian cystectomy (3 patients), myomectomy and ovarian cystectomy at the same time (3 patients), bilateral salpingo-oophorectomy (1 patient), supracervical hysterectomy (1 patient) and total abdominal hysterectomy with salpingo--oophorectomy (1 patient).

RESULTS
The patients' mean age and BMI were 33.85 years (14-50) and 22.95 (18.73-45.17), respectively. The mean operative time was 72.69 min (45-120). The diameter of trans-abdominal incision was 3-6cm and the mean diameter of removed lesions was 76.88 mm (47-200). The mean intraoperative decrease of haematocrit and haemoglobin value was 4.8% (0.2-12.4) and 1.4 g/dl (0.2-3.7), respectively. Blood transfusion was required in case of 3 patients but only in one case it was caused by intraoperative blood loss. There were no significant intra- or postoperative complications. 16 patients needed analgesics for 2.33 days after surgery. Body temperature up to 38 degrees C was observed in 4 patients for 2.5 days. The average time of hospitalization after the surgery was 4.58 days. We have noted a negative correlation between the size of trans-abdominal incision and several factors: operative time, intraoperative blood loss, period of analgesic therapy and time of hospitalization after the surgery. None of these factors was correlated with patients' age or BMI. One-month follow up after the surgery revealed satisfactory wound healing and no complains in case of all patients. All patients deemed the cosmetic effect of the surgery very good.

CONCLUSION
Minilaparotomy seems to be a very simple, useful and safe surgical technique which might be an alternative to laparotomy in the management of benign gynecologic diseases. Minilaparotomy is of great value, especially in situations when laparoscopic or vaginal approach is too complicated or too dangerous due to technical reasons.


A genetically determined pharmacokinetic and pharmacodynamic interaction between quinidine and single doses of encainide in healthy volunteers has previously been described. In subjects with the extensive metabolizer phenotype, quinidine blunted encainide-induced QRS prolongation (a marker of sodium channel block) because it impaired encainide biotransformation to the potent active metabolites O-desmethyl encainide (ODE) and 3-methoxy-O-desmethyl encainide. Therefore, the purpose of this study was to test the hypothesis that quinidine would inhibit sodium channel block (and by inference arrhythmia suppression) during encainide therapy in patients with the extensive metabolizer phenotype. Surprisingly, however, in eight extensive metabolizer patients, the extent of QRS prolongation during chronic encainide therapy was unaltered by quinidine (139 +/- 21 vs. 139 +/- 22 msec) whereas arrhythmia suppression was enhanced (64 +/- 22 to 77 +/- 19%; P = .05). Plasma concentration data demonstrated that although encainide metabolism to ODE was partially impaired by quinidine, subsequent 3-methoxy-O-desmethyl encainide formation from ODE was virtually completely inhibited; thus steady-state plasma ODE remained unchanged whereas plasma encainide increased 10-fold (21 +/- 30 to 240 +/- 118 ng/ml; P less than .05). In contrast, no changes in disposition or in pharmacodynamics were observed in two poor metabolizers. It is concluded that the effect of this drug interaction in patients is determined by differential sensitivities to inhibition by quinidine of encainide O-demethylation and subsequent ODE 3-methoxylation. Evaluation of potential drug interactions should include assessment of possible genetic factors as well as of steady-state effects.


Female rats show a gonadotrophin‐releasing hormone (GnRH)/luteinising hormone (LH) surge in the presence of a preovulatory level of oestrogen, whereas males do not because of brain defeminisation during the developmental period by perinatal oestrogen converted from androgen. The present study aimed to identify the site(s) of oestrogen action and the critical period for defeminising the mechanism regulating the GnRH/LH surge. Animals given perinatal treatments, such as steroidal manipulations, brain local implantation of oestradiol (E2) or administration of an NMDA antagonist, were examined for their ability to show an E2‐induced LH surge at adulthood. Lordosis behaviour was examined to compare the mechanisms defeminising the GnRH/LH surge and sexual behaviour. A single s.c. oestradiol‐benzoate administration on either the day before birth (E21), the day of birth (D0) or day 5 (D5) postpartum completely abolished the E2‐induced LH surge at adulthood in female rats, although the same treatment did not inhibit lordosis. Perinatal castration on E21 or D0 partially rescued the E2‐induced LH surge in genetically male rats, whereas castration from E21 to D5 totally rescued lordosis. Neonatal E2 implantation in the anterior hypothalamus including the anteroventral periventricular nucleus (AVPV)/preoptic area (POA) abolished the E2‐induced LH surge in female rats, whereas E2 implantation in the mid and posterior hypothalamic regions had no inhibitory effect on the LH surge. Lordosis was not affected by neonatal E2 implantation in any hypothalamic regions. In male rats, neonatal NMDA antagonist treatment rescued lordosis but not the LH surge. Taken together, these results suggest that an anterior hypothalamic region such as the AVPV/POA region is a perinatal site of oestrogen action where the GnRH/LH regulating system is defeminised to abolish the oestrogen‐induced surge. The mechanism for defeminisation of the GnRH/LH surge system might be different from that of sexual behaviour, in terms of the site(s) of oestrogen action and critical period, as well as the neurotransmitter system involved.