The effects of structural analogues of ceramide on rat brain mitochondrial ceramidase (mt-CDase) were investigated. Design of target compounds was mainly based on modifications of the key elements in ceramide and sphingosine, including stereochemistry, the primary and secondary hydroxyl groups, the trans double bond in the sphingosine backbone, and the amide bond. Mt-CDase was inhibited by (1) all stereoisomers of D-erythro-ceramide (D-e-Cer) with an IC50 of 0.11, 0.21, and 0.26 mol % for the L-threo, D-threo, and L-erythro isomers, respectively; (2) all stereoisomers of sphingosine with IC50 ranging from 0.04 to 0.14 mol %, N-methyl-D-erythro-sphingosine (N-Me-Sph, IC50 0.13 mol %); and (3) D-erythro-urea-C16-ceramide (C16-urea-Cer IC50 0.33 mol %). The enzyme was not inhibited by N-methyl ceramide (N-Me-C16-Cer), 1-O-methyl ceramide (1-O-Me-C16-Cer), 3-O-methyl ceramide (3-O-Me-C16-Cer), cis-D-erythro ceramide (cis-D-e-C16-Cer) and 3-O-methyl-D-erythro-sphingosine (3-O-Me-Sph). It was less potently inhibited by D-erythro-sphinganine (D-e-dh-Sph, IC50 0.20 mol %), D-erythro-dehydro sphingosine (D-e-deh-Sph, IC50 0.25 mol %), (2S)-3-keto-sphinganine (3-keto-dh-Sph, IC50 0.34 mol %), (2S) 3-keto-ceramide (3-keto-C16-Cer, IC50 0.60 mol %), and ceramine (C18-ceramine, IC50 0.62 mol %), 1-O-methyl-D-erythro-sphingosine (1-O-Me-Sph), cis-D-erythro-sphingosine (cis-D-e-Sph), (2S)-3-ketosphingosine (3-keto-Sph), (2S)-3-keto-dehyrosphingosine (3-keto-deh-Sph), and N,N-dimethyl-D-erythrosphingosine (N,N-diMe-Sph) were weak inhibitors whereas ceramide-1-phosphate (Cer-1-P) and sphingosine-1-phosphate (Sph-1-P) stimulated the enzyme. Thus, for inhibition, the enzyme requires the primary and secondary hydroxyl groups, the C4-C5 double bond, the trans configuration of this double bond, and the NH-protons from either the amide of ceramide or the amine of sphingosine. Therefore, these results provide important information on the requirements for ceramide-enzyme interaction, and they suggest that ligand interaction with the enzyme occurs in a high affinity low specificity manner, in contrast to catalysis which is highly specific for D-erythro-ceramide (D-e-Cer) but occurs with a lower affinity. In addition, this study identifies two competitive inhibitors of mt-CDase; urea-ceramide (C16-urea-Cer) and ceramine (C18-ceramine) that may be further developed and used to understand the mechanism of mt-CDase in vitro and in biologic responses.


social phenomena. This detailed comparative case study contributes substan-tially to the rapidly expanding interdisciplinary literature on a fundamental issue in economic history: the relationship, mediated by nutrition and disease, between envi-ronment and population. It also shows one significant way in which the autocratic state in early modern Europe could foster the welfare of its citizens, a relevant to the wider claims that an increasingly effective provision of public goods was a major component of the miracle."


INTRODUCTION: In analysing the electromyographic (EMG) signal, researchers are often led to interpret variations of the signal as variation in strength of muscle contraction. However, the relationship between the force exerted and the electrical activity of a muscle are not well established. This is due to the considerable variation of data acquisition and processing techniques, the detection site of the muscles analysed, as well as the alterations in their length and the type of contraction. The object of this paper was to evaluate the correlation between electrical activity and muscular strength.

METHODS AND PROCEDURES: The flexor muscles of the wrist of the non dominant member of 21 female volunteers (mean age = 21 years, sd = ± 1.5) with no history of skeletal muscle dysfuntion, were analysed. The EMG signal was captured by active surface electrode (DELSYS), over the belly of the muscle in the longitudinal sense of the fibres, having a gain of 10 Hz. The electrode was coupled to a 16 channel 12/36 electromyograph (AqDados - LYNX TECNOLOGIA ELETRONICA LTDA), which permitted a gain of 50 Hz. The system bandwidth was 10 to 500 Hz, with an overall gain of 1,000. The data acquisition rate was 1,000 Hz. In order to eliminate possible interferences, a ground electrode was coupled to the distal segment of the forearm. Muscular strength was measured by means of a load cell (model MM/50 kg, KRATOS), placed perpendicularly in the center of the palm surface of the hand. The electrode and the load cell were connected to a 16 channel signal acquisition system (AQDADOS 4.0, LYNIX). The temperature of the room was kept at 23oC, ± 1. The EMG registers and the strength were collected simultaneously. Result were obtained from the average of three repetitions, shown in RMS and Kgf respectively. The data was collected with the hand fixed to a device which limited the wrist to 45o of flexion and 45o of extension, providing an isometric contraction.

RESULTS AND DISCUSSION: The results demonstrated a positive correlation between electromyographic activity and strength of contraction (r = 0.76) in the 45o flexion position, whereas, for the 45o extension position, the correlation was not significant (r = 0.23), considering the sample analysed. The data suggest that there is a positive correlation between EMG and strength, depending on the position of the muscle analysed.


The problems which young people face with in order to get employed and survive, to compete successfully in the labour market has always been relevant to the society. It is obvious that after the completion of the training institutions the graduates can hope to get employed if their specialty is in high demand in the labour market. Permanent labour market demand and supply indicators are monitored and analysis allows to foresee the changes of the tendencies and trends to find out which specialty is needed most and have the most job opportunities in the world of work. Therefore, the research problem is revealed by the following questions: What are the opportunities to get employed having accounting profession? Are the people, gained such education, in demand in the labour market?
The aim of the investigation – to evaluate the accounting specialty graduates' employment opportunities in the labour market.
Youth situation in the labour market is not favourable, and still significant positive changes still are not visible, because in recent years in recent years there at the labour centre applied approximately 70 thousand young people under 25 and about 20 thousand graduates. However, an analysis of the need for accounting professionals and graduates who have acquired the specialty of integration into the labour market statistics show that the demand for these professionals is not decreasing. As pointed out by some labour market analysts, this is one of the most stable professions and such individuals have significant employment opportunities in this field. This is also confirmed by the results of analysis: every year, employers offer about 2-3 thousand jobs for accountants and book-keepers; there are favourable employment opportunities in all regions of the country, as more and more businessmen are choosing financial services companies receive all levels of accounting services; every year graduates, who have acquired the specialty, number is decreasing, so the competition is to prepare professionals in the labour market is weakening; vacancy rate remains stable (on average by 0.6 per cent.), excess supply in the market for these professionals is not high, i.e. 2 persons apply for 1 vacancy.


From the Publisher:
This book is for C and C++ programmers looking to move their skill set into web development, Visual Basic programmers looking for a more powerful language and ASP developers who are interested in what C# has to offer. The only requirement is that you are an experienced developer, familiar with at least one other high level language used on Windows - either C++, VB or J++.


In this paper, a new system of pitch estimation is presented. The system is designed to be robust to challenging noise conditions. This robustness to the presence of noise in the signal is achieved by developing a new representation of the speech signal, based on the operation of damped harmonic oscillators (DHOs), and temporal mode analysis of their output. The resulting representation is shown to possess qualities that are only gradually degraded in the presence of noise. A harmonic grouping based system is used to estimate the pitch frequency. This method is easily extended to simultaneously track the pitch of more than one speaker. In a series of experiments the accuracy and noise robustness of the proposed system was compared with that of a number of prominent pitch estimation and tracking systems. The results show that the proposed system's overall performance is much better than any of the other systems tested, especially in the presence of very large amounts of noise. Furthermore, the proposed system is comparatively inexpensive in terms of processing and memory requirements.


This paper aims to explore some of the professional skills engineering students require, namely leadership, communication, and teamwork. An important tool that may aid in developing those skills is facilitation, a process that encourages information sharing and clear communication, which provides more opportunities for team members to better collaborate. A virtual facilitator was developed to aid in online communication. It provides prompts and interventions designed by using Chris Argyris's Model II communication techniques to guide the user to communicate in more open ways. This quasi-experimental study explores whether students exposed to virtual facilitator software are more likely to model communication techniques displayed by the virtual facilitator. Teams of students worked online on a time-sensitive project. The virtual facilitator intervened in the conversations of teams in a treatment group, while it remained idle in the Control group. Pre-tests and post-tests were administered to measure whether exposure to the virtual facilitator increased students' capacity to enact interventions. Based on Albert Bandura's observational learning theory, researchers expected that students exposed to the virtual facilitator would report the use of more facilitative behaviors.


An analysis of the performance of Automatic Dependent Surveillance-Broadcast (ADS-B) data received from the Grand Forks, North Dakota International Airport was carried out in this study. The purpose was to understand the vulnerabilities of Universal Access Transceiver (UAT) ADS-B system and recognize the effects on present and future Air Traffic Control (ATC) operation. The Federal Aviation Administration (FAA) mandated all the General Aviation aircraft to be equipped with ADS-B. The aircraft flying within United States and below the transition altitude (18,000 feet) are more likely to install an UAT ADS-B. At present unmanned aircraft systems (UAS) and autonomous air traffic control (ATC) towers are being integrated into the aviation industry and UAT ADS-B is a basic sensor for both class 1 and class 2 Detect and Avoid (DAA) systems. As a fundamental component of future surveillance system, the anomalies and vulnerabilities of ADS-B system need to be identified to enable a fully utilized airspace with enhanced situational awareness. The data received was archived in GDL-90 format, which was parsed into readable data. The anomaly detection of ADS-B messages was based on the FAA ADS-B performance assessment report. The data investigation revealed ADS-B message suffered from different anomalies including drop out; missing payload; data jump; low confident data and altitude discrepancy. Among those studied, the most severe was drop out and 32.49% of messages suffered from this anomaly. Dropout is an incident where ADS-B failed to update within a specified rate. Considering the potential danger being imposed, an in-depth analysis was carried out to characterize message dropout. Three flight parameters were selected to investigate their effect on drop out. Statistical analysis was carried out and Friedman Statistical Test identified that altitude affected drop out more than any other flight parameters.


Background Distrust in the American healthcare system is common among Afro-Caribbeans but the role of this distrust in conflict over life-sustaining treatment is not well described. Objective To identify the ways that distrust manifests in ethics committee consultation for conflict over life-sustaining treatment among Afro-Caribbean patients. Methods This was a retrospective cohort study at a large academic hospital of all ethics committee consultations for life-sustaining treatment among Afro-Caribbean patients and their surrogates. We reviewed medical records and identified cases in which ethics consultants described distrust as playing a role in the conflict over life-sustaining treatment. Results Of the 169 ethics committee consultation cases for conflict over life-sustaining treatment, 11 (6.5%) involved patients who self-identified as Afro-Caribbean. Distrust played a role in several of these cases, with surrogates of three patients, in particular, illustrating the way that perceived heath disparities, past labelling and concerns about continued maltreatment generated distrust leading to conflict over life-sustaining treatment. Conclusions Exploring issues of distrust may help ethics consultants identify the source of conflict over life-sustaining treatment among Afro-Caribbean patients.


BACKGROUND
Dual antiplatelet therapy (DAT) with clopidogrel plus aspirin is a well-established antithrombotic strategy, with hemorrhage being the chief adverse event (AE) of concern. Outside of clinical trials, few published data describe the magnitude and nature of hemorrhage-related AEs from DAT.

METHODS
To estimate the numbers and rates of emergency department (ED) visits for hemorrhage-related AEs (hemorrhage or evaluation for potential hemorrhage) from DAT in the United States and put them in the context of those from warfarin, we analyzed AEs from the National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance project, 2006-2008, and outpatient prescribing from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey, 2006-2007.

RESULTS
Based on 384 cases, there were an estimated 7654 (95% confidence interval [CI], 3325-11 983) ED visits annually for hemorrhage-related AEs from DAT compared with 2926 cases and an estimated 60 575 (36 117-85 033) ED visits from warfarin. Approximately 60% of ED visits for DAT consisted of epistaxis or other minor hemorrhages (eg, bleeding from small cuts). The risk of hospitalization for ED visits involving acute hemorrhages was not significantly different between DAT and warfarin (risk ratio, 0.73; 95% CI, 0.38-1.08). The estimated rate of ED visits involving acute hemorrhages from DAT was 1.2 per 1000 outpatient prescription visits vs 2.5 per 1000 outpatient prescription visits for warfarin (risk ratio, 0.49; 95% CI, 0.15-0.83).

CONCLUSIONS
These findings indicate that the acute hemorrhagic risk with DAT is clinically significant and reinforce the importance of practitioners and patients recognizing and anticipating this risk.


OBJECTIVE: We aimed to observe and investigate the clinical significance of vascular endothelium growth factor (VEGF) levels in exhaled breath condensate (EBC) from patients with acute respiratory distress syndrome (ARDS). METHODS: An improved EcoScreen condenser was used to collect EBC from 31 ARDS patients on mechanical ventilation and from 22 healthy subjects. Serum and EBC VEGF levels were analyzed with ELISA. VEGF levels in the EBC of patients with different grades of lung injuries were analyzed. The correlation between VEGF levels and clinical indicators was analyzed. RESULTS: Serum and EBC VEGF levels were linearly and positively correlated with a correlation coefficient of 0.694 (P< 0.01). The VEGF level in the EBC of ARDS patients was significantly lower than that in the control group (P< 0.01). The VEGF level in the EBC of the mild ARDS group was higher than that in the moderate-severe ARDS group (P< 0.01). The VEGF level in the EBC of the survival group was higher than that in the mortality group. The VEGF level in the EBC of ARDS patients was positively correlated with PaO2/FiO2 and PaO2 and was negatively correlated with lung injury score (LIS) and A-aDO2/PaO2. CONCLUSION: The changes in VEGF levels in the EBC of ARDS patients can Respiratory Medicine, reflect the severity of lung injury. Therefore, VEGF level in EBC can be used as an auxiliary index for judging the severity and prognosis of ARDS patients.


To be successful with global software development (GSD), development knowledge needs to be shared among the developers and stakeholders, and the quality of the exchanged information must be assured. Therefore, mature processes, methods and tools have to be in place. If a unified and integrated solution does not exist, this impedes the exchange of knowledge (and the migration of people between projects). In GSD, such a diversity can lead to new problems: offshore development teams have to repeatedly re-adjust to method variants used by the respective business units. This can lead to misinterpretation of information and risks for project success. We report on re-aligning the varying software engineering methods and unifying the methodology throughout Capgemini sd&m. We also standardized quality assurance procedures and tightly integrated them with the engineering methodology. By this, we arrived at a comprehensive company-wide Enterprise Software Engineering Model that effectively supports knowledge transfer from clients to the onshore and offshore team.


Matrix completion is a modern missing data problem where both the missing structure and the underlying parameter are high dimensional. Although missing structure is a key component to any missing data problems, existing matrix completion methods often assume a simple uniform missing mechanism. In this work, we study matrix completion from corrupted data under a novel low-rank missing mechanism. The probability matrix of observation is estimated via a high dimensional low-rank matrix estimation procedure, and further used to complete the target matrix via inverse probabilities weighting. Due to both high dimensional and extreme (i.e., very small) nature of the true probability matrix, the effect of inverse probability weighting requires careful study. We derive optimal asymptotic convergence rates of the proposed estimators for both the observation probabilities and the target matrix.


The thermodynamic curvature scalar R is evaluated for supercooled water with a two-state equation of state correlated with the most recent available experimental data. This model assumes a liquid-liquid critical point. Our investigation extends the understanding of the thermodynamic behavior of R considerably. We show that R diverges to -∞ when approaching the assumed liquid-liquid critical point. This limit is consistent with all of the fluid critical point models known so far. In addition, we demonstrate a sign change of R along the liquid-liquid line from negative near the critical point to positive on moving away from the critical point in the low density "ice-like" liquid phase. We also trace out the Widom line in phase space. In addition, we investigate increasing correlation length in supercooled water and compare our results with recent published small angle x-ray scattering measurements.


In the recent past there was a widespread working assumption in many countries that problems of food production had been solved, and that food security was largely a matter of distribution and access to be achieved principally by open markets. The events of 2008 challenged these assumptions, and made public a much wider debate about the costs of current food production practices to the environment and whether these could be sustained. As in the past 50 years, it is anticipated that future increases in crop production will be achieved largely by increasing yields per unit area rather than by increasing the area of cropped land. However, as yields have increased, so the ratio of photosynthetic energy captured to energy expended in crop production has decreased. This poses a considerable challenge: how to increase yield while simultaneously reducing energy consumption (allied to greenhouse gas emissions) and utilizing resources such as water and phosphate more efficiently. Given the timeframe in which the increased production has to be realized, most of the increase will need to come from crop genotypes that are being bred now, together with known agronomic and management practices that are currently under-developed.


The aim of the project is to solve traffic congestion which is a severe problem in many modern cities all over the world. To solve the problem, we have designed a framework for an automatic and dynamic traffic light control system and developed a simulation model with codes in to help build the system on hardware. Generally, each traffic light on an intersection is assigned a constant green signal time. It is possible to propose dynamic time-based coordination schemes where the green signal time of the traffic lights is assigned based on the present conditions of traffic. This is achieved by using IR sensors across the road to monitor the length of vehicles blocking the road traffic. The signals from the IR receivers are fed to the microcontroller to follow the program with the time as desired. This is converted to DC using a Bridge rectifier. The microcontroller is also interfaced to an Omni vision camera and a memory card module for monitoring traffic violations.


Introduction Up to 60% of dyspeptic patients have a normal upper endoscopy. Endoscopy is unable to diagnose myoelectrical disorders which can cause dyspeptic symptoms including epigastric discomfort, early satiety, bloating, nausea and vomiting. Although patients with functional dyspepsia complain of epigastric symptoms, the relation between these symptoms and gastric motility remains controversial. Electrogastrography (EGG) is a simple, non-invasive method for assessing the gastric pacemaker slow wave. Gastric emptying study (GES) is typically the first test in evaluation of gastric motor function using a radiolabelled test meal. The ultrasound of the stomach (USS) is a recent non-invasive and cheap modality to evaluate gastroduodenal motility. We wanted to compare the information given by three different gastric motility tests in patients with endoscopy negative dyspepsia (END). Methods A series of 77 dyspeptic helicobacter pylori negative patients (60 female: 17 male, ages 18–65 years) diagnosed according to the Roman III criteria and a normal upper endoscopy, underwent a standard fasting and postprandial EGG, a technetium labelled mashed potato GES and an ultrasound of the stomach given a soup test meal. The EGG was considered abnormal if <70% of slow wave activity was recorded at 3 cycles/min. Delayed or increased gastric emptying was diagnosed if the T½ for the test meal was outside the normal range for our unit (<15 or >45 min, respectively). The USS was considered normal if the gastric emptying rate was between 45% and 78%. Results Thirty-one (40%) patients had both GES and USS test showing gastroparesis with mainly symptoms of nausea and vomiting (20/31, 64%). Eighty per cent (25/31) of these patients had an abnormal EGG, having as a predominant pattern an abnormal pre and post prandial test (12/31, 38%). Interestingly 17 people (22%) had normal GES and USS, with abnormal EGG in 82% of patients (14/17). Ten of these patients (58%) were experiencing nausea and vomiting as well. Only 2 (2.5%) patients had findings of dumping syndrome on GES and USS. There was more heterogeneity in the results of these tests with patients referring bloating and epigastric discomfort. Conclusion In patients with endoscopy negative dyspepsia, gastroparesis is very common and particularly with symptoms like nausea and vomiting. GES and USS can provide a firm diagnosis and possibly influence treatment strategies. We think these investigations should be incorporated into dyspepsia guidelines at the point where endoscopy is reported as normal. We are currently investigating the role of EGG for the poor correlation with the other tests.


The fact that infectious mononucleosis is reported chiefly from institutional groups suggests that its recognition in private practice is not common. This is to be expected because of the benignity of the disease and its similarity to relatively brief systemic infections which may not suggest the necessity of making supplementary leukocyte and differential blood counts. This disease entity will be commonly recognized only when its symptomatology becomes of interest to the clinician and when its characteristic lymphocytic blood reaction can be demonstrated with a fair degree of regularity. The statements (which will be challenged) of such competent hematologists as Kracke and Garver1that morphologically the disease cannot be distinguished with certainty from acute lymphatic leukemia emphasize the need for a survey of recent reports. The present paper is based on data acquired over a period of twelve years. Although it may be presumptuous to speak of a disease


Abstract China's economy has seen rapid development ever since its reform and opening-up strategy was launched in 1978. Strong economic expansion over the past four decades has taken China from low-income to upper-middle-income status. Looking back at the transformation that China has made, however, we must recognise that the old growth story is coming to an end. The phase of development driven by investment in physical capital will be increasingly supplanted by investment in assets such as knowledge and social capital as well as investment in preservation of natural capital. Recognising the challenges that China is facing, with this paper we aim to offer an approach to growth and development that could spell out a new development strategy for the country as the 21st century progresses. China will focus on the technologies with high-quality growth prospects: modern service sectors, including health, education, transport, communications and IT, artificial intelligence, finance, logistics, sustainable urban infrastructure and new food and land-use systems. With today's technologies, China can help the Belt and Road Initiative (BRI) countries embark on a much more sustainable, more efficient and greener form of development, avoiding historical problems of pollution and congestion, with China itself moving up the value chain at the same time.


Anaemia is a leading cause of maternal morbidity, mortality and poor birth outcomes
in developing countries. In Malawi, education on anaemia and provision of
prophylaxis iron supplements during pregnancy are key strategies that are used to
reduce the high prevalence of anaemia in this population. Therefore, as part of
Surveillance of Micronutrient Programmes in Malawi, a cross-sectional study was
done to assess maternal knowledge and practices related to anaemia and iron
supplementation in rural areas. A total of 629 (mean age 27.9 years) randomly
selected women were interviewed in the Northern, Central and Southern regions using
a pre-tested questionnaire. The data were entered in EpiInfo 6.04d and analyzed in
SPSS 9.0 for Windows. The results showed that 96.6% of the women were aware of
anaemia, with at least two thirds knowing its causes, ways of prevention, and
treatment. As expected, health facilities are the primary source of iron supplements
(97.1%). On whether or not pregnant women actually take the supplements, the study
found that 22.5%, 29% and 33.8% of women from the Central, Northern and Southern
regions, respectively reported taking the supplements for one month only during their
most recent pregnancy (χ2=6.79, p=0.009). Overall, about 9% reported taking the
supplements throughout pregnancy, but the proportion was higher (22.5%) in the
Central than the Southern (2.5%) and Northern (0.5%) regions. The single most
important reason for non-compliance was nausea (43.6%), with 34.9% of those
reporting nausea resorting to withdrawal. On a positive note, 47.4% of women from
the Southern region reported taking the supplements with nsima (stiff maize gruel) to
overcome nausea. Therefore, this study shows that Malawi's efforts to increase
awareness on anaemia in women of reproductive age in rural areas are largely
effective. However, non-compliance with iron supplementation is a big challenge
which requires strategic planning and implementation of ways to ensure that pregnant
women consistently take iron supplements throughout pregnancy. Keywords : anaemia, knowledge, iron, Malawi, pregnancy. AJFAND Vol. 9 (1) 2009: pp. 551-564


Macrofouling is one of the major problems on a marine net cage culture. The attachment of
macrofouling could cover the net cage and thus reduce the water circulation in the cage. Application of
copper oxide paints may be able to solve that problem. A field experiment with Completely Randomizes
Design was applied with 9 treatments: paint without biocide; paints contained: 5% Copper Oxide; 10%
Copper Oxide; 1% Chlorothalonil; 1% Chlorothaloni + 5% Copper Oxide; 1% Chlorothaloni + 10%
Copper Oxide; 1% Zinc Omadine; 1% Zinc Omadine + 5% Copper Oxide; 1% Zinc Omadine + 10%
Copper Oxide, each treatment was replicated 3 times. The research was done on July – September 2007
at Hanura Bay Lampung. Data of the abundance and diversity of macrofouling were collected weekly.
The results showed that the application of copper oxide paints affected the macrofouling attachment
significantly (P < 0, 01). The best result was antifouling paints contained Copper Oxide, and
combination between Copper Oxide with Chlorothalonil and Zink Omadine. However, from the
economical point of view, paint with 5% Copper Oxide could be suggested for preventing macrofouling
attachment on the marine net cage


This paper discusses the information behaviour of hikers on the West Highland Way in Scotland by exploring meaningful experiences described by fifty participants walking the route. Using an ethnographic approach, participants were interviewed in the field at sites on the West Highland Way using semi-structured questions. Qualitative results are discussed and analysed using inductive thematic analysis and links to literature are established. Two types of meaningful experience were found in the interview data: connections with nature and social connections. Profound natural connections were found to feature embodied information from sensory interaction with the environment, resulting in a contemplative mindset and offering well-being benefits. Social connections with family, friends and fellow walkers were also described as meaningful, situating the activity as a 'higher thing' and demonstrating further well-being benefits. This initial study indicates that natural and social connections are key to meaningful experience in walking the West Highland Way. A broader information behaviour study based on this work will further explore the use of embodied information, contemplation in information science, serious leisure as a 'higher thing', and well-being benefits.


A method of ion-beam-induced reduction in oxides is used to produce metal-bismuth nanowires embedded into a matrix of a highly insulating dielectric—bismuth oxide. The metal film is formed in the process of reduction of the metal oxide by selective removal of oxygen atoms under irradiation by the beam of protons through a mask. The mask containing pairs of parallel nanowires with contact pads was fabricated using 50 kV electron-beam lithography in a single layer of 200-nm-thick ZEP-520 (Zeon Chemicals L.P., ZEP-520 electron-beam resist) electron-beam resist. Electrical properties of the fabricated nanowires have been studied. Broadening of the fabricated metal wires with respect to the initial mask width was found to be dependent on the energy of irradiating protons. This effect may be attributed to the scattering of protons in the oxide-film. It is shown that the method of selective atom removal combined with high aspect ratio e-beam lithography is a feasible technique for fabrication of metal nanowires ...


Solid photothermal materials with favorable biocompatibility and modifiable mechanical properties demonstrate obvious superiority and growing demand. In this work, polydopamine (PDA) induced functionalization of regenerated silk fibroin (RSF) fibers has satisfactory photothermal conversion ability and flexibility. Based on multilevel engineering, RSF solution containing PDA nanoparticles is wet spun to PDA-incorporating RSF (PDA@RSF) fibers, and then the fibers are coated with PDA via oxidative self-polymerization of dopamine to form PDA@RSF-PDA (PRP) fibers. During the wet spinning process, PDA is to adjust the mechanical properties of RSF by affecting its hierarchical structure. Meanwhile, coated PDA gives the PRP fibers extensive absorption of near-infrared light and sunlight, which is further fabricated into PRP fibrous membranes. The temperature of PRP fibrous membranes can be adjusted and increases to about 50 °C within 360 s under 808 nm laser irradiation with a power density of 0.6 W cm-2 , and PRP fibrous membranes exhibit effective photothermal cytotoxicity both in vitro and in vivo. Under the simulated sunlight, the temperature of PRP fiber increases to more than 200 °C from room temperature and the material can generate 4.5 V voltage when assembled with a differential thermal battery, which means that the material also has the potential for flexible wearable electronic devices.


Remodeling senescent blood vessels The retina is a thin layer of nervous tissue at the back of the eye that transforms light into neuronal signals. The retina is essential for vision and is supported by networks of blood vessels. In diabetic retinopathy, a common cause of vision loss, these microvessels degenerate and regrow in an aberrant manner. Such degeneration and regrowth can compromise the functioning of retinal nerve cells. Binet et al. observed that, after rapid proliferation, vascular endothelial cells in diseased blood vessels engaged molecular pathways linked to cellular senescence (see the Perspective by Podrez and Byzova). Senescent vascular units summoned an inflammatory response in which neutrophils extruded neutrophil extracellular traps onto diseased vessels to remodel them. This endogenous repair mechanism promoted the elimination of senescent blood vessels and could lead to beneficial vascular remodeling. Science, this issue p. eaay5356; see also p. 919 Remodeling of senescent vascular endothelial cells in the retina is mediated through neutrophil extracellular traps. INTRODUCTION Vision provides a critical survival advantage but requires a tight coupling between neuronal energy demands and their vascular supply. The degeneration and consequent aberrant regrowth of retinal vasculature is the hallmark of diseases such as diabetic retinopathy, retinopathy of prematurity, and age-related macular degeneration, which collectively are the most common causes of loss of sight in industrialized countries. Although considerable effort has been devoted to understanding how diseased blood vessels form, relatively little is known of the processes at play during late stages of pathological angiogenesis when blood vessels remodel and subsets of diseased vasculature regress. RATIONALE The retina is part of the central nervous system and thus has limited regenerative capacity. A relative exception to this rule are retinal blood vessels, which have a greater propensity to remodel depending on metabolic demand. We investigated the cellular mechanisms activated during the remodeling and regression of pathological blood vessels in retinopathy. We focused on a mouse model of oxygen-induced retinopathy, which has distinct and timed phases of vascular degeneration, neovascularization, and vascular regression. Our findings were verified in human patients with proliferative diabetic retinopathy. Understanding how diseased blood vessels remodel and yield functional networks has the potential to lead to strategies that enhance vascular normalization and helps to explain why retinas in certain patients have the propensity to repair themselves more readily than others. RESULTS We found that vascular remodeling in retinopathy is associated with bouts of sterile inflammation and tardy recruitment of neutrophils, an immune population typically associated with a first wave of invading leukocytes. We observed that, after rapid proliferation, vascular endothelial cells in diseased blood vessels engaged molecular pathways shared with aging and cellular damage that lead to cellular senescence. Senescent vascular units then released a secretome of cytokines and factors that attracted neutrophils and triggered the production of neutrophil extracellular traps (NETs). Through extrusion of NETs, neutrophils eliminated diseased senescent vasculature by promoting its apoptosis. By crippling the ability of neutrophils to produce NETs by genetically removing the peptidyl arginine deiminase type IV (PAD4) enzyme, clearance of senescent cells was impaired and regression of pathological angiogenesis compromised. Similar effects were observed with the neutrophil-depleting antibody anti-Ly6G or by pharmacological inhibition of the neutrophil receptor CXCR2. CONCLUSION We conclude that neutrophils, through the release of NETs, targeted pathological senescent vasculature for clearance and thus prepare the ischemic retina for reparative vascular regeneration. These findings imply that elimination of senescent blood vessels leads to beneficial vascular remodeling. Although cellular senescence is not necessarily synonymous with aging, our study may provide insight into a general mechanism in which senescent endothelial cells trigger NETosis and predispose to thrombotic events such as myocardial infarction, atherosclerosis, and stroke, which are typically seen in older populations. Senescent blood vessels trigger neutrophil extracellular traps in retinopathy. (A) Human samples and a mouse model were used to elucidate mechanisms of vascular remodeling in retinopathy. (B) Upon rapid proliferation, vascular cells in pathological tufts triggered pathways of cellular senescence, leading to cytokine secretion and the recruitment of neutrophils. (C) Factors secreted by senescent cells triggered NETosis. (D) NETs promoted the removal of senescent endothelial cells, ultimately leading to regression of pathological angiogenesis and promoting the regeneration of functional vessels. In developed countries, the leading causes of blindness such as diabetic retinopathy are characterized by disorganized vasculature that can become fibrotic. Although many such pathological vessels often naturally regress and spare sight-threatening complications, the underlying mechanisms remain unknown. Here, we used orthogonal approaches in human patients with proliferative diabetic retinopathy and a mouse model of ischemic retinopathies to identify an unconventional role for neutrophils in vascular remodeling during late-stage sterile inflammation. Senescent vasculature released a secretome that attracted neutrophils and triggered the production of neutrophil extracellular traps (NETs). NETs ultimately cleared diseased endothelial cells and remodeled unhealthy vessels. Genetic or pharmacological inhibition of NETosis prevented the regression of senescent vessels and prolonged disease. Thus, clearance of senescent retinal blood vessels leads to reparative vascular remodeling.


This article is an examination of African American high school student activism during the black freedom struggle by youth from Lawnside, New Jersey; one of ten self-governing African American communities in the United States.  A critical factor in Lawnside's historical narrative is that its young people both historically and today attend segregated elementary school and then integrated high school in the historically all white community of Haddon Heights.  From 1965-1971, many African American young people from Lawnside were inspired to address decades of inequality and African American educational and cultural concerns by engaging in acts of collective violence and non-violent direct action.  These protest efforts included a boycott, two sit-ins, a protest march, and a formal list of demands. African American high school students from Lawnside expressed similar grievances to African American youth in other locations, they demonstrated considerable activist autonomy from parents and outside organizations, and female students often held positions of influence and leadership.


Passive bistatic radar (PBR) system can utilise suitable signal from illuminator of
 opportunity to improve radar proficiency. In conventional PBR, a heterodyne
 receiver and concept is employed. This is due to the PBR requiring reference signal
 from a direct transmission for synchronization, and then the signal is down converted
 to the base band where target detection is evaluated by analyzing the ambiguity
 function of the received signal. On the other hand, by using the forward scattering
 phenomena and technique in specific mode of PBR, the operation can be further
 enhanced and improved especially in target detection and classification. This specific
 system is identified as the passive forward scattering radar (FSR). One of the main
 condition of passive FSR is the operational mode limited to within the radar
 baseline. In this scenario, the desired received signal is formed through the
 shadowing of a direct signal by the target shape rather than back scattering signal
 from the target such as in conventional radar system. Passive forward scattering
 radar system offers a number of advantages including enhanced target cross section,
 long coherent intervals of the receiving signal, absence of signal fluctuations,
 reasonably simple hardware, economical as it does not need a transmitter system and
 a spectrum allocation, practically unseen to surveillance receivers, portable due to its
 smaller size, no synchronization needed for reference signal from direct signal of
 illuminator, straightforward signal pre-processing for target detection and enhanced
 classification capability.
 Thus, the aim of this thesis is to develop and prove the concept of passive forward
 scattering radar especially for ground detection and classification. The objective is to
 implement the experimental analysis and results for vehicle detection and
 classification by exploiting the latest 4G LTE technology signal. This thesis clarifies
 in details the LTE based passive forward scatter radar receiver circuit, the detection
 scheme and the classification algorithm. In addition, the proposed passive forward scatter radar circuit employed the self-mixing technique at the receiver, hence it did
 not require a synchronization signal from the LTE base station. The classification
 capability in passive forward scattering radar increases the effectiveness of the
 system.
 Three vehicle categories with different sizes and shapes were tested, namely
 Compact, Saloon and Small Sport Utility Vehicle (SUV). The passive FSR
 experiment results show that the vehicles were successfully detected, even by raw
 received signals without any complicated signal processing techniques and the
 proposed classification system provided outcomes of satisfactory classification
 performance. The Doppler spectrum scattered by the vehicle is used as the features
 for input to the classification system. The classification algorithm was developed
 based on Principal Component Analysis (PCA) and k-Nearest Neighbours (k-NN).
 In addition, the baseline crossing range distance from the radar receiver, as well as
 vehicle's speed, was successfully predicted.
 In general this thesis presents the first classification analysis and performance for the
 passive forward scatter radar system. The great potential of the passive forward
 scatter radar system provides a new research area in passive radar that can be used
 for diverse applications. The thesis also proved that if the FSR mode can be
 integrated or hybrid with the conventional passive radar system and still have similar
 performance competency, the system can achieve tremendous improvement. Hence,
 it opens up a new frontier in passive radar that can be used for many applications
 including border protection, microwave fences, building monitoring, traffic
 surveillance, and so forth.


INTRODUCTION: Vertical velocity of the center of mass (COM) and body orientation described by joint angles at the instant of take-off have been suggested as among the most important factors contributing to maximum height of a dive after take-off from a spring-board (Miller, 1980; Sanders & Wilson,1988; Miller & Munro,1984). The present study examined several kinematic and kinetic variables proposed in the literature as potential predictors of diving performance and incorporated them in a model that used multiple regression techniques to predict those variables most directly related to the maximum height achieved during a springboard dive. A secondary purpose of the study was to identify those variables that distinguish between the forward and backward group of dives using techniques of analysis of variance.

METHODS: Four (4) divers were filmed using high-speed cinematography (100Hz) while performing simple dives (½ somersault) from the 1m. spring-board. At the same time, the reaction forces between the diver's foot and the board were recorded (500 Hz) by placing four (4) strain gauges beneath the surface of the board. Nine (9) dives from the four (4) groups were analyzed in total, and kinematic and dynamic variables were derived from the digitized film.

RESULTS: The analysis confirmed that almost 90% of the variance in maximum height was explained by the vertical velocity of the COM and the amount of the board's downward deflection at the instant of take-off. The amount of hip flexion for the forward dives and knee flexion for the backward dives were also highly correlated with the height of the dive. On the other hand, the angle of take-off and the board's vertical velocity were not significant predictors of height. Forward and backward dives were significantly different (p<.01) in terms of the maximum height achieved, the vertical velocity of the COM at take-off, the vertical reaction forces applied on the diver's foot at the instant of take-off and the horizontal distance the COM traveled during the execution of the dive. Divers achieved greater height and entered the water further away from the board when performing a forward type of dive than when performing a dive from the backward group. In addition, they were capable of achieving higher vertical take-off velocities and applying greater force on the board when performing dives from the forward group as opposed to backward dives.

CONCLUSIONS: The results of the present study are discussed in terms of the possible coordination strategies a diver can use for creating the necessary conditions during the take-off phase that will guarantee the success of a dive.


We have examined the HLA profiles of the Hagahai and the Haruai people, two linguistic groups in the remote western Schrader mountains who have only recently had administrative contact, and compared them with those of other populations in Papua New Guinea. None of the antigens detected in the two groups was found missing in other populations although significant differences in allele frequencies exist. Recent contact history does not appear to have played any significant role in shaping these differences. Similarly, no evidence of differential selection pressures contributing to HLA heterogeneity was found. The genetic profiles of the Hagahai and the Haruai appear to be a result of recent admixture between unrelated, genetically disparate groups.


We experimentally demonstrate strong coupling between a one-dimensional (1D) single-atom array and a high-finesse miniature cavity. The atom array is obtained by loading single atoms into a 1D optical tweezer array with dimensions of 1×11. Therefore, a deterministic number of atoms is obtained, and the atom number is determined by imaging the atom array on a CCD camera in real time. By precisely controlling the position and spacing of the atom array in the high finesse Fabry-Perot cavity, all the atoms in the array are strongly coupled to the cavity simultaneously. The vacuum Rabi splitting spectra are discriminated for deterministic atom numbers from 1 to 8, and the sqrt[N] dependence of the collective enhancement of the coupling strength on atom number N is validated at the single-atom level.


In this paper we studied the effect of geomagnetic storm on Global Positioning System (GPS) derived total electron content (TEC) at low latitude Varanasi (Geomagnetic lat 14°, 55' N, geomagnetic long 154° E) during the period of May 2007 to April 2008. During this period 2 storms were found, which were occurred on 20 November 2007 and 9 March 2008. In this study vertical total electron content (VTEC) of single Pseudorandom Noise (PRN) and average of VTEC of same PRN before 10 days of storm, which is called background TEC, were used to see the effect of these storms on the variation of TEC. From this study this is found that during the storm of March 2008 the TEC increases in main phase of storm while in the case of November 2007 storm, TEC decreases during the main phase of storm but increases in the recovery phase (next day) of storm.


Sustainability reporting has become a central instrument in displaying a company's strategy and engagement with a more sustainable society. Life cycle assessment (LCA) is an important tool in this context as it is aimed to analyze the entire life cycle of the product/service, instead of focusing on one focal firm. However, the lack of standardized guidelines in its application raises questions regarding the usefulness and validity of results. This study contributes to the improvement of sustainability reporting through the identification of the uncertainty sources in life cycle methodologies that have the biggest impact in the definition of business and environmental strategies, exploring a supply chain‐oriented analysis. The focus is on life cycle inventory (LCI) and life cycle impact assessment (LCIA). A multiobjective optimization‐based methodology is applied to a supply chain case study in the pulp and paper industry. Environmental and economic objectives are considered. Results show that different LCIA methods and different normalization data sets result in significantly different business and environmental strategies. However, different system models and cultural perspectives at the LCI step and variations in the characterization factors tend to lead to the same decisions. Important insights are gained regarding the impact of nonstandardized analysis of the application of LCA in supply chain design and planning decisions and consequently on business strategy definition and sustainability reporting. Furthermore, the importance of operations research methods to improve LCA‐based studies and of bridging the gap between LCA and supply chain management bodies of knowledge is highlighted in this work.


Histone acetylation and deacetylation are key epigenetic modifications that influence gene expression in both normal and neoplastic cells. Histone deacetylases (HDACs) have been the target for cancer therapeutics due to their demonstrated role in modulating tumor onset and progression in a subset of cancers. We have shown that treatment with pan HDAC inhibitors leads to reduced tumor growth and increased tumor cell differentiation of cultured Embryonal Rhabdomyosarcoma (ERMS) cells. However, the role of specific HDACs in ERMS remains unknown. To determine the function specific to each HDAC in ERMS, we have employed the Clustered Regularly Interspersed Short Palindrome Repeats (CRISPR)/Cas9 nuclease-mediated genome editing technology to enable effective knockout of individual HDAC genes in ERMS. Our CRISPR/Cas9 system uses a transient and multiplex gene targeting approach that induces loss-of-function mutations with high efficiency and allows rapid phenotypic analysis. Combining this system with stable selection of mutant clones with null mutations, we have systematically targeted all class I HDAC genes in ERMS cells. Initial characterization reveals distinct functions of class I HDAC genes in ERMS tumorigenesis. HDAC1 loss-of-function in ERMS cells promotes tumor growth. By contrast, HDAC3 or HDAC8 loss-of-function reduces tumor cell viability. HDAC2 loss-of-function does not affect tumor growth but induces robust differentiation of ERMS cells. In future studies, candidate genes/pathways regulated by HDACs will be identified by an integrated approach of Chromatin Immunoprecipitation (ChIP) and gene expression profiling studies. To validate HDAC mutant phenotypes observed in vitro and assess pre-clinical efficacy of targeted HDAC therapies, CRISPR/Cas9 inducible ERMS lines are currently being developed to facilitate tumor xenograft studies in vivo. Overall, our initial gene targeting results reveal distinct roles of class I HDAC genes in modulating ERMS tumor growth and differentiation. Our results suggest that therapeutic efficacy of pan HDAC inhibitors may be compromised by simultaneously inhibiting tumor-promoting and tumor-suppressive functions of HDACs. Targeted HDAC therapies therefore, may have more potent therapeutic benefits. Citation Format: Michael Phelps, Terra Vleeshouwer-Neumann, Jenna Bailey, Nicole Hickman, Eleanor Chen. Characterization of histone deacetylases in embryonal rhabdomyosarcoma. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 2865. doi:10.1158/1538-7445.AM2015-2865


A Dissertation submitted in Partial Fulfillment of the Requirements for the Degree
of Master of Science in Economic Policy and Planning of Mzumbe University


Phase change materials (PCM) are being utilised world over for energy storage and temperature smoothening applications. Defence Laboratory Jodhpur (DLJ) has initiated a R&D programme to apply PCM in solving many heat related problems being faced by Indian forces during desert operations specially failure of mission-critical components. under the programme, special organic PCM (Patent application no. 2258/DEL/2007 and low melting metal alloys have been developed well tuned to desert diurnal cycle. The PCM panels, when applied as an internal lining in buildings, structures and vehicles can moderate the extreme temperature within human tolerable range (below 40 ° C) without the use of any external power for cooling. The panels can also act as power saver in air conditioned buildings. A cool vest has also been developed with chargeable PCM packs to provide comfortable microenvironment to a soldier on field duty (below 30 ° C) for 2-3 hrs. To improve reliability of mission critical electronic instruments during desert operation, technology of absorptive PCM heat sinks is under development at DLJ. The special heat sink will absorb heat generated by component for critical mission (up to 1 hr) independent of environment temperature and thus ensure smooth functioning of critical components even in extreme hot conditions. In present paper status of PCM technology world over has been reviewed along with the brief account of research on PCM at DLJ.


Several studies indicate that dyslexics have a deficit in the categorical perception (CP) of phonemes when listening to speech. After reviewing data supporting the reliability of the CP deficit, we examine its possible site in the framework of a three-stage model of speech perception (auditory, phonetic and phonological). Different sources of evidence suggest that the deficit has a speech specific component. Further, the speech perception deficit appears to be phonological in nature insofar as dyslexics appear to be better than control subjects in discriminating allophonic distinctions, i.e. phonetic distinctions irrelevant for lexical processing in their language. Such sensitivity to allophonic variations in dyslexics might arise from a weakness in phonological couplings between phonetic features during perceptual development, which, in turn, can have specific implications for the build up of grapheme-phoneme correspondences. It may explain why dyslexics encounter significant problems in phonologically-demanding tasks like reading without experiencing similar difficulties in speech perception.


A recent meta-analysis on ability grouping by Kulik and Kulik (1982) was used as an example to demonstrate how a researcher might plan for adequate sample sizes and power in future research. Data sufficient to estimate minimum sample sizes and power were gleaned from the meta-analysis study or obtained from its authors. Distributions of harmonic mean sample size and estimated power were displayed and ranges of estimates for each were presented using effect sizes from the meta-analysis with fixed". Although effect sizes were relatively symmetric about .10, power and harmonic mean sample sizes were quite skewed. Recommendations for major professors, researchers and journal editors were made to assist in the evaluation and planning of research.


Hyaluronic acid (HA) is a major component of the glycocalyx involved in the vascular wall and endothelial glomerular permeability barrier. Endocytosed hyaluronidase HYAL1 is known to degrade HA into small fragments in different cell types, including endothelial cells. In diabetes, the size and permeability of the glycocalyx are altered. In addition, patients with type 1 diabetes present increased plasma levels of both HA and HYAL1. To investigate the potential implication of HYAL1 in the development of diabetes-induced endothelium dysfunction, we measured endothelial markers, endothelium-dependent vasodilation, arteriolar glycocalyx size, and glomerular barrier properties in wild-type and HYAL1 knockout (KO) mice with or without streptozotocin (STZ)-induced diabetes. We observed that 4 weeks after STZ injections, the lack of HYAL1 1) prevents diabetes-induced increases in soluble P-selectin concentrations and limits the impact of the disease on endothelium-dependent hyperpolarization (EDH)–mediated vasorelaxation; 2) increases glycocalyx thickness and maintains glycocalyx structure and HA content during diabetes; and 3) prevents diabetes-induced glomerular barrier dysfunction assessed using the urinary albumin-to-creatinine ratio and urinary ratio of 70- to 40-kDa dextran. Our findings suggest that HYAL1 contributes to endothelial and glycocalyx dysfunction induced by diabetes. HYAL1 inhibitors could be explored as a new therapeutic approach to prevent vascular complications in diabetes.


Among the several approaches that have been attempted at studying opinion dynamics, the Sznajd model provides some particularly interesting features, such as its simplicity and ability to represent some of the mechanisms believed to be involved in real-world opinion dynamics. The standard Sznajd model at zero temperature is characterized by converging to one stable state, implying null diversity of opinions. In the present work, we develop an approach—namely the adaptive Sznajd model—in which changes of opinion by an individual (i.e. a network node) implies in possible alterations in the network topology. This is accomplished by allowing agents to change their connections preferentially to other neighbors with the same state. The diversity of opinions along time is quantified in terms of the exponential of the entropy of the opinions density. Several interesting results are reported, including the possible formation of echo chambers or social bubbles. Additionally, depending on the parameters configuration, the dynamics may converge to different equilibrium states for the same parameter setting, which suggests that this phenomenon can be a phase transition. The average degree of the network strongly influences the resultant opinion distribution, which means that echo chambers are easily formed in systems with low link density.


AIM: We prepared two models, namely butyrate-induced irritable bowel syndrome (IBS) model rats and a post-inflammatory IBS (PI-IBS) model mice using dextran sulfate sodium (DSS). In the present study, we investigated the involvement of TRPM8 in visceral hyperalgesia in the two IBS models. METHODS: Butyrate-induced IBS model was prepared by intracolonic treatment with butyrate for 4 days in SD male rats. PI-IBS model was prepared by drinking freely 3% DSS until Day 4, then changing 3% DSS to tap water during recovery period. Visceral pain was induced by intracolonic treatment with the TRPM8-selective agonist WS-12, and the observed visceral pain-like behaviors ware mesured. TRPM8 immunoreactivities were detected using immunohistochemical techniques. RESULTS: In rectal histology of butyrate-induced IBS model rats, the number of TRPM8-expressing nerve fibers in the mucosal layer ware significantly increased compared with normal rats. In behavioral observation, WS-12-induced visceral pain-like behaviors were increased. In PI-IBS model mice, an increase in visceral pain-like behaviors was observed on Day 4, and the pain symptom observed until Day 14. CONCLUSIONS: These results suggest that the increase of TRPM8-expressing nerve fibers in lower gastrointestinal tracts is involved in hyperalgesia in IBS model animals.


OBJECTIVE This study aimed to analyze the clinicopathologic characteristics, management, and outcome of patients with intraepithelial extramammary Paget's disease of the vulva (EMPDV). MATERIALS AND METHODS This retrospective study included medical records and pathological slides of 18 female patients with EMPDV between January 2001 and December 2012. Diagnosis was confirmed using conventional hematoxylin and eosin staining. RESULTS The median age was 65 years. The distribution of lesions was from labium majus, labium minus, clitoris, and distal vaginal wall. The appearance was erythematous patches, hypopigmentation, and hyperpigmentation. The symptoms were pruritus, erosions, burning sensation, and pain. The mean duration of symptoms was 24 months. Ten patients received local excision, 3 accepted wide local excisions and successful skin grafting, and 5 underwent vulvectomies. Frozen sections showed that 3 and 15 patients had positive and negative margins, respectively. The average length of follow-up was 70 months. During a follow-up period, 3 patients were lost. One patient with positive margins and one with negative margins recurred and the overall recurrence rate was 11.1%. CONCLUSION The diagnosis of EMPDV is often delayed but has good prognosis. A complete surgical resection is an effective treatment. Skin grafting may be a good method to promote incision healing.


See article on page 330

Patients with gastro-oesophageal reflux (GORD) are usually advised to modify their dietary habits.1 Among the most popular beliefs is the recommendation to avoid fatty foods which are thought to be detrimental in GORD for several reasons, including reduced lower oesophageal sphincter tone2 and delayed gastric emptying. This latter effect may, in turn, result in an increase in the number of transient lower oesophageal sphincter relaxations (TLOSRs) elicited through a vago–vagal reflex originating in the mechanoreceptors located in the subcardial area.3TLOSRs are considered to be the main motor mechanism associated with the occurrence of reflux episodes both in asymptomatic subjects and reflux patients with or without oesophagitis.

With regard to the therapeutic benefit of a low fat regimen in GORD, a review of the literature has shown that there is a paucity of data to support …


Objectives Intervention studies are needed in occupational health in order to test if work improvements are effective, although not always possible. In the last decade, propensity score analysis has been widely used in clinical settings for treatments for which randomised controlled trials are unlikely to be conducted, such as socioeconomic factors in public health. It gives an estimate of a treatment effect in making treated and untreated group comparable for confounding factors by modelling treatment probability. We aimed to describe the frequency of propensity score cited in occupational health literature and its use. Methods Using the key words "occupational" and "propensity score", studies were selected from PubMed database (last 20 years). Frequency of citation was compared to two other requests "clinical" "propensity score" - "public health" not "occupational" "propensity score". Embase and Web of sciences were also used to find extra papers. Relevant information was extracted including use of propensity score. Results Twenty-four papers were found in PubMed with propensity score in occupational health [0.01% of all citations of this area, versus 1210 (0.06%), and 2731 (0.07%) in clinical or other public health domains respectively P < 0.001]. Among papers in occupational health, 12 were relevant, published since 2005, mostly from US teams (n = 10). The analyses included many subjects (median 7314), coming from pre-existing databases. The studies dealt with treatment evaluation (n = 2), economic evaluation (n = 2), and risk factors analysis (n = 5). Three papers studied implementation of programs in occupational setting, two for economic or quality purpose, one for effectiveness of multidisciplinary primary prevention program including work adaptation. Conclusions Few studies used propensity score analysis, two used this method for evaluating interventions (safety or coaching programs) and only one considered work adaptations/rehabilitation. More widespread use of this methodology in large workers datasets might give information of efficiency of work adaptation when intervention studies are not suitable.


This study presents design optimization of spot welded structures to attain maximum strength by using the Nelder-Mead (Simplex) method. It is the main idea of the algorithm that the simulation run is executed several times to satisfy predefined convergence criteria and every run uses the starting points of the previous configurations. The material and size of the sheet plates are the pre-assigned parameters which do not change in the optimization cycle. Locations of the spot welds, on the other hand, are chosen to be design variables. In order to calculate the objective function, which is the maximum equivalent stress, ANSYS, general purpose finite element analysis software, is used. To obtain global optimum locations of spot welds a methodology is proposed by modifying the Nelder-Mead (Simplex) method. The procedure is applied to a number of representative problems to demonstrate the validity and effectiveness of the proposed method. It is shown that it is possible to obtain the global optimum values without stacking local minimum ones by using proposed methodology.


The working experience of the National Institute for Cancer Research (INRC) of Genova, Italy, in the use of Internet technology for second opinions and teleconsultations in histology and cytology is presented. In the first section, the current state of the art of telepathology is reviewed and the main requirements, which generally address a telepathology system, are briefly analyzed. The second section investigates the experience of using Internet technology at INRC in current telepathology consultations. The evolution from static to dynamic telepathology in relation to the speed of the current communication channel is discussed. Finally, the concept of collaboration laboratories, defined in previous works as collaboratories, is introduced.


Proviral integration of a simian T-cell leukemia virus, S(H)TLV-I, highly homologous to human T-cell leukemia virus type 1 was examined in cellular DNAs isolated from lymphoid organs of lymphomatous and healthy baboons from the Sukhumi monkey colony. Most of the sick and some of healthy monkeys contained HTLV-I-related sequences in their chromosomal DNAs. Judging from the integration site of the provirus genome, S(H)TLV-I-infected cells had selective preferences and proliferated monoclonally.


Perennial ryegrass/white clover mini-swards were used lo determine whether sward responses to slurry were modified by subsequent simulated rainfall (SR). Combinations of two SR volume rates (6.5 and 13 mm), three SR timings (3, 24 and 48 h after slurry application) and two slurry types (cattle, pig) were compared with a fertilizer control (no SR). Scorch, smother and growth of marked stolons and tillers were monitored after slurry application, and yields of both species were recorded. Slurry coverage of plastic squares indicated that smother may be greater on horizontally orientated leaves (clover). Reduced grass leaf growth and numbers of clover growing points in the week following slurry application were attributed mainly to smother, and possibly other phytotoxic effects of slurry. Reasons for the superior clover growth with cattle slurry arc unknown, although its higher P and K content may have contributed. Timing of rainfall is important in influencing sward responses to slurry application. Results suggest that application of slurry may be most beneficial when it immediately precedes rainfall and that longer intervals between slurry application and rainfall reduce grass and clover growth through either greater ammonia loss or slurry negative effects.


The evolving computed tomographic (CT) findings in three patients with different types of dysmyelinating white matter diseases (Krabbe, Canavan, ketotic hyperglycinemia) are presented. Serial CT scans suggested that the abnormal, low density white matter, which is characteristic of many white matter diseases, is present for only a limited time, corresponding to active dys- or demyelination. The low density abnormality gives way to a nonspecific final common pathway manifested as severe atrophy on CT. Ventricular enlargement is accentuated in this form of atrophy which appears to be the final stage in a wide variety, if not all, of white matter diseases.


Stressors have been used since 90 nm technology to improve device performance to overcome the limitations of scaling. The stressors, including, - CPEN, TPEN, SMT, and e-SiGe to improve NMOS and PMOS drive current exhibit proximity dependence. In addition, unintentional stressors such as STI edge proximity introduce additional layout dependencies. Two devices with the same L and W can have significantly different drive strength depending on their surroundings. There have been limited studies to optimize the design layout to reduce the layout-dependent stress degradation. Circuit and layout designers have few tools they can use to quickly and effectively optimize the layout to reduce device degradation due to layout-dependent stress effects. In this paper, we present a comprehensive set of CAD utilities, and stress-related layout guidelines to optimize the layout for full custom macros to reduce the layout-dependent stress effects prior to doing full timing characterization, including stress effects.


Were it possible under all circumstances, in the treatment of appendicitis, to follow the dictum to operate within the first twenty-four to thirty-six hours from the onset of the disease, we would not be confronted with the varied pathology and the many mooted questions of dealing with it in attempting to treat this disease successfully. The early operation will, however, probably never become the universal practice, and we will still continue to encounter all of the different pathologic conditions that are associated with neglected cases of the disease. The reasons why the early operation will never become the universal practice in appendicitis are chiefly the following: (a) The family physician, and not the surgeon, is usually called to diagnose and treat the disease in the beginning. It is expecting too much of the family physician when we look to him to diagnose the disease and to call the surgeon all


Research is the automation of decision-making on the justification of the type of unloading section of the terminal for single-piece cargo — external or internal input of the railway track is rational according to the criterion of minimum total costs. The relevance of the research topic is associated with the widespread solution of this type of business problems in the modern conditions of the transport and warehouse market. Cargo terminals connect modes of transport and transform cargo flows, which determines both the key position of cargo terminals in modern supply chains, and the complexity of tasks to be solved in their design. For operational management of transport and logistics processes, it is necessary to quickly make business decisions, which can be provided by software implementation of a number of settlement procedures.Used dynamic and linear programming, syntax and tools of the Pascal ABC programming language, analytical, marketing, and project methods; materials of general access and official sites, own research.A software product for automating the calculation of technical and operational parameters of a railway cargo terminal is described. The program allows you to calculate a set of technical and economic parameters of the cargo terminal operation, in particular, the size of the annual car traffic, the required length of the railway unloading section, as well as annual operating (production) costs and capital costs for the construction of the car unloading section by options.The software product can be useful both in the educational process of secondary and higher education, and in practical business when making business decisions on planning the operation of a cargo terminal.


The diagnosis of penile induration (Peyronie's disease; IPP) requires an appropriate history, clinical examination, autophotography and plain films in cases of calcified plaques, but ultrasound is the modality of choice. Besides the benefit of an exact staging (Kelâmi method) high-frequency ultrasound probes offer the possibility of detecting nonpalpable plaques early detection of changes in the tunica albuginea. Evaluation of inflammatory changes and disappearance of hyperechoic signs around the plaques or an increasing density of the corresponding corpus cavernosum can be detected by ultrasound, but sometimes to a restricted extent. In selected cases MRI offers the additional benefit of early detection of inflammatory changes of the dependent corpus cavernosum. Our own experience in the diagnosis of Peyronie's disease by ultrasound and MRI in cases of inflammatory changes are presented, especially after administration of Gd-DTPA. For hemodynamic disorders causing erectile dysfunction, in 50% of cases with IPP combined, pharmacocavernosometry and pharmaco-cavernosography are of considerable value. The use of modern diagnostic imaging modalities, e.g. ultrasound and especially MRI, increases the diagnostic impact in cases of IPP.


ABSTRACT Decades of research have shown that technological change in schools depends on multiple interrelated factors. Structural equation models explaining the interplay of factors often suffer from high complexity and low coherence. To reduce complexity, a more robust structural equation model was built with data from a survey of 349 Swiss primary school teachers. It confirms that educational technology integration is dependent on individual teachers' readiness, which is in turn influenced by school readiness. Teacher readiness to integrate educational technology is based on perceived skills and beliefs. Facets of school readiness include educational technology resources in classrooms, perceived importance of technology integration, goal clarity, head teacher support, as well as formal and informal exchange among teachers.


BACKGROUND Freehand ventricular catheter placement may represent limited accuracy for the surgeon's intent to achieve primary optimal catheter position. OBJECTIVE To investigate the accuracy of a ventricular catheter guide assisted by a simple mobile health application (mhealth app) in a multicenter, randomized, controlled, simple blinded study (GAVCA study). METHODS In total, 139 eligible patients were enrolled in 9 centers. Catheter placement was evaluated by 3 different components: number of ventricular cannulation attempts, a grading scale, and the anatomical position of the catheter tip. The primary endpoint was the rate of primary cannulation of grade I catheter position in the ipsilateral ventricle. The secondary endpoints were rate of intraventricular position of the catheter's perforations, early ventricular catheter failure, and complications. RESULTS The primary endpoint was reached in 70% of the guided group vs 56.5% (freehand group; odds ratio 1.79, 95% confidence interval 0.89‐3.61). The primary successful puncture rate was 100% vs 91.3% (P = .012). Catheter perforations were located completely inside the ventricle in 81.4% (guided group) and 65.2% (freehand group; odds ratio 2.34, 95% confidence interval 1.07‐5.1). No differences occurred in early ventricular catheter failure, complication rate, duration of surgery, or hospital stay. CONCLUSION The guided ventricular catheter application proved to be a safe and simple method. The primary endpoint revealed a nonsignificant improvement of optimal catheter placement among the groups. Long‐term follow‐up is necessary in order to evaluate differences in catheter survival among shunted patients.


Since surface flashover of insulators in vacuum restricts the operation of the power equipment, improvement of surface flashover performance is of considerable importance in various fields. Previous studies show that surface flashover performance is closely related to the trap parameters of materials. In this paper, the crystallization behavior of low density polyethylene (LDPE) is modified by phenolphthalein. It results in the change of the trap parameters, leading to the enhancements in surface flashover performance. Results of differential scanning calorimeter (DSC) and scanning electron microscope (SEM) show that the crystallization behavior of LDPE is greatly changed by phenolphthalein. The crystallinity increases initially and then decreases with the increase of phenolphthalein concentration, and its maximum value occurs at 0.4 wt%. The spherulite size of LDPE composites decreases obviously with the increasing phenolphthalein concentration. The results of thermally stimulated current (TSC) show that both the shallow trap (γ peak) and the deep trap (α peak) become deeper with the increase of phenolphthalein concentration. Furthermore, the impulse and dc surface flashover voltages present the optimum values at 1 wt% phenolphthalein concentration, which can be enhanced by 30.8% and 48.4%, respectively. It is concluded that LDPE with the smaller spherulite size indicates the deeper trap and the better surface flashover performance. This paper reveals the relationship between surface flashover performance and crystallization behavior of LDPE, and proposes a new method to enhance the surface flashover performance of semi-crystalline polymers in vacuum.


"Red Data Book of Ukraine. Vegetable Kingdom" Afterword The results of the third edition of the Red Data Book of Ukraine (2009) are summed up. This edition includes 826 species (611 vascular plants, 46 bryophytes, 60 algae, 52 lichens, 57 mosses). The approaches to species selection and category comparing assessment, which are accepted by Ukraine and IUCN, are highlighted as well as species distribution according to phytoceonological and political regions. Approaches to the selection of species for inclusion in the lists of the Red Data Books of Ukraine and Poland are analyzed.


: A new operation for recurrent pterygium with a corneal graft of varying thickness is described. After extensive excision of the pterygium the corneal defect, together with the lamellar and the bare sclera, is covered with the full-thickness corneal graft under the operating microscope. In a group of ten patients who had previously undergone surgery up to 6 times, no recurrences were observed in follow-up periods ranging from 6 months to 3 years. The functional and cosmetic results are satisfactory.


Steroid cyclophanes, each having a macrocyclic ring attached to four bile acid moieties via chiral lysine connectors, were synthesized, and the binding of the 2-naphthylphenylketone (guest) to the steroid cyclophanes in water was investigated. The circular dichroism spectra of the steroid cyclophane with cholic acid and L-lysine were significantly affected by the binding of the guest, and the induced circular dichroism based on the absorption of the achiral guest was also observed. The binding of the guest to the steroid cyclophane with cholic acids and D-lysines induced changes in the circular dichroism spectra with the opposite sign of the molecular ellipticities. An induced circular dichroism spectral change was not observed upon binding of the guest to the analogous host without OH sites. These results strongly suggest that the guest is conformationally fixed through hydrogen bonding between the carbonyl group of the guest and the steroidal hydroxyl group of the host. The assembly of only four steroid residues on the macrocyclic ring probably provided a hydrophobic nanocavity for hydrogen bonding.


New carbocyclic ribonucleosides with unsaturated groups at the C-2 position of the nucleobase were designed as potential RNA antiviral compounds. The design was based on the expectation that the monophosphates of these compounds would be inhibitors of the enzyme, IMPDH. Appropriate methodologies were developed to achieve the target molecules. Results from the initial in vitro antiviral studies are mentioned. The IMPDH-associated mechanism of the antiviral activity of the most active compound is supported by enzyme inhibition studies.


We aimed to investigate the association between Red Blood Cell Distribution Width (RDW) and Neutrophil-to-Lymphocyte Ratio (NLR), simple, rapidly assessed markers from the complete blood count with vascular calcification (VC)/stiffness and cardiovascular disease (CVD) in chronic kidney disease (CKD). Dephosphorylated, uncarboxylated matrix Gla-protein (dp-ucMGP), and central/peripheral hemodynamics' parameters were measured in 158 CKD patients, including Hemodialysis and Peritoneal Dialysis. Spearman's rho analysis showed that RDW correlated with C-reactive protein (CRP) (r = 0.29, p < 0.001), dp-ucMGP (r = 0.43, p = < 0.0001), central diastolic blood pressure (DBP) (r = −0.19, p = 0.02), and albuminuria (r = −0.17, p = 0.03). NLR correlated with the duration of CVD (r = 0.32, p < 0.001), CRP (r = 0.27, p = 0.01), dp-ucMGP (r = 0.43, p < 0.0001), central DBP (r = −0.32, p < 0.0001) and eGFR (r = −0.25, p = 0.04). In multiple regression models, circulating dp-ucMGP was an independent predictor of RDW (β = 0.001, p = 0.001) and NLR (β = 0.002, p = 0.002). In CKD patients, RDW and NLR are associated with traditional and novel markers of VC and CVD.


Faults in combinational circuits are either permanent or intermittent. Intermittent faults tend to be environment-dependent; hence altering the environment might rectify these faults. These faults can be detected by applying random input-vectors (IV). The existence of random intermittent faults might require applying more random IV before detection. The detection of permanent faults requires fewer random IV but correction demands location and replacement of the faulty device, if repair is not feasible. Thus correction of a permanent fault costs more than that of an intermittent fault. The correction cost can be reduced by detecting the type of fault. Since most operational failures in a circuit are due to intermittent faults, it is very important to detect the type of fault in order to find a cheaper solution. This paper discusses the behavior of permanent and intermittent faults in combinational circuits, and introduces a test-detection model (TDM) for these faults. The error latency for an intermittent fault is derived. Two test-strategies are intermixed in the model: random testing for fault-detection, and deterministic testing for deciding on the type of fault. The activity of intermittent faults that requires the minimum number of IV for detection is emphasized. Simulation is used to demonstrate the validity of TDM. Although the variables required in TDM can be difficult to evaluate, estimation of their values is not impossible. A worst-case analysis can always be adopted, where variables are easily evaluated, to find an upper bound on the error latency; thus detection of an intermittent fault is assured with a very high probability. The cost-saving offered by intermittent-fault corrections shows the practical aspect of TDM.


Results are presented of a study of heat transfer effects in hydrodynamically lubricated plain journal bearings.

The relevant literature is reviewed along with current procedures for the design of bearings. The computational difficulties associated with a full three-dimensional analysis are discussed.

Recent evidence from related work on pad thrust bearings has shown that the heat conducted to the stationary pads is a consistently small proportion of the total film energy dissipation. On the basis of this evidence a quasi-three-dimensional mathematical model is investigated. This analysis incorporates a quadratic temperature distribution through the film thickness, thereby accounting for heat transfer to and from the moving journal but neglecting heat transfer to and from the bush. The variation of viscosity with temperature is considered along and around the lubricant film.

Tests have been carried out on bearings of diameter 76.2mm, length to diameter ratios 0.5 and 1.0, and clearance ratios 0.001 and 0.002, over the speed range 1000 to 8000 r.p.m.. The heat conducted across the bush wall was deduced from a detailed mapping of the temperature distribution in the bush, and was found to represent around 10% of bearing power loss at high Peclet number, but to account for the removal of the bulk of the power loss at low Peclet number. At low speed the proportion of film cooling provided by bush conduction was significantly dependent upon load.

The test results are compared with results from the mathematical model and a recently published design procedure. Whilst there was good agreement between results from the- two prediction methods, these predictions did not agree well with the experimental results. The most significant discrepancy lay in the lubricant flowrate, which was in general poorly predicted.

Reasons for the discrepancies are discussed, and it is concluded that their source was associated with viscosity variation through the film thickness - a factor not modelled in either of the prediction methods.


Bone marrow stromal cells (BMSCs) usually refers to a group of multipotential, heterogenous members within the bone marrow that act as stem/progenitor cells of the bone tissue and are indirectly responsible for hematopoiesis. They could differentiate into diverse phenotypes, including endothelial cells, fibroblasts, adipocytes, osteoblasts, osteoclasts, etc. which together form the skeletal structure and compose most of the hematopoietic microenvironment (HME) sponsoring the regular production of blood elements. However, when blood diseases happening, these sponsors neglect their duty to become hypofunctional or even revolt to support tumor growth resulting in the suppression of normal hematopoiesis and progression of the disease. Consequently, in this review, we focus on BMSCs, a crucial part of the HME, discussing their changes under the pathological condition and expounding their profound roles involving in several hematopoietic diseases. By understanding the performance of BMSCs, more potential therapeutic applications and targets will be discovered and thus, the available regimen could be supplied to achieve a satisfactory curative effect.


Current neuropsychological research demonstrates an association between the Apolipoprotein-E e 4 allele (APOE e 4) and poorer cognitive outcomes in older adults. However, there is a general lack of consensus regarding the effect the e 4 allele has on executive functioning in cognitively intact older adults, and there is even less study of the effects the e 4 allele has on specific executive function processes, such as response inhibition. While behavioral task performance may lack the sensitivity to detect subtle differences in cognitively intact, at-risk individuals, neural activity may better differentiate between individuals who are more likely to develop Alzheimer's disease (AD). Compensatory theories of aging posit at-risk individuals may employ compensatory mechanisms in the form of bilateral neural recruitment and greater frontal activation. While electrophysiological methods, such as ERP and EEG, have been employed to investigate neural activity related to the e 4 allele, few studies have examined the differences in these neural markers between cognitively intact older adult carriers and non-carriers. The present study examined EEG oscillatory activity as a biomarker to target these gaps in the existing literature by investigating event-related beta activity in cognitively intact e 4 carriers ( n = 21) and non-carriers ( n = 23) during a response inhibition task. Our findings support compensatory theories of aging by demonstrating cognitively intact older adults employ compensatory mechanisms in the form of bilateral recruitment and greater frontal recruitment specifically during a task requiring inhibitory control. Additionally, these compensatory mechanisms are even greater in individuals at greater risk for developing AD. Results underscore the utility of assessing task-related neural activation during executive function tasks so as to better differentiate individuals at an increased risk for future cognitive impairment. The present study further demonstrates that EEG oscillatory activity, and more specifically beta band activity, may be a useful prodromal marker of cognitive decline.


Choice making in freight demand is critical to any firm as transportation cost can reach as much as 75% of the total cost of finished and shipped goods. The knowledge of the factors that influences the choice decision making for shippers will be of particular interest to carriers and the shippers alike. The study therefore set out to determine the factors that influence the choice of carriers for companies; evaluate the factors and degree of influence or level of significance of these factors or attributes. Five (5) firms' decision-making processes were studied for a combined total of 508 road trucking choice decision for what type or who does the shipment of their products and raw materials to and away from their respective manufacturing plants between January and June 2014. The firms were given a set of attributes or factors so that they are ranked using Likert scale of 1 to 5 to identify their level of significance. Multiple regression technique was used to establish the relationship between the factors and the choice of carriers. Regression analyses using analysis of variance, variance inflation factors and t-Test was done at 95% confidence level. The results showed that freight charges, quality of service, trust, price elasticity of freight demand and customer relations were the most significant factors/attributes that influenced the choice of a carrier in the five hundred and eighty shipments recorded for all firms in the study.


Problem statement: Poly (vinyl chloride) suffers from poor heat stability. The thermal
degradation of the polymer leads to the evolution of hydrogen chloride gas, extensive discoloration of
the polymer and lowering of physical and mechanical properties. Approach: Binary blends of Poly
(Vinyl Chloride) (PVC) and Poly (Glycidyl Methacrylate) (PGMA) have been prepared by solution
blending aimed at the improvement of thermal and mechanical properties. Results and Conclusion:
Thermal properties of the blends were studied using Scanning Calorimetry (DSC), Thermogravimetry
(TGA) and potentiometric rate of dehydrochlorination. The increase of the PGMA content in the blend
leads to thermal stability of the blend as shown from the thermogravimetry and the rate of
dehydrochlorination results. All blends exhibited one major glass transition temperature (Tg) whose
position on the temperature scale was lowered with increased level of PGMA. The miscibility of
blends was also confirmed by the use of Scanning Electron Microscope (SEM). The improvement of
the mechanical properties of various blends of the two polymers was also obtained.


OBJECTIVES
Emergency department (ED) patient satisfaction remains a high priority for many hospitals. Patient surveys are a common tool for measuring patient satisfaction, and process improvement efforts are aimed at improving patient satisfaction scores. In some institutions, patient satisfaction scores can be calculated for each emergency physician (EP). ED leaders are faced with the task of interpreting individual as well as group physician scores to identify opportunities for improvement. Analysis of these data can be challenging because of the relatively small numbers of returned surveys assignable to a single physician, variable numbers of surveys returned for each physician and high standard deviations (SDs) for individual physician scores. The objective was to apply statistical process control methodology to analyze individual as well as group physician patient satisfaction scores. The novel use of funnel plots to interpret individual physician patient satisfaction scores, track individual physician scores over two successive 8-month periods, and monitor physician group performance is demonstrated.

METHODS
Patient satisfaction with physicians was measured using Press Ganey surveys for a 65,000-volume ED over two successive 8-month periods. Using funnel plots, individual physician patient satisfaction scores were plotted against the number of surveys completed for each physician for each 8-month period. Ninety-fifth and 99th percentile control limits were displayed on the funnel plots to illustrate individual physician patient satisfaction scores that are within, versus those that are outside of, expected random variation. Control limits were calculated using mean patient satisfaction scores and SDs for the entire group of physicians. Additional funnel plots were constructed to demonstrate changes in individual physicians' patient satisfaction scores as a function of increasing numbers of returned surveys and to illustrate changes in the group's patient satisfaction scores between the first and second 8-month intervals after the institution of process improvement efforts aimed at improving patient satisfaction.

RESULTS
For the first 8-month period, 34,632 patients were evaluated in and discharged from the ED, with 581 surveys returned for 21 physicians. The mean (±SD) overall group physician patient satisfaction score was 81.8 (±24.7). Returned surveys per physician ranged from 2 to 58. For the second period, 34,858 patients were evaluated and discharged from the ED, with 670 patient satisfaction surveys returned for 20 physicians. The mean (±SD) overall physician score for all surveys returned during the second period was 85.0 (±22.2). Returned surveys per physician ranged from 8 to 65.

CONCLUSIONS
The application of statistical control methodology using funnel plots as a means of analyzing ED group and physician patient satisfaction scores was possible. The authors believe that using funnel plots to analyze scores graphically can rapidly help determine the significance of individual physician patient satisfaction scores. In addition, serial funnel plots may prove to be useful as a means of measuring changes in patient satisfaction, particularly in response to quality improvement interventions.


A hybrid middleware for RFID-based parking management system is presented in this paper. The publish-subscribe approach is combined with group communication in overlay networks in the design of event monitors and application service connectors to comprise the core of a hybrid middleware. In this paper, group communication relevant to P2P networks is the focus of middleware technology development. A group of peer nodes provide an efficient abstraction to handle events from RFID readers and vehicle identity detectors to be processed by services and applications that run in the conventional IP networks. Programming abstractions for publish-substribe messaging (multicast and single) from the reference P2P systems are used to build new extensions. The hybrid middleware provides an efficient communication transport between the peer-based networks and existing application services and mobile communication infrastructure that require conventional IP-based networks. The simulation results show that the approach improved the performance of the P2P network. This paper provides an implementation model that can significantly lower the infrastructure cost for building an electronic parking management system.


Abstract Phagocytosis is a pivotal immunological process, and its discovery by Elia Metchnikoff in 1882 was a step toward the establishment of the innate immune system as a separate branch of immunology. Elia Metchnikoff received the Nobel Prize in physiology and medicine for this discovery in 1908. Since its discovery almost 140 years before, phagocytosis remains the hot topic of research in immunology. The phagocytosis research has seen a great advancement since its first discovery. Functionally, phagocytosis is a simple immunological process required to engulf and remove pathogens, dead cells and tumor cells to maintain the immune homeostasis. However, mechanistically, it is a very complex process involving different mechanisms, induced and regulated by several pattern recognition receptors, soluble pattern recognition molecules, scavenger receptors (SRs) and opsonins. These mechanisms involve the formation of phagosomes, their maturation into phagolysosomes causing pathogen destruction or antigen synthesis to present them to major histocompatibility complex molecules for activating an adaptive immune response. Any defect in this mechanism may predispose the host to certain infections and inflammatory diseases (autoinflammatory and autoimmune diseases) along with immunodeficiency. The article is designed to discuss its mechanistic complexity at each level, varying from phagocytosis induction to phagolysosome resolution.