Periodontal diseases are an inflammatory diseases of periodontal tissue. The 6 th epidemiological survey of this disease inThailand during the year 2006-2007 reported that most of the elderly have periodontitis. The cause of periodontal disease is bacteria, which induces infections by plaque formation and cause inflammatory. Periodontal disease can be detected by many methods such as periodontal probing depth, bacterial culture, enzyme-linked immunosorbent assay (ELISA), and immunoassay of saliva and gingival crevicular fluid (CGF) specimens. The biological markers in CGF including myeloperoxidase (MPO) which is an enzyme found in azurophilic granule of neutrophil. When host response to injuries, neutrophil release MPO to catalyze halogenation reaction. Hypochlorous acid, the end product of this reaction, is toxic to bacteria. The color product obtained from MPO catalyzed selected substrate can be easily detect by eye or colorimetry. Thus MPO may be a potential enzyme for development of diagnostic kit for screening periodontal disease.


This article initiates the conversation on the conceptualisation of child neglect in Namibia, reporting findings from a small study undertaken in 2017. The research is a collaboration between academics at the University of Namibia, Africa, University of Bristol and Cardiff University in the UK. The study is the first of its kind in Namibia, offering original knowledge about what constitutes neglect for children in the local context of child-rearing practice. Qualitative interviews with practitioners in schools and social-care organisations were undertaken in three of the fourteen political regions of Namibia. Interviews ascertained participants' thoughts and understandings of child neglect at individual and community levels. Teenage pregnancy and substance misuse emerged as central to the conceptualisation of neglect within the local context, with a tension between Western and indigenous child-rearing practices. This article offers rich insights into the social construction of child neglect amongst indigenous communities in Namibia, identifying a need for knowledge gathering into broader aspects of child health and well-being within Namibia's diverse indigenous peoples. The authors call for future co-produced research, which engages local communities and stakeholders in investigating this issue, to improve the health and well-being of Namibian children in congruence with the United Nations Sustainable Development Goals.


Purpose: The aim of this hospital-based study was to assess the prevalence and associated factors of pterygium among adult patients visiting the Ophthalmology Outpatient Department (OPD) in the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), Thimphu. Methods: A cross sectional study was carried out in the ophthalmology OPD in the national referral hospital, Thimphu from 1st January, 2018 to 31st December, 2018, during which 1599 adult patients were selected through systematic random sampling. Results: The prevalence of pterygium was 12.8% (95% CI: 11.2 -14.5). Among 271 eyes with pterygium, the distribution of grade 1, grade 2 and grade 3 pterygium was 34.7%, 56.1% and 9.2% respectively. Pterygium was most common in the age group of 36-55 years. The significant factors associated with pterygium were age group, occupation and usage of sunglasses. Individuals who were 36-55 years (adjusted OR 2.70, 95% CI 1.82-4.0) and >55 years (adjusted OR 2.17, 95% CI 1.34-3.50) had significantly higher risk than 18-35 years (p< 0.002), and not using sunglasses (adjusted OR 1.97, 95% CI 1.17-3.33, p = 0.007) significantly increased the risk of pterygium. Indoor occupation, particularly being a student was protective against pterygium (OR 0.08, 95% CI 10.02-0.33, p< 0.001). Only 14.1% used sunglasses and among them, 27.6% were aware that sunglasses can protect from ultraviolet radiation. Conclusions: This study found a high prevalence of pterygium among adults aged 18 years and above. Those aged 36-55 years and an occupation involving outdoor activities were affected more. Encouraging usage of sunglasses may reduce pterygium.


ABSTRACT We combined tissue culture and flow cytometry to assess the activities of various temperatures, chemicals, and disinfectants on the viability and infectivity of spores of Encephalitozoon intestinalis. Surfanios and benzalkonium chloride, disinfectants currently used in the hospital, were remarkably efficient in destroying spore viability and infectivity.


Bernard Perrot had produced sophisticated glass objects from ~1666 to 1709 in Orléans, particularly white enamelled artefacts and ruby glass. We present here the first non-invasive Raman study of sixteen white glass artefacts which are assigned to B. Perrot or his followers. These glasses are enamelled except one of them and belong to the museum collections of Orléans and Sèvres. The prominent characteristic of these artefacts is their white bodies which were produced in imitation of porcelain. The small thickness of enamel applied to these glasses imposes the use of a high magnification (x200) long working distance microscope objective for Raman analysis. Pigments and opacifiers were identified and the production technology was discussed. White opacification was obtained by three compounds: calcium phosphate (bone opacification) for blown utensils, calcium antimonate for figurines and cassiterite for thin enamels. The characteristic arsenic-rich European cobalt was identified in the blue enamels with the characteristic Raman signature of arsenic apatite as observed for 17 and 18 soft-paste porcelains and Limoges enamels. The easy Raman detection of arsenic–rich phases also allows on-site identification of ruby glass made according to Perrot's technique (precipitation of Au° colloids by arsenic). The amount and crystallinity of calcium phosphate being variable appears to be a potential tool to discriminate between different production periods or workshops.


Much information is accumulating on the effect of cerium oxide nanoparticles (CNPs) as cell-protective agents, reducing oxidative stress through their unique ability of scavenging noxious reactive oxygen species via an energy-free, auto-regenerative redox cycle, where superoxides and peroxides are sequentially reduced exploiting the double valence (Ce3+/Ce4+) on nanoparticle surface. In vitro and in vivo studies consistently report that CNPs are responsible for attenuating and preventing almost any oxidative damage and pathology. Particularly, CNPs were found to exert strong anticancer activities, helping correcting the aberrant homeostasis of cancer microenvironment, normalizing stroma-epithelial communication, contrasting angiogenesis, and strengthening the immune response, leading to reduction of tumor mass in vivo. Since these homeostatic alterations are of an oxidative nature, their relief is generally attributed to CNPs redox activity. Other studies however reported that CNPs exert selective cytotoxic activity against cancer cells and sensitize cancer cells to chemotherapy- and radiotherapy-induced apoptosis: such effects are hardly the result of antioxidant activity, suggesting that CNPs exert such important anticancer effects through additional, non-redox mechanisms. Indeed, using Sm-doped CNPs devoid of redox activity, we could recently demonstrate that the radio-sensitizing effect of CNPs on human keratinocytes is independent from the redox switch. Mechanisms involving particle dissolution with release of toxic Ce4+ atoms, or differential inhibition of the catalase vs. SOD-mimetic activity with accumulation of H2O2 have been proposed, explaining such intriguing findings only partially. Much effort is urgently required to address the unconventional mechanisms of the non-redox bioactivity of CNPs, which may provide unexpected medicinal tools against cancer.


Mastermind is code-breaking board game whose principle is to find as fast as possible the guess pattern of code pegs in color and position based on feedback realized by key pegs. The game is targeted at development of logical thinking. The process of the decoding can be realized also using computer. Mathematical analysis, strategy solution, algorithm development of solution and computer simulation program in MS Excel of decoding of the position order of already found and disordered colored pegs are shown in the paper.


In this series, we advocate that the starting point for any measurement system in the current business environment is the need to move away from classical cost and profit perspectives to more valuebased perspectives. Accordingly, we discuss the emerging environment for asset maintenance that is foundational for new frameworks to develop operations and maintenance performance indicators for industrial asset maintenance. The issues discussed in this series substantiate our new concept termed 'value-based maintenance performance management'. This is in line with an ongoing joint industry project on development and implementation of maintenance performance indicators for the petroleum industry in Norway.


The effects of streptomycin on the otoconial layer of the adult guinea pig were investigated using scanning electron microscopy. Administration of streptomycin induced a reduction of otoconia with formation of giant otoconia. These phenomena reached their maximum 4 weeks after the cessation of streptomycin intoxication in the utricle and between 2 and 6 weeks after in the saccule. Otoconia began to recover in the utricle 4 weeks and in the saccule 6 weeks after the cessation of streptomycin intoxication with an increasing number of small otoconia. Eight or 10 weeks after the cessation of streptomycin intoxication, the otoconial layer has completely recovered in both the utricle and saccule.


The purpose of the project was to ensure that novel plants produced by somatic hybridisation of O. sativa and O. granulata in previous DFID PSP research are made available for the rice breeding community. It was envisaged that the germplasm could be used to transfer traits to cultivated rice and these may include drought tolerance and adaptability to low levels of solar radiation which occur in the wet season in most areas where rice is grown. Detailed molecular characterisation using microsatellite primers showed that the original population of 55 plants was composed of 33 cybrids and 22 O. sativa plants, of which 7 were somaclonal variants. There are no plans to further utilise this germplasm.


Autonomous agents must often detect affordances: the set of behaviors enabled by a situation. Affordance detection is particularly helpful in domains with large action spaces, allowing the agent to prune its search space by avoiding futile behaviors. This paper presents a method for affordance extraction via word embeddings trained on a Wikipedia corpus. The resulting word vectors are treated as a common knowledge database which can be queried using linear algebra. We apply this method to a reinforcement learning agent in a text-only environment and show that affordance-based action selection improves performance most of the time. Our method increases the computational complexity of each learning step but significantly reduces the total number of steps needed. In addition, the agent's action selections begin to resemble those a human would choose.


The Yellowstone–East Snake River Plain hotspot track has been intensely studied since several decades and is widely considered to result from the interaction of a mantle plume with the North American plate. An integrated conclusive geodynamic interpretation of this extensive data set is however presently still lacking, and our knowledge of the dynamical processes beneath Yellowstone is patchy. It has been argued that the Yellowstone plume has delaminated the lower part of the thick Wyoming cratonic lithosphere. We derive an original dynamic model to quantify delamination processes related to mantle plume–lithosphere interactions. We show that fast (∼300 ka) lithospheric delamination is consistent with the observed timing of formation of successive volcanic centres along the Yellowstone hotspot track and requires (i) a tensile stress regime within the whole lithosphere exceeding its failure threshold, (ii) a purely plastic rheology in the lithosphere when stresses reach this yield limit, (iii) a dense lower part of the 200 km thick Wyoming lithosphere and (iv) a decoupling melt horizon inside the median part of the lithosphere. We demonstrate that all these conditions are verified and that ∼150 km large and ∼100 km thick lithospheric blocks delaminate within 300 ka when the Yellowstone plume ponded below the 200 km thick Wyoming cratonic lithosphere. Furthermore, we take advantage of the available extensive regional geophysical and geological observation data sets to design a numerical 3-D upper-mantle convective model. We propose a map of the ascending convective sheets contouring the Yellowstone plume. The model further evidences the development of a counter-flow within the lower part of the lithosphere centred just above the Yellowstone mantle plume axis. This counter-flow controls the local lithospheric stress field, and as a result the trajectories of feeder dykes linking the partial melting source within the core of the mantle plume with the crust by crosscutting the lithospheric mantle. This counter-flow further explains the 50 km NE shift observed between the mantle plume axis and the present-day Yellowstone Caldera as well as the peculiar shaped crustal magma chambers.


5141 Ezrin is a member of the ERM family (Ezrin-Radixin-Moesin) and serves as a physical and functional linker between the plasma membrane and the actin cytoskeleton. By organizing membrane-cytoskeleton - associated complexes, Ezrin mediates cellular activities such as survival, adhesion, migration and invasiveness, thereby influencing tumor development and progression. Ezrin expression is enhanced in metastases of mammary and pancreatic adenocarcinoma, osteosarcoma and melanoma. Previously, we identified Ezrin as a critical regulator of metastasis in a mouse model of the pediatric cancer rhabdomyosarcoma (Yu, et al., Nature Medicine, 2004). Although many studies highlight the important role of Ezrin in tumorigenesis, little is known about the regulation of Ezrin expression. We have found that Six1, a homeodomain-containing transcription factor required for skeletal muscle development, can bind to the Ezrin gene (VIL2) promoter and regulate its transcription. Recently, we discovered that epigenetic covalent modifications to histones within nucleosomes of the Ezrin gene promoter are linked to Ezrin expression. Moreover, Six1 regulates Ezrin gene transcription through recruitment of the CREB-binding protein (CBP).


Objective. To present our experience of using transperitoneal subcostal access, Palmer's point (3 cm below the left costal margin in the midclavicular line), and its right corresponding site, in urologic laparoscopy. Methods. We used Palmer's point and the right corresponding site for initial access in 302 urologic surgeries (62 cases with prior surgeries). The record of these cases was reviewed. Results. Success rate of initial access is 99.4%, and complication rate of puncturing is only 3.4% with no serious complication. In the cases with prior surgeries, there were only two cases with access complication on the right side (minor laceration of liver). For people with BMI more than 30 kg/m2 (12, 3.9%), the success rate was also 100 percent. Conclusions. Palmer's point and the corresponding right location are feasible, effective, and safe for initial access in urologic laparoscopic surgeries. This entry technique should be used routinely in urologic laparoscopic surgeries.


Postural control is the ability to maintain equilibrium and orientation in a gravitational environment. It is dependent on feedback and feedforward mechanisms that generate appropriate corrective movement based on body-sway motion detected primarily by visual, vestibular, and proprioceptive sensory systems. Since information from the various senses is not always accurate (e.g. by disease) or available (e.g. with eyes closed), the postural control system must adapt to maintain stance. This thesis aimed to investigate postural control and adaptation to threats of balance. Effective approaches for the clinical measurement of postural control still remains to be developed. In the past, it has been common to investigate patients' balance by having them stand upon compliant foam blocks with eyes open and closed since standing on foam is believed to affect the accuracy of information from cutaneous mechanoreceptors on the soles of the feet. However, when assessing balance on foam blocks with different compliances and mechanical properties, it was found that postural sway was larger on firmer compliant surfaces, which also increased the importance of visual information. Postural adaptation was also investigated by repeatedly perturbing balance using muscle vibrations. In healthy, young persons, a slow adaptive change was observed. This adaptation involved decreased costs of standing including decreased energy, body movement and muscle activity and changes to the relationship between muscle activity and movement. The characteristics of the adaptation also depended on the availability of visual information. The elderly had poor postural control with and without being perturbed but were able to adapt to improve their poor balance. However, decreased mechanoreceptive sensation in the elderly prevented them from adapting their balance to the level of younger test subjects. Sleep deprivation decreased attention and alertness and resulted in decreased postural control and adaptation. The findings in this thesis extend what is known about motor learning. The adaptive learning capability of the postural control system, and hence the accurate reconstruction of the kinematics and kinetics of movement, was dependant on ones own mechanoreceptive somatosensation and availability of visual information. Decreasing attention and alertness through sleep deprivation decreased adaptive capabilities, suggesting an important role for sleep in memory and consolidation of a new motor skill. (Less)


This textbook presents an understanding of how basic physical descriptions can be translated into mathematical analogues that provide an opportunity to investigate environmental processes. Examples come from a range of hydrologic, atmospheric, and geophysical problems. The emphasis is on simple examples and calculations that add to understanding. The book provides a sense for the meaning of mathematical expressions, a physical feel for their relations to processes, and confidence in working with mathematical solutions. The goal of this book, in essence, is to present the timeless basic physical and mathematical principles and philosophy of environmental modeling, often to students who need to be taught how to think in a different way than they would for more narrowly-defined engineering or physics problems. Minimum prerequisites for the student reader include a knowledge of calculus through differential equations, but the book provides the mathematical and physical tools needed as the occasion arises.


Abstract. Compositional and geochemical profiles were established for a 59-cm sediment core extracted from a small pothole pond in a Taxodium (bald cypress) swamp 830 m inland from Lake Pontchartrain in south-eastern Louisiana, USA. The core consists of a top organic unit (peat to clayey peat) from 0–29 cm above a bottom clay unit at 30–59 cm depth. Four distinct zones, marked by gradual changes in organic content and elemental concentrations, occur in the clay unit. These changes probably reflect two cycles of slowly changing water depths. Hurricane Isaac's signature, a brown clay band at 3–5 cm, is identified based on the stratigraphic and compositional correspondence with the storm's event layer, documented from nearby sites. Sedimentary and geochemical similarities between this material and clastic bands at 15–19 and 23–25 cm identify those two intervals as potentially representing earlier floods. The Cl/Br ratio presents a potentially useful method for distinguishing fluvial and marine flooding.


We show that the recently observed superconductivity in twisted bilayer graphene (TBG) can be explained as a consequence of the Kohn-Luttinger (KL) instability which leads to an effective attraction between electrons with originally repulsive interaction. Usually, the KL instability takes place at extremely low energy scales, but in TBG, a doubling and subsequent strong coupling of the van Hove singularities (vHS) in the electronic spectrum occurs as the magic angle is approached, leading to extended saddle points in the highest valence band with almost perfect nesting between states belonging to different valleys. The highly anisotropic screening induces an effective attraction in a p-wave channel with odd parity under the exchange of the two disjoined patches of the Fermi line. We also predict the appearance of a spin-density wave instability, adjacent to the superconducting phase, and the opening of a gap in the electronic spectrum from the condensation of spins with wave vector corresponding to the nesting vector close to the vHS.


OBJECTIVE
The objective of this study was to evaluate, for patients with ovarian cancer, the feasibility, reliability, and complications of a laparoscopic second look and to compare them with those of a second look by laparotomy.

METHODS
Twenty patients treated by initial surgery and adjuvant chemotherapy for ovarian carcinoma underwent a laparoscopic second look, immediately followed by a comparative laparotomy. All were in complete remission after chemotherapy. Both operations were performed according to a predefined checklist, identical for both surgical techniques and for each patient: after liberation of adhesions, an exhaustive intraperitoneal inspection was performed, with systematic peritoneal cytology and biopsies. Each patient therefore was her own control for the two techniques.

RESULTS
The positive predictive value of laparoscopy for the diagnosis of residual disease was 100% (6 of 6 cases), while the negative predictive value was 86% (2 false-negative cases out of 14). Because of the presence of postoperative adhesions, the rate of complete intraperitoneal investigation was 95% for laparotomy versus 41% for laparoscopy. The complication rate of laparoscopy requiring laparotomy was 5.3%.

CONCLUSIONS
After treatment of ovarian cancer, a laparoscopic second look appears to be less reliable than one performed by laparotomy. The presence of severe postoperative adhesions is the main obstacle to an exhaustive, reliable, and safe laparoscopic second look.


Within the last decades heavy-duty gas turbines have
become more relevant for the energy sector, especially due to the
changing requirements on fossil power plants. In combination
with high fluctuating renewables, such as wind and solar energy,
combined cycle power plants provide the needed operational
flexibility along with high thermal efficiency. In order to meet
the ambitious reduction targets for future CO2 emissions, the
extension of renewable power solutions is mandatory.
Meanwhile further development of fossil power plants is
important, to ensure a secure energy supply at all conditions and
to back up the worldwide increasing power demand.
Enhancements for heavy-duty gas turbines focus on higher
thermal efficiency and increasing power output, whilst
providing a high operational flexibility.
This study analyzes the future performance potential for
heavy-duty gas turbines in combined cycle power plants, by
further development of the main gas turbine components:
compressor, combustion chamber and turbine, including the
cooling system. The performance potential will be evaluated
separately for each component and in combination for on- and
off-design operation. The thermodynamic power plant design
will be calculated with the performance software GTlab of the
German Aerospace Center. Furthermore the fuel and CO2
savings for different levels of component technology
development will be quantified. Concluding a potential
evolution timeline for combined cycle power plants until the
year 2050 will be given.
The results show that there is a high potential regarding to
thermal efficiency and power output, by conventional
component improvements of heavy-duty gas turbines. Also the
improved components lead to a significant reduction of fuel
consumption and CO2 emissions.


This report describes a PCR primer pair that targets the aZgD GDP mannose gene of Pseudomonas aeruginosa and produces a specific 520-bp PCR product useful for R aeruginosa identification. This PCR assay was tested with 182 isolates of I? aeruginosa and 20 isolates of other bacterial species, and demonstrated 100% specificity and sensitivity. The test was also able to detect I? aeruginosa directly in clinical samples such as sputum or throat swabs obtained from cystic fibrosis patients. The combination of this primer with a universal bacterial primer, acting as a control to assess DNA quality in the sample, resulted in a robust PCR method that can be used for rapid l? aeruginosa detection.


We describe a characterization of the conceptual and emotional changes on environmental issues in a sample of firms certified under the ISO 14001 standard. Business communications regarding the main Spanish industrial firms have been downloaded from the ABI/INFORM database and processed using Vantage Point software, in order to study the evolution of the main concepts and emotions before and after the certification year. Our study concludes that in the years before certification environmental management was fundamentally tied to operative issues, broadly pivoting on the immediate impact of a firm's productive activities. Environmental management gains strategic traction in the years after certification, positioning itself near corporate decision-making concepts and associated with adjectives that denote relevance and positivity. The sentiment analysis points at an increased positivity of environment-related issues, accompanied by a general decrease in negative emotions and an increased presence of expectation and planning emotions.


Clustering algorithms have become a popular tool in computer security to analyze the behavior of malware variants, identify novel malware families, and generate signatures for antivirus systems. However, the suitability of clustering algorithms for security-sensitive settings has been recently questioned by showing that they can be significantly compromised if an attacker can exercise some control over the input data. In this paper, we revisit this problem by focusing on behavioral malware clustering approaches, and investigate whether and to what extent an attacker may be able to subvert these approaches through a careful injection of samples with poisoning behavior. To this end, we present a case study on Malheur, an open-source tool for behavioral malware clustering. Our experiments not only demonstrate that this tool is vulnerable to poisoning attacks, but also that it can be significantly compromised even if the attacker can only inject a very small percentage of attacks into the input data. As a remedy, we discuss possible countermeasures and highlight the need for more secure clustering algorithms.


The stable grasp is the basis of robotic manipulation. It requires balance of the contact forces and the operated object. The status of the grasp determined by vision is direct according to the object ' s shape or texture, but quite challenging. The tactile sensor can provide the effective way. In this work, we propose the visual-tactile fusion framework for predicting the grasp. Meanwhile, the object intrinsic property is also used. More than 2550 grasping trials using a novel robot hand with multiple tactile sensors are collected. And visual-tactile intrinsic deep neural network (DNN) is evaluated to prove the performance. The experimental results show the superiority of the proposed method.


INTRODUCTION AND OBJECTIVES: Narcotic use is a growing public health concern and poses significant challenges in the perioperative period. The aim of this study was to characterize the relationship between pre-operative narcotic use and post-operative outcomes in patients undergoing radical cystectomy. METHODS: We performed a retrospective cohort study comprising all patients residing in Tennessee or contiguous states who underwent radical cystectomy at a single institution from January 2013 to August 2015. Controlled substances data were obtained from the Tennessee Controlled Substances Medication Database from 1 year prior to surgery through 1 year after surgery and linked to clinical and demographic data abstracted from the medical record. We identified clinical, demographic, and prescription data that were associated with post-operative outcomes using bivariate non-parametric statistical testing and multivariate generalized linear model, Poisson regression and logistic regression when appropriate. RESULTS: 267 patients underwent radical cystectomy, 134 of whom were prescribed narcotics in the year prior to cystectomy. There was a statistically significant association between the number of in-hospital complications and the pre-operative morphine equivalent dose (MED) on bivariate (RR 1.021, P=0.024) but not on multivariate analysis (RR 1.01, 95%CI 1.00-1.03, P=0.0795). Additionally, there was also a statistically significant association between the total number of complications within 90 days of discharge and the pre-operative MED for 1 year prior to surgery on bivariate (RR 1.021, 95% CI 1.002-1.04, P=0.027) and on multivariate regression (RR 1.02, 95% CI 1.00-1.04, P=0.029). Among patients that filled a narcotic prescription prior to cystectomy, MED in the year prior to surgery was an independent predictor of length of stay (OR 1.08, 95%CI 1.01-1.16, P=0.019). There was no association between MED for the year prior to surgery and Emergency Department visits (p=0.41) or readmissions (p=0.88). CONCLUSIONS: For patients undergoing radical cystectomy at a quaternary care referral center, morphine equivalent dose was an independent predictor of complications and was an independent predictor of length of stay in those patients who had filled a narcotic prescription in the year before surgery. Our findings suggest that greater vigilance of narcotic use prior to cystectomy is warranted and that narcotic stewardship in patients being considered for cystectomy could have benefits in the perioperative period. Source of Funding: None


Currently, the syndromic management of HIV/AIDS is based on a biomedical model that focuses on the ABC (Abstain, Be faithful, Condomise) model. The ABC model overlooks the issue of indigenous cultural practices, sexual behaviours, knowledge and attitudes of the society. A grounded theory study was used for the research. The population for the research on which this article is reporting, was selected from the Vhavenda ethnic group using purposive sampling. In-depth interviews were held at the participants' own homes. The outcome of the study on which this article is reporting, may assist in identifying indigenous health beliefs, attitudes and practices that will assist in curbing the spread of HIV/AIDS. The findings revealed that cultural practices, such as premarital counselling, polygamy and widow inheritance, are believed to be influential in making women more susceptible to sexually transmitted diseases, including HIV/AIDS. The practice of abstinence, as emphasised at initiation schools, should be incorporated into current policies and preventative practices. The findings further demonstrate that policy-makers who formulated the HIV/AIDS strategy have limited knowledge of the health beliefs, attitudes and practices of the people they serve. They thus find it difficult to draw up promotion and prevention strategies that meet the needs of the community. It is therefore imperative that our health-care training curriculum be reviewed to make provision for the incorporation of sound and effective indigenous practices to reduce the spread of HIV/AIDS and to eliminate or refine practices that are harmful and detrimental to people's health. The cultural practices that were proved reliable and effective will be recommended for integration into health education.


The relation between oxytocin-induced type A uterine contractions and fetal arterial PO2, measured continuously with an intravascular oxygen electrode, was studied in nine chronically catheterized sheep during late pregnancy. Oxytocin provoked dose-related increases in intrauterine pressure (IUP) and decreases in fetal PaO2. There was a significant positive relationship between changes in IUP and the maximum decrease in fetal PaO2 (average r = 0.696, df = 92; P less than 0.001). We conclude that changes in uterine activity contribute to transient fetal hypoxemia, and that administration of exogenous oxytocin provides an experimental paradigm to examine the consequences of this relationship.


Budd-Chiari syndrome is a rare and serious condition characterised by obstruction to the outflow of hepatic venous blood. Thrombophilias, malignancies, infections and pregnancy have been implicated as causes. Anticoagulation, portacaval shunt placement and orthotopic liver transplant are the treatment options. Here we present the management of a patient who developed Budd-Chiari syndrome during her puerperium and needed two liver transplants. Case report A 26-year-old para two presented during her third pregnancy to the joint antenatal-haematology clinic. She had a past history of antiphospholipid syndrome, recurrent deep vein thrombosis and pulmonary embolism and was on clexane 80 mg twice a day during pregnancy. At 35 weeks she developed nausea, epigastric pain, chest pain and vasculitis, hence labour was induced and she delivered a baby boy normally. On the second postnatal day she developed severe right upper quadrant pain, hepatosplenomegaly and raised liver function tests. CT and MRI confirmed hepatic vein thrombosis. She developed ascites and recurrent sepsis and received orthotopic liver transplant 3 months after delivery. 2 weeks later she developed hepatic artery thrombosis and hence received repeat transplant. She was discharged 5 months following her delivery. Discussion Budd-Chiari syndrome during pregnancy has been rarely reported. Our patient developed Budd-Chiari syndrome on the back ground of two prothrombotic events namely pregnancy and antiphospholipid syndrome and needed two orthotopic liver transplants within a span of 3 weeks. There have been no such cases reported in the literature. This case highlights the extreme difficulty in managing these patients.


One of the most urgent challenges facing the world today is ensuring local water security under rapid climate variability and change. This is of particular importance in a country like India, where over half of the people are involved in farming, and agricultural losses due to climate change are estimated to be as high as 30 per cent by 2080. This ethnography in the arid village of Bhiwadi, West Rajasthan empirically links the reintroduction of local water harvesting technologies with the building of sustainable social reproduction in subsistent communities. By emphasising both the role of gender and the informal economy – and institutions – this ethnography provides a more thorough picture of the individuals and collective actors involved in localised and resilient technologies within global economic and climatic processes.


Abstract Viola L. are the larval food plants for a charismatic group of butterflies in Speyeria Scudder, 1872, which contains several rare and declining taxa in California and across North America. A current impediment to restoring Viola in California is a lack of knowledge of germination requirements. In this study we focused on determining conditions for successful germination of V. pedunculata Torr. & A. Gray, the food plant of the federally listed endangered Speyeria callippe (Boisduval, 1852) subsp. callippe, and V. purpurea Kellogg subsp. quercetorum (M.S. Baker & J.C. Clausen) R.J. Little, the food plant of the imperiled southern Coast Range butterfly, S. adiaste (Edwards, 1864) subsp. clemencei (Comstock, 1925). We examined the effects of gibberellic acid, seed color, elaiosome removal, and duration of stratification on germination success. We found that both taxa germinate exceptionally well (73–100%) after a prolonged period of after-ripening and 6–10 wk of stratification. Gibberellic acid and elaiosome removal did not have strong effects on germination of V. pedunculata, and both dark and mottled V. purpurea subsp. quercetorum seeds germinated equally well. We make recommendations for successful lab germination of these two native violets, setting the stage for additional research to help restore their populations as well as their herbivores.


BF is a dialytic procedure employing the new AN69 polyacrylonitrile membrane, which is more permeable to both water and solutes than the traditional AN69. A postdilutional bicarbonate infusion is necessary in BF. The treatment time is 3 hours. Six patients, previously on regular acetate (HD) or bicarbonate dialysis (BHD) with AN69 were treated for 18 months with BF. Biochemical and hematological parameters (BUN, creatinine, uric acid, CA, P, K, Na, blood pH, HCO3, hematocrit) and clinical signs were evaluated in BF, and compared to those of HD and BHD. An improvement in biochemical and hematological parameters accompanied by better clinical signs was seen in BF as compared to HD and BHD. In our opinion this is due both to better removal of small and middle molecules and the bicarbonate infusion, and to the shorter dialytic session.


Background and purpose — In a previous registry report, short-term implant survival of hip resurfacing arthroplasty (HRA) in Finland was found to be comparable to that of total hip arthroplasty (THA). Since then, it has become evident that adverse reactions to metal debris (ARMDs) may also be associated with HRA, not only with large-diameter head metal-on-metal THA. The aim of the study was to assess medium- to long-term survivorship of HRA based on the Finnish Arthroplasty Register (FAR). Patients and methods — 5,068 HRAs performed during the period 2001–2013 in Finland were included. Kaplan-Meier survival analysis was used to calculate survival probabilities and their 95% confidence intervals (CIs). Cox multiple regression, with adjustment for age, sex, diagnosis, femoral head size, and hospital volume was used to analyze implant survival of HRA devices with revision for any reason as endpoint. The reference group consisted of 6,485 uncemented Vision/Bimetric and ABG II THAs performed in Finland over the same time period. Results — The 8-year survival, with any revision as an endpoint, was 93% (CI: 92–94) for Birmingham Hip Resurfacing (BHR), 86% (CI: 78–94) for Corin, 91% (CI: 89–94) for ReCap, 92% (CI: 89–96) for Durom, and was 72% (CI: 69–76) for the Articular Surface Replacement (ASR). The 10-year survival, with any revision as an endpoint, for reference THAs was 92% (CI: 91–92) and for all HRAs it was 86% (CI: 84–87%). Female HRA patients had about twice the revision risk of male patients. ASR had an inferior outcome: the revision risk was 4-fold higher than for BHR, the reference implant. Interpretation — The 10-year implant survival of HRAs is 86% in Finland. According to new recommendations from NICE (The National Institute for Health and Care Excellence), an HRA/THA should have a revision rate of 5% or less at 10 years. None of the HRAs studied achieved this goal.


Lens culinaris Medikus also known as Lens esculenta Moench., lentil or masur is polyphenols, saponins and carbohydrates rich food grain. The polysaccharides and polyphenols interfere in (deoxyribonucleic acid)DNA extraction and isolation which is an important and basic step for molecular, biological and genetic study of a plant. The present study was an attempt to isolate high quality genomic DNA fromLens culinarisMedikus leaves usingmodified Cetyl trimethyl ammoniumbromide (CTAB)method without using liquid nitrogen. The genomic DNAwas isolated fromleaves using absolute ethanol and chloroform ethanol solution as fixatives and was quantified using spectroscopic and agarose gel electrophoresis method. The concentration of DNA extracted from the leaves of the Lens culinaris Medikus using absolute ethanol and chloroform ethanol solution as fixativeswas found to be in the range of 2.08- 2.30 µg/ml. The DNA isolated using absolute ethanol was better in quality as it showed better optical density. DNA was observed as blue band on agarose gel. This method is rapid, simple and efficient for isolating DNA fromplants rich in phenolic compounds without the use of liquid nitrogen.


Stellar collisions are an important formation channel for blue straggler stars in globular and old open clusters. Hydrodynamical simulations have shown that the remnants of such collisions are out of thermal equilibrium, are not strongly mixed and can rotate very rapidly. Detailed evolution models of collision products are needed to interpret observed blue straggler populations and to use them to probe the dynamical history of a star cluster. We expand on previous studies by presenting an efficient procedure to import the results of detailed collision simulations into a fully implicit stellar evolution code. Our code is able to evolve stellar collision products in a fairly robust manner and allows for a systematic study of their evolution. Using our code we have constructed detailed models of the collisional blue stragglers produced in the N-body simulation of M 67 performed by Hurley et al. in 2005. We assume the collisions are head-on and thus ignore the effects of rotation in this paper. Our detailed models are more luminous than normal stars of the same mass and in the same stage of evolution, but cooler than homogeneously mixed versions of the collision products. The increased luminosity and inefficient mixing decrease the remaining main-sequence lifetimes of the collision products, which are much shorter than predicted by the simple prescription commonly used in N-body simulations.


Temperature dependence of the aggregation mechanism of silver atoms deposited on liquid substrates is reported. The experiment shows that the aggregation mechanism of the silver atoms conforms to the two-stage growth model approximately when the substrate temperature changes. The fringe effect of the substrates was visible in the experiment and the coverage ratio of the silver atom clusters in the central region of the sample was smaller than that on the edge of the sample. As the nominal film thickness increased, the coverage ratio went up rapidly first, then its growth speed slowed down and finally the coverage ratio approached a saturation value. The film thickness corresponding to the saturation coverage ratio decreased obviously with the increase of the substrate temperature. For a fixed nominal film thickness, as the oil temperature increased, the coverage ratio decreased. The evolvement behavior of the average length of the silver aggregate branches is similar to that of the coverage ratio in the central region of the sample. The diffusion mechanism of the silver atomic clusters towards the sample edge is also presented.


I n 2008, the European Society of Hypertension (ESH) [1] and the American Heart Association/American Society of Hypertension [2] published guidelines for home blood pressure (HBP) monitoring and both recommended this method to be widely applied in clinical practice in both the initial diagnostic phase in patients with elevated blood pressure (BP) and also in the long-term follow-up of treated hypertension. These recommendations are based on the evidence about the prognostic value of HBP, its diagnostic ability, its cost-effectiveness, and its good acceptance by hypertensive patients [1,2]. Several studies have assessed the diagnostic value of HBP monitoring by taking ambulatory blood pressure (ABP) monitoring as reference method [1–4]. These studies, however, were quite heterogeneous with regard to their methodology and/or their objectives. First, 11 studies included untreated patients (n1⁄4 1866), whereas seven studies included treated hypertensive patients (n1⁄4 1059) [3,4]. Moreover, these previous studies included individuals on triple therapy, diabetic patients, patients with renal failure, on hemodialysis, or children and adolescents [3,4]. Second, the diagnostic endpoint was either white-coat hypertension, masked hypertension, sustained hypertension, white-coat effect, masked uncontrolled hypertension, resistant hypertension, or a mixture of these. Third, some studies have taken daytime ABP as reference whereas others focused on 24-h ABP as their reference, and different HBP schedules have been used [3,4]. The results of all these studies, although largely varying according to the diagnostic endpoint, tend to agree in indicating a higher specificity and higher negative predictive value with lower sensitivity and lower positive predictive value for the HBP monitoring method as compared with ABP monitoring.


This paper will first talk about the history, production, and importance of the dictionaries. Dictionaries play an important role in developing the social culture so it is quite necessary and reasonable to take them as a kind of research subject. Lexicography, which is generally considered to be built on modern linguistics, must possess its own theoretical system and research methodology. In terms of the properties of lexicography, the paper will discuss such aspects as multidisciplinary integration, open perspectives, and practice orientation. Any new perspective to deal with the dictionary may be possible or feasible on condition that it satisfies the requirements of lexicography. With the development of translatology and lexicography, the translatological dictionaries (TD) came into being. The TD has already become a research subject under translatology in China.


Exposure to chemical contaminants must be estimated when performing ecological risk assessments. A previous article proposed a habitat area and quality conditioned population exposure estimator, E[HQ]P, and described an individual‐based, random walk, Monte Carlo model (SE3M) to facilitate calculation of E[HQ]P. In this article, E[HQ]P was compared with exposure estimates from a baseline risk assessment that evaluated mink and great blue heron exposure to fluoride at a federal Superfund site. Calculation of E[HQ]P took into consideration a receptor's forage area, movement behavior, population size, and the areal extent and quality of suitable habitat. The baseline assessment used four methods that did (total and unit Tier 2) and did not (total and unit Tier 1) consider habitat area or quality; where "total" included all exposure units on site and "unit" only a given exposure unit. Total Tier 1 estimates were consistently higher than E[HQ]P (e.g., 169.1 mg/kg·d versus 21.6 mg/kg·d). Risk managers using total Tier 1 results for decision making would be unlikely to underestimate exposure; however, implementability of correspondingly lower remedial objectives could be challenging. Unit Tier 1 estimates were higher (e.g., 96.5 mg/kg·d versus 61.6 mg/kg·d) or lower (e.g., 3.5 mg/kg·d versus 51.1 mg/kg·d) than E[HQ]P depending on variations in landscape features. Total Tier 2 and E[HQ]P estimates were similar (e.g., 20.7 mg/kg·d versus 21.6 mg/kg·d) when an ecologically questionable average exposure was assumed. Unit Tier 2 estimates were consistently well below E[HQ]P (e.g., 17.8 mg/kg·d versus 61.6 mg/kg·d) when an average exposure was not assumed. Risk managers using unit Tier 1 or 2 results could be basing their decisions on potentially large underestimates of exposure. By forgoing average exposure assumptions, and explicitly addressing landscape heterogeneity, SE3M appears capable of yielding exposure estimates that are not as potentially misleading to risk managers as those produced with traditional averaging methods.


Electricity supply in Nigeria is a huge problem with great economic and political consequences. After unbundling and privatization of generation and distribution companies, not much improvement has been experienced by electricity consumers; this is due to lack of investment in infrastructure. Lack of investment in infrastructure especially from private investors is caused largely by non-cost reflective tariff among other factors highlighted in this study. While many believe tariff has to be controlled such that it does not go beyond the reach of average citizens, many also believe that the average citizens can pay much more than the current tariff. The latter is evident considering the average amount spend on the use of portable gasoline generators by most homes and small enterprises both in rural and urban centers. The whole life cost method is used to show here that it costs a home or business premise that operates a portable gasoline generator for 6 hours daily NGN 37, 000 per month and costs NGN 157,000 to operate 20 kVA diesel generator. This shows the consumers' capacity to pay the appropriate tariff that can attract investors to the sector.


In the system of social relations conflicts are an important determinant of human activity. At the same time, negotiations are its integral attribute in the process of regulation of social contradictions. Regardless of the level of negotiations, whether it is bargaining on the market for a certain product or the solution of military-strategic international tasks — the question arises about the effectiveness of this process. How much we will spend, what we will get as a result, how to estimate it and how long it will take — the most important issues that arise in an attempt to analyze the result of any negotiations. The evaluation characteristics of the high or low effectiveness of the negotiations are based, at best, on qualitative methods, at worst — on a descriptive evaluation of the outcome, which is based on two criteria: agreement between the parties and satisfaction with the process. Both indicators can indeed provide some information about the change in the balance of power, whether or not the goals are achieved, etc. However, in this case, important variables such as time, material costs and reputation are not taken into account. Can satisfaction with the result (even of all the agents of the conflict) be considered the main criterion for the effectiveness of the negotiation process? The article is devoted to the analysis of modern approaches to the concepts of "efficiency" and "effectiveness", as well as to the study of the applicability of these phenomena in the context of the evaluation of the negotiation process.


Agricultural vehicle navigation includes both on-road and on-field operations. The objective for on-road navigation is to guide the vehicle traveling on paved or prepared road according to a scheduled path plan, and for on-field guidance is to guide the vehicle following crop rows without overrun on crops. In this paper, the authors have presented an on-field navigation system with redundant sensors of a vision sensor, a fiber optic gyroscope (FOG), and RTK GPS. A steering controller has been developed to implement steering control based on guidance information obtained from guidance sensors. The navigation system has evaluated on an agricultural vehicle. A research platform has been developed based on a Case-IH Magnum 8920 2-wheel drive agricultural tractor. Results indicated that the multiple sensor based agricultural vehicle navigation system was capable of guiding the tractor traveling between crop rows accurately.


Critically ill patients frequently have invasive catheters placed to monitor hemodynamic pressures and to calculate hemodynamic indices. Correct leveling to the appropriate anatomical structure is critical as the pressure readings guide management of fluids, drug administration, and other interventions. The authors of this study investigated the accuracy with which registered nurses and respiratory technologists were able to level hemodynamic transducers to the phlebostatic axis using visual checks, a carpenter's level, and a laser leveling device. The results indicate that both groups were unable to accurately level transducers with visual checks alone. Use of a leveling tool improved accuracy. The laser level was superior for accuracy and speed and preferred for dexterity required, ease of use and patient safety. The data supports the need for a tool to accurately level hemodynamic transducer systems and suggests that the laser leveling device is the tool of choice.


Reef herbivory is a critical ecological process that can control community structure in a reef and can determine recovery potential; therefore, herbivores are an important input in coral reef resiliency.  In Lagonoy Gulf, herbivorous reef fishes were surveyed from 22 sampling stations with 93 transects of which 149 species belonging to 14 families were recorded. Although no differences between stations were detected among their biomasses, sizes, abundance and number of species; clustering of stations showed significant differences between clusters. Functional grouping suggests that almost all reefs experienced overfishing as average biomasses were relatively low, with grazers weighing only 112 kg ha-1, scrapers with 56 kg ha-1, browsers 14 kg ha-1, and territorial damselfish 70 kg ha-1.  Marine Protected Areas (MPA) were noted to have no impact on reefs' herbivore community structure since it was almost similar with outside-MPAs and non-MPAs, but then, MPAs have higher overall values than the two other areas. Generally, presence of herbivore fishes in Lagonoy Gulf is a good indicator of the reef's potential recovery before and after a disturbance event.  Furthermore, the diverse herbivore population of the Gulf enhances functional redundancy.


Eight wild perennial Glycine species (G. argyrea, G. canescens, G. curvata, G. cyrtoloba, G. latifolia, G. microphylla, G. tabacina, and G. tomentella) were evaluated for resistance to isolates of races 1, 3, and 14 of Heterodera glycines. In a second experiment, reproduction of isolates of races 3, 5, and 14 of H. glycines on five of the wild perennial species was determined. Seventy-one derived fertile lines (2n = 40) that were hybrids between G. max cv Clark 63 and G. tomentella also were evaluated for resistance to isolates of races 3, 5, and 14. All of the wild perennial Glycine species were resistant (Female Indices [FI] less than 10) to all of the isolates that were tested on them. In most cases no females matured. The soybean cvs. Clark 63 and Altona, which were tested at the same time as the hybrids, were susceptible to all isolates of H. glycines tested. When the tests were combined and a single FI calculated with the average number of females on Lee 74, one derived fertile line was resistant to race 3, three derived fertile lines were resistant to race 5, and five derived fertile lines were resistant to race 14. Thus, transfer of resistance to H. glycines from G. tomentella to G. max apparently occurred.


Six anionic and five nonionic surfactants were tested for their effect on the fungistatic action of clotrimazole against Candida albicans. All of the anionic agents that did not contain an ethylene oxide group were capable of potentiating the anti-Candida activity of clotrimazole, whereas all five members of the polyoxyethylene surfactant group, including four nonionic agents and one anionic agent, acted in an antagonistic fashion. The combination of clotrimazole and the anionic surfactant dioctyl sodium sulfosuccinate was the most potent in synergy and, thus, more precise studies were made with this combination. Although appropriate combinations of the two drugs showed a potent fungicidal activity against proliferating cultures, none of these combinations tested was lethal when cell growth was restricted by nutritional deficiency. The lethal effect of the combined drugs was partly reversed when growing cultures were treated in the presence of an osmotic stabilizer. Whether cells were treated with moderate and higher concentrations of clotrimazole and dioctyl sodium sulfosuccinate, alone or in combination, there was little change in cell wall content of total protein, carbohydrate, or lipid from that in untreated control cells. However, there was a significant decrease in the cell wall content of phospholipid when moderate concentrations of the two drugs were combined.


We develop the average effective energy-momentum tensor for a spherically symmelric cosmology with randomly oriented spin using the improved energy-momentum tensor in the framework of the self-consistent Einstein-Cartan theory with spindensity. PACS numbers: 9530S, 9880C. 4775,0340G. 0450


Sutureless bioprosthetic valves such as the Sorin Perceval S valve (SPV) have been used in patients with aortic stenosis that require surgical aortic valve replacement (SAVR). These prostheses have been marketed on the basis of their rapid implantation techniques with avoidance of sutures and reduced aortic cross-clamp times. We report a case of an early failure of a SPV nearly 4 years after implantation in a 58-year-old woman who was low-risk. While the patient's symptoms initially improved with SAVR with a sutureless bioprosthetic valve, they progressively worsened as the valve degraded, and the leaflets became increasingly calcified and stenotic ultimately, requiring reoperative SAVR with a St. Jude mechanical valve. This case raises the issue of the lack of much-needed data describing the long-term durability and hemodynamic performance of these valves, particularly in a low-risk patient with excellent functional status. We hope to shed further insight into the lack of long-term studies on patients with SPV to assess their longevity and long-term effectiveness, as well as elucidation of possible prevention and monitoring of these potential complications. The use of newer generation prostheses, although attractive for their ease of implantation, potentially carries higher long-term risk due to shorter durability leading to reintervention to address valve deterioration. This is especially true in low-risk patients who are young and active. Cardiology and cardiothoracic surgery societies need to develop a universal registry with follow-up of all valves in order to track and study the durability of these valves, and to evaluate for incidence of known and potential complications.


Abstract: The reduction in net CO2 emissions from increased carbon sequestration in soil and slower decomposition of soil organic matter under most long-term no-till (NT) situations can potentially be offset by a concomitant increase in nitrous oxide (N2O) emissions after tillage reversal on long-term NT soils. The objective of this work was to quantify N2O emissions after tillage reversal on two contrasting western Canadian Prairie soils managed under long-term (∼30 yr) NT. We measured one growing season (2010) of soil N2O emissions on a Black Chernozem and Gray Luvisol at Ellerslie and Breton, AB, respectively, following 30 yr of NT and N fertilizer application at two rates (0 and 100 kg N ha−1) subjected to tillage reversal and no disturbance (i.e., continuing NT). Tillage reversal after long-term NT was associated with higher N2O emissions in both soils but was significant only in the Gray Luvisol with 0 kg N ha−1. Long-term N fertilizer applications of 100 kg N ha−1 were associated with higher growing season soil N2O emissions and higher levels of soil N (i.e., a positive, long-term soil N balance) at both sites. Regardless of tillage, the difference in growing season nitrous oxide emissions from the 0 and 100 kg N ha−1 plots on the Gray Luvisol were much greater than the Black Chernozem. A modest increase in N2O emissions upon tillage reversal on a long-term NT soils could translate to a significant increase to agricultural greenhouse gas inventories in the event of large-scale tillage reversal on agricultural land in western Canada.


We offer here a "Refereeing Template" to guide a more constructive and systematic peer review process. This template provides the following algorithm for constructing a peer review: (i) list the key claims of the manuscript; (ii) determine if the data (and interpretations of the data) support said claims; and, only as a last step, (iii) offer an opinion as to whether the supported claims deserve publication in the targeted journal. The Refereeing Template is designed to improve the quality and clarity of reviews by emphasizing claims, arguments backed by supporting evidence, as the basis for evaluating the quality of a manuscript, and translating that evaluation into an assessment of impact and significance.


Protoplasts of Claviceps purpurea (ATCC 20102) were prepared in 0.8 m-sucrose containing 10 mm-CaCl2 and 10 mm-MgCl2. Protoplasts could revert to the filamentous state but not after treatment with water. Most of the protoplasts (about 80%) were highly vacuolated and these were separated from the non-vacuolated protoplasts and cell debris on the basis of their low density. Only the vacuolated protoplasts were able to synthesize ergotamine and ergocryptine de novo. Protoplasts were about 50% less active than the control mycelium. The control mycelium was more active in the uptake of labelled precursors than both protoplasts and freshly harvested mycelium. In the amino acid pool of protoplasts, alanine was present in a concentration which exceeded that of proline by a factor of six and that of phenylalanine by a factor of 100. This finding is consistent with the incorporation ratios of these amino acids into ergotamine when isotope dilution of the added radiolabel is considered. A significant stimulation of incorporation of constituent amino acids into ergotamine and ergocryptine occurred when d-lysergic acid was added to protoplasts and mycelium.


OBJECTIVE
To study the clinicopathological characteristics, diagnosis and differential diagnosis of hypopharyngeal carcinosarcoma.

METHOD
Clinical data of one case with hypopharyngeal carcinosarcoma proved by pathology were analyzed retrospectively. The related literatures were reviewed.

RESULT
The masses were surgically removed,and the postoperative diagnosis was confirmed to be carcinosarcoma by histopathological examination. After radiotherapy and chemotherapy, the patient recovered well postoperatively without recurrence during 18-month follow-up.

CONCLUSION
Carcinosarcoma of the hypopharynx is an extremely rare malignant tumor with distinctive histological, clinical and immunohistochemical features. The final diagnosis depends on histopathology. This tumor should be differentiated from other tumors such as sarcomatoid carcinoma and the reaction of radiotherapy of carcinoma. Surgery is the proper treatment strategy for carcinosarcoma of the hypopharynx. The patients with locally advanced, postoperative residual tumor or tumor without clear safe surgical margin should undergo radiotherapy, and the postoperative follow up should be in time.


BACKGROUND
Flight attendants may have an increased risk of some cancers from occupational exposure to cosmic radiation and circadian disruption.

METHODS
The incidence of thyroid, ovarian, and uterine cancer among ∼6000 female flight attendants compared to the US population was evaluated via life table analyses. Associations of these cancers, melanoma, and cervical cancer with cumulative cosmic radiation dose and metrics of circadian disruption were evaluated using Cox regression.

RESULTS
Incidence of thyroid, ovarian, and uterine cancer was not elevated. No significant, positive exposure-response relations were observed. Weak, non-significant, positive relations were observed for thyroid cancer with cosmic radiation and time zones crossed and for melanoma with another metric of circadian disruption.

CONCLUSIONS
We found little evidence of increased risk of these cancers from occupational cosmic radiation or circadian disruption in female flight attendants. Limitations include few observed cases of some cancers, limited data on risk factors, and misclassification of exposures.


As educators seek innovative ways to engage students in the learning process, educational escape rooms have emerged as a promising motivational learning strategy. This paper presents a study on the design and playing of such escape rooms by pre-service secondary mathematics and informatics teachers using online tools. The study involved students collaboratively creating their escape rooms and introducing them to their peers. We gathered data through observation, questionnaires, evaluation cards, and their webpages regarding their opinions on the potential of these rooms as a teaching tool. Results indicate that most students found the educational escape rooms to be highly engaging and useful in promoting collaboration, and problem-solving skills. Therefore, they are open to using educational escape rooms in their future teaching. The study sheds light on the potential of student-led design of educational escape rooms as a means of preparing future teachers to incorporate this motivational tool into their teaching practice, with implications for teacher education programs and classroom practice.


The Schinus terebinthifolius Raddi is a native plant of South America popularly known in Brazil as aroeira. It is a medium-sized plant, which demonstrates a high adaptive potential in various environments, besides having various medicinal properties such as anti-inflammatory and antidiarrheal. Bacterial susceptibility tests were carried out and the minimal inhibitory concentration (MIC) was obtained. The results were interpreted based on the conventionally microbiological protocols and data from the CLSI. For the microbiological tests, microorganisms obtained from the American Type Culture Collection (ATCC), specifically, (Pseudomonas aeruginosa, Staphylococcus aureus and Encherichia coli) were used. Of the tested bacterial strains, only the Staphylococcus aureus 6538 presented susceptibility to the aroeira's hydroalcoholic extract, forming zones of inhibition of 8.0 mm of diameter up to the MIC of 35.3 mg/mL, while the other tested strains showed to be resistant in all the concentrations of hydroalcoholic extract of the Schinus terebinthifolius Raddi bark. Our aim is to analyze the "in vitro" antibacterial potential of the 70% hydroalcoholic extract of the Schinus terebinthifolius Raddi.


This paper explores research - theses and dissertations - on the work and health of basic education teachers carried out between 1997 and 2006, in Brazil, to survey to which forms of sufering these professionals are submited. It shows that most studies on mental health draw on psychology and medical and biological sciences. They dialog with both the methodological, theoretical framework of work psychopathology and education studies on teachers' discontent. Finally, the text points out the limits and perspective of the research on the working conditions and health of teachers.


The effect of intracerebroventricular injection of the mitosis inhibitor colchicine on expression of mRNA for nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), and neurotrophin 3 was studied in the rat brain with in situ hybridization. Colchicine up-regulates mRNA for NGF and BDNF in many of the neuronal systems normally expressing these factors. In addition, after colchicine treatment NGF and BDNF mRNAs were localized in several brain areas where they normally cannot be detected. Thus, NGF mRNA was present, for example, in many motor nuclei and in the basal forebrain, and BDNF mRNA was seen in many nuclei in the brain stem and in catecholamine neurons, including dopamine neurons in the substantia nigra. The latter neurons have recently been shown to be sensitive to BDNF, and the present results show that these neurons can produce this factor themselves. A decrease in mRNA for BDNF and neurotrophin 3 was seen only in the granular-cell layer of the hippocampal formation. A strong hybridization signal for BDNF and neurotrophin 3 mRNA was also observed over several myelinated tracts in treated rats, supporting the hypothesis that glial cells as well as neurons can produce these trophic factors.


Optimizing a communication of a Q-antenna access point (AP) with K single antenna terminals is not straightforward. Since a global optimization might not be solvable in real time, the AP has several alternatives involving both the physical layer, e.g. beam-forming and power/bit allocation, and the DLC, such as scheduling. The purpose of this paper is twofold. First, for K/spl les/Q we compare traditional bit allocation strategies with a novel modified approach, especially in terms of fairness. Second, we focus on the combinatorial problem that arises when K>Q, and propose several alternatives for the scheduling of the users into groups, which is done together with the bit allocation. Simulations show that better performance is obtained at the expense of complexity.


The phase-lagged boundary condition concept is briefly reviewed, both for its classical application to vibrating blades and rotor/stator interaction. A simple conceptual model for rotor/stator interaction, compatible with the phase lagged boundary conditions is proposed. Careful comparisons between single-passage and full annulus inviscid simulations have been made to validate the method and demonstrate that potential differences between both approaches are associated to slight changes in the scheme due to the phase-shifted periodic boundary conditions. Finally the Erdos and Shape Correction methods are compared.Copyright © 2001 by ASME


Background: The relationship between non-reassuring fetal heart rate (FHR) pattern, acidemia at birth and neonatal morbidity remains unclear. Our aim was to compare low versus high pH cord blood infants of women detected with a Category II FHR pattern for which the impact is unclear.
Methods: A prospective study of 185 low-risk pregnant women in labor at > 370/7 weeks of gestation with a singleton fetus was conducted at a single center. Category II trace was defined by the presence of tachycardia or bradycardia, variable and late decelerations, marked variability at least 30 minutes in the 120 minutes prior to delivery. The primary outcome included the need for resuscitation and Neonatal Intensive Care Unit (NICU) admission. The cohort was also stratified into three categories according to admission to NICU and pH threshold ([i] umbilical artery blood pH 7.15 and admitted; [iii] not admitted).
Results: 23% (43/185) of infants of women detected with Category II FHR pattern needed NICU admission. Category II FHR pattern was associated with low pH at birth, and the need for resuscitation was more frequent among infants in the lower pH group (73% vs. 10%, p < 0.05). Indices of right (tricuspid annular plane systolic excursion [TAPSE]: 7.3 ± 0.9 mm) and left ventricular performance (fractional shortening: 31% ± 8.9%, transmitral E'/A' 0.9 ± 0.3) were low compared to normative data for healthy infants. CK, CK-MB, and left-to-right/bidirectional shunts at PFO and PDA were higher overall at 72 hours of age.
Conclusions: Category II FHR is associated with resuscitation at birth, NICU admission, and length of hospitalization.


The mission of justice for contracts seems to be solely one of gatekeeping. As long as the justice of the bargaining stage is secured and the parties' agreement complies with a proper floor of legitimacy, contract law, on this conventional approach, must simply follow the parties' preferences. Doctrines that govern contractual performance and breach by appealing to justice considerations are thus portrayed as either confused or misguided. The justice rhetoric either covers for other, notably economic, considerations or undermines contract law's liberal underpinnings.

Against this common wisdom, this Article develops a theory of contractual justice, which is implicit in this significant body of doctrines. Contractual justice is a species of relational justice, and is thus informed by the most fundamental normative underpinnings of private law in a liberal polity, namely, the maxim of reciprocal respect for self-determination and substantive equality. Focusing on the justice of on-going contractual relationships, modern contract law properly solidifies a cooperative conception of contract performance, which targets a contract-specific form of relational injustice associated with the heightened interpersonal vulnerability to which sequential contractual performance gives rise.

The task of this Article is threefold. It articulates and defends the normative commitment to contractual justice that is implicit in contract law's rules of the game, epitomized by the duty of good faith and fair dealing. It further explains and justifies the legal form of these rules, being normative defaults, rather than either majoritarian defaults or mandatory rules. And finally, it demonstrates how the refinement of both their substance (relational justice) and their form (normative defaults) can help direct the future development of these complex and currently somewhat disoriented set of doctrines and, more broadly, reclaim the central place of justice in the law of contract of a liberal legal order.


Cancer of the maxillary sinus is a relatively rare condition. It represented, according to Schreiner, 1.8 per cent of all cases of cancer at the New York State Institute for the Study of Malignant Disease, and, according to Ewing, 1.95 per cent of all cases of cancer admitted to the Memorial Hospital in 1916–1917. Not all tumors involving the antrum are primary in the antrum. Many tumors of the superior alveolar process invade the antrum secondarily. These have a more favorable prognosis than tumors which are primary in the sinuses. Of 168 malignant tumors of the antrum examined by New (1926), 39 had invaded the antrum secondarily. Of 75 cases reported by Holmgren and Berven, only 43 were proved to be primary in the antrum. Stein found that 50 per cent of all antral tumors were primary. The present report includes 11 cases, all of which were proved squamous-cell carcinoma, and all of which were, as nearly as could be determined, primary in the antrum. It is quite possible, however, that some of these may have had their origin in the ethmoid cells, since in almost every case the ethmoids were more or less involved at the time of operation.


Abstract Reactive gas emissions (CO, NOx, VOC) have indirect radiative forcing effects through their influences on tropospheric ozone and on the lifetimes of methane and hydrogenated halocarbons. These effects are quantified here for the full set of emissions scenarios developed in the Intergovernmental Panel on Climate Change Special Report on Emissions Scenarios. In most of these no-climate-policy scenarios, anthropogenic reactive gas emissions increase substantially over the twenty-first century. For the implied increases in tropospheric ozone, the maximum forcing exceeds 1 W m−2 by 2100 (range −0.14 to +1.03 W m−2). The changes are moderated somewhat through compensating influences from NOx versus CO and VOC. Reactive gas forcing influences through methane and halocarbons are much smaller; 2100 ranges are −0.20 to +0.23 W m−2 for methane and −0.04 to +0.07 W m−2 for the halocarbons. Future climate change might be reduced through policies limiting reactive gas emissions, but the potential for explicitl...


Introduction: By 30 years after diagnosis, 73% of child and adolescent cancer survivors develop at least one chronic health condition. However, there is little information on the health care needs of rural adults treated for child and adolescent cancer and whether they lack access to care to identify and manage chronic health problems. We explored health care barriers of rural and urban adult survivors of childhood and adolescent cancer.

Methods: We performed semi-structured interviews with 36 adult survivors (currently ages 19-56; mean=41.3 years) identified by Utah Cancer SEER Registry. Eligible survivors were diagnosed before age 21 from 1973-2005. We randomly selected participants from gender, age (18-29, 30-45, and 46-60), and rural/urban strata (rural defined as living in a county with less than 75% of population in an urban area [population ≥2,500]). Interviews were performed from April-June 2012. We asked survivors questions about their health insurance coverage, current use of health care, and barriers to accessing care, and whether they discussed their cancer history with their current provider. Interviews were recorded, transcribed, and analyzed for themes using NVivo 9. Themes were compared by urban and rural status.

Results: Half of participants were male and 90% (N=34) were white. The average age at diagnosis was 12.6 years (SD=6.7). The most common cancers were gonad/germ cell (N=8; 22%), leukemia (N=7; 19%), and lymphoma (N=6, 17%). A total of 15 survivors were rural and 21 urban. The majority of both urban and rural survivors were insured.

Common themes among both rural and urban survivors included: general satisfaction about the services covered by their health insurers, concern about increasing insurance costs, and a history of being denied insurance in the past due to their cancer. Most survivors had a primary health care provider; however, urban survivors described seeing specialty providers more often than rural survivors. About half of survivors discussed their cancer diagnosis and treatment with their current primary care provider. Barriers to discussing their cancer history with providers included a belief that their cancer was in the past so there was no need to discuss it with providers, an impression that their providers did not think their cancer history was worth discussing, and a belief that health problems would have already emerged because their cancer diagnosis and treatment occurred years ago.

Health care barriers described only by rural survivors included: difficulty finding quality health care for specific health problems, limitations in finding providers that were familiar with cancer survivors, and having to drive long distances to see providers. Interestingly, most rural survivors were willing to travel long distances to get the care they needed.

Conclusions: Survivors were generally satisfied with their health insurance, but were concerned about future coverage. Despite access to primary care providers, many survivors are unaware of their health risks and do not discuss their cancer history with their providers. Rural survivors lack access to providers who are knowledgeable about cancer and specialty care to screen for specific health conditions. Both rural and urban child and adolescent cancer survivors and their health care providers require education about the risk of late effects from childhood cancer.

Citation Format: Anne C. Kirchhoff, Echo L. Warner, Elyse R. Park, Roberto E. Montenegro, Jennifer Wright, Antoinette M. Stroup, Mark Fluchel, Anita Y. Kinney. Health care barriers for rural and urban adult survivors of child and adolescent cancer. [abstract]. In: Proceedings of the Fifth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2012 Oct 27-30; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(10 Suppl):Abstract nr A39.


The techniques of energy dispersive EXAFS (EDE), diffuse reflectance Fourier transform infrared spectroscopy (DRIFTS) and mass spectrometry (MS) have been combined to study the structure and function of an oxide supported metal catalyst, namely 5 wt% Rh/Al2O3. Using a FreLoN camera as the EDE detector and a rapid-scanning IR spectrometer, experiments could be performed with a repetition rate of 50 ms. The results show that the nature of the rhodium centers is a function of the partial pressures of the reacting gases (CO and NO) and also temperature. This combination of gases oxidizes metallic rhodium particles to Rh(CO)2 at room temperature. The proportion of the rhodium adopting this site increases as the temperature is raised (up to 450 K). Above that temperature the dicarbonyl decomposes and the metal reclusters. Once this condition is met, catalysis ensues. Gas switching techniques show that at 573 K with NO in excess, the clusters can be oxidized rapidly to afford a linear nitrosyl complex; re-exposure to CO also promotes reclustering and the CO adopts terminal (atop) and bridging (2-fold) sites.


The purpose of this descriptive study was to determine urban African-American clergy's awareness of Alzheimer's disease and willingness to provide support to elders and their family/caregivers. Interviews were conducted with nine African-American clergy who presided over churches in central Kentucky. Collectively, all clergy had previous experience providing pastoral care to adults with Alzheimer's disease and were literate regarding its treatment. Study findings also revealed clergy were inclined to partner with their internal "health care" ministries and/or members with specialized knowledge of mental health services in an effort to provide education and emotional support to congregants in need. These findings have implications for social workers building collaborative community treatment relationships.


We present a photonics integrated circuit on silicon substrate withreconfigurable nonreciprocal transmission that exhibits a large isolationratio and low insertion loss. It also offers ability for all-optical function-alities, like optical computing gates, or a flip-flop. The circuit is a mixedcavity system of which the linear transmission can be tuned as a Fanoresonance or electromagnetically induced transparency (EIT) using twointegrated heaters. With high optical intensity inside the cavity, the Fanoresonance and EIT peak induce a strong distortion due to thermal non-linearities in the cavity, and these distortions depend on the transmissiondirection due to the asymmetric power distribution in the cavities. Theresulting large isolation ratio is attributed to the inherent sharp slope ofthe Fano resonance and the large extinction ratio of the EIT peak. Thus,a high-power forward-propagating signal will trigger the nonreciprocalphenomenon for low-loss transmission, while backward transmission willsee high loss irrespective of its power level, which is an outstanding im-provement upon previously reported nonlinearity induced nonreciprocityin silicon photonics. The reconfigurability of the high transmission direc-tion comes from the efficient control of the mode excitation and couplinginside the cavity using the integrated heaters. Also, by using a separatepump laser, the device could be developed for all-optical functions likeswitching, logic and computing.


Pulse detection has in recent years received extensive attention in physiological health monitoring, and continuous blood pressure estimation models based on pulse waveform analysis have shown great promises. Two widely used technologies for noninvasive detection of the pulse waveform are photo-plethysmography and tonometry. Although the signals from PPG and tonometry are rooted in different physiological mechanisms, the technologies are typically used separately. The simplistic approach of estimating cardiovascular responses based on single sensor sources is discorrelated with the complexity of the human body. To acknowledge this, we have developed a low-cost, low-power sensor prototype combining PPG and force-sensing capabilities. The proposed solution is able to accurately detect the pulse waveform, both optically and tactually, in addition to estimating the sensor interface pressure. We hypothesize that the combined solution can be used to ameliorate one or more of the challenges associated with the separate technologies in physiological monitoring, and thus potentially give continuous pulse waveform based blood pressure estimation models valuable additional inputs, ultimately leading to increased estimation accuracies and measurement confidence.


In industries where firms can adjust product mix in response to price changes, the process can be delayed by adjustment costs. An example is fishermen who change fishing grounds to target different species. If adjustment costs are sufficiently large, this may hamper the fishermen's response so that regulatory tools that are not efficient in the long run are useful in the short run. Moreover, adjustment costs can influence the choice of species targeted. In this paper dynamic supply equations are specified using a revenue function approach. Different hypotheses about the dynamics of the supply equations are tested for Norwegian trawlers. (JEL Q22, D21)


The three-dimensional (3D) crack propagation is a hot issue in rock mechanics. To properly simulate 3D crack propagation, a modified maximum tangential tensile stress criterion is proposed. In this modified criterion, it is supposed that cracks propagate only at crack front in the principal normal plane. The tangential tensile stress at crack front in the principal normal plane in local coordinates is employed to determine crack propagation, which is calculated through coordinate transformation from global to local coordinates. New cracks will propagate when the maximum tangential tensile stress at crack front in the principal normal plane reaches the tensile strength of rock-like materials. Compared with the previous crack propagation criteria, the modified crack propagation criterion is helpful in calculating 3D crack stress intensity factor, and can overcome the limitations of propagation step determined by individual experiences in previous studies. Finally, the 3D crack propagation process is traced by element-free Galerkin method. The numerical results agree well with the experimental ones for a frozen resin sample with prefabricated 3D cracks.


Aim: This study aimed to investigate the prevalence of the hepatitis B virus and hepatitis C virus in patients undergoing hemodialysis in Karabuk city. Material and Methods: For patients presented to the Karabuk University Training and Research Hospital for hemodialysis between January 2016 and December 2018, HBsAg, anti-HBs, and anti-HCV assays were conducted using the chemiluminescence method and HBV DNA, HCV RNA and HCV genotyping tests were conducted using real-time polymerase chain reaction. The data was retrospectively evaluated. Results: Of 345 patients undergoing hemodialysis, 211 (61.2%) were male and 134 (38.8%) were female. The mean age of the patients was 62 (15–96) years. Moreover, 0.9% (n = 3) of patients were HBsAg positive and 4.3% (n = 15) were anti-HCV positive. Three patients with HBsAg positivity were also HBV DNA positive. Of the 15 patients who were antiHCV positive, 12 were also HCV RNA positive. Of these, eight patients had the HCV genotype 1b and four patients had the genotype 4. Anti-HBs seropositivity was detected in 65.8% of patients. The highest Anti-HBs seropositivity rate was observed in patients aged <40 years (76%) and the difference between age groups was statistically significant (p = 0.002). Conclusion: In our study, the prevalence of HBsAg seropositivity in patients undergoing hemodialysis (0.9%) was lower than that reported by the Turkish Society of Nephrology (2.65%). This difference may arise from the high anti-HBs seropositivity rate. Conversely, the prevalence of anti-HCV seropositivity (4.3%) was similar to the mean prevalence in Turkey (4.2%). Infection prevention measures against viral hepatitis should be strictly implemented, especially in hemodialysis units.


Over the last few decades, the improvement of tomato aroma and flavour has gained growing attention among breeders, agronomists and food technologists, as it is reputed as a key tool to further consolidate tomato consumption in the global market. However, this represents a difficult task, since more than 400 volatile organic compounds (VOCs) differently contribute to tomato aroma and its flavour perception. The recent development of molecular tools has allowed us to identify some of the major alleles influencing the volatile composition of tomatoes. Nonetheless, such composition involves an intricate weave of polygenic systems, highly influenced by external, pre and postharvest factors. With few exceptions, our knowledge about the effects of these determinants is still scarce, making it difficult to draw sound conclusions to best manage the future genetic potential. The present review examines the existing knowledge on major VOCs influencing tomato organoleptic quality, including their classification, metabolic pathways, genetics, and technical features that affect their concentrations in fruits. Particular emphasis is placed on preharvest and postharvest factors influencing their quantitative and qualitative expression, whose integrated study with omic tools will be increasingly necessary for the perspective of disseminating reliable operational indications throughout the production/distribution chain.


Prolonged unopposed estrogen exposure is a widely accepted risk factor in breast cancer development. However, the mechanisms through which estrogens induce breast carcinogenesis have not been definitively unraveled. For testing whether estrogens exert their transforming effects through a non-receptor-mediated mechanism, we have treated the spontaneously immortalized human breast epithelial cells MCF-10F, which are estrogen receptor alpha negative, with 17-beta estradiol (E(2)) or its metabolite 4-OH-estradiol (4-OH-E(2)), each one either alone or in combination with the antiestrogen ICI-182-780. Treated cells were maintained for several passages in culture and evaluated for colony formation in agar-methocel (CE), tri-dimensional growth in collagen matrix, invasiveness in matrigel, and cell cycle analysis by flow cytometry. Both E(2) and 4-HO-E(2), at all the doses tested, in the presence or absence of ICI-182-780, increased CE and decreased the cells' ductulogenic capacity. They also increased the invasiveness and the number of cells in the S phase of the cell cycle. Our data clearly demonstrate that E(2) and 4-OH-E(2) increase cell proliferation and induce transformation in MCF-10F cells, phenomena that are not abrogated by ICI-182-780. The failure of the antiestrogen to abrogate the transformation phenotypes led us to hypothesize that estrogen-induced transformation is occurring by a non-estrogen receptor alpha-mediated process, more probably through the genotoxic effect of the estrogen metabolite 4-HO-E(2).


Abstract N6-methyladenosine (m6A), one of the most abundant RNA modifications, is involved in the progression of many diseases, but its role and related molecular mechanisms in endometriosis remain unknown. To address these issues, we detected m6A levels in normal, eutopic, and ectopic endometrium and found the m6A levels decreased in eutopic and ectopic endometrium compared with normal endometrium. In addition, we proved that methyltransferase-like 3 (METTL3) downregulation accounted for m6A reduction in endometriosis. Furthermore, we observed that METTL3 knockdown facilitated the migration and invasion of human endometrial stromal cells (HESCs), whereas METTL3 overexpression exerted opposite effects, suggesting that METTL3 downregulation might contribute to endometriosis development by enhancing cellular migration and invasion. Mechanistically, METTL3-dependent m6A was involved in the DGCR8-mediated maturation of primary microRNA126 (miR126 and pri-miR126). Moreover, miR126 inhibitor significantly enhanced the migration and invasion of METTL3-overexpressing HESCs, whereas miR126 mimics attenuated the migration and invasion of METTL3-silenced HESCs. Our study revealed the METTL3/m6A/miR126 pathway, whose inhibition might contribute to endometriosis development by enhancing cellular migration and invasion. It also showed that METTL3 might be a novel diagnostic biomarker and therapeutic target for endometriosis. Summary sentence Suppressive METTL3 enhances cell migration and invasion by attenuating DGCR8-mediated maturation of pri-miR126 in an m6A-dependent manner, thus contributing to endometriosis development. Graphical Abstract


We propose a new method to create adaptive background models. Traditionally, each pixel has an adaptive background model which consists of Gaussian mixtures. Each model can approximate small changes and periodic changes of pixel values and it helps us to detect moving objects. However, it cannot adapt to some illumination changes such as gradually varying illumination, precipitously varying illumination and so on. The other model such as using a texture or using prediction of pixel value is effective to handle these changes. Therefore, a hybrid background model which is combined with more than two kind of models. In our approach, we use two different types of the background model. The one is the stochastic background model. The other is the predictive background model based on the exponential smoothing.


A Novel coronavirus (CoV) named '2019-nCoV' or 'COVID 19 by the World Health Organisation (WHO) could be a disease of respiratory and gastrointestinal tracts infections that's extremely transmissible and dangerous. Covid19 has reached to a hundred and fifty nations, together with China the place wherever eruption of respiratory disorder started at the beginning of Dec 2019 pass on metropolis town, Hubei Territory, China, and that has swayed  WHO to decide the disease around the world a pandemic.¹ Currently it is reported to have caused around 199M infections and 4.24 million deaths on a worldwide scale within the Year of 2019 and 2020. Prompt Detection and Treatment of Covid-19 is crucial to intercept the proliferation and transmission of the disease. Within the case of Antimicrobial resistance (AMR) a rampant use of broad spectrum antibiotics (BSA) in treatment of COVID19, a microorganism infection: associate degree calculable 75% of COVID19 patients got antibiotics (ABX) against co-infections and secondary infections².


Although diverticulitis is a common disease affecting the gastrointestinal tract, few is known about the optimal surgical treatment of its most severe form: perforated diverticulitis.
Regardless of the selected operation, perforated diverticulitis is associated with mortality rates up to 30%. Mortality is related to age and comorbidity of the patient, severity of disease and the availability of a specialist colorectal surgeon.
Today, the most frequently performed operation remains Hartmann's procedure, which leaves the patient with an end colostomy. Specialist colorectal surgeons are more likely to perform resection with primary anastomosis, with comparable outcome as Hartmann's procedure.
Recently a new surgical treatment strategy has been introduced in which resection of the affected bowel segment is prevented: laparoscopic lavage and drainage of the abdomen. A national wide randomized controlled study has started in 2010 to compare the three different treatment strategies in perforated diverticulitis with generalized peritonitis.
Besides a high mortality rate on short-term, patients after perforated diverticulitis have a poor long-term survival compared to the general Dutch population. This is mainly caused by the general condition of this category of patients. They also have an impaired quality of life compared to the general population, mainly caused by the attendance of their end colostomy. When this stoma is prevented (primary anastomosis) or reversed, quality of life returned to normal.
Reversal of Hartmann's procedure is a technical difficult operation, associated with complications and even mortality. A new minimal invasive surgical technique has been developed, that showed favorable results compared to the standard.


In terms of the volume of coffee is the second largest commodity traded in international trade and one of the most valuable globally traded agricultural commodities in human history. In addition, coffee is one of the most widely consumed beverages globally. In this way, it has a significant impact on millions of people worldwide, from farmers to consumers. The results show that the global coffee trade has grown steadily since 2000. In addition, the number of scientific publications in coffee is also growing exponentially. This article aims to collect and process the literature related to coffee. One of the essential scientific bibliographic databases, Scopus, was chosen and belonged to Elsevier. It contains more than 80 million records. This is one of the central archives in the literature that uses peer review to validate the research. A review of the literature revealed that there are few publications on the global coffee trade. Three historical stages of the coffee trade are identified and analyzed in the post-World War II period. The most important topics of these periods are dissected by the authors: fairtrade, coffee sustainability, coffee value chain, and various forms of regulation.


In the outpatient psychiatric care setting, patients with major depression and anxiety comply poorly with traditional tricyclic antidepressants and specific serotonin re-uptake inhibitor treatment. The purpose of this study was to examine whether the low drop out rate reported with tianeptine in randomised studies is also reflected in daily outpatient psychiatric practice. In a six-week prospective multicentre study, treatment with tianeptine (12.5mg thrice daily) in 314 patients with major depression and anxiety, drawn from 25 randomly selected outpatient psychiatric practices across India was assessed. Outcome measures were frequency of drop outs due to side-effects and change in depression and anxiety rating scale scores. Intention to treat analysis showed that 7 patients (2.3%) discontinued treatment due to side-effects. Patients with an improvement of at least 50% from baseline on Montgomery Asberg Depression Rating Scale (MADRS) increased from 18.5% at week 3 to 53.0% at week 6; on the Hamilton Anxiety Rating Scale (HARS), patient responders likewise increased from 22.6% at three weeks to 52.2% at six weeks. When used in the setting of day to day outpatient psychiatric practice, tianeptine is a well-tolerated and effective antidepressant. It could serve as a useful alternative, and improve the present low compliance with treatment in patients with major depression and anxiety.