We set out to study GPs' understanding of gambling addiction, their experiences of, and confidence in, managing these patients in primary care, their perceived role and feasibility, their views on funding gambling treatment services, etc. To this end, we carried out a postal questionnaire survey of all GPs (N=136) in Solihull, England. Ninety eight (98) of the 136 (72%) GPs returned completed questionnaires. Three-quarters of GPs had seen gambling addicts in their practice but none had ever received any training in the management of gambling addiction. The large majority of GPs acknowledged that gambling addiction was an important public health problem with significant potential adverse impacts. 90.8% of GPs expressed lack of confidence in managing these patients but most were keen to do more to help, and receive training. Although they saw this disorder being within their remit, they highlighted that potential resource implications ought to be addressed if gambling addicts are to be successfully managed in primary care. Much more needs to be done to improve the identification and treatment of gambling addicts in primary care settings. Most GPs saw the care of these patients as within their remit, were willing to get involved and were receptive to more training. We hope our findings will inform the development and implementation of any future training program for GPs. Keywords: Gambling addiction; Primary care; General practitioners; Management


An 80-year-old female with aortic regurgitation and angina was scheduled for aortic valve replacement and coronary artery bypass graft. After the induction of anesthesia, central venous catheter and pulmonary artery (PA) catheter were placed into the right internal jugular vein. At the weaning from cardiopulmonary bypass, we noticed pulmonary artery pressure (PAP) on the monitor indicating the PA catheter tip being wedged. Therefore, we pulled the PA catheter until the wedging PAP wave disappeared. However, immediately after repositioning of the PA catheter, massive fresh bleeding was found in the endotracheal tube. We estimated the cause of pulmonary bleeding was PA rupture due to malpositioned PA catheter because surgeons had not manipulated the PA during the operation. Soon after restarting the cardiopulmonary bypass, pulmonary bleeding was stopped. Examination with fiberoptic bronchoscope revealed no further bleeding and weaning from cardiopulmonary bypass was accomplished smoothly. Postoperative course was uneventful.


The electrical character (flux-pinning, Josephson junction, or resistive) of the grain boundaries in approximately twenty flux-grown YBa{sub 2}Cu{sub 3}O{sub 7{minus}{delta}} bicrystals was determined in previous studies. A selection of these same bicrystals now have been thinned for study by transmission and scanning transmission electron microscopy. High-spatial resolution imaging and analytical techniques reveal microstructural differences among these boundaries that are consistent with their diverse electrical characteristics. The observations offer preliminary insight into some of the feature that control the grain boundary superconducting properties and re-emphasize the very fine scale on which the grain boundary electrical character is determined. 11 refs., 6 figs.


Both habitat patchiness and behaviorally-mediated indirect effects (BMIEs; predator- induced changes in prey behavior that affect the prey's resources) are important in many food webs, but the relationships between these 2 factors have yet to be investigated. To explore effects of habitat patchiness and variation in perceived risk of predation on food-web dynamics, we conducted a factorial experiment in a model aquatic food chain of predator-prey-resource using 2 contrasting predators (adult blue crab Callinectes sapidus and toad fish Opsanus tau), juvenile blue crab as prey, and mussel Geukensia demissa as resource. Both predator presence and habitat patchiness influenced the prey's preference for consuming resources at patch edges instead of interiors. The preference of prey for consuming resources at habitat edges was 4 times stronger in continuous oyster reef habitat than in smaller habitat patches. This suggests that interior resources in continuous habitat experience a refuge from consumption, but this refuge is largely lost in patchy habitat. The mere presence of predators reduced the prey's preference for consuming resources at habitat edges. This BMIE was significant for the ambush predator (toadfish) and the treatment containing both predators, but not for the actively hunting predator (adult blue crab). We conclude that habitat patchiness and predator presence can jointly affect resource distribution by inducing shifts in prey foraging behavior, revealing a need to incorporate BMIEs into habitat fragmentation studies. This conclusion has broad and growing relevance as anthropogenic factors increasingly modify predator abundances and fragment coastal habitats. © Inter-Research 2012.


Experimental differential cross sections for the optical collision process K(4s)2S + Ar + hν → K(4p)2P + Ar are reported. The characteristic interference structures are used to determine the repulsive parts of the KAr X2Σ and B2Σ potential curves by comparison with the results of exact quantum coupled-channel scattering calculations. By a least-squares procedure we obtain potentials with a relative accuracy of typically 1% in the range 0 ≤ V ≤ 1000–1500 cm−1, corresponding to absolute values of 2–4 cm−1 for the larger and 10–15 cm−1 for the smaller distances sampled by the experiment.


The purpose of this study is to conduct a correlational analysis among pitch, nasalance, and acoustic quality parameters estimated by two speech analysis softwares NasalView(version 1.31), Dr. Speech 4.5(Tiger Electronics). Thirty females and 25 males with normal voice participated in the study. The Pearson correlation coefficient was determined through a statistical analysis. The results came out as follows; Firstly, there was a correlation between F? and voice quality parameters, however there was no correlation between F? and nasalance. Secondly, nasalance showed a correlation with voice quality parameters.


Background Preconditioning to ischemia is a phenomenon whereby a brief episode of sublethal ischemia and other nonlethal stressors produce protection against a subsequent detrimental ischemic insult. As mitochondrial dysfunction is related to necrotic and apoptotic neuronal death after cerebral ischemia, the authors examined if ischemic preconditioning is capable of inducing mitochondrial tolerance. Methods Forebrain ischemia was induced by bilateral common carotid artery occlusion with simultaneous hypotension for 8 min in Wistar rats (275–300 g). A 3-min ischemic episode performed 48 h before the 8-min ischemia was used for preconditioning. The extents of hippocampal CA1 neuronal damage were evaluated 7 days after reperfusion by neuro-specific nuclear protein immunostaining. Brain mitochondria were isolated 48 h after animals were subjected to the sham operation or the 3-min conditioning ischemia. Loss of cytochrome c from mitochondria after cerebral ischemia in vivo and after exposure of brain mitochondria to calcium in vitro was used as an indication of mitochondrial dysfunction. Results Results showed that ischemic preconditioning induced by a 3-min ischemic episode dramatically reduced the loss of hippocampal CA1 neurons resulting from a subsequent 8-min ischemia 7 days after reperfusion, and this protection was associated with a preservation of mitochondrial cytochrome c as examined after early reperfusion. Exposure of isolated brain mitochondria to calcium produced a dose-dependent increase in cytochrome c release either at 30°C or at 37°C. Compared with those animals receiving only sham operation, cytochrome c release caused by 100 &mgr;m calcium was significantly reduced in conditioned animals. Conclusion Regarding the importance of mitochondrial dysfunction in mediating ischemic neuronal death, the above results indicate that mitochondria may serve as end-effecting organelles to ischemic preconditioning.


Cluster analysis is a field of data analysis that extracts underlying patterns in data. One application of cluster analysis is in text-mining, the analysis of large collections of text to find similarities between documents. We used a collection of about 30,000 tweets extracted from Twitter just before the World Cup started. A common problem with real world text data is the presence of linguistic noise. In our case it would be extraneous tweets that are unrelated to dominant themes. To combat this problem, we created an algorithm that combined the DBSCAN algorithm and a consensus matrix. This way we are left with the tweets that are related to those dominant themes. We then used cluster analysis to find those topics that the tweets describe. We clustered the tweets using k-means, a commonly used clustering algorithm, and Non-Negative Matrix Factorization (NMF) and compared the results. The two algorithms gave similar results, but NMF proved to be faster and provided more easily interpreted results. We explored our results using two visualization tools, Gephi and Wordle.


Mobile ad hoc network (MANET) is kind of wireless networks architecture, which is an infrastructureless, autonomous, stand-alone network. Therefore, MANET can be flexibly and simply deployed in almost any environment. But it has a limited wireless coverage and limited connectivity that is exclusive to the MANET boundary. The growth of the Internet and its services and applications and the trend in fourth generation (4G) wireless networks toward full-IP networks, lead to an increasing demand for enabling MANET nodes to connect to Internet and use its services and applications. Mobile IP and IP micro-mobility protocols enable the mobile host to access Internet and change points of attachment without losing the connection. So, with the cooperation between MANET routing protocols and IP mobility protocol, Internet connectivity to MANET nodes can be achieved. In this paper, we propose integrated network architecture to extend the cellular IP access network to multiple MANETs. We also propose an integration routing protocol for connecting MANET to cellular IP Access network and Internet. The proposed protocol supports mobile nodes mobility between different MANETs


Abstract We examined the relationships between ambient temperature, activity level, and vegetation structure of microhabitats used by Ornate Box Turtles; vegetation structure of these habitats should influence microclimatic conditions and, thus, the thermoregulatory value of microhabitats. Thirty-four Ornate Box Turtles (Terrapene ornata ornata) were radio-tracked during 1997 and 1998 in the Nebraska Sandhills. Activity level was negatively related to ambient temperature. Active turtles used areas with more bare ground in both years, and more forb cover in one year, whereas inactive turtles used areas with more shrub and litter cover. Providing habitat components that function as thermoregulatory cover may be an important consideration for land management plans in areas where this species is found.


Book synopsis: This introduction collects 17 innovative approaches to engineer novel and improved proteins for diverse applications in biotechnology, chemistry, bioanalytics and medicine. As such, key developments covered in this reference and handbook include de novo enzyme design, cofactor design and metalloenzymes, extremophile proteins, and chemically resistant proteins for industrial processes. The editors integrate academic innovations and industrial applications so as to arrive at a balanced view of this multi-faceted topic.

Throughout, the content is chosen to complement and extend the previously published two-volume handbook by the same editors, resulting in a superb overview of this burgeoning field.


Portion of the electronically processed agendas and transactions of all kinds constantly increases and also the volume and importance of the processed agendas grows. Therefore, the need for supervision and inspection of these transactions is also increasing. One possibility is to accomplish control e.g. with the use of specialised mining instruments. The main disadvantage of this approach is the fact that the discovered suspicious transaction was completed long ago and it is impossible to change it. In such a case, we need to inspect and evaluate transactions in the real time still before their completion. But the complexity of real-time analysis of transaction rapidly grows with the increasing set of aspects of this assessment. This paper describes the conception, architecture and possibilities to utilize a system which contains mainly the on-line risk analysis and simultaneously it enables an automatic adaptation by the means of utilizing conclusions from a feedback analysis of mining instruments of the data warehouse. This system is suitable e.g. for the automatic on-line analysis of risks of credit card payments, authenticity of the submitted projects (at university), the submitted tax or customs declarations, etc. Without any detriment to generality, we shall use the last mentioned application domain for explaining the system properties.


Background Abnormal storage of white adipocyte tissue (WAT) is the major factor causing obesity. The promising strategies for obesity treatment are building up the brown adipocyte tissue (BAT) and/or expedite fatty acid catabolism. Traditional Chinese Medicine (TCM) sheds light on preventing obesity. Ginger is one of the most effective herbs for antiobesity by accelerating browning WAT. To fortify the antiobesity effect of ginger, an ancient Chinese herbal decoction composed of four herbs, Angelicae Sinensis Radix (ASR), Astragali Radix (AR), Jujuba Fructus (JF), and Zingiberis Rhizoma Recens (ZRR; ginger), was tested here: this herbal formula was written in AD 1155, named as Danggui Buxue Tang (DBT1155). Therefore, the antiobesity function of this ancient herbal decoction was revealed in vitro by cultured 3T3-L1 cells. Materials and Method The lipid accumulation was detected by Oil Red O staining. Furthermore, the underlying working mechanisms of antiobesity functions of DBT1155 were confirmed in 3T3-L1 cells by confocal microscopy, western blot, and RT-PCR. Results DBT1155 was able to actuate brown fat-specific gene activations, which included (i) expression of PPARγ, UCP1, and PCG1α and (ii) fatty acid oxidation genes, i.e., CPT1A and HSL. The increase of browning WAT, triggered by DBT1155, was possibly mediated by a Ca2+-AMPK signaling pathway, because the application of Ca2+ chelator, BAMPTA-AM, reversed the effect. Conclusion These findings suggested that the herbal mixture DBT1155 could potentiate the antiobesity functions of ginger, which might have potential therapeutic implications.


Mononuclear macrophages derived from the bone marrow (myeloid cells) are key cellular components of the innate immune system in different organs. In this minireview, we are focused on both brain and blood macrophages, known as microglia and mono- cytes, respectively. We provide a succinct summary of the cells ' functions under both normal and pathologic conditions, with particular reference to common neurodegenerative disorders, such as Alzheimer and Parkinson disease. In this minireview, we aim to summarize available literature on microglial and myeloid involvement in CNS disease, directing the reader toward relevant and translatable interpretations of mye- loid cell function in CNS health and neurodegeneration.


Detecting cancers at their early stage would decrease mortality rate. For instance, detecting all polyps during colonoscopy would increase the chances of a better prognoses. However, endoscopists are facing difficulties due to the heavy workload of analyzing endoscopic images. Hence, assisting endoscopist while screening would decrease polyp miss rate. In this study, we propose a new deep learning segmentation model to segment polyps found in endoscopic images extracted during Colonoscopy screening. The propose model modifies SegNet architecture to embed Gated recurrent units (GRU) units within the convolution layers to collect contextual information. Therefore, both global and local information are extracted and propagated through the entire layers. This has led to better segmentation performance compared to that of using state of the art SegNet. Four experiments were conducted and the proposed model achieved a better intersection over union "IoU" by 1.36%, 1.71%, and 1.47% on validation sets and 0.24% on a test set, compared to the state of the art SegNet.


PURPOSE
To evaluate the clinical characteristics of men presenting for other complaints whose ejaculatory function inquiry indicated premature ejaculation (PE).

METHODS
The data of 536 PE patients, including those who presented with the complaint of PE (group 1) and those presenting with other complaints who were diagnosed with PE (group 2) as a result of ejaculatory function inquiry using estimated intravaginal ejaculation latency time (IELT) and Premature Ejaculation Diagnostic Tool (PEDT), were retrospectively evaluated. Age, PE type, comorbidities, recommended treatments, and treatment acceptance status of all patients were recorded. These characteristics were compared for each group.

RESULTS
Among all the patients, those who presented with PE complaints constituted 22.4%. Among the patients with both PE and ED, 98.1% applied with ED complaint and only 1.9% with PE complaint. The percentage of patients with one comorbidity was significantly higher in group 2 (p = 0.032). 90.1% of all patients and 88.5% of patients in group 2 accepted the recommended treatment for PE. The mean age and comorbidities were significantly higher in patients that refused the treatment. The most common reason for treatment refusal was the patients' lack of expectation for treatment.

CONCLUSIONS
This study shows that men more frequently tend to seek treatment for ED than PE, and treatment acceptance rate may be higher when the patients with PE complaints who don't seek treatment are reached through ejaculatory function inquiry. The presence of comorbidities negatively affects the treatment expectation and acceptance as well as treatment seeking behavior of men with PE.


Organizational trust is one of the most fundamental concepts in evoking positive work related attitude among employees. Trust is a formidable building block between employee and organization. This study examines the relationship between organizational trust and job satisfaction, which is considered as one of the most critical work attitude in an organization. It also examines the role of gender as a moderator between organizational trust and job satisfaction. Data is collected from National Capital Region (NCR) of India. The respondents were part of organizations that come under the umbrella of Tourism industry. Statistical techniques like simple linear equation and hierarchical multiple regression were used to find the results. The results indicate that trust significantly predicts job satisfaction and gender moderates their relationship. The outcomes are discussed and scope for further research is delineated.


Officially, Australian society recognizes the diversity of languages and cultures that make up the population, and encourages respect for different traditions and beliefs. However, the reality is often far from this ideal, especially in healthcare, where those who do not speak English can find themselves at a disadvantage. This study explored the experiences of such patients. It aimed to capture the experiences of six older German-born women who had undergone planned admission to hospital. A qualitative descriptive design informed by phenomenology was applied through the means of semi-structured, in-depth interviews that were tape-recorded and transcribed. Three main themes were identified: 'nursing for the masses', 'nursing the individual' and 'communication and language'. This paper is concerned with the third theme only. Findings related to 'communication and language' are presented in terms of three sub-themes: barriers, interpreters and culture. Findings demonstrate the effects that lack of communication can have on patients who already feel vulnerable and anxious. While doctors booked interpreters for meetings with patients, nurses did not do so and consequently misunderstandings, frustrations and unsafe practice occurred. Language and communication issues far outweighed considerations about culture. These findings challenge nurses to respond to and address the mutual frustration of language barriers between themselves and patients.


White rust (Albugo occidentalis) is a major foliar fungal disease of spinach (Spinacea oleracea) in Texas and the Southeastern USA. It causes leaf yellowing, decreasing product quality and marketability. There is a need for evaluating broad spectrum fungicides and new plant defence activators that have the potential to enhance leaf quality in spinach. Two of those fungicides are acibenzolar-S-methyl (ACIB) and strobilurin derivatives (STRO). ACIB appears to mimic natural systemic acquired resistance response in plants, while STRO inhibits mitochondrial respiration in fungi. We conducted three consecutive studies to a) determine the effects of ACIB rates and combinations with STRO and mefenoxam + copper hydroxide (MEFE-Cu) for the control of white rust, and b) evaluate potential phytotoxicity expressed as leaf chlorosis. After two weekly applications in 1998, ACIB, STRO and ACIB + STRO significantly reduced the % of leaf area infected with white rust in the spinach cv. Cascade. In 1999, ACIB + STRO and ACIB + MEFE-Cu had the best white rust efficacy, with ACIB equally effective when applied at reduced rates. After three applications in 2000, STRO, ACIB + STRO, and ACIB + MEFE-Cu had significantly lower white rust values than the control, ACIB or MEFE-Cu. The combination ofACIB + STRO did not cause leaf chlorosis in any year. Use of preventive applications of ACIB + STRO at 7-10 day intervals appear to be an effective strategy to improve leaf quality in spinach.


Intense infrared (IR) light emission from liquid Ar-Xe mixtures has been observed using 12 keV electron-beam excitation. The emission peaks at a wavelength of and the half-width of the emission band is . Maximum intensity has been found for a 10 ppm xenon admixture in liquid argon. The conversion efficiency of electron-beam power to IR light is about 1% (10000 photons per MeV electron energy deposited). A possible application of this intense IR emission for a new particle discrimination concept in liquid noble gas detectors is discussed. No light emission was found for perfectly purified liquid argon in the wavelength range from 0.5 to on the current level of sensitivity.


An experiment investigated the effects of picture motion on individuals' emotional reactions to images. Participants in the study viewed moving and still versions of 27 different images extracted from a variety of film and television programs. Subjective measures (self‐reports) and physiological data (skin conductance and heart rate) were obtained to provide convergent data on affective responses. Results indicate that picture motion significantly increased arousal, particularly when the image was already arousing. Both skin conductance and self‐report data supported this finding. Picture motion also tended to prompt more heart‐rate deceleration, most likely reflecting a greater allocation of attention to the more arousing images. In this study, the influence of picture motion on affective valence was evident only in the self‐report measures; positive images were experienced as more positive and negative images as more negative when the image contained motion.


Chinese Sturgeon Natural Reserve (CSNR) is a typical river ecosystem in the middle of the Yangtze River. An evaluation system of the river ecosystem services of CSNR was established using the so-called Market Price Approach , Expense Payment Method , Contingent Valuation Method , Substituted Value Method , Cost Analysis Method and Opportunity Cost Method . The results showed that the total values of the ecosystem goods and services of the natural reserve amount to an estimated 73.57 million USD. The use-values and non use-values were 72.5 and 27.5%, respectively. The direct use values, including fisheries, water supplies and others, reach a total of about 24.23 million USD; On the other hand, the indirect use values, which include endangered species, purification costs and degradation losses, have been estimated at cost levels of approximately 29.12 million USD, indicating with 39.6% its important role of the total value. Meanwhile the non-use values of CSNR in the Yichang Reaches of the Yangtze River were assessed by a contingent valuation method (CVM) and the willingness to pay (WTP), The study shows that the annual non-use values of CSNR is up to 20.22 million USD, of which its existence values is in the range of 8.59 million USD, its bequest values 8.03 million USD, and the option values around 3.6 million USD. This preliminary analysis indicates that this natural reserve represents a special hydro-ecosystem in China with the sturgeon as target species, which is highly valued. The value of endangered aquatic species is up to 25.2% of the total, which places much emphasis on aquatic species. Investment in scientific research and management is presently quite low, amounting to only 0.7% of the total; this fact incidates that research work should be given more concern and support. Limited by the data availability, data processing capacity and time given, result of this initial investigation only represents part of CSNR s assessable value, however, considering the reality that lots of water resource and hydropower projects are now on the way, this valuation will still be helpful to inform the public with the importance of protecting endangered aquatic wildlife and such special hydro-ecosystem.


Introduction: We recently described a mechanism of peripheral immunosuppression in patients with glioblastoma (GBM), through which circulating activated neutrophils release Arginase I and suppress T cell function. The presence of activated neutrophils within the circulation of patients with GBM is of unclear etiology. To further explore this phenomenon and correlate these changes with clinical factors that could influence neutrophil biology, we performed phenotypic and functional analysis of neutrophil populations from GBM patients.

Methods: Resting neutrophils were purified from GBM patients and normal donors by dextran sedimentation of red blood cells followed by separation on a percoll gradient. In vitro activation of resting neutrophils was induced with formyl-Methionyl-Leucyl-Phenylalanine (fMLP). Circulating activated neutrophils were identified within the PBMC layer following Ficoll density centrifugation. Intratumoral neutrophils were identified within fresh human GBM samples reduced to single cell suspensions using a combination of mechanical and enzymatic disruption. Flow cytometry was used to measure expression of known markers of neutrophil activation and binding (CD11b, CD11c, CD18, CD62L, and CD66). In vitro binding studies were performed by labeling neutrophils with BCECF (2′,7′-bis-(2carboxyethyl)-5-(and-6)-carboxyfluorescein); labeled neutrophils were placed over HMEC monolayers activated with tumor necrosis factor-α (TNF-α). Binding curves were generated by serial spectrophotometric analysis after sequential washes. Clinical data, including treatment with steroids and tumor recurrence status, were retrospectively compiled for each patient.

Results: Resting neutrophils within GBM patient did not differ from normal donors in terms of baseline adhesion marker expression, adhesion marker expression after in vitro activation, or ability to adhere to endothelial cells in vitro. As expected, intratumoral neutrophils demonstrated a fully activated phenotype, expressing increased levels of CD11b, CD18 and CD66 and decreased levels of CD62L, along with a transmigrated phenotype represented by lower levels of CD11c. Interestingly, circulating activated neutrophils expressed elevated CD66 and decreased CD62L in conjunction with lower levels of CD11b, CD18 and CD11c. In review of clinical data, patients with primary GBM harbored increased numbers of circulating activated neutrophils when compared to patients with recurrent tumors. Although steroid treatment had no effect on marker expression, as no difference was detected on resting or in vitro activated neutrophils when patients were stratified according to steroid treatment, primary GBM patients treated with steroids had an increased prevalence of circulating activated neutrophils when compared to steroid-treated recurrent patients.

Conclusions: Together, these data support a tumor-specific process through which intravascular activation of neutrophils is followed by arrested transmigration and persistence of activated neutrophils within the circulation of patients with GBM. This effect appears to be augmented by treatment with steroids. Ongoing studies are focused on further exploring interactions between tumor and neutrophils at the vascular interface.

Citation Format: Trisha R. Sippel, Rae Russell, Timothy Ung, Marci Klaassen, Allen Waziri. Disrupted transmigration of neutrophils in glioblastoma patients is augmented by steroid treatment. [abstract]. In: Proceedings of the AACR Special Conference on Tumor Immunology: Multidisciplinary Science Driving Basic and Clinical Advances; Dec 2-5, 2012; Miami, FL. Philadelphia (PA): AACR; Cancer Res 2013;73(1 Suppl):Abstract nr A44.


We have observed two cases of aplastic anaemia diagnosed during the second trimester of pregnancy. In both patients a cesarean section was performed (in 32 and 37 week of gestation). During the course of pregnancy the patients received transfusions of erythrocytes and platelets. In one case high doses of methylprednisolone were administered. The same patient was given immunoglobulins IV prior to the delivery and the number of platelets increased to 100 x 10(9)/L. One baby had respiratory distress syndrome and died 3 months after birth. The second baby is 9 months old now and is in good health. Haematological improvement did not occur post partum and immunosuppressive treatment with antithymocyte globulin and cyclosporine was performed in both patients. Despite of that remissions did not occur and one patient died 7 months after delivery. The second patient still has haematological problems and is red cell and platelet transfusion dependent. We discuss the pathogenetic aspects of aplastic anaemia occurring during pregnancy, as well as the therapeutic problems before and after delivery.


Background Patients attending the UK's only 'Centre of Excellence for Childhood Lupus', routinely attend clinic appointments 3 monthly. During appointments there is pressure for clinicians to review complex medical presentations in a timely manner. As a service we recognise the importance of holistic, multi-disciplinary care and the need to consider the patients' and families' priorities in relation to lupus and its management. The challenges faced by patients in asking questions and asserting influence over a medial consultation are widely acknowledged. Aim To develop a 'screening tool' to facilitate this process. Method The tool was developed through consultation with patients, parents and the multi-disciplinary team. Age-appropriate versions were developed to facilitate completion by children as well as their parents'. Parents identified concerns regarding their child's health as well as areas in which they were struggling themselves regarding their child's health. Patients and their parent were asked to complete the screening questionnaire in the waiting-room before clinic. Their responses were reviewed by clinicians present thus influencing conversations within the appointment. Where appropriate, families could meet with members of the multi-disciplinary team separately. Completed questionnaires were filed within patients' case notes. Data were collated to inform lupus service development. Results 36 screening tools were completed (19 young people and 17 parents) over a 10 month period. The most frequently reported concerns for young people were: fatigue (81%), appearance (58%) and pain (53%). Among parents, the greatest concerns were their child's fatigue (65%), pain (65%), emotions (59%), sleep (59%) and support from school (53%). Parent's concerns for themselves were associated with their child's future and their emotions about their child's health (59%). Conclusion Questionnaires received positive feedback from service-users and staff regarding ease of completion, utility for highlighting issues for discussion within clinic or otherwise and value in normalising the role of psychology in the management of lupus. The data have been used to influence service development including development of a 'health passport' to facilitate communication between family, hospital and school and development of workshops regarding fatigue management and transition.


Software engineers need to know how to evaluate different methods of developing software. A group of new development methods have emerged under the general label "agile development." These techniques are sometimes called "light weight" as opposed to "heavy weight" techniques such as those based on the waterfall model. Two classic ethical techniques - utilitarian and deontological analyses - can offer insights into the arguments surrounding, agile methods. These and other applied ethics techniques offer software engineers a more precise language for articulating their ideas about software engineering issues that involve human values.


We investigate the interaction of multiply charged ions with metallic surfaces. Simulations are presented displaying the formation of hollow atoms when slow highly charged ions approach the surface. It is shown that above surface neutralization proceeds via hollow-atom formation. Relaxation of the multiply excited states to the ground state occurs only subsequent to the close encounter with the topmost atomic layer. Recent experimental data on K Auger emission and image acceleration confirm this scenario.


Occupational exposure to polyvinyl chloride (PVC) dust has been occasionally associated with lung disease. Our aim was to evaluate the in vitro toxicity of various types of PVC particles in relevant cell culture systems. Six samples from the normal industrial suspension process (PVC-S) and eight samples from the emulsion process (PVC-E) were studied. Cytotoxicity was assessed, using the MTT assay, after 20 h of incubation in A549 cells and in primary cultures of alveolar macrophages (AM) and type II pneumocytes (TII) obtained from rats (r-AM, r-TII) or from human surgical specimens (h-AM, h-TII). Hemolysis was assessed after 2 h of incubation with human erythrocytes (h-RBC). A positive control (crystalline SiO 2 , Min-U-Sil) and relevant additives of these PVC particles were tested concurrently. No toxicity of PVC-S particles could be established up to 5 mg/ml in the hemolysis test and 2.5 mg/ml in the MTT assay. In contrast, 4 out of 8 PVC-E particles induced significant toxicity, with EC50 values ranging from 0.7 to 3.7 mg/ml in the hemolysis test and from 0.2 to 1.2 mg/ml in primary cells. The most toxic particles were those that contained the additives with the highest in vitro cytotoxicity. There was a good correlation between EC50 values obtained in relevant bioassays. The sensitivity order of the cell systems was A549 < h-RBC , h-TII h h-AM < r-TII h r-AM for the particles. In conclusion, PVC-E particles produced a moderate in vitro toxicity for primary rat and human pulmonary cells, probably because of the residual presence of additives.


Introduction: Breast lesions are a broad spectrum of lesions consisting of several distinct entities each with specific characteristics. Early evaluation of lesions with timely accurate diagnosis can alleviate anxiety of patients and also can be lifesaving. The most common cancer among Indian women is Breast cancer accounting to 25.8 per 100,000 women. Materials and Methods: A total of 100 cases of neoplastic and non-neoplastic lesions of breast were evaluated from June 2015 to June 2018 which were sent to department of pathology, Dr B R Ambedkar Medical College, Bangalore, Karnataka. Specimens were fixed in formalin of 10%. Appropriate areas were selected from the specimen and grossed, processed, sectioned, stained using haematoxylin and eosin and were observed under microscope. Results: out of 100 resected specimens, 19 cases were non-neoplastic, 46 were benign, and 35 cases were malignant. The most common benign breast lesion was Fibroadenoma (31%) and the most common malignant breast lesion was invasive carcinomaNo Special type (22%). Conclusion: Histopathological evaluation helps in distinguishing benign, insitu, borderline and malignant breast lesions and is the mainstay of accurate and confirmatory diagnosis. This helps in evaluating the risk of patient in developing cancer and appropriate treatment can be planned accordingly for each case.


A Smart Grid intelligently monitors and controls energy flows in an electric grid. Having up-to-date distributed readings of grid conditions helps utilities efficiently scale generation up or down to meet demand. Narrowband powerline communication (PLC) systems can provide these up-to-date readings from subscribers to the local utility over existing power lines. A key challenge in PLC systems is overcoming additive non-Gaussian noise. In this paper, we propose to use a cyclostationary model for the dominant component of additive non-Gaussian noise. The key contributions are (1) fitting measured data from outdoor narrowband PLC system field trials to a cyclostationary model, and (2) developing a cyclostationary noise generation model that fits measured data. We found that the period in the cyclostationary model matched half of the period of the main powerline frequency, which is consistent with previous work in indoor PLC additive noise modeling.


Background: After the establishment of Primary Health Care (PHC) program in Iran, health indicators have improved every year. This progress was so rapid that a number of shortcomings and weaknesses of the PHC program remained silent behind its successes. This study aimed to assess the status of Iran's PHC system (strengths, weaknesses, opportunities and threats) in terms of health system's control knobs. Methods: The search was conducted through two English 'databases of Web of Knowledge and PubMed, two English publications of Science Direct and Springer and two Persian databases of Magiran and SID. Keywords were selected from MeSH and included primary health care, PHC and Iran in both Persian and English. No time limit was considered. Results: Iran's PHC system has numerous successes in dealing with health system's control knobs; which largely part of that related to the health network implementation, the role of Behvarz, improvement of health indicators in rural areas and the elimination of urban-rural inequality, but there are some weaknesses, opportunities and threats in the Iranian PHC system as well. Conclusion: By considering socio-economic changes the current structure of PHC system needs to be reformed to coordinate with phenomenon of chronic diseases, accidents and aging. The current information system in PHC does not provide the required information for decision makers and policy makers so it needs to be transformed to the electronic system with unique electronic health file for individuals.


The pharmacokinetics and pharmacodynamics of antihemorrhagic vitamin, menatetrenone after intravenous injection as the lipid emulsion, were compared to those as the micellar solutions. Menatetrenone was selectively delivered to the liver, lungs and spleen and retained in them. Hepatic and splenetic concentration at 6 h (C6h) increased 21.6- and 27.1-fold, respectively, and the area under the tissue concentration-time curve up to 6 h (AUC(0-6h)) were 2.3- and 11.4-fold, respectively, when compared with its micellar solution. Antihemorrhagic effect of menatetrenone was assessed using warfarin-induced hypoprothrombinemic rats. The lipid emulsion of menatetrenone decreased the prothrombin time at 6h after intravenous injection more effectively than micellar solution. The dose response curves indicated that the efficacy of the lipid emulsion was 2.4-2.9 times that of a micellar solution, and this was correlated with AUC(0-6h) rather than C6h. The plasma level of clotting factor VII and the hepatic level of descarboxyprothrombin were also recovered more effectively, while no significant differences were noted between the two formulations for the plasma level of factor II or descarboxyprothrombin at the dose levels examined. Although selective delivery of menatetrenone in the liver by the lipid emulsion was due to phagocytosis by non-parenchymal cells, menatetrenone in the whole liver appeared to contribute to recovery from hypoprothrombinemia.


Considering its provenance, one should not really expect this to be a navigator's textbook. All three authors are geodesists and it is dedicated to that outstanding American geodesist, Dr Ben Remondi. Perhaps a more descriptive title for it would be ' GPS for Geodesists'. Navigation applications are relegated to three short paragraphs in chapter 12, some 268 pages into the text, and even a section on the integration of GPS with inertial systems is devoted entirely to possible applications for surveying. That said, there is valuable information here for those interested in discovering more about GPS basics than is usually given in navigation-orientated textbooks, although a fair knowledge of mathematics is required. The basic theories of satellite orbits and GPS signal modulations are given in some detail and there is an excellent section on atmospheric/ionospheric refraction. Curiously, the section on dilution of precision (DOP) is rather superficial and makes little attempt to explain the relevance of the different types of DOP. However, DOP is not as important for surveyors as it is for navigators, which is perhaps the explanation. According to the Foreword, it is intended as a classroom text, and it will no doubt fulfil that intention well, particularly for students of land surveying. There are no obvious errors; it is well written and illustrated, and it does not concern itself with lengthy descriptions of receivers out of date before publication. However, only about one-third of the book is devoted to GPS itself, the rest being taken up with land surveying and geodetic applications which, although interesting, are probably not the main concern of members of this Institute. For professional navigators, there are other volumes on GPS that are probably better value, as well as providing easier reading. W. Blanchard


Allergic bronchopulmonary aspergillosis (ABPA) is an immune-mediated inflammatory disease caused by hypersensitivity to Aspergillus fumigatus. A wide spectrum of plain radiographic appearances has been described in ABPA, though none are pathognomonic of ABPA. The common radiological abnormalities encountered are fleeting pulmonary opacities, bronchiectasis, and mucoid impaction. Uncommon radiological findings encountered in ABPA include pulmonary masses, perihilar opacities simulating hilar adenopathy, and pleural effusions. However, miliary nodules as a radiological presentation of ABPA are very rare and only one case has been reported in literature. It is often misdiagnosed and mismanaged as tuberculosis; thus, the clinician should be vigilant enough to diagnose this very rare entity.


A novel process was developed for direct synthesis and in situ coating of flame-made nanostructured particles in one step. Rutile TiO2 particles made by flame spray pyrolysis (FSP) were coated in a single step with SiO2 layers in an enclosed flame reactor. This in situ particle coating was accomplished by a hollow ring delivering hexamethyldisiloxane (HMDSO) vapor (precursor to SiO2) through multiple jets in swirl cross-flow to Al-doped nanostructured rutile TiO2 aerosol freshly made by FSP. The effect of HMDSO injection point, vapor concentration and coating vapor – aerosol mixing intensity on product particle morphology was investigated. The titania particles were uniformly SiO2-coated with controlled and uniform thickness at a production rate of about 30 g/h and exhibited limited, if any, photoactivity. In contrast, spraying and combusting equivalent mixtures of the above Si/Al/Ti precursors in the above reactor resulted in particles segregated in amorphous (SiO2) and crystalline (TiO2) domains which exhibited high photocatalytic activity.


Background Gut microbiota composition of intensive care unit (ICU) patients suffering from Clostridium difficile-positive diarrhea (CDpD) is still poorly understood. This study aims to use 16S rDNA (and metagenome) sequencing to compare the microbiota composition of 58 (and 5) ICU patients with CDpD (CDpD group), 33 (and 4) ICU patients with C. difficile negative diarrhea (CDnD group), and 21 (and 5) healthy control subjects (control group), as well as CDpD patients in A+B+ (N=34; A/B: C. difficile TcdA/B), A-B+ (N=7), and A-B- (N=17) subgroups. For 16S rDNA data, OTU clustering (tool: UPARSE), taxonomic assignment (tool: RDP classifier), α-diversity and β-diversity analyses (tool: QIIME) were conducted. For metagenome data, metagenome assembly (tool: SOAP), gene calling (tools: MetaGeneMark, CD-HIT, and SoapAligner), unigene alignment (tool: DIAMOND), taxon difference analysis (tool: Metastats), and gene annotation (tool: DIAMOND) were performed. Results The microbial diversity of CDpD group was lower than that of CDnD and control groups. The abundances of 10 taxa (e.g. Deferribacteres, Cryptomycota, Acetothermia) in CDpD group were significantly higher than that in CDnD group. The abundances of Saccharomycetes and Clostridia were significantly lower in CDpD in comparison with control. A+B+, A-B+ and A-B- subgroups couldn't be separated in principal component analysis, while some taxa are significantly different between A+B+ and A-B- subgroups. Conclusion CDpD might relate to the decrease of beneficial taxa (i.e. Saccharomycetes and Clostridia) and the increase of harmful taxa (e.g. Deferribacteres, Cryptomycota, Acetothermia) in gut microbiota in ICU patients. C. difficile type might be slightly associated with gut microbiota composition.


The relationship between the development of economics and economic performance is not reducible to any set of simple rules. Among the historians of economic thought there is even a handful of those who perceive the progress in economics mostly as an outcome of the attempts to solve the problems, inconsistencies and paradoxes within economic theory itself. Seen from this perspective, economic reality has minor (or no) importance. On the other hand, the endeavours to modify a mainstream approach are significantly greater in times of economic downturns. Seeing that economics is in such a state of 'intellectual ferment' nowadays, it is worth reconsidering the connection between economics and the economy. Thus the main aim of the paper is to analyse the current state of economic science in relation to the last economic slump. Although it is of course not possible to predict the future trajectories of economic theorising, taking into consideration the nature of the crisis the most feasible and potentially most fruitful areas are indicated.


The observed scatter in intergalactic Lyα opacity at z . 6 requires large-scale fluctuations in the neutral fraction of the intergalactic medium (IGM) after the expected end of reionization. Post-reionization models that explain this scatter invoke fluctuations in either the ionizing ultraviolet background (UVB) or IGM temperature. These models make very different predictions, however, for the relationship between Lyα opacity and local density. Here we test these models using Lyα-emitting galaxies (LAEs) to trace the density field surrounding the longest and most opaque known Lyα trough at z < 6. Using deep Subaru Hyper Suprime-Cam narrow-band imaging, we find a highly significant deficit of z ' 5.7 LAEs within 20 h−1 Mpc of the trough. The results are consistent with a model in which the scatter in Lyα opacity near z ∼ 6 is driven by large-scale UVB fluctuations, and disfavor a scenario in which the scatter is primarily driven by variations in IGM temperature. UVB fluctuations at this epoch present a boundary condition for reionization models, and may help shed light on the nature of the ionizing sources.


Gas and water samples were collected from coalbed methane (CBM) wells, rivers, and springs in the southern Junggar Basin (SJB). These samples were analyzed for gas composition, stable isotopes, 16s ribosomal ribonucleic acid sequence, chemical compositions, and radioisotopes. The objective of this study was to understand CBM genesis in the Junggar Basin, the reason for abnormal CO2 accumulation, the development of microbial communities, the source of coalbed water, and the timing of methanogenesis. The CBM genesis is complex in the SJB, but it is closely related to microbial activities. The stagnant zone, which experiences limited groundwater recharge, may represent a relatively closed system where CO2 is easily trapped and the residual CO2 becomes progressively enriched in 13C. Only two families of methanogens (i.e., Methanobacteriaceae and Methanospirillaceae) are present in the coalbed waters, indicating that CO2 reduction is the main pathway for generating microbial gas. The coalbed water samples from the Houxia and Manasi–Hutubi regions plot around the local meteoric water line (LMWL), indicating recharge by modern meteoric water and rivers. However, the samples from the Miquan and Fukang regions plot below the LMWL, reflecting older snowmelt water recharge. Isotopic dating indicates that the age of coalbed water in the Miquan and Fukang regions is 43.5–2000 ka. Early coalification and later hydrological events collectively determined the regional variations in CBM genesis and gas composition in the SJB.


Magnetotactic bacteria are a diverse group of microorganisms with the ability to use geomagnetic fields for direction sensing. This magnetotactic behavior can help microorganisms move towards favorable habitats for optimal growth and reproduction. Highly efficient genomic editing is very useful for a comprehensive understanding of the magnetotactic mechanism at the molecular level. In this study, we adapted an engineered CRISPR-cas9 system for efficient inactivation of gene in a widely used magnetotactic bacteria model strain, Magnetospirillum magneticum AMB-1. By combining an engineered nuclease-deficient Cas9 and single-guide RNA, a CRISPR interference system was successfully developed to silence amb0994 expression. More importantly, we succeeded in the construction of a single amb0994 gene deletion mutant using CRISPR-Cas9 with approximate 60-fold high efficiency compared to classical homology double-crossing replacement procedure. This mutant synthesized normally the magnetosomes, but reacted quicker and with less time than the wild-type strain to abrupt magnetic field reversals. A dynamics simulation by modeling M. magneticum AMB-1 cell as an ellipsoid showed that the difference of the motions between wild and Δamb0994 is due to flagellar influence. The behavior observation being consistent with dynamics simulation indicated that Amb0994 is involved in the cellular response to magnetic torque change via controlling flagella. Besides the contribution to a better understanding of the magnetotaxis mechanism, this study demonstrates the CRISPR system as a useful genetic toolbox for high-efficiency genome editing in magnetotactic bacteria.


Semantic Table Interpretation (STI), or Semantic Table Annotation, is the process of understanding the semantics of tabular data with reference information identified in knowledge graphs (KG). In this paper, we first present insights gained from the design and implementation of DAGOBAH SL, a top performing STI system in state-of-the-art benchmarks, and we discuss the unsolved challenges that need to be addressed to make STI more effective in practice. Pre-trained generative Large Language Models (LLMs) have demonstrated their powerful versatility in tackling a broad spectrum of natural language understanding tasks. We envision their potential for improving STI systems. We describe several appealing research ideas that could lay the foundation for future development of Generative Semantic Table Interpretation.


Occupational therapists routinely use teaching–learning approaches to support clients in their acquisition of skills supporting occupational performance goals. This paper is the first of a two-part presentation that positions teaching–learning in occupational therapy through a discussion of the Four-Quadrant Model of Facilitated Learning (4QM). The 4QM provides a means of informing clinical reasoning when using teaching–learning approaches in occupational therapy. Although developed to actualise teaching–learning approaches with children, it has the potential to be applied more broadly. This first paper explores the relationship between occupational therapy principles and the use of teaching–learning approaches. It draws on current literature to understand the use of learning strategies as therapeutic tools. In this context, the 4QM is presented as a way of organising occupational therapy intervention when a teaching–learning approach is used.


Recruiting and retaining well-prepared teachers for rural and regional schools,remains an ongoing issue faced by all State based jurisdictions in Australia. Based on recent national research, and focused on meeting the needs of teacher educators to better support new teachers to prepare for and experience success as new teachers in rural locations, this ALTC funded project, Renewing Rural and Regional Teacher Education Curriculum (RRRTEC) set out to address this issue by investigating what teacher education could do differently to better prepare teachers for rural and regional workforce needs. As a result of this two year study involving further research, materials audits and curriculum development, a website has been created and designed specifically for all teacher educators to publicly and freely access and use. The RRRTEC website is located at www.rrrtec.net.au . The website has been created as an accessible resource for teacher educators, principals, mentors and others supporting new teachers in rural schools. Focusing on the classroom, the school and the community, it provides a range of high quality resources that will provide easy access to rural and regional teacher education research, curriculum resources and pedagogical strategies for their teacher education students.


BACKGROUND
 In a rapidly ageing population new and efficient ways of providing health and social support to older adults are required that not only preserve independence but also maintain quality of life and safety.

 OBJECTIVE
 The NEX project aims to develop an Internet of Things integrated system coupled with Artificial Intelligence to offer unobtrusive health and wellness monitoring to support older adults to live independently in their home environment. The primary objective of this study is to develop and evaluate the technical performance and user acceptability of "The NEX system". The secondary objective is to apply machine learning algorithms to the data collected via the NEX system to identify and eventually predict changes in the routines of older adults in their own home environment.

 METHODS
 Mixed methods research (online survey and focus groups) was conducted with 426 participants including older adults (aged 60 and above), family caregivers, health care professionals and home care workers to inform the development of the NEX system (Phase 1). The primary outcome will be evaluated in two successive trials (the Friendly Trial (Phase 2) and the Action Research Cycle trial (Phase 3). The secondary objective will be explored in the Action Research trial (Phase 3). For the Friendly Trial, 7 older adult participants aged 60 years and above and living alone in their own homes for a 10-week period were enrolled in the trial. Thirty older adult participants aged 60 years and above and living alone in their own homes will be recruited for the Action Research trial for a 10-week period (Phase 3).

 RESULTS
 Phase 1 of the project (n=426) participants was completed in December 2020 and Phase 2 (n=7 participants for a 10-week pilot study) was completed in September 2021. The expected completion date for the third project phase (30 participants for 10-week usability study) is June 2022.

 CONCLUSIONS
 The NEX project has considered the specific everyday needs of older adults and other stakeholders which have contributed to the design of the integrated system. The innovation of the NEX system lies in the use of IoT technologies and AI to identify and predict changes in the routines of older adults. The findings of this overall project will contribute to the e-Health research agenda focusing on the improvement of healthcare provision and patient support in home and community environments.


Since the discovery of graphene in 2004, two dimensional materials (2D) have become the focus of tremendous research owing to their unprecedented properties. Atomically thin nature of 2D materials gives rise to unique physicochemical properties, which makes them attractive for flexible electronics, chemical and biological sensing, energy storage, and solar cells. In this dissertation, sensing and energy related applications of 2D materials are studied. In chapter 1, graphene based ammonia sensors are presented, in which nano-structuring graphene significantly improves the sensitivity towards ammonia due to the formation of highly reactive edge defects. It was found that sensitivity could be further enhanced by decoration of Pd nanoparticles on the nano-structured graphene. In chapter 2, hydrogen sensors based on solution processed transition metal dichalcogenides (TMDs) nanosheets-Pd nanoparticles composites are introduced. The sensors can detect hydrogen at room temperature with high sensitivities. The ease of fabrication holds a great potential for low-cost and scalable manufacturing of chemical sensors. In chapter 3, the fabrication and characterization of graphene/Si heterojunction solar cells are described and various methods to improve the power conversion efficiency (PCE) are presented. A single layer graphene is highly transparent; therefore suitable as a transparent Schottky electrode for solar cells. However, the PCEs of the pristine graphene/Si solar cells are low due to the high sheet resistance of graphene as well as the low Schottky barrier height between pristine graphene and Si. We improved the PCE by a magnitude of order (achieving 9% PCE) with Au nanoparticle decoration followed by a nitric acid treatment owing to the dramatic reduction in the series resistance of the cells and the enhanced Schottky barrier height. Furthermore, we used NiO as a transparent and stable hole doping material for graphene, in which NiO doped cell shows enhanced PCE with high stability. In chapter 4, MoS2 nanosheet-Ru nanoparticle composite is introduced as a highly efficient catalyst for hydrogen evolution reaction. The MoS2-Ru composite shows much smaller onset potential and Tafel slope compared to pristine MoS2 nanosheets indicating its superior catalytic performance for hydrogen evolution. The fabrication and characterization of the composite is described and its enhanced catalytic performance is discussed.


PURPOSE
Retinopathy of prematurity (ROP) causes serious blindness because of the vasculopathy that results from the abnormal oxygen dynamics. However, the systemic kinetics of bone marrow-derived endothelial progenitor cells (BM-derived EPCs) during the "postnatal vasculogenesis " of ROP has yet to be elucidated. Thus, the authors investigated the kinetics of BM-derived EPCs using a murine oxygen-induced retinopathy (OIR) model.

METHODS
OIR was induced in C57BL/6J mice by continual aeration with 75% oxygen from postnatal day (P) 7 to P12 that afterward returned to normal room air.

RESULTS
The frequency of circulating EPCs (Sca-1(+)/c-Kit(+) cells in blood) in an OIR model estimated by FACS decreased immediately after the hyperoxic phase (P12) and then increased at the hypoxic phase (P17) compared with control. Further, EPC colony-forming assay of BM-Lin(-)/Sca-1(+) (BM-LS) cells exhibited a conversion from the predominant primitive EPC colony production at P12 to the definitive EPC colony at P17. In the OIR retinas of BM-transplanted mice with BM-LS cells of EGFP transgenic mice, there was less incorporation of GFP(+) cells into vascular structures at P12, whereas there was a drastic recruitment into the "tufts " and for the intact vasculature at P17. Moreover, the definitive EPC colony cells intravitreally injected into OIR significantly abrogated pathologic versus primitive vascular growth.

CONCLUSIONS
Taken together, these findings propose that the deviation of functional bioactivities of BM-derived EPCs contributing to intact vascular development under the abnormal oxygen dynamics may provide important mechanistic insight into pathologic vascular development in ROP.


The patient was a 25-year-old healthy male who experienced fever, chills, and abdominal pain for 5 days prior to the hospital visit. He was diagnosed with acute hepatitis A, and at admission he presented with anuric acute kidney injury and hepatic encephalopathy. He received continuous renal replacement therapy followed by intermittent regular hemodialysis. His urine output increased to 1,610 ml/day after 31 days. On day 32, he suddenly developed a headache and visual disturbance and experienced three short convulsions, which were followed by postictal confusion and high fever. T2 and FLAIR MRI images of the brain revealed hyperintense signal alterations in bilateral subcortical regions of the temporoparietal and occipital lobes, consistent with posterior reversible encephalopathy syndrome. His mental status was fully recovered after 7 h of conservative treatment, including antihypertensive therapy. On hospital day 56, the renal function of the patient had recovered, and he was discharged without neurologic sequelae.


Almost one in five of the staff working in the NHS is from a black and minority ethnic (BME) background, yet we now know that the treatment and opportunities that they get in the workplace often do not correspond with the values that the NHS represents. We also know that this has significant adverse impacts on the effective and efficient running of the NHS, including on the quality of care received by all patients.

It was in response to this evidence that the Workforce Race Equality Standard (WRES) was mandated across the NHS in April 2015. Since its introduction, the WRES has required healthcare providers to self-assess on this agenda and to understand the specific challenges they face in ensuring all staff are treated equally and are supported to fulfil their full potential.

This is the second WRES annual data report and the most comprehensive one so far. It will be invaluable to all NHS provider organisations – provider trusts, commissioning organisations, Arm's Length Bodies, as well as
to the new models of care – the Vanguards and Sustainable and Transformational Plans (STPs) – in understanding the challenges we face on workforce race equality.

The WRES continues to prompt inquiry and assist healthcare organisations to develop and implement evidence-based responses to the challenges their data reveal. It assists organisations to meet the aims of the NHS Five
Year Forward View and complements other NHS policy frameworks such as Developing People – Improving Care, as well as the principles and values set out in The NHS Constitution.


Abstract Winter wheat is one of the widespread crops in Ukraine. The search for methods to increase the yield and consumer properties of wheat, without compromising environmental safety, is one of the important scientific problems. The principles of precision agriculture point to the proper positioning of the seeds, recommending the method of "upward germination" (positioning the wheat germ vertically). The main objective of this study was to develop a new geometric model of wheat grain with a displaced centre of mass, as well as to conduct the theoretical research and numerical experiments on the orientation of grains using their multiple impact interaction with inclined surfaces. A new model of germ consisting of two different end semispheres and amid-line truncated cone was proposed, with a displaced centre of mass. Taking into account the physical properties of the objects, the concept of arrangement of gravity orientation of seeds in a stream was applied. This concept was based on various ratios of kinetic parameters of bodies with a displaced centre of gravity following an impact. The results showed that the orientation process can be controlled by changing the inclination angles and the length of the walls of the tray orientator within the working velocity range. This must be done before impact interaction of 0.2-0.3 m s−1 when the inclination angles of the impact interaction planes are 24-32°C.


OBJECTIVE
To investigate prevalence of Salmonella enteritidis-positive eggs, excretion of the organism in fecal droppings, and infection of internal organs after oral inoculation of White Leghorn hens with S enteritidis phage type 8.

ANIMALS
30 White Leghorn laying hens.

PROCEDURE
At 25 weeks of age, hens were each inoculated orally with 10(10) colony-forming units of S enteritidis, then were observed for 8 weeks.

RESULTS
Salmonella enteritidis Y-BP2 did not cause any clinical signs of disease or decrease in egg production. However, at 1 week after inoculation, 63.9% of the eggs collected from inoculated hens were culture positive for S enteritidis. The organism was isolated from the shell washings, egg shells, yolk, and albumen. A total of 592 eggs from S enteritidis-inoculated hens were examined. Of these eggs, 157 (26.5%) were positive for S enteritidis on external shell washings alone, 17 (2.9%) were positive for S enteritidis internally, and 44 (7.4%) were positive for S enteritidis externally and internally. The percentage of culture-positive eggs gradually decreased between postinoculation weeks 2 and 5, then gradually increased to a high of 76% at week B. At 3, 7, and 10 days after S enteritidis inoculation, cloacal swab specimens from 3 hens were positive for S enteritidis. Salmonella enteritidis was recovered from ovary, oviduct, liver, and cecal junction from S enteritidis-inoculated hens.

CONCLUSIONS
Our results indicated that birds infected with this isolate produced S enteritidis-positive eggs at high frequencies initially, that decreased over time. When S enteritidis antibody began to decrease, reaching geometric mean titer < or = 40, the frequency of S enteritidis-positive eggs increased.


Abstract Patients treated with immune checkpoint inhibitors (ICIS) are prone to immune related adverse events (irAEs), making it important to pay attention to these adverse events. Herein, we report a case of onychopathy after treatment of extensive small cell lung cancer (ES-SCLC) with durvalumab; this is the first report of onychopathy caused by durvalumab in a patient with lung cancer. The change in the patient's nails mainly manifested in the form of pigmentation and the thickening of the nails. Antifungal ointment was ineffective, and these changes were unrelated to malnutrition or any other factors. In addition, this case shows that onychopathy may occur within 2 years after treatment, indicating that these patients need long-term follow-up.


The fact that the nation faces a serious and growing shortage of manpower in the health sciences scarcely needs further elaboration. It has been the subject of numerous reports, articles, and conferences within the past decade. Numerous factors have played a role in the development of this shortage: a rapid growth in the population; a populace increasingly well educated and thus increasingly well aware of the potential benefits of good medical care; a populace of growing affluence with consequent ability to demand and pay for good medical attention; the rapid growth of third-party payment plans, both private and public, which have extended health benefits to still larger segments of the population; and the remarkable expansion of biomedical research programs, which have been financed by the public by one means or another. At the outset, I should like to accept the manpower shortage as well established and point out further that


In cyber-physical system (CPS), software components (i.e., computational elements) are tightly intertwined with physical entities to produce distinguishing behavioural modalities. CPS, as a field, is relatively new, emerging, and somewhat fragmented in development. There are multiple agencies, entities, and activities being undertaken to address a nexus of emerging issues including cyber-threats and attack in critical systems. However, the development of CPS, as a field, albeit with good intentions and efforts, appears to be largely 'self-organising'. In response, we suggest governance, as posited in complex system governance, as an organising construct for critical cyber-physical systems to provide more cohesion. complex system governance (CSG) is focused on design, execution, and evolution of 'metasystem' functions necessary to provide for communication, control, coordination, and integration (C3I) in CPS. First, we introduce the concept of critical CPS, emphasising current domination of self-organisation as the driving force in developing viable CPS. Second, a CSG model is introduced to suggest an alternative for more purposeful system design and evolution. The paper concludes implications for future research directions.


Chronic osteomyelitis of patella, a rare clinical entity has been reported mostly in 5-15 years of age group, but is rare in adults. Literature search yields only few cases reported worldwide. We report a case of chronic osteomyelitis of right patella in a 16 year old male with a previous history of trauma. He presented with pus discharging from the right knee with limitation of joint movement. Radiographs showed lytic lesions of complete patella which was confirmed on computed tomography. Since the lesion was grossly spread over the complete patella, patellectomy was done. Our case suggests that chronic osteomyelitis is more likely to be caused by post-traumatic open injury to knee.


The aim of this study was to investigate the activity of the parasympathetic limb of the baroreflex arch in a canine model of obesity-related hypertension. Twelve male beagle dogs were randomized into 2 groups. Six dogs were fed with normal canine food and 6 were submitted to a 10-week high-fat diet (HFD). We have evaluated the consequences of HFD on heart rate (HR) and blood pressure (BP) circadian cycles and methylscopolamine dose-response curves. Binding of [(3)H]-AF-DX 384 and adenylyl cyclase activity were investigated to determine the density and functionality of M(2)-cholinoceptors on right atrial membranes from control and HFD dogs. HFD induced a significant increase in body weight (15+/-1 vs 12+/-1 kg), systolic BP (161+/-5 vs 145+/-4 mm Hg), diastolic BP (92+/-3 vs 79+/-2 mm Hg), and HR (96+/-4 vs 81+/-3 bpm). Circadian rhythms of HR and BP observed in the baseline period were abolished after 9 weeks of HFD. After propranolol (1 mg/kg) pretreatment, the dose of methylscopolamine able to induce 50% maximum tachycardia was significantly increased after 9 weeks of HFD (7.4+/-0.3 vs 4.7+/-0.1 microg/kg). In the control group, the experimental period failed to modify these parameters. The numbers of M(2)-cholinoceptors measured in right atrial membranes were significantly lower in HFD than in control groups (54+/-6 vs 27+/-6 fmol/mg protein). The ability of carbachol to inhibit isoproterenol-stimulated adenylyl cyclase activity was significantly lower in HFD than in control groups (IC(50)=47+/-12 vs 6.4+/-1.4 micromol/L). However, the basal activity of adenylyl cyclase was unchanged by HFD. HFD decreases M(2)-cholinoceptor number and function in cardiomyocytes. This could explain the abolition of circadian rhythm of HR and the changes in chronotropic effect brought about by methylscopolamine.


Abstract Objective Screening mammography has potential benefits as well as harms, but these are not always communicated to women. We therefore explored how women discuss screening mammography, the subject positions made available in their discourse, and the implications of these for informed choice. Design: We conducted 16 individual interviews with women aged 44-72 years who were attenders (n = 11) and non-attenders (n = 5) of screening, and analysed transcripts through Foucauldian Discourse Analysis. Main Outcome Measures: A semi-structured interview guide, informed by literature and researcher expertise, was used to collect data. Results: The women constructed screening mammography as either helpful or potentially harmful. We identified three subject positions—The Responsible Woman (who attends screening), The Irresponsible Woman (who does not attend screening), and the Judicious Woman (who engages in alternate breast health practices). Conclusion: These subject positions have the potential to limit women's choices, constrain shared decision-making with health professionals, and restrict women's engagement in risk-reducing behaviours. An expanded range of options ultimately offers an alternate future in which women's autonomy to control their own bodies is better supported.


Aminoglutethimide (AG) and hydrocortisone (HC) were given to 20 patients with advanced prostatic cancer resistant to conventional hormonal therapy. Most patients had painful bone metastases and were heavily pretreated. 12 of 16 patients required narcotic analgetics. 8 of 20 were bedridden. AG + HC produced relief of bone pain in 12 patients (75%) and only 4 required narcotics after treatment. The performance status improved in 8 of 20 patients (40%). However, the number of bone metastases seen in bone scans decreased in only 4 patients (22%). The level of serum alkaline phosphatase decreased in 11 of 18 patients and that of acid phosphatase in 8 of 16 patients. The reduction of bone pain lasted approximately 4 months (range 1-15 months). The median lifespan between the start of AG treatment and death was 8 months (range 2-22 months). There was no difference in survival between responders and nonresponders. 3 patients had skin rash, 1 lethargy and 1 thrombocytopenia.


I t seems almost intuitive that developing a large and rich vocabulary is central to learning to read. Logically, children must know the words that make up written texts in order to understand them, especially as the vocabulary demands of content-related materials increase in the upper grades. Numerous studies have documented that the size of a person's vocabulary is strongly related to how well that person understands what he or she reads, not only in the primary grades, but in high school as well. Yet here's the practical problem. Right from the beginning of schooling, there are profound di erences in vocabulary knowledge among young learners from di erent socioeconomic groups. Just consider the following statistics: by age 4, a child's interaction with his or her family has already produced signi cant vocabulary di erences across socioeconomic lines, di erences so dramatic that they represent a 30 million word "catastrophe" (i.e., children from high-income families experience, on average, 30 million more words than children from low-income families).* Recent analyses indicate that environmental factors associated with vocabulary development and emergent literacy skills are already present among children as early as 15 months of age. By first grade, unfortunately, the repercussions become all too clear: children from high-income families are likely to know about twice as many words as children from low-income families, putting these children at a signi cantly higher risk for school failure. Even more disturbing, however, is that these statistics are often treated as inevitable, more or less a byproduct of poverty or lowincome status. ink of the consequences! is would mean that these children could be designated as reading failures before they ever enter through the schoolhouse doors. Luckily, there is now a rich and accumulated new knowledge base that suggests a far di erent scenario. Consider these points:


Increasing evidence indicates that oxidative damage exists in schizophrenia. Available literature about possible mechanisms of oxidative stress induction was reviewed. Furthermore, possibilities of measuring biomarkers of schizophrenia outside the central nervous system compartment, their specificity for different types of schizophrenia and potential therapeutic strategies to prevent oxidative injuries in schizophrenia were discussed. Data were extracted from published literature found in Medline, Embase, Biosis, Cochrane and Web of Science, together with hand search of references. Search terms were: schizophrenia, oxidative stress, antipsychotics, antioxidants and fatty acids. Finding a sensitive, specific and non invasive biomarker of schizophrenia, which could be measured in peripheral tissue, still stays an important task. Antioxidant enzymes, markers of lipid peroxidation, oxidatively modified proteins and DNA are most commonly used. As it considers the supplemental therapy, according to our meta-analysis vitamin E could potentially improve tardive dyskinesia, while for the effect of therapy with polyunsaturated fatty acids there is no clear evidence. Oxidative stress is a part of the pathology in schizophrenia and appears as a promising field to develop new therapeutic strategies. There is a need for well designed, placebo controlled trials with supplementation therapy in schizophrenia.


Glycoside hydrolase family 77 (GH77) belongs to the alpha-amylase superfamily (Clan H) together with GH13 and GH70. GH77 enzymes are amylomaltases or 4-alpha-glucanotransferases, involved in maltose metabolism in microorganisms and in starch biosynthesis in plants. Here we characterized the amylomaltase from the hyperthermophilic bacterium Thermus thermophilus HB8 (Tt AMase). Site-directed mutagenesis of the active site residues (Asp293, nucleophile; Glu340, general acid/base catalyst; Asp395, transition state stabilizer) shows that GH77 Tt AMase and GH13 enzymes share the same catalytic machinery. Quantification of the enzyme's transglycosylation and hydrolytic activities revealed that Tt AMase is among the most efficient 4-alpha-glucanotransferases in the alpha-amylase superfamily. The active site contains at least seven substrate binding sites, subsites -2 and +3 favoring substrate binding and subsites -3 and +2 not, in contrast to several GH13 enzymes in which subsite +2 contributes to oligosaccharide binding. A model of a maltoheptaose (G7) substrate bound to the enzyme was used to probe the details of the interactions of the substrate with the protein at acceptor subsites +2 and +3 by site-directed mutagenesis. Substitution of the fully conserved Asp249 with a Ser in subsite +2 reduced the activity 23-fold (for G7 as a substrate) to 385-fold (for maltotriose). Similar mutations reduced the activity of alpha-amylases only up to 10-fold. Thus, the characteristics of acceptor subsite +2 represent a main difference between GH13 amylases and GH77 amylomaltases.


We analyze the dynamics of the Peruvian NEET population during the last two decades using data from the Peruvian National Household Surveys. We identify the NEET population and its characteristics, classifying it by intensity. We find that the NEET population is primarily urban, made up of women and individuals who have just finished high school. Additionally, we find that a large proportion of women in the NEET population are willing to work. Finally, we observe that the proportion of NEET among the young population is declining over time.


This article begins with a definition of the terms 'early warning' and 'surprise', and examines whether the failure of Israeli Intelligence to warn Israeli decision-makers in 1973 conforms to these definitions. After examining the conventions of Israeli military intelligence regarding anticipating a surprise, and the conceptions on which these were based, the article demonstrates how events in late 1973 indicated a possible Arab attack on Israel, but also the manner in which the Concept used to measure these warnings proved more resilient than the warnings. Discussions in the few days preceding war, when information was accumulating, are subjected to particular attention. The development of a sub-conception, with the original framework allowed and changed the forecast from 'no war' to 'low probability' of war. The persistence of the Concept is attributed to both strategic intelligence and also to the doctrine of deterrence. Like deterrence, intelligence success is hard to measure. One can never be sure that a surprise attack has been prevented as a result of early warning.


The paper presents a general architecture for a P2P data sharing facility within a multi-agent framework, where peers as autonomous high-level nodal agents cooperate with each other to solve global tasks. A node may have several lower level local agents including local databases and partial global ontologies. In addition there are also minder agents coordinating the activities of the peers that offer the same type of service, thus providing fault-tolerance. The ability of this architecture in data and task sharing has been demonstrated by considering query processing and directory update strategies.


Identifying air pollutants that pose potential adverse health exposures in retail stores will facilitate exposure mitigation. Assessing the role of ventilation in mitigating this exposure is important to understand the energy implications of maintaining acceptable indoor air quality. In this work, we summarize results from 28 papers that report ventilation rates and/or pollutant concentrations in retail stores. These results were compared to available standards as well as data collected in non-retail environments. The findings of this review are: (1) half of the stores tested met/exceeded ASHRAE Standard 62.1-2010 (ASHRAE 2010a; or California Code of Regulations Title 24-2010) for ventilation; (2) PM2.5, acrolein, formaldehyde, and acetaldehyde exceeded their established, most conservative limits/reference exposures for a few of the stores tested in the United States, and outside the United States, researchers reported PM10, benzene, and trichloroethylene as additional pollutants found at concentrations that exceeded their limits; (3) alternative control methods would be more effective, and possibly more economical, than ventilation; (4) meeting or exceeding the ventilation requirements does not necessarily negate the presence of pollutants above their suggested limits; and (5) using disability-adjusted-life-year (DALY) as a metric of disease burden, two pollutants were identified as priority hazards in retail stores: PM2.5 and acrolein. Control strategies should focus on decreasing exposure of retail employees to these pollutants generated indoors or infiltrated from outdoors.


The purpose of this study was to determine the most effective treatment of fertilizing doses on the results of quality tests of sprouts and growth of chilli seeds (Capsicum annuum) between bulk seeds, seeds in packaging, and direct extraction results seeds. The experimental method used was a factorial randomized block design. The first factor is the type of seeds, namely: bulk seeds (A), in packages (B), and direct extraction results (C). The second factor is the fertilizer dosage using NPK "Mutiara" (16:16:16), namely: 5 gr / l (X), 10 gr / l (Y), 15 gr / l (Z). The parameters observed included the number of live plants and the number of leaves. The results showed that the bulk seed germination power was 91.25%, the seeds were packaged and the results of direct extraction were 95.5%. After breeding and given fertilization treatment, it was found that fertilization with a dose of 5 gr / l showed the highest average growth compared to other treatments. So it can be concluded that fertilization with a dose of 5 gr / l is most effectively given to the seedling stage. Therefore fertilization with a dose of 5 gr / l is most recommended for seed producers so that the capital spent can be reduced.


Adaptive attitude is a type of attitude that is used to adjust to another type
of attitude or situation. This attitude control people's behavior to motivate
themselves or others. The object of this study is a film entitled The Devil Wears
Prada by Lauren Weisberger. This study focuses on the adaptation as the exertion
of the main character to achieve her life goal.
In this research, the writer wants to achieve some objectives of the study.
The first objective is the writer wants to explain the demands of Andrea's new
workplace toward her. Secondly, by analyzing The Devil Wears Prada, the writer
wants to describe how Andrea adapts to her new workplace as her exertion to
achieve her goal and the last objective is the writer wants to describe what
adaptation type of Andrea revealed in the movie.
The writer used a descriptive qualitative research as a method of this study
since the data were in the form of written words and they were descriptively
analyzed. There were several steps in analyzing adaptation of Andrea Sachs as her
exertion to achieve her goal of life in the film. First of all, the film was watched
repeatedly and read the script to get a better understanding of the story. Secondly,
I listed the data that are related to the topic and then categorized them into the
demands of Andrea's new workplace, how does Andrea adapt to her new
workplace as the exertion to achieve her life goal and what type of adaptation of
Andrea revealed in the movie. The next step was interpreting the data according to
the theory related to the topic in order to clarify and analyze the attitude.
Finally, from the analysis, the writer finds out that Andrea is a young
woman who has strong motivation and she never gives up to reach what she
wants. She can adapt to her new workplace easily even it is very different with her
personality. She is able to accept all the differences and take them as spirit to
make her goal of life come true. After the writer has finished the analysis, the
writer found that ritualism is kind of adaptation which revealed through Andrea's
behavior.
By studying and analyzing Lauren Weisberger's The Devil Wears Prada,
the writer suggests that the readers can get more knowledge and understanding
about adaptation, since its function as a power to achieve a goal of life. For those
who intend to discuss more about adaptation, this study is expected to be one of
the references in supporting their researches. Therefore, they are supposed to
present a better description about adaptation or other broader aspects of it.


Bacteriocins are antimicrobial peptides that possess a number of desirable properties that can be utilized for application in various industries including the food and pharmaceutical industries. Enterocin NKR-5-3B (Ent53B) and lacticin Q (LnqQ) are well characterized bacteriocins that exhibit exceptional stability and potent antimicrobial activity. Here we report the establishment of a dual-plasmid expression system of these bacteriocins by exploiting the quorum sensing production system of nisin known as the nisin inducible controlled expression (NICETM) system. Using this dual-plasmid expression system, the production of Ent53B and LnqQ can be controlled by the addition of exogenous nisin at sub-lethal concentration, either in pure or crude form, to induce the transcription of the genes responsible for the production of these bacteriocins. Using this system, cheap cultivation media instead of the commonly used complex and expensive cultivation media, can be utilized in the production of these bacteriocins thereby significantly lowering the production cost – one of the major limiting factors for its large-scale application. Additionally, this system provides a robust control of bacteriocin production thereby creating an effective bacteriocin application delivery system.


T hrough evolution, several animal species have been endowed with salivary anticoagulants, presumably to secure their nutritional requirements for fluid blood from their prey. It has been known for centuries that the bites of leeches, certain snakes, insects, and vampire bats can result in local and systemic bleeding. The use of the medicinal leech, Hirudo medicinalis, for therapeutic bloodletting goes back to the middle ages. The major anticoagulant from the saliva of the medicinal leech, hirudin, was purified two decades ago and found to be a highly specific inhibitor of thrombin.' The complementary DNA for hirudin was later cloned and expressed,2 and recombinant hirudin has emerged today as an interesting candidate to replace heparin in acute anticoagulant therapy.


This research was aimed to estimate income from rubber farming folk and envistige rubber farmer buying power through term of trade indicators.  This research is conducted at Village Air Sekamanak District Ketahun North Bengkulu. Eighty nine labourfarmers were selected using Stratified Random Sampling method. The result of this research found that the farmers  terms of trade is 1.43 in May and 1.45 in June. These results indicate that in the month May and June of rubber farmers in the study area during the month were categorized into levels of prosperity.Average farm income of smallholder rubber farmers in the study area is Rp 1,945,690.37 Ut in May, while the average income in June amounted to Rp 1,945,117.34 Ut. Keywords: terms of Trade, Smallholder labours, rubber


A marching Euler solver, GEM3D, was used to predict the Mach 3 flow field for the wing and body of a High-Speed Civil Transport concept. The analysis focused on a typical cruise lift coefficient of 0.1 at alpha = 3 deg. The Euler solution indicated that embedded shocks formed on the upper surface of the inboard wing panel and at the leading-edge of the outboard wing panel, due to its supersonic leading edge condition. According to a simple static-pressure criterion, the embedded wing upper-surface shocks were sufficiently strong to separate a turbulent boundary layer. Comparison of aerodynamic coefficients from the Euler solver with those from linear theory shows that the linear theory estimates of lift and drag are optimistic, which would lead to optimistic estimates of cruise range.


Economic burden studies are important for use in advocating with Ministries of Finance and donors for increased investments in public health problems such as malaria. In September 2001, the authors convened a workshop at which a framework for the assessment of the economic burden of malaria in the African region was presented to health economists from 10 countries of the region. The framework document proposes the use of any one of three approaches – production function, cost of illness and willingness to pay – for the assessment of the burden of malaria to the economies of African countries. Between 2002 and 2005, six countries (Chad, Ghana, Mali, Nigeria, Rwanda and Uganda) undertook studies to assess the economic burden of malaria using the framework. The objective of this article is to report on the methodology, results and policy implications of the country economic burden studies. Of the six countries whose results are presented in this report, Ghana and Nigeria used all three approaches to estimate the economic burden of malaria. Uganda, Rwanda and Chad implemented the production function and the cost of illness approaches, while Mali used only the cost of illness approach. All countries implementing the cost of illness and willingness to pay approaches that required household surveys employed a multi-stage sampling methodology and used a structured questionnaire as the principal instrument for the collection of primary data from the households. Districts were selected to reflect the malaria epidemiological profile of the countries and a total of 5,498 households were sampled. Relevant secondary data on the institutional cost of malaria in the countries were obtained through checklists designed for the purpose, while other secondary data on the economy like the Gross Domestic Product (GDP), labour force, stock of capital, etc. were obtained from the National Statistical Services, Penn World Tables, World Bank Tables, African Development Bank, among others. Malaria was found to be a significant explanatory variable for national income in Chad, Ghana, Nigeria and Uganda, countries that estimated macroeconomic models to assess the impact on malaria on the economy. In these countries, the incidence of malaria had a negative impact on aggregate national output, with the loss in growth of the economy or the "malaria penalty" ranging from 0.41% in Ghana to as high as 3.8% and 8.9% in Nigeria and Chad respectively. The loss in economic growth in Rwanda is much smaller at 0.08%. The studies reveal that the impact of malaria on the growth in real gross domestic product is negative and decreases for every increase in malaria morbidity rates. The cost of illness approach results corroborate those obtained from the production function approach, indicating that malaria causes an enormous drain on the national economies. At the household level, the studies reveal a pattern of immense burden, particularly for the poorest households. In Ghana for example, the direct costs of malaria to the household is US$ 6.87, while it is US$ 11.84 and US$ 17.5 in Nigeria and Mali respectively. When the total cost of malaria was calculated, it was found that the countries were spending huge sums of resources for the control of malaria, resources that could have been devoted to other productive sectors, had the disease not been so prevalent. There is need for more investment in malaria endemic countries to combat the disease to at least US$ 1.5 billion to US$ 2.2 billion annually, levels advocated by the WHO Commission on Macroeconomics and Health, as these investments would lead to lives saved, enhanced productivity and improved quality of life, particularly for the most vulnerable population. Keywords: Africa, Malaria, Economic burden, Cost of illness, Direct costs, Indirect costs


Abstract Sections in strongly to moderately curved foreland fold-thrust belts may be restorable, but retrodeformation of two-dimensional (2D) serial sections produces overlap of their hinterland ends, making the incompatibility problem obvious. Outward-radiating displacement vectors predict along-strike stretching that increases toward the outer portions of arcuate foreland fold-thrust belts. Balancing of curved foreland fold-thrust belts becomes a three-dimensional (3D) material balance problem, involving non-plane strain. We propose a technique that will solve the 3D balancing problem if: (1) boundary pin lines, consisting of strike-boundary and normal-boundary lines, are present and identifiable; (2) a set of constant-length lines can be defined; (3) a set of section lines is constructed normal to tectonic strike; and (4) a set of boundary and internal constant-area regions is defined. This technique recognizes as false the unstated assumption that the deformed and undeformed state coordinate frames are identical. Accordingly, the displacement vector field of curved orogens does not parallel the deformed state strike normals. Instead, physically possible displacement vector fields require body rotations about a set of vertical axes during deformation, indicating that, during deformation, out-of-plane motions occur normal to the deformed-state strike normals relative to the external deformed-state coordinate frame. The final position of the plane strain surfaces parallels the deformed-state position of the strike normals, because they rotate into this position.


Initial-rate measurements and stopped-flow spectrophotometric experiments over a wide range of pH implicate an enzyme group of pKa approximately 6.6 affecting the aldehyde binding reactions. It is possible, though not proved, that the group involved is the cysteine residue involved in catalysis. Stopped-flow fluorescence studies show that a group of pKa greater than 8.5 facilitates hydrolysis of the NADH-containing acyl-enzyme species. The identity of this group is quite unknown. Studies with 4-nitrobenzaldehyde show that this substrate gives marked substrate inhibition at quite low (less than 20 microM) concentrations. The mechanism of catalysis seems to be the same as for propionaldehyde oxidation. It is argued that proton release occurs with both substrates on hydrolysis of the NADH-containing acyl-enzyme and not before hydride transfer, as has been previously suggested [Bennett, Buckley & Blackwell (1982) Biochemistry 21, 4407-4413].


Christian missions have often been seen as the religious arm of Western imperialism. What is rarely appreciated is the role they played in bringing about an end to the Western colonial empires after the Second World War. Missions, Nationalism, and the End of Empire explores this neglected subject. Respected authorities on the history of missions explore new territory in these chapters, examining from diverse angles the linkages between Christianity, nationalism, and the dissolution of the colonial empires in Asia and Africa. This work not only sheds light on the relation of religion and politics but also uncovers the sometimes paradoxical implications of the church's call to bring the gospel to all the world.


This paper focuses on the mechanical design of superconducting magnets with a new modular approach developed by a mechanical research laboratory (the LMT-Cachan). The structure of superconducting magnets exhibits many frictional contact zones, the loading conditions are complex and the results must be more and more accurate. The use of classical finite element method can be heavy and difficult. So a new modular approach, described here in, can treat the same problem with more efficiency and with a less numerical cost.