Bacteriorhodopsin, either as purple membrane sheets or as detergent-solubilized protein, was found to incorporate spontaneously into both large unilamellar vesicles (LUVs) and sized multilamellar vesicles (MLVs) under either gel-phase or liquid-phase conditions. These results were obtained with LUVs of various lipid compositions, including dimyristoylphosphatidylcholine (DMPC), DMPC and cholesterol, dioleoylphosphatidylcholine (DOPC), and DOPC and cholesterol. The lipid to protein (L/P) ratio of all proteoliposomes arising from these preformed vesicles continually increased in the presence of protein-free vesicles. Under fluid-phase conditions, the mixing of LUVs of DMPC with proteoliposomes showed vesicle growth independent of lipid concentration, suggesting that growth was due to lipid transfer. However, under gel-phase conditions a more rapid, concentration-dependent increase in the L/P ratio of the proteoliposome was observed, suggesting that growth occurred by a mechanism other than lipid transfer from vesicles to proteoliposomes. The use of the proteoliposome as an artificial lipid-protein membrane model is discussed.


As an ancient arthropod with a history of 390 million years, spiders evolved numerous morphological forms resulting from adaptation to different environments. The venom and silk of spiders, which have promising commercial applications in agriculture, medicine and engineering fields, are of special interests to researchers. However, little is known about their genomic components, which hinders not only understanding spider biology but also utilizing their valuable genes. Here we report on deep sequenced and de novo assembled transcriptomes of three orb‐web spider species, Gasteracantha arcuata, Nasoonaria sinensis and Gasteracantha hasselti which are distributed in tropical forests of south China. With Illumina paired‐end RNA‐seq technology, 54 871, 101 855 and 75 455 unigenes for the three spider species were obtained, respectively, among which 9 300, 10 001 and 10 494 unique genes are annotated, respectively. From these annotated unigenes, we comprehensively analyzed silk and toxin gene components and structures for the three spider species. Our study provides valuable transcriptome data for three spider species which previously lacked any genetic/genomic data. The results have laid the first fundamental genomic basis for exploiting gene resources from these spiders.


Neuronal activity-responsive gene expression plays a key role in the proper development, refinement, and plasticity of neural circuits, and the dysregulation of these gene responses have been implicated in developmental and cognitive disorders. Thus, identification and molecular characterization of the cis-regulatory DNA elements driving this response in neurons has the promise to profoundly advance our understanding of neurological disease mechanisms. The transcription factor cAMP/Ca2+-responsive element binding protein (CREB) is an important stimulus-responsive factor in many cell types of the body. CREB and its transcriptional co-activators are important for gene regulation in the brain and play a critical role in cognitive development, neuronal survival, and learning and memory. In the following studies we performed mechanistic analysis in human and mouse neurons to understand genome-wide binding of CREB and its neuronal co-activator, CREB Regulated Transcriptional Co-activator 1 (CRTC1, a.k.a. TORC1) at non-coding regulatory elements in response to neuronal depolarization. In addition, we investigated post-translational modifications of CRTC1 in response to BDNF treatment to better understand the biochemical basis of this co-factor's activation in mouse neurons. ! iv! Using human induced pluripotent stem cell (iPSC)-derived neurons we hoped to explore CREB-associated regulatory element function that cannot be studied in rodent models. While transcriptional and epigenomic analysis of human post-mortem brain samples has allowed for recent advances in identifying neuronal cis-regulatory regions of the genome, these approaches cannot address the dynamic, experience-dependent nature of their function in neuronal gene expression programs. We have identified human and mouse neuronal activity-dependent regulatory elements using ChIP-seq for both histone modifications and transcription factors in human pluripotent stem cell derived neuronal cultures, and thus provide a resource map of neuronal activity responsive regulatory elements across the human and mouse genomes. We identified human neuronal stimulus-dependent binding sites for CREB and CRTC1, including those that contain SNPs associated with neurological disorders, such as the schizophrenia-associated locus of CACNB2. Other CREBassociated regulatory elements potentially control expression of primate-specific transcripts and could be important sites of genetic divergence. Further functional investigation of these sequences will allow us to understand their role in human disease and evolution.


A controlled, open-label and randomized study was conducted to evaluate the safety and efficacy of the oral iron chelator deferiprone (L1) in thalassemia major patients from Hong Kong. Forty-nine patients were recruited in total (median age: 20 years; range: 8 to 40 years). The division of the patients was determined based on liver iron content and put into either the poorly-chelated (Group I) or well-chelated (Group II) groups. In Group I, 20 patients received combined therapy of L1 daily plus desferrioxamine (DFO), in a reduced frequency of twice weekly, while the control group consisted of 16 patients who were treated with DFO alone. In Group II, six patients received L1 only, while the control group consisted of seven patients treated with DFO alone. Only patients who participated for longer than 6 months were analyzed for efficacy (n = 44). The median study period was 18 months. Transient and mild gastrointestinal upset (31%), joint pain (15%) and liver enzyme elevation (23%) were the most common side effects noted for L1. No case of neutropenia was observed in this study. Serum ferritin (SF) levels showed significant decline in the poorly-chelated patients using combined therapy (L1 and reduced frequency DFO) as compared to those on DFO alone. However, their pre- and post-study liver iron content was not significantly different. Evaluation of the well-chelated group demonstrated no significant change in SF or liver iron content in both the study and control arms. We conclude that the short-term use of L1, with or without DFO, was safe and efficacious in our Chinese patient cohort. The long-term efficacy of reducing iron overload by treatment regimens including L1 requires further study.


Rhizosphere isolates of Bacillus and Pseudomonas species isolated from the roots of eggplants (Solanum melongena L.) were collected in eggplant cultivated areas in various geographical districts of Turkey. Isolates were evaluated for siderophore, protease and cyanide production along with the cell wall degrading enzyme production as well as phosphate solubilizing and nitrogen fixing capacities. The isolates showing good performance were tested against Fusarium oxysporum f. sp. melongenae, a highly destructive fungal agent for eggplants, for the antagonistic activities. The isolates designated as 11-4, 13-1, 56K-3, 65A-3, 67A-2, 76A-1, 85A-2, 10a, 318b, 346a, 379c, 007-1, 007-4, and 048-2 were found promising in inhibition of F. oxysporum f. sp. melongenae in vitro conditions. The isolates differing in their antagonistic responses to F. oxysporum f. sp. melongenae would be identified in species level. Also, the best performing isolates for the reduction of disease severity and increased plant growth would be further evaluated via more biochemical parameters such as indole acetic acid production (IAA) and total antioxidant status (TAS).

 Key words: Pseudomonas (spp.), Bacillus (spp.), Fusarium oxysporum, rhizobacteria, mycelial inhibition, siderophore production


Halophytes are valuable plants for their ability to live in extreme habitats on the earth where water sources deplete continuously. We investigated ontogenetic variability in phenolic composition and antioxidant activity of Salsola soda L., (Chenopodiaceae) a halophyte, distributed in coastal regions of Lake Burdur which is a saline lake in the Lakes District in southwest Turkey. In vitro radical scavenging activity of collected plants between June and October was detected using the 1,1-diphenyl,2-picryl hydrazyl (DPPH), and superoxide (SO) radical scavenging activity (RSA) and cupric reducing antioxidant capacity (CUPRAC). Total phenolic content (TPC) and total flavonoid content (TFC) were detected by specific qualitative tests. Caffeic acid, chlorogenic acid, ferulic acid, p-coumaric acid, naringin, quercetin, and, rutin were detected by HPLC-DAD. TFC, DPPH and SO RSA and, CUPRAC were maximum in the last developmental stage, fruiting, (October), ( p <0.05). TPC was higher in the vegetative stage than that in the generative stage. Caffeic acid, naringin, rutin and ferulic acid were higher than the other phenolic components in S. soda extracts. S. soda is a potential plant that has some bioactivities thanks to its valuable phytochemicals like flavonoids.


A 10 year study under natural winter conditions at 2 sites tested the hypothesis that mule deer (Odocoileus hemionus hemionus) and elk (Cervus elaphus nelsoni) forage equally on 4 sagebrush (Artemisia L.) taxa. Each year approximately 2,500 available leaders on 244 plants on the Northern Yellowstone Winter Range were examined for browsing. Browsing levels increased with winter severity, reaching 91% of leaders browsed for mountain big sagebrush (A. tridentata ssp. vaseyana [Rydb.] Beetle), the preferred taxon (p< 0.05) that averaged 56.1% at the 2 sites. Wyoming big sagebrush (A.t. ssp. wyomingensis Beetle and Young) was narrowly preferred (38.6%) over basin big sagebrush (A.t. Nutt. ssp. tridentata) (30.3%). Black sagebrush (A. nova Nels.) was least preferred (17.0%). Differences in preference among taxa were smallest during the severest winters when more elk were present thereby increasing total sagebrush utilization. Mule deer diets averaged 52% sagebrush over the study. Many sagebrush plants were damaged and even killed by heavy browsing during the study. Promoting sagebrush productivity should be a management objective on similar winter game ranges.


Hourly tide-gauge data along the coast of China are used to evaluate changes in extreme water levels in the past several decades. Mean sea level, astronomical tide, nontidal component and the tide-surge interaction was analyzed separately to assess their roles in the changes of extreme sea levels. Mean sea level at five tide gauges, Kanmen, Keelung, Zhapo, Xiamen and Quarrybay, show significant increasing trends during the past decades (1954–2013) with a rate of about 1.4–3.5 mm/yr. At Keelung, Kaohsiung and Quarrybay the mean high waters increased during 1954–2013 with a rate from 0.6 to 1.8 mm/yr, while the annual mean tidal range rose at the same time by 0.9 to 3.8 mm/yr. In terms of storm surge intensities, there is interannual variability and decadal variability but five tide gauges show significant decreasing trends, and three gauges, at Keelung, Xiamen and Quarrybay, exhibited significant increases of extreme sea levels with trends of 1.5–6.0 mm/yr during 1954–2013. Significant tide-surge interactions were found at all 12 tide gauges, but no obvious change was found during the past few decades. The changes in extreme sea levels in this area are strongly related to the changes of mean sea levels (MSL). At gauges, where the tide-surge interaction is large, the astronomic tides are also an important factor for the extreme sea levels, whereas tide gauges with little tide-surge interaction, the changes of wind driven storm surge component adds to the change of the extreme sea levels.


Economical and efficient warming of pre-transfusion human blood has been a subject of extensive investigation. The objective of this study is to identify and analyze the effect of enhanced microwave warming of bank blood. The sample here has been assumed to be a 2D cylinder interacting with microwave irradiation. The mathematical interpretation for the study is performed by solving the equation of electromagnetic wave propagation along with the equation of energy balance and pertinent boundary conditions. The samples after being subjected to both lateral and radial irradiations of same intensity are investigated for the power absorption in the sample with respect to the sample size. The preliminary observations obtained are further analyzed and extended for spatial distribution scrutiny. The collaborative analysis of the spatial distributions of temperature and power in the human blood along with high heating rate and low thermal non-uniformity determine the optimal heating strategy. The observations at different sample sizes recommend radial irradiation as the optimal heating strategy for samples corresponding to OP: 1 and 3, and lateral irradiation for samples corresponding to OP: 2, respectively. Considering all the aspects, the present work recommends an efficient way for enhanced microwave assisted heating of body fluid samples (2D cylindrical geometry) with known or measurable dielectric properties.


Transfusion-dependent β-thalassemia (thalassemia major and thalassemia intermedia) (BT) requires repeated blood transfusions for survival due to ineffective erythropoiesis. Consequently, iron overload can predispose the patient to atrial fibrillation (AF) despite the improved prognosis achieved with transfusion and chelation therapy. We sought to study the impact of AF on BT patients through a large database analysis. The current study used data from the Agency for Healthcare Research and Quality's Healthcare Cost and Utilization Project National Inpatient Sample collected from 2016–2019. A total of 17,150 admissions were included, of which 2100 (12.2%) admissions had a concomitant diagnosis of AF. Admissions with AF were older (mean age, 72.1 vs. 47.3 years; P < .001) and more likely to have congestive heart failure (CHF), hypertension, valvular heart disease, and renal disease. BT admission was associated with a higher AF prevalence than non-BT admission across all age groups. AF was not associated with an increased risk of in-hospital mortality (adjusted odds ratio [aOR], 1.36; 95% confidence interval [CI], 0.67–2.78; P = .398) or an increased length of stay (LOS) (aOR, 1.00; 95% CI, 0.78–1.29; P = .997) in the general cohort. In a subgroup analysis, AF was associated with increased in-hospital mortality in women (aOR, 2.73; 95% CI, 1.09–6.8; P = .031). Predictors of in-hospital mortality were increasing age, CHF, and liver disease, while predictors of prolonged LOS were diabetes mellitus, CHF, and increasing age. Further studies are warranted to develop strategies to improve the quality of care and outcome in this population.


Summary Despite the widespread dissemination of HIV information through public awareness campaigns in Mali, disclosing seropositivity to one's steady sexual partner (SSP) remains difficult for people living with HIV (PLHIV). Disclosure is a public health concern with serious implications and is also strongly linked to the quality of life of PLHIV. This study aimed to analyse factors associated with voluntary HIV disclosure to one's SSP, using a community-based cross-sectional study on 300 adult PLHIV in contact with a Malian community-based organization working in the field of AIDS response. A 125-item questionnaire was administered by trained personnel to study participants between May and October 2011. Analysis was restricted to the 219 participants who both reported having a SSP and answered to the question on disclosure to their SSP. A weighted multivariate logistic regression was used to determine variables independently associated with disclosure. In total, 161 participants (73%) reported HIV disclosure to their SSP. Having children (odds ratio [95% confidence interval]: 4.52 [1.84–11.12]), being accompanied to the survey site (3.66 [1.00–13.33]), knowing others who had publicly declared their seropositivity (3.12 [1.59–6.12]), having higher self-esteem (1.55 [1.09–2.19]) and using means other than anti-retroviral treatment to treat HIV (0.33 [0.11–1.00]) were independently associated with disclosure. This study identified several factors that should be considered for the design of interventions aimed at facilitating disclosure if/when desired in this cultural context.


This research was survey which title "Pengaruh Variabel-variabel Motivasi Terhadap Kinerja Karyawan Bagian Sortir Di PT. Insan Citra Prima Sejahtera Unit Tuban." The objectives of it were knew motivation which is given to the employees, knew employee performance, and influence between motivation whivh content of physicology need, safety need, social need, achievement need, and self actualization need to the employee performance, and the last objective was knew dominant influence of them in sort department PT. Insan Citra Prima Sejahtera.
Populations of this research were all of sort department fix employee of PT. Insan Citra Prima Sejahtera, there was 150 peoples. Sample of it was used Slovin with amount 60 peoples. Analyze data tool was used rating scale and multiple regression. Hyphotesis test was used f test, t test and regression coefficient.
Analyze data results was showed physicology need had average score 193,25 which meaned high value. Safety need had average score 187,5 also high value. The same value which average score 181,5 was social need. Achievement need had average score 187 also had same value eith another. It also happened in actualization need with average score 175,75. totally average score of motivation was 185,5 which high value. Performance of sort department employee had average score 184 alco meaned high value. F test result has wort 40,481, that was meaned motivation could influent to the amployee performance. T test result showed physicology, safety and social need had pocitive infulent to the performance. But achievement and self actualization had no influent to it. The dominant value is showed of physicologiy need because it had biggest regression coeficient of them.


Case report of a 3 week old baby with polyneuritis caused by perinatal acquired cytomegalovirusinfection. Neurological complications are in the acquired form of cytomegalovirusinfection. In acute paralyses of unknown origin CMV-infection should also be included in diagnostic considerations in childhood.


The security of ordinary digital signature schemes relies on a computational assumption. Fail-stop signature (FSS) schemes provide security for a signer against a forger with unlimited computational power by enabling the signer to provide a proof of forgery, if it occurs. Signing long messages using FSS requires a hash function with provable security which results in slow signature generation. In this paper we propose a new construction for FSS schemes based on linear authentication codes which does not require a hash function, and results in a much faster signature generation at the cost of slower verification, and a longer secret key and signature. An important advantage of the scheme is that the proof of forgery is the same as a traditional FSS and does not rely on the properties of the hash function. The scheme can be used in a distributed setting where signature generation requires collaboration of k signers. The paper concludes with some open problems.


Epileptic seizures are generated by an abnormal synchronization of neurons unforeseeable for the patients. In this study we analyzed invasive electroencephalogram (EEG) recordings in patients suffering from medically intractable focal epilepsy with two non-linear methods, Approximate Entropy (ApEri) and Lempel-Ziv (LZ) complexity. ApEn and LZ complexity quantify the regularity and complexity of a time series, respectively, and are well suited to the analysis of non- stationary biomedical signals of short length. Our results show an increase in ApEn and LZ complexity values during seizures at the focal electrodes. These changes could also be seen at some extra focal electrodes. After the seizure ends, the values of both non-linear metrics return to values lower than those before the seizure. Moreover, we quantified the changes in LZ complexity, showing the complexity increase during the seizure and its notable decrease after its end. Our results suggest that these techniques are useful to detect changes due to epileptic seizures in the EEG.


Rom very ancient times the church and the churchyard have afforde'd refuge to villagers in time of war. For this reason, wherever practicable, churches have been built on heights, to be the more easily defended. The church served not only as a house of prayer but also as a protecting citadel, defending the lives and property of its children. Already in the 4th century the Armenians had made strong citadels of their churches. The Franks in Merovingian times (481-751) built fortified churches of which that of St. Jean at Poitiers still stands, as well as the church at Remainmontier. After the Saracen invasion most of the churches in the south of France were surrounded with defence works, whereas in northern France they were not defended before the English wars in the fourteenth century. In the Middle Ages most of the churches in the strip of land between the Rhine and the Nahe, called the Gau, were fortified. Osthofen had defence works as early as 1241. In the Middle Ages, too, fortified churches were built in Alsace and Lorraine, or else the existing ones were greatly strengthened. An especially characteristic example is Chazelles in Lorraine, built in the 12th century, in which we are first struck by the placing of the church-tower between the choir and the nave and then by the loop-holes and machicolations.


BACKGROUND
Biomechanical behaviour evaluation of a suture is an important information for the surgeon to choose the best technique to perform.

OBJECTIVE
To assess the biomechanical behavior of the native and mechanically sutured bronchi.

METHODS
Ten bronchi were harvested from slaughtered pigs and then randomly separated in two groups, a control intact group and a sutured group where specimens were cut in half and sutured, to evaluate mechanical properties during a tensile test using a loading frame machine. In addition optoelectric motion tracking system was used to evaluate suture profile motion during the test.

RESULTS
Significant differences (p < 0.05) were found between the two groups for the parameters investigated. The control group showed a higher maximal stress resistance and stiffness than the suture group, while elongation at rupture was increased in the sutured group. All the sutures broke in symmetric manner, as the mean of the side difference of the sutured specimens was 0.93 ± 0.80 mm at rupture.

CONCLUSIONS
Biomechanical behaviour of native and sutured bronchi was evaluated, giving highly reproducible parameters regarding mechanical properties that may help clinicians and bioengineers to rationalize the choice for a particular suture material or suture technique, increasing surgical outcomes.


Abstract The 2005 standards published by the Higher Learning Commission of the North Central Association are intentionally general, placing less emphasis on quantifiable and arbitrary inputs and more emphasis on institutional effectiveness and assessment of student learning. The non-prescriptive nature of the new standards makes it difficult for librarians to determine an appropriate compliance strategy. The authors advocate use of the 2004 ACRL Standards for Libraries in Higher Educationfor assessment of an academic library to provide the comprehensive evaluation required to demonstrate compliance with the North Central Association standards. A comprehensive listing of the North Central provisions affecting libraries and other material are provided to assist in such an evaluation.


Introduction: A significant proportion of individuals with psychotic illness are either refractory to, or intolerant of, standard antipsychotic pharmacotherapy.  There is currently only one medication available with proven effectiveness in this population.  Clozapine while providing a superior response rate requires significant physical health care monitoring both before and during treatment. The medication requires weekly hematologic monitoring and intensive metabolic screening. Methods: A site was selected for establishment of a new Clozapine Clinic to provide services for individuals with treatment refractory psychotic symptoms or individuals with medication side effects deemed to be related to standard antipsychotic medications. Individuals were selected without predetermined exclusion criteria such as age or physical comorbidity.  Patients were accepted into the Clozapine Clinic with a combination of physical health and mental health assessments.  The Clozapine Clinic was fortunately located in close proximity to a County Primary Care Clinic and County Tertiary Care Hospital, both of which were helpful in obtaining baseline physical health assessments and diagnostic tests and concurrent hematologic and metabolic laboratory monitoring Results: A new Clozapine Medication Support service line was established using a collaborative care model with existing County facilities.  At total of 10 new and established individuals were enrolled into the Clozapine Clinic, with weekly, biweekly and monthly psychiatric and physical health monitoring. The Clozapine Clinic continues to receive referrals for individuals in need of complex care with this unique psychopharmacologic agent. Conclusions: Clozapine pharmacotherapy for treatment resistant psychotic symptoms provides a model for integrated care in this population.  Using a collaborative relationship and employing integrated care principles as the model, the complex care of new and established Clozapine patients was provided at an existing County Mental Health Clinic. Weekly hematologic and metabolic monitoring was achieved by partnering with the affiliated hospital laboratory in order to provide rapid, same day results. A dedicated Clozapine Clinic Nurse was employed to provide the coordination of physical health assessments, psychiatric evaluations and laboratory monitoring. In less than a year, the Clozapine Clinic services at this clinical site were expanded to approximately 10 individuals, with additional individuals awaiting entry. Clozapine pharmacotherapy for treatment refractory psychiatric illness is vastly underutilized in large part due to the complexity in coordination of physical health and mental health needs.  This underutilization leads to high levels of morbidity and mortality in the psychiatric population. Implications for Integrated Care Practice: Since a significant percentage of patients with chronic psychotic illness are either intolerant or refractory to standard antipsychotic medications, Clozapine remains the only effective agent available.  However, with its significant need for monitoring of physical health side effects, integrated care models of treatment provide the most cost effective, efficient and comprehensive model for addressing the whole person health care needs of this special population. Integrated Care models represent the solution to the underutilization of Clozapine pharmacotherapy in treatment resistant populations.


A calibrated steady-state, finite-difference, ground-waterflow model was constructed to simulate ground-water flow in three glaciofluvial aquifers, defined in this report as the upper, middle, and lower aquifers, in an area of about 114 mi surrounding the city of Grand Rapids in north-central Minnesota. The calibrated model will be used by Minnesota Department of Health and communities in the Grand Rapids area in the development of wellhead protection plans for their water supplies. The model was calibrated through comparison of simulated ground-water levels to measured static water levels in 351 wells, and comparison of simulated base-flow rates to estimated base-flow rates for reaches of the Mississippi and Prairie Rivers. Model statistics indicate that the model tends to overestimate ground-water levels. The root mean square errors ranged from +12.83 ft in wells completed in the upper aquifer to +19.10 ft in wells completed in the middle aquifer. Mean absolute differences between simulated and measured water levels ranged from +4.43 ft for wells completed in the upper aquifer to +9.25 ft for wells completed in the middle aquifer. Mean algebraic differences ranged from +9.35 ft for wells completed in the upper aquifer to +14.44 ft for wells completed in the middle aquifer, with the positive differences indicating that the simulated water levels were higher than the measured water levels. Percentage errors between simulated and estimated base-flow rates for the three monitored reaches all were less than 10 percent, indicating good agreement. Simulated ground-water levels were most sensitive to changes in general-head boundary conductance, indicating that this characteristic is the predominant model input variable controlling steady-state water-level conditions. Simulated groundwater flow to stream reaches was most sensitive to changes in horizontal hydraulic conductivity, indicating that this characteristic is the predominant model input variable controlling steady-state flow conditions.


Immature zygotic hybrid embryos of sunflower were cultured on MS medium supptemented with BAP in the range of 0.5 O2.5 mgll. Adventitious shoot buds were induced on the hypocotyl region of the immature embryos of a cross between a commercial male sterile line (2341+) and a restorer line (RFl). These adventitious buds were grown to shoots, rooted and transferred to the field. Fertile plants were obtained which set seeds in approximately two and a half months from initiation. This method will help shorten generation time an therefore can be profitably used in sunflower breeding progrâmmes.


One hundred and twenty-nine patients were studied with regard to healing of duodenal ulcers with 30 mg omeprazole once daily, recurrence rates after 2 and 4 weeks' treatment in patients with ulcers healed after 2 weeks, and recurrences in rapid and slow healers. Cumulative healing rates were 77% and 98% after 2 and 4 weeks, respectively. Eighty-one patients (65%) were without ulcer symptoms after 2 weeks, and 43 (34%) were improved. Seven of 45 patients (16%; 95% confidence limits, 6-30%) with ulcers healed after 2 weeks had relapsed after another 2 weeks of placebo; 3 were asymptomatic. The overall relapse rate after 6 months was 62%. There were no statistically significant differences in relapse rates between 2 and 4 weeks' treatment of patients with ulcers healed after 2 weeks or between rapid and slow healers. Ulcer size, smoking habits, and alcohol consumption were not significantly related to healing or relapse.


Low-number transplantation of pancreatic islets into the livers of diabetic rats leads to transformation of the downstream liver acini into clear-cell foci of altered hepatocytes (FAHs). These FAHs correspond to the glycogen-storing (clear-cell) phenotype of hepatocellular preneoplasias and develop into hepatocellular adenomas (HCAs) and hepatocellular carcinomas (HCCs) within 6 to 24 months. In addition, they show metabolic alterations that resemble well-known insulin effects, most likely constituting the result of the local hyperinsulinemia. Thus, we investigated FAHs, HCAs, and HCCs for altered expression of insulin receptor, insulin receptor substrate-1 (IRS-1), Raf-1 and Mek-1. Light and electron microscopic immunohistochemistry revealed a translocation of insulin receptor from the plasma membrane (normal tissue) into the cytoplasm in clear-cell FAHs and an increase in insulin receptor expression in HCAs and HCCs. FAHs also showed an increase in IRS-1 gene expression, investigated by in situ hybridization and quantitative reverse transcription-PCR. IRS-1, Raf-1, and Mek-1 proteins were strongly overexpressed in FAHs and tumors, as compared with the unaltered liver tissue. These overexpressions were closely linked to the clear-cell phenotype of preneoplastic and neoplastic hepatocytes, because basophilic FAHs (later stages) and basophilic tumors showed no overexpressions. In this endocrine model of hepatocarcinogenesis, severe alterations of insulin signaling were induced by the pathological local action of islet hormones in the livers and may substantially contribute to the carcinogenic process.


Based on a Lefebvrian view of spatiality, the paper endeavors to offer a spatial understanding of how information and knowledge are digitally reconstructed by ICT systems. It proposes an analytical model of theoretical approximations of learning in ICT learning environments termed Infogramic Analysis. This model aims to identify patterns of power, domination and struggle within digital information channels of human/ICTs communication and interaction and to advance our understanding of how learning occurs in digital communication and of how ICTs organize our representations and realities of the world within and around us, and consequently necessitate and direct decisions of social action.


AFLP is a widely used DNA fingerprinting technique, resulting in band absence - presence profiles, like a bar code. Bands represent DNA fragments, sampled from the genome of an individual plant or other organism. The DNA fragments travel through a lane of an electrophoretic gel or microcapillary system, and are separated by length, with shorter fragments traveling further. Multiple individuals are simultaneously fingerprinted on a gel. One of the applications of AFLP is the estimation of genetic similarity between individuals, e.g. in diversity and phylogenetic studies. In that case, profiles of two individuals are compared, and the fraction of shared (comigrating) bands is calculated, e.g. using the Dice similarity coefficient. Two comigrating bands may share the same fragment, but band sharing could also be due to chance, if two equally sized, but different fragments are amplified. This is called homoplasy. Homoplasy biases similarity coefficients. Homoplasy could also occur within a lane, if two different fragments of equal length are amplified, resulting in a single band. We call this collision. The main objective of this thesis is the study of collision and homoplasy in AFLP. The length distribution of AFLP fragments plays an important role. This distribution is highly skewed with more abundant short fragments. By simulation the expected similarity for unrelated genotypes is calculated. As much as 40% of the bands may be shared by chance in case of profiles with 120 bands. The collision problem is analogous to the birthday problem, which has a surprising solution. The collision problem is even more extreme, making it even more surprising. Profiles with only 19 bands contain collision(s) with probability 1/2. These findings have consequences for practice. In some cases it is better to prevent the occurrence of collisions by decreasing the number of bands, in other cases a correction for homoplasy and collision is preferred. Modified similarity coefficients are proposed, that estimate the fraction of homologous fragments, correcting for homoplasy and collision. Partially related to homoplasy and collision, we study the codominant scoring of AFLP in association panels. Examples of AFLP in lettuce and tomato serve as illustrations.


Aims: To introduce new terminology and validate its reliability for the analysis of optical coherence tomography (OCT) scans, compare clinical detection of cystoid macular oedema (CMO) and subretinal fluid (SRF) with OCT findings, and to study the effect of photodynamic therapy (PDT) on the foveal morphology. Methods: Patients with subfoveal, predominantly classic choroidal neovascularisation (CNV) secondary to age related macular degeneration (AMD) undergoing PDT were evaluated with refraction protocol best corrected logMAR visual acuity (VA), slit lamp biomicroscopy, stereoscopic fluorescein angiography (FFA), and OCT. New terminologies introduced to interpret the OCT scans were: neuroretinal foveal thickness (NFT), bilaminar foveal thickness (BFT), outer high reflectivity band thickness (OHRBT), intraretinal fluid (IRF), subretinal fluid (oSRF), and vitreomacular hyaloid attachment (VMHA). Results: Fifty six eyes of 53 patients were studied. VA was better in eyes with a thinner outer high reflectivity band (OHRBT) (p = 0.02) and BFT (p = 0.05). BFT was less in eyes that had undergone a greater number of PDT treatments (p = 0.04). There was poor agreement between OCT and clinical examination in the detection of CMO and subretinal fluid (κ = 0.289 and κ = 0.165 respectively). To validate the interpretation and measurements on OCT, two groups of 20 scans were analysed by two independent observers. There was good agreement between the observers in the detection of IRF, oSRF, and VMHA (p<0.001). Measurements of NFT and BFT had a high reproducibility, and of OHRBT reproducibility was low. Conclusions: New terminology has been introduced and tested. OCT appears to be superior to clinical examination and FFA in the detection of CMO. In this study, better vision was associated with a thinner OHRBT and/or the absence of SRF giving insight into the biological effect of PDT.


Abstract The current study examines the effects of the sociocultural context of primary school reading among Arabic- and English-speaking students in the UAE. Using a sample of 16,391 fourth graders (English: n = 10,507; Arabic: n = 5,884) from the 2016 Process in International Reading Literacy Study (PIRLS), results revealed that while early language environment and classroom practices play a role for all students, specific factors differ for Arabic- and English-speaking students. Specifically, the results suggest that some early language variables do not impact later reading achievement for Arabic-speaking students. However, certain classroom practices have a positive effect on Arabic reading in primary school. The discussion focuses on possible explanations of these group differences and the importance of tailoring early language experiences and classroom practices to complement specific linguistic and sociocultural contexts.


We describe a new approach to quantify in vivo anti-infective activity by simulating effect site pharmacokinetics of antibiotics in vitro. This approach is based on (i) the in vivo measurement of interstitial drug pharmacokinetics (PK) at the target site and (ii) a subsequent pharmacodynamic (PD) simulation of the time versus drug concentration profile in an in vitro setting. To demonstrate the feasibility of this approach, individual time-concentration profiles of ciprofloxacin were measured in the interstitial space fluid of eight healthy volunteers by microdialysis following iv administration of 200 mg. Thereafter, different isolates of Pseudomonas aeruginosa were exposed in vitro to the interstitial ciprofloxacin concentration profile obtained from in vivo experiments. This led to a 1- to 3-log10 decrease in the number of viable organisms after 8 h. Significant correlations were observed between the maximal bactericidal effect and several PK surrogate parameters, notably the AUC/MIC ratio (P: = 0.0005), the C:max/MIC ratio (P: = 0.006) and the time > MIC (P: = 0.02). Furthermore, the data were analysed with an integrated PK-PD model allowing a much more detailed evaluation of the data than using MIC. The model employed an E:max relationship to link unbound ciprofloxacin concentration to bacterial kill rate. In conclusion, our experiments show that therapeutic success and failure in antimicrobial therapy may be explained by pharmacokinetic variability at the target site. Therefore, the in vivo PK-in vitro PD approach presented in our study may provide valuable guidance for drug and dose selection of antimicrobial agents.


The initial objective of the research project reported in this paper was to examine the strategic approaches,
processes and factors involved when foreign companies make its foray into an Asian market. The study focused on
the South-East Asian Market, specifically Malaysia, given both the regions and the country's growing importance
in international trade. The theoretical underpinnings of this paper focus on foreign investment, modes of entry,
export marketing, strategic alliances, investment criteria, firm characteristics, international business, external
factors, host and home country factors, and Asian culture and management.


In this study, a named entity recognition was constructed and applied to the identification of Chinese medicine names and disease names. The results can be further used in a human-machine dialogue system to provide people with correct Chinese medicine medication reminders. First, this study uses web crawlers to sort out web resources into a Chinese medicine named entity corpus, collecting 1097 articles, 1412 disease names and 38714 Chinese medicine names. Then, we annotated each article using TCM name and BIO tagging method. Finally, this study trains and evaluates BERT, ALBERT, RoBERTa, GPT2 with BiLSTM and CRF. The experimental results show that RoBERTa's NER system combining BiLSTM and CRF achieves the best system performance, with a precision rate of 0.96, a recall rate of 0.96, and an F1-score of 0.96.


Previous work has shown that, unlike other species, placental lactogen (PL) in the bovine (bPL) has a mol wt of approximately 32,000 and exists in several different forms with different isoelectric points. This study was carried out to develop a more rapid purification scheme, whereby the yield of bPL obtained was increased while at the same time the possibility of artifacts from a prolonged purification protocol was decreased. A procedure was developed in which a fraction enriched in bPL-containing granules was obtained after gentle disruption of the binucleate cells of the fetal cotyledon. The fetal portion of the placentomes from midpregnant cows was minced with scissors and vigorously stirred in order to remove and disrupt binucleate cells within the fetal villi. The supernatant from this step was fractionated by differential centrifugation followed by a four-step discontinuous Percoll gradient of 1.03-1.08 g/ml. A granule-enriched fraction was isolated from the 1.04 g/ml zone from which membrane-enclosed protein was released by freezing and thawing. Membranes and insoluble proteins were sedimented by high speed centrifugation to yield an extract which contained approximately 20% of the hormone initially in the tissue. Two subsequent chromatographic steps, gel filtration on Sephadex G-75 and high performance reversed phase chromatography with a C-4 column, resulted in a preparation of greater than 98% homogeneity. Two-dimensional gel electrophoresis of purified bPL revealed at least nine protein spots in the 31,000-33,000 mol wt range with isoelectric points ranging from 4.85-6.3. All forms exhibited parallel dilution curves in a RIA for bPL. It would appear, therefore, that multiple forms of bPL exist and that they are not artifacts of the prolonged purification protocol previously used.


Redundancy, delayering, downsizing, and various other forms of organizational change have become increasingly prevalent. This article focuses on the impact of different forms of organizational change on managers' perceptions of the organizations they work within and the comparison between changes that involve redundancy and/or delayering and those that do not involve such changes. The literature has many accounts of the negative effects associated with redundancy and delayering, but are these effects unique to these types of change or are they a consequence of negative experiences of a range of organizational changes? Hypotheses were tested to assess, first, whether there are differences between different levels of management, notably between directors and nondirectors in the way they perceive organizational change, second, to assess how change has affected managers' perceptions of their organizations and their working lives, and third, to explore if different forms of change are associated with differences in managers' perceptions of their organizations "as a place to work". Hypotheses were tested with data from a cross-sectional survey with 830 managers from the UK. Organizational changes include cost reduction and culture change programmes, delayering, mergers/demergers, outsourcing, redundancy programmes, and contract/ temporary workers. The analyses reported here indicate clearly that specific forms of change are associated with managers' reports of their experiences at work; some forms of change (notably redundancy and delayering) seem to have particularly damaging implications for managers' experiences in the workplace. The analyses also show that there is a difference in the way directors and nondirectors perceive the changes. Finally, the article considers strategies for ameliorating the effects of change including the role of HR.


Children's conceptions and experiences of learning greatly influence how and what they learn. Traditional forms of schooling typically position learners at the periphery of decisions about their own learning. Curriculum, pedagogy, and assessment practices emphasize the attainment of system-mandated learning outcomes, and this emphasis predetermines much of what is deemed by adults to be important or worthwhile student learning. Children consequently come to view their school learning in fragmented, individualistic, and narrowly adult-defined and controlled ways.
 Many state schooling system settings permit only limited choice and decision making by children. However, the history of compulsory education also contains numerous instances of schoolchildren organizing and taking collective action against the wishes of adults on issues that are of concern to them; and of states, communities, and individual schools where radically different schooling approaches have been attempted, both inside and outside the publicly funded system. These "free," "alternative," or "democratic" schooling initiatives are part of long-standing "progressive" education counter-discourses that aim to demonstrate the benefits of child-centered and even child-determined schooling. Such initiatives have encountered both resistance and support in schooling systems and consequently offer useful lessons with regard to contemporary discourses around children's rights and student voice, as well as their contribution to schooling system reform.
 In recent decades, the combined effects of the United Nations Convention on the Rights of the Child (UNCRC) and growing scholarly interest in "student voice" research and reform efforts in ordinary schools have increased expectations that children should have a meaningful say in their learning at school. The UNCRC underpins polity efforts to facilitate young people's active participation in decision making in areas that affect them across the social agencies. Although contemporary "student voice" initiatives offer some promise for more of a "partnership" between adults and children in the ordinary school, they are often conceptualized and enacted at a superficial or tokenistic level. In continuing to position children simply as students who need the protection and direction of adults, schools fail to give adequate attention to the rich ways in which out-of-school learning contributes to a child's holistic identity, to the learning strategies young people use in their day-to-day lives outside of compulsory schooling settings, and how these might help shape children's agentic participation in meaningful decision making about what and how they learn while at school.
 A greater focus on the discursive processes of informal and everyday learning in family and community, and on the learning strengths or funds of knowledge children acquire in these settings, encourages the kinds of school and classroom conditions in which children and young people actively explore aspects of their world that interest them, experience agency in and commitment to their learning, and make choices about who they spend time with and what they prioritize in their learning. Informal learning affords young people the ability to naturally self-assess their learning and develop sophisticated understandings about what works for them and why. When young people actively engage with physical, technological, and social spaces, to advance their learning, they also learn to appreciate the utility of the tools and people around them. All these competencies or capabilities have relevance for what occurs in formal schooling settings also.
 Getting to know about the informal learning experiences of young people outside school influences the ways teachers think about who their learners are, learning as a phenomenon, and about the pedagogical repertoire they use to develop and enhance children's capabilities. These pedagogical insights enable teachers to subtly or radically change their approaches to learning, the interactional framework of the classroom, and the teachers' relations with families and with the local community that children negotiate each day.


Dongnongdongmai No.1 (Dn1) is one of the few winter wheat varieties that can successfully overwinter at temperatures as low as -25°C or even lower. To date, few researches were carried to identify the freeze tolerance genes in Dn1 and applied them to improve plant resistance to extreme low temperatures. The basic helix-loop-helix (bHLH) transcription factor MYC2 is a master regulator in JA signaling, which has been reported to involve in responses to mild cold stress (2°C and 7°C). We hypothesized that MYC2 might be part of the regulatory network responsible for the tolerance of Dn1 to extreme freezing temperatures. In this study, we showed that wheat MYC2 (TaMYC2) was induced under both extreme low temperature (-10°C and-25°C) and JA treatments. The ICE-CBF-COR transcriptional cascade, an evolutionary conserved cold resistance pathway downstream of MYC2, was also activated in extreme low temperatures. We further showed that overexpression of any of the MYC2 genes from Dn1 TaMYC2A, B, D in Arabidopsis led to enhanced freeze tolerance. The TaMYC2 overexpression lines had less electrolyte leakage and lower malondialdehyde (MDA) content, and an increase in proline content, an increases antioxidant defences, and the enhanced expression of ICE-CBF-COR module under the freezing temperature. We further verified that TaMYC2 might function through physical interaction with TaICE41 and TaJAZ7, and that TaJAZ7 physically interacts with TaICE41. These results elucidate the molecular mechanism by which TaMYC2 regulates cold tolerance and lay the foundation for future studies to improve cold tolerance in plants.


The k-nearest neighbor (kNN) classification has been widely adopted in data mining applications. In the age of big data, kNN classification process has to be outsourced to the cloud. However, as data may contain sensitive information, outsourcing data services directly to public clouds inevitably raises privacy concerns. To ensure the privacy of data, it is a well- known method to encrypt them prior to uploading to the cloud, which also brings great challenges to effective kNN classification. Homomorphic encryption (HE) allows operations on encrypted data, which provides a viable solution to kNN classification over encrypted data. However, existing works using HE to enable secure kNN classification all encrypt data attribute-wise that are limited by classification efficiency. In this paper, we designed an efficient and secure kNN classification protocol over encrypted data using vector HE, namely ESkNNC, which could encrypt data record-wise. Security analysis shows that ESkNNC achieves function secrecy, besides confidentiality of data, confidentiality of query record, and hiding data access patterns. Compared with kNN classification techniques over plaintexts, ESkNNC achieves the same 98% accuracy with the precision of 2 digits. Furthermore, we propose a batching method of test data that significantly saves communication cost up to 90%.


This study was attempted to kinematical characteristics of the El-grip swing with 1turn to el-grip in elite horizontal bar for the purpose of improving performance. The subjects were three males who were 2002 Busan Asian Games in men`s team. The three dimensional motion analysis with DLT method was executed using three video cameras of analyzing the actual competition situation. In point of analyzing the actual competition situation, it is expected that gymnastics and coaches have the effective informations, and the following conclusion had resulted. 1. In case of release, It is impotant to make fast horizontal velocity of CM, high vertical position of CM, large hip and shoulder angle. Also It should be performed release motion of trunk rotation angle(+). 2. During LHR the action should be made at higher position than the CM and the shoulder joint is moving within . It is important to make large lunk rotation angle. 3. During Hop, the RHR motion should be done in high position with short time and fast twisting action and to reduce the vertical speed is important.


Colorectal cancer is the most common critical disease both in the developed and developing countries. Capecitabine, which has served in clinical practice at least for 10 years, is a first-line antidigestive tract cancer drug for its better efficacy, patient compliance, and lower side effects. An ultra-high-performance liquid chromatography tandem mass spectrometry (UHPLC-MS/MS) method has been developed and completely validated for simultaneous determination of capecitabine and its five metabolites in human plasma from colorectal cancer patients after administration of capecitabine tablet. One-step liquid-liquid extraction was successfully applied using ethyl acetate and isopropanol (19 : 1, V : V) for sample pretreatment. Chromatographic separation was achieved within 5 min based on an Atlantis T3-C18 column (3.0 µm, 2.1 × 100 mm) with gradient elution using mobile phases consisting of 0.0075% formic acid in water (pH 4) and in acetonitrile, and the flow rate was 0.3 mL/min. Linear range was approximately 20.0–5000.0 ng/mL for all analytes. Linear correlation coefficients were >0.99 for all regression curves. The intraday and interday accuracy and precision of the method were within ±15.0% and less than 15.0%, respectively. The mean recovery and matrix effect as well as stability of all the analytes ranged from 59.27% to 90.15% and from 74.84% to 114.48% as well as within ±15.0%. This simple, rapid, and sensitive method was successfully applied in 42 sparse clinical samples to verify its practicability.


Rutile-dominated nodules from the Kampfersdam and Jagersfontein kimberlite pipes in South Africa contain euhedral olivines and spinels, graphic intergrowths of olivine and rutile, and massive rutile. In a similar nodule from the Pulsator dump in Kimberley, rutile and ilmenite are graphically intergrown with enstatite. These are interpreted as having crystallized from a Ti-rich silicate magma. The Jagersfontein samples contain Ca-Cr-NbZr-beaing armalcolite that may also be magmatic or, together with Nb-rich titanite and calcite, may have .formed by metasomatic reaction of the rutile-dominated cumulate assemblage with a Ca-rich fluid, possibly the residue from the magma that precipitated the cumulate assemblage. Despite some similarities in paragenesis and mineral chemistry, there are important differences between the rutile-olivine nodules and the MARID nodulemetasomatized peridotite group. These include the paucity of phlogopite and absence of K-richterite in the former, precluding a simple genetic relationship between the two groups.


Colorectal cancer is one of the common malignant tumors, which seriously threatens human health. Its morbidity and mortality rank the third and the second among all malignant tumors. The progress of colorectal cancer is a complex process involving the accumulation of genetic and epigenetic changes. Epigenetic changes of colorectal cancer mainly include DNA methylation, histone modification, non-coding RNAs (such as microRNAs and lncRNAs), which are of great significance to early diagnosis and prognosis evaluation, and to chemosensitivity assessment for colorectal cancer, providing a new thought for the treatment of colorectal cancer.


Abstract Chinese consumers have been the most dynamic driving forces during China's two decades of reforms. The purpose of this research is to get insight into the Shanghai consumers' consumption, perceptions, and uses with regard to food products. It provides detailed information about consumers' consumption habits, market outlet choices and consumption trends. Furthermore, this paper identifies the most important variables which influence the frequency of consumers' consumption of selected food products.


Introduction: As women suffer worse functional outcomes of stroke than men, they may also face more challenges with community reintegration but data are scarce. We examined sex differences in participation after stroke and which factors might account for these disparities. Methods: INSTRUCT is an individual participant data pooling study of incident strokes obtained from 13 population-based cohorts worldwide. Two of the cohorts (Melbourne '96-'99 and Auckland '02-'03) included assessment of participation at 5 years after stroke using the London Handicap Scale (LHS). The LHS is used to assess the individual's perspective of their involvement in life situations including orientation (person's awareness of surroundings), physical independence, mobility, occupation, social interaction and economic self-efficiency. The total score ranges from 0 (worst disadvantage) to 100 (no disadvantage). Linear regression was used to compare LHS total scores and sub-domains for women compared to men. Study-specific multivariable models incorporated adjustment for socio-demographics, stroke-related factors, pre-stroke health and post-stroke factors were combined using random-effects meta-analysis. Results: At 5 years after stroke, there were data on participation for 351/592 (59%) of survivors in Melbourne and 266/881 (30%) of survivors in Auckland. Women suffered greater participation restriction than men (total LHS, pooled mean difference, MD -5.55 [95% CI -8.47, -2.63]). The magnitude of the difference attenuated after adjusting for covariates (pooled MD -2.48 [-4.99, 0.03]). Significant confounders in study-specific models included age, stroke severity, pre-stroke dependency and pre-stroke dementia for Melbourne; and age, stroke severity and pre-stroke dependency for Auckland. In sub-dimensions, women had greater restriction than men in mobility, physical independence and occupation. Additionally, women in Melbourne experienced poorer social integration and orientation than men. Conclusion: Greater restriction in participation after stroke among women than men was mostly attributable to their advanced age and greater pre-stroke dependency. Interventions targeting participation could reduce the impact of stroke in women.


In a recent work (Borras et al., Phys. Rev. A {\bf 79}, 022108 (2009)), we have determined, for various decoherence channels, multiqubit initial states exhibiting the most robust possible entanglement . Here we explore some geometrical features of the trajectories in state space generated by the decoherence process, connecting the initially robust pure state with the completely decohered mixed state obtained at the end of the evolution. We characterize these trajectories by recourse to the distance between the concomitant time dependent mixed state and different reference states.


This paper presents a dual-band feed network for K-/Ka-Band phased array transceiver modules. It is intended to interface receive and transmit beamformer chips and the antenna elements with the remaining front-end circuitry. The whole arrangement consists of two printed circuit boards (PCBs) which are mounted on both sides of an aluminum 1:4 rectangular waveguide (RWG) power divider/combiner. It includes transitions from grounded coplanar waveguide (GCPW) to RWG. These are self-diplexing and thus an integral part of the whole feed network. Due to the RWG aluminum body, this integration approach offers adequate heat transfer capabilities and increased space for surface mount devices (SMDs). Because of its high frequency selectivity, image reject filters in the Rx-path can be dispensed with. The manufactured passive demonstrator exhibits reflection coefficients below −10 dB from 18.7 GHz to 20.5 GHz (Rx-band) and from 29.2 GHz to 30.5 GHz (Tx-band) and an insertion loss of $3.9\ \text{dB} < \text{IL} < 4.8\ \text{dB}$ and $2.8\ \text{dB} < \text{IL} < 3.6\ \text{dB}$ at these frequencies. Although the Rx- and the Tx-paths share the same RWG divider/combiner, they are diplexed with an isolation of more than 30 dB in both bands.


Amsterdam School of Communications Research/ ASCoR, University of Amsterdam, Kloveniersburgwal 48, 1012 CX Amsterdam, firstname.lastname@example.com In the mass media, medical genetics is often represented in terms of great promises of a healthier, and therefore, 'better' future for humankind. The public representations of genetics suggest a view in which locating genes for cancer, cardio-vascular diseases, or certain behavioral characteristics will lead to better cures for diseases. On television, the metaphors of medical genetics 'conquering the unknown' and genes as 'keys' or 'secrets of life' are backed by visual images of scientists in white lab coats conducting experiments in the laboratory with highly technical equipment. The metaphors and visual images derive from the collective imagery of medical genetics, and reconstruct this imagery over and over again (Van Dijck, 1998). Metaphors and visual images play a crucial role in the communication of scientific and technological issues to wider publics. Metaphors and visualizations are used to popularize and concretize the otherwise complex practice of genetic research, and the otherwise invisible genes. They are also effective ways of addressing the audiences in their multiple roles (Michael, 1999), and constructing linkages between the past, the present, and the future (Brown et al., 2000). Discussing genes in terms of 'letters in the book of life' (Condit, 1999; Van Dijck, 1998), and using images from inside the laboratory suggest that science is a global endeavor in fighting against 'nature' by means of civilization (books, technical equipment). Both metaphors and visuals seem to suggest a modern view of 'science as progress' (conquer the unknown, news visuals from the laboratory where the 'breakthrough' took place). Despite the crucial role of metaphors and visual images, they have seldom been studied together. This paper traces the uses of metaphors and visual images in the construction of popular images of medical genetics. The aim is to discuss what kind of an image of science, in general, and medical genetics, in particular, these metaphors and visuals suggest. The popular images, I argue, build upon a complex interplay between the popular metaphors and visual imagery concerning medical genetics. The interplay between visual images and metaphors is discussed in relation to the construction of links between the past, the present and the future as well as in terms of the audiences. Substantially, the study is based on the coverage of medical (human) genetics on Finnish television news during the period 19872000.


Reformers heralded the twentieth century as "The Century of the Child." In international law, that description proved prophetic. Children's rights have moved from the margins of discussion to center stage. The 1989 United Nations Convention on the Rights of the Child is the most rapidly and universally accepted human rights document of our century. The Convention is striking evidence of a major twentieth-century revolution in how we conceptualize children's law. This essay provides a condensed and admittedly impressionistic account of the development of the best interest standard and of the arguments raised both for and against it. The author concludes that the future of custody law lies in perfecting the best interest standard, not in abandoning it for simpler alternatives that lack a child-centered justification.


Abstract Priest, N. D., Hoel, D. G. and Brooks, P. N. Relative Toxicity of Chronic Irradiation by 45Ca β Particles and 242Cm α Particles with Respect to the Production of Lung Tumors in CBA/Ca Mice. Radiat. Res. 166, 782–793 (2006). Approximately 1800 female CBA/Ca mice were exposed by inhalation at three dose levels to β particles from 45Ca-labeled fused aluminosilicate particles (FAP), to α particles from 242Cm-labeled FAP, or to carrier control FAP. Another group of mice inhaled no FAP and were designated as untreated cage controls. The FAP in combination with these radionuclides was used to achieve the same spatial and temporal distribution of α- and β-particle dose within the irradiated mice. Some mice were killed to determine the clearance of radiolabeled FAP from their lungs, and the remainder were allocated to a life-span study. All animals were subjected to a detailed necropsy. To facilitate the identification of small tumors, the lungs were rendered transparent in methyl salicylate and examined under back illumination for the presence of lesions. Lung nodules and other microscopic lesions were excised for histological examination. The median survival of mice in all groups was approximately 910 days. The control animals lived longer than those that were irradiated, but it was difficult to determine a dose–response relationship for survival among the exposed mice. Benign adenomas and, less frequently, malignant adenocarcinomas were identified in all animal groups. The prevalence of these tumors was ∼28.8% in the control mice, which is consistent with the results of other studies using the same strain of mouse. After exposure to radionuclide-labeled FAP, there was a significant dose-related increase in the prevalence of lung tumors in 242Cm- (peak prevalence 55%) and 45Ca-exposed (peak prevalence 48.6%) mice. The prevalence of tumors in the mice that received 242Cm-labeled FAP was approximately twice that in the mice that inhaled 45Ca-labeled FAP within the range of doses employed (0.55–4.69 Gy). Using the ratio of the slope of the linear component of the dose–response curves, the toxicity of the α particles relative to the β particles was 1.5 (90% CI: 0.7, 9.0) for all adenomas and 9.4 (90% CI: 5.0, 23.0) for the less frequent adenocarcinomas. The relative toxicity for adenocarcinomas was found to decrease with increasing dose.


Pregnancy disorders include, most commonly, hypertensive disorders, which include gestational hypertension, preeclampsia, and chronic hypertension with superimposed preeclampsia. Various etiological factors prove to be both risks as well as protective factors, which include genetic factors, maternal smoking (it is inversely related to preeclampsia; that is, smoking decreases the incidence of preeclampsia), and other medical comorbidities such as hypertension, diabetes, asthma, and others, including older maternal age and high body mass index. Usually, high maternal and fetal mortality rates are seen with the diagnosis of hypertensive disorders in pregnancy, and severe morbidity is seen in cases of preeclampsia, eclampsia, and HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count), along with raised levels of liver enzymes and blood disorders such as low platelet counts. Preeclampsia is considered one of the most serious consequences of pregnancy. These disorders are often presented as newly diagnosed high blood pressure and proteinuria during the last trimester. But it can prove to be fatal for both the mother and the fetus. Though the causative factors of preeclampsia are still unknown, specific clinical and histopathological researchers propose that preeclampsia can be due to pathological changes in the placenta. The basic aim of this article is to discuss various histopathological changes in the placenta due to preeclampsia, but minor topics that affect the pathophysiology of the placenta due to preeclampsia are also mentioned. Furthermore, the effective management of maternal syndrome complications in pregnancy has also been discussed.


ABSTRACT Plant roots grow into the soil for efficient acquisition of various nutrients, such as inorganic nitrogen, ammonium, and nitrate. A previous study has revealed the genetic diversity of foliar functions of Arabidopsis thaliana ecotypes in an environment containing ammonium; however, the function of roots remains unclear. This work focuses on the root system architecture (RSA) of Arabidopsis ecotypes to investigate the genetic factors regulating ammonium-dependent RSA changes. Arabidopsis ecotypes were grown on vertical agar medium containing ammonium as a major nitrogen source, and root growth and RSA were determined. Arabidopsis ecotypes showed differential sensitivity to ammonium. The shoot dry weight of some ecotypes decreased, whereas that of other ecotypes increased in ammonium medium. The RSA changes also varied among the different ecotypes in response to ammonium. The total root length, measured as the sum of primary root and lateral root length, of some ecotypes was reduced, whereas that of other ecotypes showed no significant difference in ammonium medium. Compared with lateral roots, the primary roots showed a sharp response to ammonium supply. Notably, the RSA showed a partial correlation with shoot dry weight in ammonium medium. Because Col-4 and Ler-0 showed opposite RSA responses to ammonium supply, these two ecotypes were selected for further genetic analysis. Quantitative trait locus (QTL) analysis of recombinant inbred lines of Col and Ler showed the involvement of several genetic factors in ammonium-dependent RSA changes. Moreover, QTL analysis revealed that the primary structure of nitrogen-related enzymes do not account for changes in RSA in response to ammonium supply.


Environmental problems, such as climate change, pollution, and environmental degradation, are important contributors to the spread of infectious diseases, such as COVID-19 and SARS. For instance, a greater concentration of ambient NO2 was associated with faster transmission of the SARS-CoV-2 virus, which causes COVID-19. However, it remains unclear whether outbreaks of infectious diseases arouse individuals' concern on the need to protect the environment and therefore promote more pro-environmental behaviors. To this end, we examined the relationship between infectious disease vulnerability and pro-environmental behaviors using data from a cross-societal survey (N = 53 societies) and an experiment (N = 214 individuals). At both the societal and the individual levels, infectious disease vulnerability increased pro-environmental behaviors. At the societal level, this relationship was mediated by citizens' level of environmental concern. At the individual level, the relationship was mediated by empathy. The findings show that infectious disease vulnerability is conducive to pro-environmental behaviors.


Contactless excitation and detection of high harmonic acoustic overtones in a thin insulator single crystal are described using radio frequency spectroscopy techniques. Single crystal [001] silicon wafer samples were investigated, one side covered with a Nb thin film, the common starting point for the fabrication of quantum devices. The coupling between electromagnetic signals and mechanical oscillation is achieved from the Lorentz force generated by an external magnetic field. This method is suitable for any sample with a metallic surface or covered with a thin metal film. High resolution measurements of the temperature dependence of the sound velocity and elastic constants of silicon are reported and compared with known results.


A single radiology department serves the three separate organizations that comprise Emory Healthcare in Atlanta--three separate hospitals, the Emory Clinic and the Emory University School of Medicine. In 1996, the chairman of Emory Healthcare issued a mandate to the radiology department to decrease its report turnaround time, provide better service and increase customer satisfaction. The area where the greatest effect could be made without involving the transcription area was the "exam complete to dictate" piece of the reporting process. A committee investigating voice recognition systems established an essential criteria for potential vendors--to be able to download patient scheduling and demographic information from the existing RIS to the new system. Second, the system had to be flexible and straightforward for doctors to learn. It must have a word processing package for easy report correction and editing, and a microphone that would rewind and correct dictation before recognition took place. To keep capital costs low for the pilot, the committee opted for server recognition rather than purchase the expensive workstations necessary for real-time recognition. A switch was made later to real-time recognition. PACS and voice recognition have proven to be highly complementary. Most importantly, the new system has had a tremendous impact on turnaround time in the "dictate to final" phase. Once in the 30-hour range, 65 percent of the reports are now turned around in less than 15 minutes, 80 percent in less than 30 minutes, and 90 percent in less than an hour.


Background: Acute Coronary Syndrome includes to a group of conditions compatible with acute myocardial ischemia and/or infarction that are usually due to an abrupt reduction in coronary blood flow. In the last decade vitamin-D deficiency as a predisposing factor for coronary artery disease is in growing interest. Prospective studies give conflicting results regarding correlation of serum vitamin D level with coronary angiographic severity in patients with acute coronary syndrome. Objective: To study the correlation between serum vitamin-D level with coronary angiographic severity in patients with acute coronary syndrome. Methodology: This cross sectional observational study was done between November 2018 and October 2019. Total 71 patients with diagnosis of first incident of acute coronary syndrome in department of cardiology, BSMMU who were underwent coronary angiogram included in this study considering the inclusion and exclusion criteria. Vitamin D was measured by chemiluminescent immunoassay after collection of venous blood at Department of Biochemistry, BSMMU. Angiographic severity was assessed by using Gensini score. Statistical analyses were carried out by using the Statistical Package for Social Sciences version 23.0 for Windows (SPSS Inc., Chicago, Illinois, USA). Results: The mean age was found 55.9±10.7 years with a range from 36 to 82 years. Majority (83.1%) patients were male. The male-female ratio was 4.9:1. Thirty (42.3%) of the patients had STEMI, 28(39.4%) had NSTEMI and 13(18.3%) had unstable angina. Negative correlation (r=-0.479; p=0.001) was found between serum vitamin D level and Gensini score in patients with acute coronary syndrome. Conclusion: In this study found that serum vitamin-D level is inversely correlated with angiographic severity in patients with acute coronary syndrome.
University Heart Journal Vol. 17, No. 2, Jul 2021; 103-107


Growth of GaN on epitaxial distributed Bragg reflectors (DBR) capable of 80% reflectivity at typical III-N based LED operating wavelengths is presented. Such structures are formed by growing single crystal multilayers of gadolinium oxide-silicon stacks on silicon (111) substrates. The large refractive index difference between gadolinium oxide and silicon (Δn = 2.2) allows highly reflective DBR mirrors to be achieved at as little as three periods. Growth of GaN is demonstrated on the DBR mirrors making these structures suitable for GaN based LED growth. DBR mirrors embedded in this engineered substrate act as a reflecting mirror for incident light from a LED grown on top of this substrate. This potentially allows increased light extraction and higher output power from these LEDs compared to that of similar LEDs grown on silicon substrates. Performance of DBR mirrors with GaN top layers as a function of the incident angle of a 488 nm laser is investigated. X-ray diffraction and TEM are used for structural characterization of these grown structures. This engineered substrate, Mirrored SiliconTM, is suitable for high volume manufacturing at 150 and 200 mm wafers sizes. (© 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim)


Chronic pancreatitis is best described as a relentless, continuous inflammatory destruction of the pancreas parenchyma, characterized by irreversible destruction of the exocrine tissues, fibrosis, and at the late stage, the destruction of endocrine cells. Current therapies for chronic pancreatitis patients focus on pain relief by medical and minimally invasive endoscopic treatment as well as surgical management with resection of diseased parenchyma and drainage of obstructed ducts. Radical treatment of chronic pancreatitis has been successful with total pancreatictomy and islet autotransplantation (TP-IAT) that may prevent maladaptive intractable pain pathways and also avoid pancreatogenic diabetes in the wellselected patient. Distinct loss of pancreatic islet cells occurs in about 30% 50% of patients during the progression of chronic pancreatitis when severe fibrosis develops at the late stage of the disease. Profound β cell apoptosis induced by stresses encountered during islet isolation and transplantation further compromises β cell survival and function after TP-IAT. The molecular mechanisms that lead to β cell dysfunction in chronic pancreatitis remain largely undelineated. In this review, we summarize factors that may contribute to β cell apoptosis during the disease progress and after TP-IAT and discuss potential interventional approaches that may prevent islet cell death during these processes. Such information is critical to the development of therapeutic protocols that can preserve the viability and function of β cell in patients with chronic pancreatitis.


The 2010 Desert Research and Technology Studies (DRATS) of the VEGGIE Food Production System in the Habitat Demonstration Unit (HDU) Pressurized Excursion Module (PEM) was the first operational evaluation of salad crop production technology in a NASA analog test. A systematic evaluation of rooting media and nutrient delivery systems were evaluated for three lettuce cultivars that have shown promise as candidates for a surface based food production system. The VEGGIE nutrient delivery system worked well, was able to be maintained by multiple operators with a minimum of training, and supported excellent lettuce growth for the duration of the test. A Hazard Analysis and Critical Control Point (HACCP) evaluation was performed using ProSan tm as sanitation agent prior to consumption was approved, and the crew was allowed to consume the lettuce grown using tbe VEGGIE light cap and gravity based nutrient delivery system at tbe completion of the 14-day DRAT field test. The DRAT field test validated the crew operations; Growth of all lettuce cultivars was excellent. The operational DRAT field testing in the HDU identified light quality issues related to morphology and pigment development that will need to be addressed through additional testing. Feedback from the crew, ground support personnel, and human factors leads was uniformly positive on the psycbological value of baving tbe crop production system in tbe excursion module. A number of areas have been identified for future work, to minimize the "footprint" of the Food Production system through creative use of unused wall and floor space in the unit. (Funded through NASA KSC FYI0 CTC grant)


With the introduction into premedical and medical courses of those subjects requisite for a proper understanding of modern medicine, there has been a prolongation of the training period for the degree of Doctor of Medicine to a point that is approaching the upper limit of reasonable requirement. As physics and chemistry were introduced into the premedical curriculum, and experimental physiology, laboratory bacteriology and practical pathology found their way into the day to day work of the medical school, the necessary clinical training was pushed forward. This, based on the traditional and ridiculous "four-system" of American education, meant four years of high school, four years of college, and four years of medical school. When additional training of a practical sort was added to this, the medical student before he actually met the problems of practice had passed out of the stage when it is easy to train his senses and his


Prediction of intestinal availability (FG), in conjunction with hepatic metabolism, is of considerable importance in drug disposition to assess oral clearance and liability to drug-drug interactions. In the current study, FG predictions were performed within a physiologically based pharmacokinetic (PBPK) model using in vitro permeability and clearance data. The prediction success was assessed in comparison with the QGut model. In addition, apparent oral clearance values, predicted using the PBPK model, were compared with in vivo observations from meta-analyses. Finally, unbound intrinsic clearance values (CLuint) were determined for 12 CYP3A substrates in eight individual human jejunal microsome (HJM) samples to assess interindividual variability in intestinal intrinsic clearance and subsequent FG predictions. Overall, the PBPK model improved FG predictions in comparison with the QGut model; this was apparent by a reduced bias and increased precision. In particular, FG predictions of indinavir, saquinavir, and terfenadine were model-dependent. The predicted oral clearance values of the drugs investigated ranged from 8.79 to 6320 l/h for tacrolimus and simvastatin, respectively, and were overall within 3-fold of the observed data with the exception of indinavir, atorvastatin, and buspirone. The individual HJM CLuint values ranged from 17 to 14,000 μl · min−1 · mg−1 for atorvastatin and saquinavir, respectively, and corresponding interindividual variability in CLuint estimates ranged from 41 to 67%. These in vitro data resulted in predicted FG values ranging from 0.03 to 0.94 for simvastatin and indinavir, respectively. The largest interindividual variability of FG was predicted for terfenadine (65%) in contrast with the low variability in the case of indinavir (3%).


This paper describes a method for enhancing semi-autonomous tele-operation of highly dexterous manipulators. The presented process enables the operator of a mobile manipulator to select an object from a remotely viewed video feed transmitted from a UGV and watch the manipulator autonomously moves its end effector to a specified offset from the designated object. The presented method is robust to sensor noise and is constructed in a modular manner that does not rely on a specific 3D sensor, manipulator, camera, or number of cameras. By grossly estimating the workspace of the manipulator and scanning the general area of interest, an octree is created in which a ray is cast into to determine the point of interest. The system is designed specifically with future Explosive Ordnance Disposal (EOD) robots in mind which will possess manipulators with high degrees of freedom.


ABSTRACT Aluminum particles are often added to solid propellants and explosives to enhance energy release, where the metal typically burns in mixtures of water vapor and carbon dioxide. In this study, information about the temperature field surrounding 5–10-µm aluminum particles burning at elevated pressure in CO2/Ar and CO2/N2 is obtained via emission and absorption spectroscopy of AlO and three-color pyrometry. Spectra of AlO fit well to Boltzmann distributions and to similar temperatures of 3000 to 3200 K in both excited and ground states, suggesting that both states are in equilibrium. Pyrometry yields slightly lower temperatures, in the range of 3000 to 3100 K. Both temperature ranges are well below the adiabatic flame temperature and the boiling point of alumina but are much closer to the predicted aluminum boiling temperature at elevated pressure. These results are consistent with a flame structure with combustion occurring at or very near the particle surface.


Background: Each year, approximately 287,000 women die from complications related to pregnancy and childbirth, with 99% of these deaths occurring in developing countries. Modern contraceptive, particularly long acting family planning methods are highly effective in reducing maternal mortality by preventing unintended or closely spaced pregnancies. This paper, therefore, aims to determine the level of utilization of long acting contraceptive methods and explore its determinants among child bearing age mothers in Arba Minch town, Gamogofa zone, Ethiopia. Method: Community based cross sectional study was conducted from May15-30 2014 among child bearing age women. Systematic random sampling technique was employed to select 358 study participants. A pre-tested and structured questionnaire was used to collect the data. Bivariate and multivariable data analysis was performed using Statistical Package for Social Sciences (SPSS) version 20 software to assess statistical association. Result: Long acting contraceptive method utilization was 13.1%. From the socio-economic factors, educational status of the mother, having functional radio or television at home, positive attitude and higher knowledge were found to be independent predictors of long acting contraceptive methods utilization. Conclusion: Utilization of long acting contraceptive method was very low despite multi-pronged activities have been undertaken throughout the country. Thus, community based health care workers should strengthen information, education and communication to ensure that women have higher knowledge and positive attitude towards long acting contraception methods.


Understanding and forecasting of summertime afternoon precipitation due to rapidly developing cumulonimbus clouds without any significant synoptic-scale influences are important to prevent and mitigate the induced disasters. Future changes in the behavior of such precipitation events have recently gained scientific and societal interests. This study investigates the environmental stability for afternoon precipitation that develops under synoptically undisturbed conditions in summer by using the outputs of 20-km-mesh, super-high-resolution atmospheric general circulation model (GCM) simulations for a present, a near-future, and a future climate under global warming with the Intergovernmental Panel on Climate Change A1B emission scenario. The Kanto Plain was chosen as the analysis area. After verifying the usefulness of the GCM present-climate outputs with observations and gridded mesoscale analyses, we examine the future changes in the environmental stability for the afternoon precipitation by conducting statistical analyses. In the future climates, temperature lapse rate decreased in the lower troposphere, while water vapor mixing ratio increased throughout the deep troposphere. The changes in the temperature and moisture profiles resulted in the increase in both precipitable water vapor and convective available potential energy. These projected changes will be enhanced with the future period. Furthermore, the statistical analyses for the di¤erences of the stability parameters between no-rain and rain days under the synoptically undisturbed condition in each simulated climate period indicated that the representations of the stability parameters that distinguish no-rain and rain events are basically unchanged between the present and the future climates. This result suggests that the environmental characteristics favorable for afternoon precipitation in the synoptically undisturbed environments will not change under global warming.


Culture-based methods were employed to recover 3929 isolates of fungi from soils collected in May and July 2014 from mound nests of Formica ulkei and adjacent non-nest sites. The abundance, diversity, and richness of species from nest mounds exceeded those of non-mound soils, particularly in July. Communities of fungi from mounds were more similar to those from mounds than non-mounds; this was also the case for non-mound soils with the exception of one non-mound site in July. Species of Aspergillus, Paecilomyces, and Penicillium were dominant in nest soils and represented up to 81.8% of the taxa recovered. Members of the genus Aspergillus accounted for the majority of Trichocomaceae from nests and were represented almost exclusively by Aspergillus navahoensis and Aspergillus pseudodeflectus. Dominant fungi from non-mound sites included Cladosporium cladosporioides, Geomyces pannorum, and species of Acremonium, Fusarium, Penicillium, and Phoma. Although mound nests were warmer than adjacent soils, the dominance of xerotolerant Aspergillus in soils from mounds and the isolation of the majority of Trichocomaceae at 25 and 35 °C suggests that both temperature and water availability may be determinants of fungal community structure in nests of F. ulkei.


!CHAOS is an INFN project aimed at creating the communication framework and the services needed for the definition of a new control system standard, mainly addressed to large experimental apparatus and particle accelerators. !CHAOS is under test at DAFNE accelerator and has been developed to overcome the strong requirements throughput of new accelerators, like superB. One of the main components of the framework is the historical engine (HST Engine), a cloud-like environment optimized for the fast storage of large amount of data produced by the control system's devices and services (I/O channels, alerts, commands, events, etc.), each with its own storage and aging rule. The HST subsystem is designed to be highly customizable, such to adapt to any desirable data storage technologies, database architecture, indexing strategy and fully scalable in each part. The architecture of HST Engine and the results of preliminary tests for the evaluation of performance are presented.


The organic growth and development of a business is something that every decision-maker has to deal with, and deal with well. How can the business grow organically without compromising the bottom line or customer deliverables? What are the challenges that face the business owner or CEO in a mercurial market with ever-changing goalposts? The modern enterprise has to find the answers to these questions to ensure it is capable of sustainable growth over the long term.


This study established a study framework to quantify the safety factors of unsaturated shallow slopes at different temperatures. This study is based on a non-isothermal soil water characteristic curve model quantifying the temperature-dependent hydraulic properties of soils. The hydraulic coupling analysis models HYDRUS 2D and The Slope Cube Module were used for finite element modeling. A slope stability analysis was performed based on the local factor of safety (LFS) theory. An increased temperature decreased the soil matric suction, suction stress, effective stress, and LFS, weakening the soil strength. Slope modeling analysis showed that soils were dominated by different water retention mechanisms before and after rainfall infiltration, and the trends caused by temperature changes also changed accordingly. This study provides insights into the relationship between soil mechanical properties and temperature, which is valuable for maintaining soil stability and preventing geological hazards.


Jetis Village has SMEs that are engaged in modeste (sewing and embroidery) which are still implemented with conventional systems in terms of production, management and marketing. This makes SME Partners have some security when they have to face the big order season or when they have to compete with other similar SMEs that have developed modern management. UKM players who are mostly the attention in this service. This service method is 1) Observation; 2) Focus Group Discussions; 3) Dissemination; and 4) Evaluation. The results of this service are 1) activities focused on partner networking, managerial strengthening, and online marketing training through social media; 2) SME Partners understand the managerial processes that are recorded and monitored starting from financial managerial, human resources, and production raw materials; 3) SME Partners are facilitated by related agencies to have networks with raw material suppliers and potential market candidates; 4) SME Partners own and are able to assist Facebook Pages which are used for online marketing .


Modern Mexico is the latest volume in the ABC-CLIO Understanding Modern Nations series, which aims to provide concise topical reference sources in a thematic encyclopedia format focusing on representative countries of world regions. Recent volumes in the series cover China and Spain, with forthcoming volumes planned for Japan and Russia. Each volume includes thematic chapters on Geography, History, Government, Economy, Religion, Social Classes and Ethnicity, Gender, Education, Language, Art, Music, Food, and other cultural subjects. In addition to the thematic coverage in these areas, series volumes include "A Day in the Life" of typical people in the country and appendices covering terminology, economic and social data, and a reference bibliography.


Background: Chronic granulomatous disease (CGD) is a primary immunodeficiency characterized by susceptibility to early-onset life-threatening bacterial and fungal infections as well as dysregulated chronic inflammation. CGD results from mutations in one of the components of the phagocyte NADPH oxidase, a multimeric complex that consists of two membrane-bound components (gp91phox and p22phox) and 3 cytoplasmic subunits (p40phox, p47phox y p67phox) that function to induce reactive O2 species (ROS) in phagocytic cells to induce microbial killing. To date, only a single patient with granulomatous colitis and compound heterozygous mutations in NCF4 encoding p40phox has been reported as a genetic subgroup of CGD. Method: We performed whole exome-sequencing in a patient with early-onset systemic histoplasmosis. Functional testing to Investigate phagocyte NADPH oxidase included dihydrorhodamine oxidation assay as well as amplex red and luminol. Protein expression was assessed by FACS and immunoblotting. Results: We found a missense homozygous variation in NCF4 within the phox homology (PX) domain, predicted to be damaging by polyphen and SIFT2 with a CADD score of 35. RT-PCR and immunoblotting demonstrated decreased p40phox protein expression protein both in neutrophils and EBV-transformed B cells from the patient, but not from controls. In addition, intracellular (IC) ROS production was significantly impaired after physiological stimulation with fMLP, Histoplasma capsulatum and Candida albicans on neutrophils and EBV-B, but not with phorbol 12-myristate 13-acetate (PMA). Conclusions: We report a novel homozygous mutation in NCF4 selectively impairing IC ROS production in a Colombian child. Remarkably, systemic histoplasmosis has not been previously reported in association with classical CGD, therefore our results expand the spectrum of genetic and infectious diseases underlying CGD in humans.


Background: Physicians from resource-constrained rural areas being lone lifesavers pose a unique challenge in resuscitating emergencies like cardiac arrest. Rural Emergency Care Training for Physicians (RECTIFY) was devised as a short course training to equip them to deal with occasional emergencies using minimal gadgets. This study was conceived to assess the effectiveness of the RECTIFY-Cardiac Arrest Resuscitation Short course (CARS) module in improving current knowledge and practice of cardiopulmonary resuscitation (CPR) among interested rural physicians of Asia. Methods: A three-tier observational study was conducted to assess current CPR knowledge with a pretested structured questionnaire and skills using a checklist, followed by a 3-h hands-on training and posttest evaluation using the same study instruments. Data were entered into Microsoft Excel and analyzed using SPSS 13.0. Results: Out of 622 participants, most of the participants (603; 96.9%) were willing to provide CPR despite poor knowledge and skills. Pretest scores averaged 1.5 ± 0.99 and 0.1 ± 0.3 for CPR knowledge and skills, respectively. Posttest scores for CPR knowledge (10.5 ± 1.5) and skills (2.8 ± 1.6) improved significantly (both P = 0.001). Whereas a majority improved upon chest compression skills, appropriate use of sophisticated gadgets like automated external defibrillators (AED) was low (2.4%) despite training. Conclusion: The level of knowledge and skill among participants was poor despite the enthusiasm and positive intent. The impact of RECTIFY-CARS on knowledge and skills among participant physicians was significant and is recommended for implementation by health policymakers in resource-poor rural settings. However, essential gadgets like AED were not impactful which necessitates the use of simpler rural alternatives.


Patients after coronary artery bypass grafting (CABG) have impaired heart rate variability (HRV) parameters. The clinical significance of impaired HRV and the influence of the cardiac rehabilitation on the HRV in this group of patients is not clear. We studied 103 patients (average age 52.2 +/- 7.8) after CABG, divided into group A (72 patients) who underwent cardiac rehabilitation (starting 15 days after the CABG) and group B (31 patients) who did not have rehabilitation. In all patients, a 24 hr ECG (including time and frequency domain HRV) was obtained before the onset of rehabilitation, after completion of the rehabilitation and after 6 months. Before the rehabilitation there were no differences in time-domain HRV between the groups, however frequency-domain HRV values were significantly higher in group A. In group A, the time-domain HRV parameters improved after 21 days of rehabilitation, whereas the frequency domain parameter components remained unchanged. At 6 months, improvement in time and frequency domain HRV parameters was noted, but the parameters were significantly higher in group A. In patients that underwent coronary artery bypass grafting, the cardiac rehabilitation time domain HRV showed improvement in both the short term (21 days) and long run (6 months). However, the frequency domain parameter was only increased over the long run. Cardiac rehabilitation speeds up the improvement of the time domain HRV and frequency domain parameters over long term observation (6 months).