Enterprise and grid computing systems are complex and subject to a broad range of changes such as configuration updates, failures, and performance degradations. These changes affect infrastructure elements such as computation and storage nodes, applications, and system management elements such as monitoring infrastructures. Today's best practices in use by system administrators to manage these changes are manual and ad-hoc. In large complex installations, this would lead to high operational costs, broken closed loop automation, and reduced agility. Providing tools and mechanisms to administrators that automate the reaction to these changes is highly desirable and is an active research area.

Policy-based management using Event-Condition-Action (ECA) rules is a well-known approach for such automated change management where management actions are executed when specified event-conditions are observed. In complex systems, the interdependence of components generates multiple events when a single change happens causing multiple rules to be triggered. The order of execution of rule actions determines the system behavior necessitating reasoning about execution order. ECA rules do not contain explicit action specifications needed for reasoning and are therefore unsuited for specifying management rules.

In this paper, we propose a specification-enhanced ECA model called Event-Condition-Precondition-Action-Postcondition (ECPAP) for designing adaptation rules. ECPAP rules contain action specifications in first order predicate logic enabling us to develop reasoning algorithms to determine enforcement order of multiple rules. The enforcement order is represented as a Boolean Interpreted Petri Net workflow. We introduce a new notion called enforcement semantics that provides guarantees about rule ordering. We have built an adaptation framework using ECPAP model and have demonstrated it for automated change management of Ganglia and HP OpenView monitoring systems. The evaluation of the framework illustrates the significance of the ECPAP model and demonstrates its applicability for managing complex IT environments.


BACKGROUND Stroke is a common and frequently occurring disease of the nervous system and one of the three major diseases leading to human death. The incidence and mortality of stroke in China increase with age. Overall, 70 % of patients with stroke have serious disability, which results in heavy burden to their families and the society. AIM To analyze the effects of Qixue Shuangbu decoction and acupuncture combined with Western medicine on immune indexes and digestive tract function in patients with acute severe stroke. METHODS A total of 68 patients with acute severe stroke admitted to Lanzhou Second People's Hospital between March 2018 and September 2021 were selected and divided into the control and observation groups according to a random number table method. The control group was administered routine Western medicine treatment, such as dehydration, lowering intracranial pressure, anticoagulation, improving cerebral blood circulation and cerebral nerve protection according to the "Guidelines for the Diagnosis and Treatment of Acute Ischemic Stroke in China." The observation group was administered Qixue Shuangbu decoction via nasal feeding tube on the basis of the routine Western medicine treatment with simultaneous acupuncture. The two groups were compared. RESULTS The acute physiology and chronic health evaluation II, organ dysfunction syndrome score, National Institutes of Health Stroke Scale, and traditional Chinese medicine syndrome scores of the two groups were significantly decreased compared with those measured before treatment, and the complements C3 and C4, and immunoglobulins (Ig) M and G were significantly increased compared with those observed before treatment (P < 0.05). After treatment, the scores of the observation group were lower than those of the control group, and the complement and Ig levels were higher than those of the control group (P < 0.05). The levels of diamine oxidase (DAO), D-lactic acid (D-LA), and calcitonin gene-related peptide (CGRP) in the two groups were significantly higher than those before treatment, while the levels of lipopolysaccharide, ubiquitin carboxyl-terminal hydrolase 1 (UCH-L1), tumor necrosis factor-α (TNF-α), interleukin (IL) -2, and IL-8 were significantly lower than those before treatment (P < 0.05). After treatment, DAO, D-LA, and CGRP were higher in the observation group than in the control group, while lipopolysaccharide, UCH-L1, TNF-α, IL-2, and IL-8 were lower than in the control group (P < 0.05). The hospitalization time of individuals in the observation group was shorter than that of the control group (P < 0.05). CONCLUSION Qixue Shuangbu decoction and acupuncture combined with Western medicine for the treatment of acute severe stroke can regulate intestinal flora, reduce inflammation, improve intestinal mucosal barrier function and immune function related indicators, and promote recovery.


Although Lloyd's method I for optimal quantization was proposed more than thirty years ago and has been frequently referred to in the literature, its convergence has so far not been shown. This correspondence proves that Lloyd's method I converges for a large class of error measures, if the density function is continuous, positive, and defined on a finite interval. The proof is done by modeling the behavior of a continuous optimization algorithm by a finite state machine. >


In last decade, various agile methods have been introduced and used by software industry. It has been observed that many practitioners are using hybrid of agile methods and traditional methods. Agile was created in large part in reaction to the predominant waterfall model, and to a lesser extent to all "traditional" methodologies. Thus, there is strong need of agile software development life cycle that clearly defines the phases included in any agile method and also describes the artifacts of each phase. The generalization of agile software development life cycle provides the guideline for average developers about usability, suitability, applicability of agile methods. This paper presents a coherent strategy for continuous integration of some good features of classical / traditional methods of software development with the agile methodology viz., Extreme Programming, Scrum etc. to enhance the current software development techniques. This inturn can be used in a highly adaptive software environment.


Glycogen synthase is a substrate for five distinct protein kinases in skeletal muscle which phosphorylate seven different serine residues on the enzyme. Cyclic-AMP-dependent protein kinase phosphorylates sites 1a, 1b and 2, phosphorylase kinase, site 2, glycogen synthase kinase 3, sites 3a, 3b and 3c, glycogen synthase kinase 4, site 2 and glycogen synthase kinase 5 site 5. Site 2 is seven residues from the N-terminus of glycogen synthase and is located in a cyanogen bromide peptide termed CB1 (apparent Mr = 9000). The other six phosphorylation sites are located in a cyanogen bromide peptide termed CB2 (apparent Mr = 24 000) at the C-terminal end of the molecule. The sequence of the N-terminal 123 residues of peptide CB2, has been completed. Sites 3a, 3b, 3c, 5, 1a and 1b are located at residues 30, 34, 38, 46, 87 and 100 from the N-terminus of CB2 respectively. Site 1a is the next serine residue after site 5. The region surrounding sites 3a, 3b and 3c is very rich in proline residues while that surrounding sites 1a and 1b contains many serine and threonine residues. The 23 residues following site 5 contain 15 aspartic acid and glutamic acid residues, while the region immediately N-terminal to site 1a is very basic. The whole region is remarkably hydrophilic and is the region at which the native enzyme is attacked by proteinases. The sites at which glycogen synthase is cleaved by trypsin, chymotrypsin and thermolysin have been identified. The finding that trypsin cleaves the enzyme C-terminal to site 3c while chymotrypsin cleaves N-terminal to site 3a has formed the basis of a simple procedure for determining the state of phosphorylation of the seven serine residues in vivo [Parker, P.J., Embi, N., Caudwell, F.B., and Cohen, P. (1982) Eur. J. Biochem. 124, 47-55].


Acetylxylan esterase from Trichoderma reesei removes acetyl side groups from xylan. The crystal structure of the catalytic core of the enzyme was solved at 1.9 A resolution. The core has an alpha/beta/alpha sandwich fold, similar to that of homologous acetylxylan esterase from Penicillium purpurogenum and cutinase from Fusarium solani. All three enzymes belong to family 5 of the carbohydrate esterases and the superfamily of the alpha/beta hydrolase fold. Evidently, the enzymes have diverged from a common ancestor and they share the same catalytic mechanism. The catalytic machinery of acetylxylan esterase from T. reesei was studied by comparison with cutinase, the catalytic site of which is well known. Acetylxylan esterase is a pure serine esterase having a catalytic triad (Ser90, His187, and Asp175) and an oxyanion hole (Thr13 N, and Thr13 O gamma). Although the catalytic triad of acetylxylan esterase has been reported previously, there has been no mention of the oxyanion hole. A model for the binding of substrates is presented on the basis of the docking of xylose. Acetylxylan esterase from T. reesei is able to deacetylate both mono- and double-acetylated residues, but it is not able to remove acetyl groups located close to large side groups such as 4-O-methylglucuronic acid. If the xylopyranoside residue is double-acetylated, both acetyl groups are removed by the catalytic triad: first one acetyl group is removed and then the residue is reorientated so that the nucleophilic oxygen of serine can attack the second acetyl group.


The aurorae of Uranus were recently detected in the far ultraviolet with the Hubble Space Telescope (HST) providing a new, so far unique, means to remotely study the asymmetric Uranian magnetosphere from Earth. We analyze here two new HST Uranus campaigns executed in September 2012 and November 2014 with different temporal coverage and under variable solar wind conditions numerically predicted by three different MHD codes. Overall, the HST images taken with the Space Telescope Imaging Spectrograph reveal auroral emissions in three pairs of successive images (one pair acquired in 2012 and two in 2014), hence 6 additional auroral detections in total, including the most intense Uranian aurorae ever seen with HST. The detected emissions occur close the expected arrival of interplanetary shocks. They appear as extended spots at southern latitudes, rotating with the planet. They radiate 5–24 kR and 1.3‐8.8 GW of ultraviolet emission from H2, last for tens of minutes and vary on timescales down to a few seconds. Fitting the 2014 observations with model auroral ovals constrains the longitude of the southern (northern) magnetic pole to 104 ± 26° (284 ± 26°) in the Uranian Longitude System. We suggest that the Uranian near‐equinoctial aurorae are pulsed cusp emissions possibly triggered by large‐scale magnetospheric compressions.


The aim of this paper is the analysis of the existing state-of-the-art implementation of information management and e-learning systems in Libya (with emphasis on TripoliUniversity). The focus is to identify the factors that act as barriers to creating innovative learning environments of E-learning excellence amongst postgraduate students in Higher Education (HE) in Libya. The paper underlines that in spite of the drawbacks faced by most HE institutions, some have managed to successfully introduce E-learning into their curriculum. Finally the paper proposes a set of recommendations for improving the effectiveness of the use of information management and E-learning systems in Libyan HE based on the results of SWOT analysis performed by the authors about using technology for educational purposes.


Although Java as expected to have a wide range of embedded applications, there exist some problems in applying Java to real-time systems. It is practical to have a hybrid architecture, in which the Java runtime environment is implemented on a real-time operating system (OS), where those parts of the application requiring real-time properties are implemented in the real-time OS, while those parts requiring GUI features, extensions of features and replacement of programs should be implemented in the Java runtime environment. In this paper, we present interface specifications between Java threads and real-time tasks based the hybrid architecture we have built, called the JTRON (Java on The industrial Real-time Operating system Nucleus) specification, and experiences based on application development using its implementation. First, cooperative computation models between Java threads and real-time tasks in the architecture are described. Based on these models, we categorize three types of communication interfaces between Java threads and real-time tasks: the real-time/OS attachment class, shared objects with explicit locking mechanisms, and stream-based communication. By standardizing the interface, not only Java programs but also real-time programs become portable and reusable. Two of the three types of interface can also be applied to other real-time OSs.


The study investigated the effect of peer tutoring instructional method on the academic achievement in Biology among secondary school students in Zaria Metropolis, Nigeria. The design for the study was pretest and posttest experimental control group design. All the 60 senior secondary schools within Zaria metropolis constituted the population of the study. Two senior secondary schools were randomly selected and made into experimental and control groups. Biology Achievement Test (BAT) was prepared by the researcher and validated by Two senior lecturers from education department, Ahmadu Bello University, Zaria and a reliability coefficient r=0.67 was arrived at. Biology Achievement Test (BAT) was administered to the students by the researcher. Data collected were analysed using t-test statistics. The results indicated that students taught biology using peer tutoring instructional method achieved higher than those taught using expository method. It was recommended that, teachers need to diversify their method of teaching biology such as peer tutoring as it will assist in higher academic achievement of learners.


I discuss a specific model of space-time foam, inspired by the modern nonperturbative approach to string theory (D-branes). The model views our world as a three brane, intersecting with D-particles that represent stringy quantum gravity effects, which can be real or virtual. In this picture, matter is represented generically by (closed or open) strings on the D3 brane propagating in such a background. Scattering of the (matter) strings off the D-particles causes recoil of the latter, which in turn results in a distortion of the surrounding space-time fluid and the formation of (microscopic, i.e. Planckian size) horizons around the defects. As a mean-field result, the dispersion relation of the various particle excitations is modified, leading to non-trivial optical properties of the space time, for instance a non-trivial refractive index for the case of photons or other massless probes. Such models make falsifiable predictions, that may be tested experimentally in the foreseeable future. I describe a few such tests, ranging from observations of light from distant gamma-ray-bursters and ultra high energy cosmic rays, to tests using gravity-wave interferometric devices and terrestrial particle physics experiments involving, for instance, neutral kaons.


One of the most toxic substances known to humans, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD or dioxin), is also highly pervasive in the environment. It is created naturally in volcanic eruptions and forest fires, and anthropogenically in waste incineration, chlorination processes and certain plastics manufacture. From reports of large industrial and other accidents, or from experimental studies, dioxin exposure has been correlated in animal models and/or humans with chloracne of the skin, organ cancers, hepatotoxicity, gonadal and immune changes, pulmonary and other diseases such as diabetes, skewing of the sex ratio, and infertility. We have demonstrated that the aromatic hydrocarbon receptor (AHR) that binds dioxin in tissues is localized in zebrafish, rat and rhesus monkey (Macaca mulatta) ovaries and in rat and human luteinizing granulosa cells (GC) (among other tissues), that labeled dioxin is specifically localized to granulosa cells of the ovarian follicle as observed by autoradiography, and that incubations of GC or ovarian fragments with environmentally relevant concentrations (fM to nM) of dioxin inhibit estradiol secretion significantly. Our experiments show that in human, non-human primate, rat, trout, and zebrafish ovarian tissues, dioxin inhibits estrogen synthesis at some level of the steroid biosynthetic pathway, most likely by inhibiting transcription of mRNAs for or activity of side-chain cleavage (Cyp11a1 gene) and/or aromatase (Cyp19a1 gene) enzymes, or conceivably other steroidogenic enzymes/factors. Such an untoward effect on estrogen synthesis in females exposed to dioxin environmentally may predispose them to defects in aspects of their fertility.


In this work, the magnetoelectric response in a series of Dy1-xHoxMnO3 crystals with substitution x from 0 to 0.4 was investigated. The measurement results showed that, as x increases, a decrease in both the polarization Pa and the magnitude of the susceptibility of the inverse magnetoelectric effect αba is observed. In addition, the field Hb increases, at which the Pc→Pa transition is observed, and the temperature range of the existence of the magnetoelectric response decreases. Thus, an increase in the substitution x suppresses the magnetoelectric effect in this series of compounds. The measurement results also indirectly indicate the prolongation of the Pa state and, consequently, of the magnetic state with a cycloid lying in the ab-plane by an external electric field Ea.
The reported study was funded by Russian Foundation for Basic Research, Government of Krasnoyarsk Territory, Krasnoyarsk Regional Fund of Science to the research project No.20-42-243008.


To determine whether afterload reduction with nifedipine is effective both at rest and during stress tests (rapid atrial pacing and contrast material overload), 14 patients with chronic severe isolated aortic insufficiency (10 asymptomatic) underwent right and left cardiac catheterization. Forty-five minutes after 20 mg of nifedipine (sublingually), left ventricular end-diastolic pressure, peak aortic pressure, systemic vascular resistance and double product decreased significantly at rest, at peak paced rate, and after angiography (P values from less than 0.05 to less than 0.001). Cardiac index increased at resting heart rate (P less than 0.01) but was unchanged during pacing. The reduction of systemic vascular resistances was inversely correlated with its initial value (r = -0.69). After nifedipine, average regurgitant fraction did not change; however its variations were significantly correlated with those of systemic vascular resistance (r = 0.69). It is concluded that in severe aortic insufficiency, nifedipine induces an effective reduction of left ventricular pre- and afterload, accompanied by an enhanced mechanical efficiency (unchanged or increased cardiac index with lower double product), both at rest and during stress tests.


THE RELATION OF NURSES WORK STRESS AND DOCUMENTATION COMPLETENESS OFEMERGENCY NURSING PROCESS IN RSUD PANEMBAHAN SENOPATI BANTUL Listyana Natalia Retnaningsih ABSTRACT Background: Nursing documentation is form of nursing activity expressing quality of treatment, which applicable for responsibility and acountability to all executed actions. But this would be difficult to reach if there any obstruction factor as work stress. In RSUD Panembahan Senopati Bantul, work stress is susceptible problem faced by nurses. Purpose: To know the relation between nurse work stress and documentation completeness of emergency nursing process in RSUD Panembahan Senopati Bantul. Research method: This research applies descriptive explorative observational method with cross-sectional planning. Research subject were nurses who work in Emergency Room (ER), Intensive of Care Unit (ICU), and operation room (IBS) whom taken with surfeited sampling technique. Result: Relation test between nurse work stress and documentation completeness of emergency nursing process conducted using Chi square test (X2) resulting 7,739 as X2 value with p-value 0,021, and contingency coefficient value is 0,426. The p value is smaller than 0,05 (alpha value) so that Ho refused and Ha is accepted, this means that there is significant relationship between nurse work stress and documentation completeness of emergency nursing process in RSUD Panembahan Senopati Bantul with medium relationship. Conclusion: There is significant relationship between nurse work stress with documentation completeness of emergency nursing process in RSUD Panembahan Senopati Bantu! with medium relationship. Keyword,' Nurses Work Stress, Nursing Documentation Completeness, Emergency Nursing Process


Aim of the study is to develop a simulation software which allows to predict the diffusion‐controlled transformation processes during oxidation and nitridation of metals and alloys. Internal oxidation and nitridation often results in a deep penetration of coarse and sometimes needle‐shaped precipitates that act as crack initiation sites, i.e., giving rise to an embrittlement of the surface layer. The method of cellular automata according to Chopard and Droz has been applied to simulate internal nitridation processes. The approach allows implementing, e.g., the diffusion‐blocking effect of the internal precipitates, and the mechanisms of nucleation and growth. As an example, TiN formation in Ni‐base alloys was simulated by treating nitrogen diffusion and precipitation separately and simultaneously. The progress of internal nitridation follows a parabolic rate law in agreement with Wagner's theory of internal oxidation and experimental results. Furthermore, the cellular automata approach is capable to predict the transition from internal precipitation to external scale formation and to implement the process of nucleation and growth of nitride and oxide precipitates.


The current context derived from the Covid-19 pandemic has abruptly modified what we knew as "the education system" globally. If before education was located mainly in the classroom, today the hybrid modality makes educational dynamics more complex and must focus on the development of critical thinking skills to foster autonomy and problem-solving abilities in teachers and students. Educators more than ever need to prepare students to work and thrive in an unknown future scenario. Professionals in the future will need to lead sustainable innovation by considering the long-term implications of their design solutions in every field. This workshop is an introduction to the Compass® methodology developed by The Index Project®. The Compass is a flexible frame of action to organize, structure, and manage problem-solving processes. The difference between this method and other design thinking models is its focus on maintaining coherence between form, impact, and context in every phase of the design process to evaluate solutions holistically and sustainably to improve people's lives.


This paper examines how much the volatility of sovereign bond markets in emerging Latin American countries is influenced by the volatility shocks to global and regional markets. After estimating the Generalised AutoRegressive Conditional Heteroscedasticity (GARCH)-based conditional volatility for sample markets, we measure the parts of sovereign bond market volatility that are attributable to the global and regional factors within the dynamic framework of a Structural Vector Autoregressive (SVAR) model. We find significant and persistent volatility spillovers from the global and regional factors to sovereign bond markets, with a dominant effect issued by the global sovereign bond market. We also find evidence that the global and regional markets are, on average, responsible for more than 45% of the variance of volatility changes in three of the five selected emerging countries over a 12-week forecast horizon.


Purpose
Hope and death anxiety as the important sources of adjustment can affect the attitude, health status and quality of life in patients undergoing hemodialysis. Hopelessness and death anxiety are considered as the important factors in patients undergoing hemodialysis, because these can avoid non-adherence and increase mortality rate. This study aims to investigate the effect of the cognitive–behavioral intervention on hope and death anxiety in patients undergoing hemodialysis.

Design/methodology/approach
In this randomized controlled clinical trial, 84 patients undergoing hemodialysis were included, who were then divided into two groups as the cognitive–behavioral intervention group (n = 42) and the control group (n = 42). The experimental group received eight sessions of individual chair-side cognitive–behavioral intervention. To measure the hope level and death anxiety, Hearth Hope Scale and Templer's Death Anxiety Scale were used as tools once at the beginning and once at the end of the study.

Findings
The mean scores of the hope levels in the intervention group significantly improved compared to the control group. Furthermore, the mean scores of the death anxiety levels significantly decreased in the intervention group compared to the control group.

Originality/value
Cognitive–behavioral interventions are significantly effective on promoting the level of hope and decreasing the level of death anxiety in patients undergoing hemodialysis. Therefore, applying this psychological intervention to design the individual education programs is recommended.


The profile, apparent contact angle (ACA), contact angle hysteresis (CAH), and wetting state transmission energy barrier (WSTEB) are important static and dynamic properties of a large-volume droplet on the hierarchical surface. Understanding them can provide us with important insights into functional surfaces and promote the application in corresponding areas. In this paper, we establish three theoretical models (models 1-3) and the corresponding numerical methods, which were obtained by the free energy minimization and the nonlinear optimization algorithm, to predict the profile, ACA, CAH, and WSTEB of a large-volume droplet on the horizontal regular dual-rough surface. In consideration of the gravity, the energy barrier on the contact circle, the dual heterogeneous structures and their roughness on the surface, the models are more universal and accurate than the previous models. It showed that the predictions of the models were in good agreement with the results from the experiment or literature. The models are promising to become novel design approaches of functional surfaces, which are frequently applied in microfluidic chips, water self-catchment system, and dropwise condensation heat transfer system.


Campbell et al. present a well-designed study that reflects the population we treat. The wide range of variables (encompassing other cardiac conditions, comorbidities, tobacco usage and use of various medications) is thoroughly analysed. However, the study seems oblivious to the major hurdle to adequate blood pressure control in patients with hypertension not adequately treated pharmacologically. The elephant in the room is compliance (and lack thereof). In our experience of the treatment of a range of such patients, poor compliance is the most prevalent reason for inadequate blood pressure control. This is equally true of public and private patients. It occurs just as frequently in cardiology clinics as it can in internal medicine or geriatrics. It is pervasive regardless of all other factors, including how many classes of medications prescribed, the geographical location and the socioeconomic status of patients. Compliance with antihypertensive medications is a common problem in our community and has significant costs. Needless to say, inadequate blood pressure control is strongly linked to concurrent or future cardiovascular and/or cerebrovascular disease. In fact, compliance affects every specialty in the treatment of any chronic condition one can think of. It has been estimated that up to 75% of patients are not taking medications as prescribed. The underlying reasons are many and varied; what a medical practitioner does next is not straightforward. It seems the only thing harder than measuring compliance is improving it. While we are not disputing the findings of this study, we remain mindful that any study in this domain will be significantly distorted by compliance issues. Accounting for this factor adequately is difficult. However, omitting it altogether is ignoring the proverbial elephant.


Intrinsically disordered protein regions (IDRs) pervasively engage in essential molecular functions, yet they are often poorly conserved as assessed by sequence alignment. To understand the seeming paradox of how sequence variability is compatible with function, we examined the functional determinants for a poorly conserved but essential IDR. We show that IDR function depends on two distinct but related properties: sequence- and chemical specificity. While sequence-specificity works via linear binding motifs, chemical-specificity reflects the sequence-encoded chemistry of multivalent interactions through amino acids across an IDR. Unexpectedly, an apparently essential binding motif can be removed if compensatory changes to the sequence chemistry are made, highlighting the orthogonality and interoperability of both properties. Our results provide a general framework to understand the functional constraints on IDR sequence evolution. One-Sentence Summary Interactions driven by intrinsically disordered regions can be understood using a two-dimensional landscape that defines binding via motif-dependent and motif-independent contributions.


The Authors, for testing the opiate receptors role in human PRL secretion, performed the following experiment: they administered: 1) to 24 women during day 2 and 4 of the puerperium, divided into 3 groups of 8 subjects, respectively 5, 10, 20 mg naloxone. 2) to 16 women during day 3 and 4 of the puerperium, divided into 2 groups of 8 subjects, during mechanical breast stimulation with a breast pump (10 min for each breast), respectively 5, 10 mg naloxone. 3) to 12 women in physiological menopause, in basal condition and after administration of oestradiol 17-n-valerate 4 mg/die over ten days, 10 mg naloxone. 4) to 7 women in physiological menopause, in basal condition and after administration of ethinyl-oestradiol 50 micrograms/die over ten days, 5 mg morphine hydrochloride. They observed that naloxone is not able to reduce either basal PRL secretion in menopausal women, or puerperal hyperprolactinemia, or PRL release induced by mechanical breast stimulation. On the contrary, an exogenous opiate administration produced a PRL significant increase (P less than 0.01) and such increase has been affected in a statistically significant way (P less than 0.05) by the oestrogen rate.


PurposeThe aim of the study was to assess the efficacy and safety of pentadafil taken before sexual activity in young Egyptian male patients with erectile dysfunction. Patients and methodsSixty-six patients with erectile dysfunction were included in a randomized, double-blinded, placebo-controlled, multicenter study. They received a dose of 20 mg of pentadafil (or corresponding placebo) in a double-blinded manner. Changes in the International Index of Erectile Function score, sexual encounter profile, and responses to Global Assessment Questionnaire, which allow patients to record changes in their erectile function, were evaluated at baseline and after 12 weeks at the end of the study. ResultsThe mean change in the International Index of Erectile Function score from baseline was higher in the pentadafil arm compared with the placebo arm. Successful penile penetration, maintenance of erection for intercourse completion, satisfaction with erection, and overall satisfaction with sexual experience were higher in the pentadafil arm compared with the placebo arm. Also, improvements in erections and in the ability to have sexual intercourse were higher in the pentadafil arm compared with the placebo arm. ConclusionPentadafil is an effective and safe medication for treatment of erectile dysfunction.


Infants consume most of their calories as formula. Because of this large fluid intake, infants normally produce dilute urine, not far off from that seen in individuals with diabetes insipidus (DI). Infants with DI are therefore prone to water intoxication if fixed antidiuresis is achieved using the long-acting vasopressin analog desmopressin (DDAVP), which induces a state of high urine concentration. DI treatment approaches applied to older children and adults, who consume the their calories as solids, are difficult to apply to infants with DI. When used in infants, oral and intranasal DDAVP can be associated with wide swings in serum sodium concentration (SNA). In comparison, precisely administered subcutaneous doses of DDAVP can be successfully used in infants with DI, and appear to be superior to oral or intranasal DDAVP therapy. Alternatively, consistent eunatremia can be simply achieved in infantile DI using low renal solute load (RSL) formula and thiazide diuretics. Low RSL formula reduces obligatory urinary water losses, and thiazide diuretics concentrate the urine to levels seen in normal formula-fed infants. This report addresses treatment options of DI in infancy and the delicate management issues involved.


Most, if not all, public hospitals in Thailand have encountered a common problem regarding the increasing demand for medical services. The increasing number of patients causes so much strain on the hospital's services, over-crowded, overloaded working hours, staff fatigue, medical error and long waiting time. This research studied the characteristics of operational processes of the medical care services at the medicine department in a large public university hospital. The research focuses on details regarding methods, procedures, processes, resources, and time management in overall processes. The simulation model is used as a tool to analyze the impact of various improvement strategies. Keywords—Patient Flow, Medicine Department, Simulation, Outpatient Department.


The Interlanguage Speech Intelligibility Benefit (ISIB) hypothesis for Talkers suggests that there is a potential benefit when listening to one's second language when it is produced in the accent of one's first language (matched-accent processing). This study explores ISIB, considering listener proficiency. According to second language learning theories, the listener's second language proficiency determines the extent to which they rely on their first language phonetics, hence the magnitude of ISIB may be affected by listener proficiency. The accuracy and reaction times of Bulgarian-English bilinguals living in the UK were recorded in a lexical decision task. The English stimuli were produced by native English speakers and Bulgarian-English bilinguals. Listeners responded more slowly and less accurately to the matched-accent stimuli than the native English stimuli. In addition, they adapted their reaction times faster to new speakers with a native English accent compared to a Bulgarian accent. However, the listeners with the lowest English proficiency had no advantage in reaction times and accuracy for either accent. The results offer mixed support for ISIB for Talkers, and are consistent with second language learning theories according to which listeners rely less on their native language phonology when their proficiency in the second language has increased.


Recent advances in deep neural networks (DNNs) lead to tremendously growing network parameters, making the deployments of DNNs on platforms with limited resources extremely difficult. Therefore, various pruning methods have been developed to compress the deep network architectures and accelerate the inference process. Most of the existing channel pruning methods discard the less important filters according to well-designed filter ranking criteria. However, due to the limited interpretability of deep learning models, designing an appropriate ranking criterion to distinguish redundant filters is difficult. To address such a challenging issue, we propose a new technique of Channel Pruning via Optimal Transport, dubbed CPOT. Specifically, we locate the Wasserstein barycenter for channels of each layer in the deep models, which is the mean of a set of probability distributions under the optimal transport metric. Then, we prune the redundant information located by Wasserstein barycenters. At last, we empirically demonstrate that, for classification tasks, CPOT outperforms the state-of-the-art methods on pruning ResNet-20, ResNet-32, ResNet-56, and ResNet-110. Furthermore, we show that the proposed CPOT technique is good at compressing the StarGAN models by pruning in the more difficult case of image-to-image translation tasks.


In recent years the focus of powertrain control has shifted perspective from control of the individual powertrain components to control of the complete powertrain, so-called integrated powertrain control. The idea presented in this thesis is to view the powertrain as one single control object and to used the engine as a torque actuator to the rest of the driveline. The investigated powertrain consists of a diesel engine with a variable geometry turbocharger, an automated manual transmission, exible driveshafts and wheels and chassis to make the vehicle complete. The vehicle in focus is a heavy duty truck. The power a diesel engine can generate is limited by the amount of fuel that can be burnt effciently. The combustion effciency is determined mainly by the amount of air that is available for combustion. An insufficientient amount of air results in in- creased particulate emissions and visible smoke, while a surplus of air results in NOx emissions. This means that active engine control not only deals with manipulation of the engine speed or the engine torque but also includes efficient control of the engine itself. The idea of integrated powertrain control is to use the engine as an active part of the control system. A turbocharged diesel engine is a complex and dierent actuator compared to other actuators used in control systems. The working region is limited, the outcome from the actuator (torque) is uncertain, the capacity varies with operating point and the performance is directional dependent. Several dierent solutions to the problem of controlling the air-to-fuel ratio for a turbocharged diesel engine are proposed. The solutions are nonlinear model-based control laws, designed using stability analysis by means of Lyapunov functions. Two applications are also studied; driveline oscillations and gearshifting in an auto- mated manual transmission. In both cases engine control becomes an essential part of the solution. The engine is used actively in order to remove oscillations in the driveline and to perform fast and smooth gearshifts. The resulting solutions are obtained by combining engine speed/torque and air-to-fuel ratio control.


Proceedings: AACR Annual Meeting 2014; April 5-9, 2014; San Diego, CA

Metastasis is the final step leading to patient death in most solid tumors, including head and neck squamous cell carcinoma (HNSCC). For metastasis to proceed, tumor cells must become mobile and invasive, losing their communal behavior. A goal of our work is to delineate the downstream effectors of growth factor signaling pathways that contribute to invasion. Using a phosphotyrosine proteomics screen we previously identified neural precursor cell expressed, developmentally down-regulated 9 (NEDD9; CasL) as a mediator of VEGF and IGF-1 signaling to invasion in HNSCC cells. NEDD9 tyrosine phosphorylation led to matrix metalloproteinase9 (MMP9) expression and secretion, invadopodia formation and enhanced invasion. To determine the molecular details of NEDD9 protein:protein interactions leading to invasion, we have generated a series of NEDD9 substrate domain tyrosine (Y to F, YXXP) and SH3 domain mutants. Mutation of all 13 YXXP motifs to FXXP blocked NEDD9 tyrosine phosphorylation, MMP9 expression and invadopodia formation. Of note, we found that NEDD9 co-immunoprecipitated with Molecule Interacting with CasL 1 (MICAL1). To further define this interaction and its downstream impact, stable NEDD9 or MICAL1 silenced HNSCC cell lines expressing select shRNAs were generated, with each exhibiting reduced migration and invasion. MICAL shRNA transfected cell lines also exhibited decreased MMP9 secretion, consistent with our findings that lack of MICAL1 decreases cell invasion and with findings of other labs that MICALs interact with Rab proteins altering intracellular trafficking. Further, we have verified that MICAL1 and NEDD9 form complexes in cells based on coimmunoprecipitation analyses. Better understanding of this pathway will undoubtedly lead to the identification of novel therapeutics for the prevention of invasion and metastasis. Supported by NIH R01CA134845 (SAR), P30 CA138313 and NIH/NCRR UL1 TR000062/TL1 TR000061 from the South Carolina Clinical & Translational Research Institute (COH).

Citation Format: Casey O. Holmes, Amanda M. Brock, Philip T. Sobash, Jessica A. Tiedeken, Steven A. Rosenzweig. Role of MICAL1 in NEDD9 invasive signaling. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 4995. doi:10.1158/1538-7445.AM2014-4995


Embedded systems typically do not have enough on-chip memory for entire an image buffer. Programming systems like OpenCV operate on entire image frames at each step, making them use excessive memory bandwidth and power. In contrast, the paradigm used by OpenVX is much more efficient; it uses image tiling, and the compilation system is allowed to analyze and optimize the operation sequence, specified as a compute graph, before doing any pixel processing. In this work, we are building a compilation system for OpenVX that can analyze and optimize the compute graph to take advantage of parallel resources in many-core systems or FPGAs. Using a database of prewritten OpenVX kernels, it automatically adjusts the image tile size as well as using kernel duplication and coalescing to meet a defined area (resource) target, or to meet a specified throughput target. This allows a single compute graph to target implementations with a wide range of performance needs or capabilities, e.g. from handheld to datacenter, that use minimal resources and power to reach the performance target.


Residents' subjective well-being is closely related to their perception of specific attributes of the city they live in, such as physical appearance, entertainment facilities, and job opportunities. This study aims to examine the effect of place image on residents' subjective well-being as well as the mediation effect of place attachment on this relationship. Residents living in Guangzhou for more than a year were targeted to collect data, and 420 valid samples were gathered. Structure equation modeling was used to test the hypothesized relationships. The results show that place image has a significant positive impact on life satisfaction and positive affect, while it has a significant negative impact on negative affect. Place identity and place dependence mediate the positive impacts of place image on life satisfaction and positive affect. Finally, management implications and limitations were discussed.


Objective: Registration of ultrasound to computed tomography (CT) images is used in several image-guided procedures, including laparoscopic surgery and radiation therapy. Conventional approaches use an external tracker calibrated to the ultrasound transducer and CT system, but several calibration steps are required. Registration can also be performed by aligning image features between modalities, but differences in feature depiction make matching difficult and initial approximate alignment is often needed. Registration using fiducials is a simpler approach but is limited by the need to implant fiducials in the anatomical region of interest so they are visible to both ultrasound and CT. This paper investigates the feasibility of using fiducials near the skin surface, and whether such fiducials can be sufficiently localized in the very near field of a 3D ultrasound transducer without significantly degrading image quality. This approach can also be used as an initialization step for feature-based registration techniques. Materials and Methods: A stand-off pad containing fiducials (n > 3) was constructed using polyvinyl chloride and steel ball fiducials that are visible in both 3D ultrasound and CT images. Experiments on phantoms were performed to assess image quality and registration errors. Controlled variables included pad thickness and ultrasound imaging parameters. Initial tests were also conducted of a potential application in partial nephrectomy surgery. Results: Image quality was degraded by an average of 6-11-13% (elevational-axial-lateral) in resolution of point targets and 5% in lesion contrast. Average fiducial localization error was 1.34 mm (axial) to 2.38 mm (lateral and elevational); average fiducial registration error (FRE) was 0.46 mm (axial), 1.08 mm (lateral) and 0.90 mm (elevational); and average total registration error (TRE) was 1.84 mm (axial), 0.89 mm (lateral) and 3.31 mm (elevational). Clinical results showed a similar FRE to that in the phantom study, but with an average TRE of 14.04 mm (over three patients). Ultimate alignment of the organ boundaries was affected mainly by motion from respiration. Conclusions: The small loss of image quality from the fiducial stand-off pad and the minimal inconvenience of using the pad at the time of the CT scan may be a worthwhile trade-off for purposes of registration since the pad provides a registration accuracy of several millimeters while still allowing subsequent feature-based registration. Future research will focus on using the registration from the fiducial stand-off pad for deformable feature-based registration of 3D ultrasound to CT for tumor localization in renal surgery.


Physical activity, sedentary behavior, and sleep are important predictors of children's health. This paper aimed to investigate socioeconomic disparities in physical activity, sedentary behavior, and sleep across the WHO European region. This cross‐sectional study used data on 124,700 children aged 6 to 9 years from 24 countries participating in the WHO European Childhood Obesity Surveillance Initiative between 2015 and 2017. Socioeconomic status (SES) was measured through parental education, parental employment status, and family perceived wealth. Overall, results showed different patterns in socioeconomic disparities in children's movement behaviors across countries. In general, high SES children were more likely to use motorized transportation. Low SES children were less likely to participate in sports clubs and more likely to have more than 2 h/day of screen time. Children with low parental education had a 2.24 [95% CI 1.94–2.58] times higher risk of practising sports for less than 2 h/week. In the pooled analysis, SES was not significantly related to active play. The relationship between SES and sleep varied by the SES indicator used. Importantly, results showed that low SES is not always associated with a higher prevalence of "less healthy" behaviors. There is a great diversity in SES patterns across countries which supports the need for country‐specific, targeted public health interventions.


Conclusion This Note proposes a method of path planning for space manipulators that reduces disturbances to the spacecraft attitude. The proposed method uses the EDM for planning the manipulator path in the joint space. The method sequentially determines the direction of small steps of joint movements that compromises the biobjectives of minimizing the disturbance to the spacecraft attitude and realizing the terminal end effector position. Numerical simulations have been made for a space robot with a two-link manipulator. The results of the simulations show the feasibility of the present path planning algorithm.


The design and reconfiguration of Material Handling Systems (MHS) at the factory scale is known to be complex. Various data and analyses are required to define the internal logistics needs the MHS must fulfill. In the literature, the identification of the MHS' needs is performed through Material Flow Analysis (MFA). The MFA is expressed through charts and diagrams which are manually developed. The manual development of charts and diagrams leads to gathering data in a disseminated way. Additionally, MFA is differently addressed in the literature; each work analyzes a different and restrained set of data. In this paper, we aim to generalize MFA by proposing a Reference Data Model (RDM) using UML (Unified Modeling Language) class diagrams. It allows the listing and structuring of all the data required for the MFA. The RDM can be used to conduct a data-driven MFA which enables data integrity and the reduction of the development time of charts and diagrams. A proof of concept is also given to show the ability to simultaneously generate charts and diagrams while ensuring data integrity.


Monotargeting anticancer agents suffer from resistance and target nonspecificity concerns, which can be tackled with a multitargeting approach. The combined treatment with HDAC inhibitors and PPARγ agonists has displayed potential antitumor effects. Based on these observations, this work involves design and synthesis of molecules that can simultaneously target PPARγ and HDAC. Several out of 25 compounds inhibited HDAC4, and six compounds acted as dual-targeting agents. Compound 7i was the most potent, with activity toward PPARγ EC50 = 0.245 μM and HDAC4 IC50 = 1.1 μM. Additionally, compounds 7c and 7i were cytotoxic to CCRF-CEM cells (CC50 = 2.8 and 9.6 μM, respectively), induced apoptosis, and caused DNA fragmentation. Furthermore, compound 7c modulated the expression of c-Myc, cleaved caspase-3, and caused in vivo tumor regression in CCRF-CEM tumor xenografts. Thus, this study provides a basis for the rational design of dual/multitargeting agents that could be developed further as anticancer therapeutics.


Today's traffic environment is not well adapted to the needs of the older pedestrian. Unfortunately, except in the case of children, little is known about the characteristics and behavior of pedestrians. Although the simple fact that older pedestrians walk more slowly than younger ones is easily supported by field data, existing data on walking speeds and start-up time (i.e., the time from the onset of a Walk signal until the pedestrian steps off the curb) have many shortcomings. A series of field studies was conducted to quantify the walking speed and start-up time of pedestrians of various ages under different conditions. Sixteen crosswalks in four urban areas were studied. Data were collected on walking speeds and start-up times relative to site and environmental factors, including street width, posted speed, curb height, grade, number of vehicle travel lanes, signal cycle length, pedestrian-signal type, street functional classification, crosswalk type, and channelization. Data on a subject group of pedestrians who appeared to be 65 years of age or older and a control group of pedestrians under age 65 were collected. Results indicate a broad range of walking speeds among pedestrians. The 15th-percentile walking speed for younger pedestrians (ages 14 to 64) was 1.25 m/sec (4.09 ft/sec); for older pedestrians (ages 65 and over) it was 0.97 m/sec (3.19 ft/sec). For design purposes values of 1.22 m/sec (4 ft/sec) for younger pedestrians and 0.91 m/sec (3 ft/sec) for older pedestrians are appropriate. Results also indicated that walking rates are influenced by a variety of factors, including the functional classification and vehicle volumes on the street being crossed, the street width, weather conditions, the number of pedestrians crossing in a group, the signal cycle length, the timing of the various pedestrian-signal phases, whether right turn on red is allowed, pedestrian signals, medians, curb cuts, crosswalk markings, stop lines, and on-street parking. However, for each of these factors, the effect on crossing speeds, although statistically significant, is not meaningful for design.


Atherosclerosis extraordinarily like the chronic human disease was reported as a consequence of Marek's disease herpesvirus (MDV) infection in specific pathogen-free (SPF) chickens. This arterial disease was induced not only in hypercholesterolemic but also in normocholesterolemic chickens by infection with MDV. Neither uninfected hypercholesterolemic nor normocholesterolemic SPF chickens developed this arterial disease. Repeated experiments have demonstrated that these results are reproducible. Grossly visible and microscopic atherosclerotic lesions were found in aortas, as well as coronary, brachiocephalic, celiac, gastric, and mesenteric arteries. Microscopic lesions were characterized by fibromuscular intimal thickening with fibrous caps overlying atheromatous change. Results of a pathogenesis experiment indicated that the earliest microscopic and gross arterial lesions occurred respectively at 1 and 3 mo post-MDV-infection. An additional important link established between infection and arterial lesions was the finding of specific MDV internal antigens in smooth muscle cells (SMC) of some medial layers of all arterial segments examined throughout the time span of lesion development (7 mo). Furthermore, lipid accumulations in arterial lesions of normocholesterolemic infected chickens and in cultured (chicken) arterial SMC suggest that a major mechanism in MDV atherosclerosis may be viral-induced alteration of cellular lipid metabolism. The distribution and morphologic character of MDV-atherosclerotic lesions closely resemble the chronic human arterial disease. Because humans are known to be widely and persistently infected with as many as five herpesviruses, these results may be particularly relevant to human atherosclerosis. Furthermore, since diabetes is an identified high risk factor of atherosclerosis, these findings may also be important in diabetes.


Evaluation of NHL goalies is often done by comparing their save percentage. These save percentages depend highly upon the defense in front of each goalie and the difficulty of shots that each goalie faces. In this paper we introduce a new methodology for evaluating NHL goalies that does not depend upon the distribution of shots that any individual goalie faced. To achieve this new metric we create smoothed nonlinear spatial maps of goalie performance based upon the shots they did face and then evaluate these goalies on the league average distribution of shots. These maps show the probability of a goalie giving up a goal from across the playing surface. We derive a general mathematical framework for the evaluation of a goalie"s save percentage. Using data from the 2009-10 NHL regular season, we apply this new methodology and calculate our new defense independent goalie rating (DIGR) for each goalie that face more than 600 shots. Results of this evaluation are given and possible extensions of the methodology are discussed.


SUMMARY: Thin sections of Staphylococcus aureus were examined in the electron microscope, before and after treatments which released part of their cell-bound penicillinase. In all cases, such treatment resulted in alteration of the mesosome structure: the mesosome was replaced by a series of pockets or invaginations in the cytoplasmic membrane. The converse situation was not always true; cocci treated in such a way as to alter the mesosome structure did not necessarily release penicillinase. This leads to the conclusion that structural alteration of the mesosome is only one of a number of steps in the release of penicillinase.


Gradual emerging patterns (GEPs) are gradual item sets that occur less frequently in one data set and more frequently in another. For instance, let 'fan speed' and 'temperature' be attributes of two numerical data sets. A gradual item set "the higher the speed, the lower the temperature" (which correlates a data set's attributes) becomes a GEP if it is less frequent (in terms of support as in frequent pattern mining) in one data set and more frequent in another. However, such patterns do not indicate how time gap impacts the emergence. Many correlations appear over time, for instance when phenomena appear after some meteorological situation due to latency. Previous works have not taken this temporal aspect into account. In this paper, we introduce temporal gradual emerging patterns (TGEPs) which are temporal gradual patterns (TGPs) whose frequency supports increase significantly between transformed data sets. For instance, a TGP "the higher the speed, the lower the temperature, almost 3 minutes later" becomes a TGEP if it occurs more frequently in one transformed data set than in another. Furthermore, we extend border manipulation to the case of mining TGEPs. In addition, we propose a more efficient ant colony optimization technique that exploits a heuristic approach to construct TGEPs.


Results of the experimental investigation of the influence of surface forces on high gradient magnetic separation of iron ores will be presented. Surface characteristics of the slurries of pure hematite and hematite ores ground below 100 μm and 40 μm were varied from pH = 1.5 to 11 and these test samples were treated in high gradient magnetic separator at magnetic fields from 0.1 T to 0.7 T. The experimental data indicate that the maximum of grade and recovery of magnetic fraction of the ore can be obtained at pH corresponding to the point of zero charge, while at other pH the grade and recovery decrease. Since pH of point of zero charge for iron oxide is different from pH corresponding to water used in iron dressing plant, adjustment of pH of the slurry could lead to a substantial increase in grade and recovery. These considerable variations of grade and recovery can be attributed to a higher probability of retention of the particles on the matrix, higher resistance of the deposited particles against the shear stress and to selective magnetic and ionic flocculation of magnetic or gangue particlec.


Thermal environmental stress can anticipate acute fatigue during exercise at a fixed intensity (%VO2max). Controversy exists about whether this anticipation is caused by the absolute internal temperature (Tint, degrees C), by the heat storage rate (HSR, cal/min) or by both mechanisms. The aim of the present study was to study acute fatigue (total exercise time, TET) during thermal stress by determining Tint and HSR from abdominal temperature. Thermal environmental stress was controlled in an environmental chamber and determined as wet bulb globe temperature ( degrees C), with three environmental temperatures being studied: cold (18 degrees C), thermoneutral (23.1 degrees C) or hot (29.4 degrees C). Six untrained male Wistar rats weighing 260-360 g were used. The animals were submitted to exercise at the same time of day in the three environments and at two treadmill velocities (21 and 24 m/min) until exhaustion. After implantation of a temperature sensor and treadmill adaptation, the animals were submitted to a Latin square experimental design using a 2 x 3 factorial scheme (velocity and environment), with the level of significance set at P<0.05. The results showed that the higher the velocity and the ambient temperature, the lower was the TET, with these two factors being independent. This result indicated that fatigue was independently affected by both the increase in exercise intensity and the thermal environmental stress. Fatigue developed at different Tint and HSR showed the best inverse relationship with TET. We conclude that HSR was the main anticipating factor of fatigue.


A novel single-carrier-based space-time code construction scheme to exploit the advantages of a frequency-selective fading channel is investigated in this paper. The proposed construction scheme is based on multiplexing independent streams of phase-rotated space-time codes in a time-interleaved fashion. The advantage of such design is that it guarantees full space-time-multipath diversity by using traditional space-time codes or MIMO signaling schemes originally designed for flat fading channels as the constituent codes. Another advantage is that this approach incurs no loss in bandwidth efficiency and it alleviates the problem of high PAPR in OFDM-based space-time codes. By employing random or algebraic rotations, the design is potentially suitable for any number of transmit antennas or multipaths. The simulation results indicate that full space-time-multipath diversity is attained using this new approach, and comparisons with some existing space-time codes designed for frequency-selective channels are made to show its performance advantage.


Recently, fluorescent dyes with a structure-inherent mitochondria-targeting capability have obtained great attention as single-molecule self-reporting theranostic agents to distinguish cancer cells from normal cells. However, there was little attempt using these dyes as a self-reporting ligand for cancer-targeted delivery of nanomaterials or drugs for personalized therapy. Herein, we developed a mitochondria-localized multifunctional nanodelivery system for cancer-targeted drug delivery and dual-modal imaging. First, a series of cyanine-structural small molecules with different-charged substituent groups have been screened based on their mitochondria targeting capability. Furthermore, the cyanine-structural molecule with the best mitochondria-targeting ability was decorated on iron oxide nanoparticles (IONP) for dual-modal imaging. The nanoprobes entered into the cancer cell via the organic anion transporting polypeptide (OATP) pathway and anchored on mitochondria due to the strong interaction between the negative mitochondria membrane and the lipophilic cationic cyanine dye. This work opened an avenue using small molecules with structure-inherent-targeting and self-reporting characteristics as a chemical ligand to develop cancer-targeting and subcellular-localized delivery system.


Introduction Several institutions and quality national agencies have fostered the creation of recommendations on what not to do to reduce overuse in clinical practice. In primary care, their impact has hardly been studied. The frequency of adverse events (AEs) associated with doing what must not be done has not been analysed, either. The aim of this study is to measure the frequency of overuse and AEs associated with doing what must not be done (commission errors) in primary care and their cost. Methods and analysis A coordinated, multicentric, national project. A retrospective cohort study using computerised databases of primary care medical records from national agencies and regional health services will be conducted to analyse the frequency of the overuse due to ignore the do-not-do recommendations, and immediately afterwards, depending on their frequency, a representative random sample of medical records will be reviewed with algorithms (triggers) that determine the frequency of AEs associated with these recommendations. Cost will determine by summation of the direct costs due to the consultation, pharmacy, laboratory and imaging activities according to the cases. Ethics and dissemination The study protocol has been approved by the Ethics Committee of Primary Care Research of the Valencian Community. We aim to disseminate the findings through international peer-reviewed journals and on the website (http://www.nohacer.es/). Outcomes will be used to incorporate algorithms into the electronic history to assist in making clinical decisions. Trial registration number NCT03482232; Pre-results.


It is a fact we are all too well aware of. The world, as we know it, continues to grow fat. The popular press has done an excellent job of educating the lay person about the link between obesity and heart disease, hypertension, etc. However, despite scientific evidence to the contrary, the effect of obesity on the kidneys' function is less well-known. Kidney disease from obesity can progress to End Stage Renal Disease (ESRD), which mandates the use of dialysis to keep the patient alive. It is hence a huge risk factor for morbidity and mortality. Last, but not the least, it puts a tremendous economic and social strain on the healthcare resources of nations around the world.


The aim of this report is to present the treatment of a 14-year-old boy with scissors-bite. Mandibular symphyseal distraction osteogenesis (MSDO) with tooth-supported distractor was performed to expand the mandible, and intermaxillary cross elastics were used. The mandible was expanded approximately 9 mm. Asymmetric widening was done by using cross elastics and MSDO simultaneously. The buccal crossbite was corrected successfully. After a 2-year observation period, widening of the mandible using this procedure was judged to be stable. (Korean J Orthod 2011;41(1):59-69)


The use of upholstery elements from flexible molded PU-foam is part of modern automotive constructions. In Europe too, hot cure moldings are more and more replaced by HR-foam. Practically all European manufacturers take profit of the advantages given by the high pressure mixing principle like loss free injection and exact metering of all components. Together with the large scale introduction of full foam seats the tool construction has proved to be a key factor for profitable production. Based on these processing elements Bayer has developed Bayfit-systems and the know how for the production of seats and backs with defined areas of different hardness. These "dual hardness foams" fulfill the demand of many car drivers for comfortable seats with improved lateral support. The economical processing of those cushions and their advanced properties under special regard of the vibration/dampening, aging and fatigue behavior are the main theme of the paper.


The progression of social figuring on huge information investigation make simplicity of doing examination on different parts of information mining through web-based social networking. One viewpoint which can be investigated through social processing is online business. This exploration will concentrate on the relationship of shopper impression of administrations given by web based business Lazada and Tokopedia in Indonesia. The research data obtained by crawling data on social media such as Facebook and Twitter. Social computing analysis method is use for Text Network Analysis. With Text Network Analysis, we can see the prevailing words are framing the systems and the affiliation words. It shapes the shopper's impression of services which given by internet business. The advantages of this investigation is the utilization of social computing in analyzing the e commerce customer for increasing the image of ecommerce by the customer perception in social media.


Through the operation of a molecular beam epitaxy (MBE) machine, I worked on developing the homoepitaxy
 of high quality InAs with a (111)A crystallographic orientation. By tuning substrate temperature, we obtained
 a transition from a 2D island growth mode to step- ow growth. Optimized MBE parameters (substrate
 temperature = 500 °C, growth rate = 0.12 ML/s and V/III ratio ⩾ 40) lead to growth of extremely smooth
 InAs(111)A films, free from hillocks and other 3D surface imperfections. We see a correlation between InAs
 surface smoothness and optical quality, as measured by photoluminescence spectroscopy. This work establishes
 InAs(111)A as a platform for future research into other materials from the 6.1 Å family of semiconductors grown with a (111) orientation.
 Continuing this work, we also have determined a reproducible set of growth conditions for the self-assembly
 of tensile-strained In1-xGaxAs quantum dot nanostructures on InAs(111)A surfaces. During
 molecular beam epitaxy, In1-xGaxAs islands form spontaneously on InAs(111)A when the Ga
 content x ≥ 50 %. We analyze the structure and composition of InGaAs/InAs(111) samples using atomic force microscopy,
 transmission electron microscopy, electron energy loss spectroscopy, and photoluminescence spectroscopy. We demonstrate
 control over the size and areal density of the islands as a function of In1-xGaxAs coverage,
 In1-xGaxAs composition, and substrate temperature.
 Furthermore, we also present a study aimed to determining the growth conditions of In1-xGaxAs
 self-assembled tensile-strained QDs on GaSb(111)A surfaces. From previous work we determined that a larger band gap
 barrier was necessary to ensure the confinement of charge carriers in the InGaAs nanostructures. Through a series of
 temperature, V/III ratio, and growth rate we determined the best parameters for GaSb(111) homoepitaxy. We then studied
 the nucleation of optimal-morphology In1-xGaxAsQDs by locking the compositions at
 In0.5Ga0.5As, studying the critical pause for group V element transition and V/III ratio prior
 and post QD growth. Several photoluminescence techniques are employed to determine the light emission properties of these structures.
 Finally, we did preliminary studies on how to achieve the dynamic lateral confinement of charge carriers in 2D and
 3D using near-THz surface acoustic phonon pulses in polar semiconductors. Using the acousto-electrical effect, we measure
 the degree to which surface acoustic waves (SAWs) confine electrons and holes limiting the number of recombination
 processes. Applications for this technological development include the external modulation of lateral confinement size
 in the SAWs and subsequent photon emission wavelength, as well as potential quantum logical gate design using acoustic pulses to drive electrons in a circuit.


Efficiently solving large-scale sparse linear systems is important for robot mapping and navigation. Recently, the subgraph-preconditioned conjugate gradient method has been proposed to combine the advantages of two reigning paradigms, direct and iterative methods, to improve the efficiency of the solver. Yet the question of how to pick a good subgraph is still an open problem. In this paper, we propose a new metric to measure the quality of a spanning tree preconditioner based on support theory. We use this metric to develop an algorithm to find good subgraph preconditioners and apply them to solve the SLAM problem. The results show that although the proposed algorithm is not fast enough, the new metric is effective and resulting subgraph preconditioners significantly improve the efficiency of the state-of-the-art solver.


BACKGROUND
Periodontitis is a chronic, polymicrobial inflammatory disease that degrades connective tissue and alveolar bone and results in tooth loss. Oxidative stress has been linked to the onset of periodontal tissue breakdown and systemic inflammation, and the success of antiresorptive treatments will rely on how effectively they can ameliorate periodontal disease-induced oxidative stress during oral infection.

METHODS
Rats were infected with polybacterial inoculum consisting of Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia, as an oral lavage every other week for 12 weeks. Daily subcutaneous injections of enoxacin, bis-enoxacin, alendronate, or doxycycline were administered for 6 weeks after 6 weeks of polybacterial infection in rats. The serum levels of oxidative stress parameters and antioxidant enzymes, including glutathione peroxidase, superoxide dismutase, and catalase, were evaluated in each of the infected, treated, and sham-infected rats.

RESULTS
Rats infected with the periodontal pathogens displayed a five-fold increase in the oxidative stress index compared with controls as a result of increased levels of serum oxidants and decreases in total antioxidant activity. The overall decrease in antioxidant activity occurred despite increases in three important antioxidant enzymes, suggesting an imbalance between antioxidant macromolecules/small molecules production and antioxidant enzyme levels. Surprisingly, the bone-targeted antiresorptives bis-enoxacin and alendronate inhibited increases in oxidative stress caused by periodontitis. Bis-enoxacin, which has both antiresorptive and antibiotic activities, was more effective than alendronate, which acts only as an antiresorptive.

CONCLUSION
To the best of the authors' knowledge, this is the first study to demonstrate that the increased oxidative stress induced by periodontal infection in rats can be ameliorated by bone-targeted antiresorptives.


Prior research has proved that an individual could be addicted to the Internet in general, but no research has been done specifically to social networking sites such as Facebook. This study investigates how factors such as personality, gender, procrastination, boredom and ones values may affect the amount of time they spend on Facebook, further concluding that they are either overly obsessive or not about the usage thereof. Further, this study tests whether those same factors influence and individuals likelihood of facing Facebook withdrawal or Facebook devotion. Prior research was conducted using scholarly articles that focused on personality types and Internet addiction. A clear framework was designed prior to this study to outline the major factors that would be targeted through the study and compared against Facebook usage. The model is tested using a two-step approach of qualitative and quantitative methods. The qualitative pre-study was first designed as a way to highlight which factors and values were most important to our particular study. Since very little is known and discussed about Facebook Addiction, it was important for us to use the qualitative pre-study to get an overall understanding of what the general public thinks on this subject matter. Based on the results from the qualitative study, we developed a quantitative survey, which includes likert-style statements that test personality type, values, boredom and procrastination. Based on a sample of undergraduate students we can prove or disprove the theory on personality types directly affecting and individuals Facebook usage. Results most strongly depict that neuroticists, females and those who are procrastinating are more likely to be addicted to Facebook.


We present an approach to detect differences in lexical semantics across English language registers, using word embedding models from distributional semantics paradigm. Models trained on register-specific subcorpora of the BNC corpus are employed to compare lists of nearest associates for particular words and draw conclusions about their semantic shifts depending on register in which they are used. The models are evaluated on the task of register classification with the help of the deep inverse regression approach. Additionally, we present a demo web service featuring most of the described models and allowing to explore word meanings in different English registers and to detect register affiliation for arbitrary texts. The code for the service can be easily adapted to any set of underlying models.


This study analyzed the coverage of the coronavirus disease of 2019 (COVID-19) news by three prominent Bangladeshi dailies named The Daily Star, The Daily Kalerkantho, and The Daily Ittefaq. The research aimed to explore the attention cycle of the selected newspapers about this ongoing outbreak. It also identified the significant differences in framing and used sources in the news stories by respective daily newspapers. The study period was 10 weeks from February 1 to April 10, 2020, considering the Global Health Emergency declaration by the World Health Organization on January 30, 2020, and the announcement of the pandemic on March 11, 2020. This research applied the content analysis method on 761 news articles. The study shows that these three newspapers gave more attention after the pandemic announcement. This study also revealed that The Daily Star emphasized on attributing responsibility to the government and statistical data frames. On the other hand, The Daily Kalerkantho highlighted the individual's responsibility frame. The Daily Ittefaq concentrated on the economic consequence frame. Regarding the news sources, The Daily Star significantly used more sources from government officials. In contrast, The Daily Kalerkantho relied more on experts, and The Daily Ittefaq frequently used international sources. Due to time limitations, this study only covered the early stage of COVID-19 in Bangladesh. So more samples with a more extended period might clearly illustrate the focus of print media regarding this pandemic. Journalism and media studies students, academicians, and journalists will be most beneficiaries of this study. As appropriate framing helps to build awareness and in-depth knowledge of the community as well as policymakers, print media should pay more attention to proper framing.

Keywords: Bangladesh, COVID-19, newspaper coverage, news framing, news source, pandemic, print media.


Background : Several health behaviour theories propose that risk perception affects the likelihood of behaviour intentions and practice. The perception of risk to HIV and AIDS among female sex workers in Malawi has not been well described. Yet knowledge of how this most at risk population perceives contagion could help in informing the design, implementation and monitoring of interventions. Methods: A cross sectional, qualitative study was conducted among female sex workers in Blantyre, Malawi between 2013 and 2014. Snowballing technique was used to recruit study participants. In depth interviews were done by six trained female research assistants among 45 female sex workers. Data were analysed using thematic content analysis. Results: There were mixed perceptions of risk to HIV infection among the sampled sex workers. While some of the study participants perceived themselves as at higher risk of acquiring infection, some considered themselves to be at no higher risk than the general population. Some study participants suggested that married women in stable relationship were at higher risk of infection than the female sex workers. Prayer and belief in God were reported to be protective from HIV acquisition while predestination or mere talking about HIV was perceived to result in vulnerability to infection. In terms of overall knowledge about HIV, this was assessed as high. Several barriers to consistent condom use were reported: non-availability at all times, high cost and unacceptable instructions of the female condom, offers of higher pay for unprotected sex by male clients and harassment and forced unprotected sex by police. Conclusions: We have reported expression of dissonance, fatalism and predestination among female sex workers in semi-urban Malawi is responses to the threat of HIV. There is need to develop context-specific safer sex programs among female sex worker in Malawi.


A History of Memorial Day is a study of how Memorial Day was viewed by many Americans as a vehicle of both national and international unity. However, this study also examines the surprising amount of controversy elicited by the celebration of Memorial Day, finding that a substantial number of Americans value Memorial Day more as a holiday from work and an occasion for recreation and relaxation than as a time to honor the country's fallen heroes.


Background Blastomycosis is a potentially fatal fungal disease that most commonly affects humans and dogs. The organism causes systemic inflammation and has a predilection for the lungs. The inflammation might lead to a hypercoagulable state with microemboli in the pulmonary circulation which could contribute to inadequate oxygen exchange in infected dogs. Hypothesis/Objectives Dogs with blastomycosis will be hypercoagulable compared with healthy case‐matched controls. Animals Client‐owned dogs with a diagnosis of blastomycosis (n = 23) and healthy case‐matched controls (n = 23). Methods Prospective case‐controlled study of client‐owned dogs presented to a veterinary teaching hospital with clinical signs compatible with blastomycosis. Complete blood counts, fibrinogen, PT, aPTT, thromboelastometry (TE), thrombin antithrombin complexes (TAT), and thrombin generation were evaluated. Results Cases had a leukocytosis compared with controls [mean (SD) 16.6 (7.6) × 103/μL versus 8.2 (1.8) × 103/μL, P < .001], hyperfibrinogenemia [median 784 mg/dL, range 329–1,443 versus median 178 mg/dL, range 82–257, P < .001], and increased TAT concentrations [mean (SD) 9.0 (5.7) μg/L versus 2.0 (2.8) μg/L, P < .001]. As compared to controls, cases were also hypercoagulable as evaluated by thromboelastometry and had increased in vitro thrombin generation on calibrated automated thrombography. Conclusions and Clinical Importance Hypercoagulability occurs in dogs with systemic blastomycosis. Additional studies are needed to explore a possible contribution of thrombogenicity to the clinical manifestations of systemic blastomycosis.


Effects of coagulation/sedimentation as a pre-treatment on the dead-end ultrafiltration (UF) membrane process were studied in terms of membrane fouling and removal efficiency of natural dissolved organic matter, using Chitose River water. Two types of experiment were carried out. One was a bench scale membrane filtration with jar-test and the other was membrane filtration pilot plant combined with the Jet Mixed Separator (JMS) as a pre-coagulation/sedimentation unit. In the bench scale experiment, the effects of coagulant dosage, pH and membrane operating pressure on the membrane fouling and removal efficiency of natural dissolved organic matter were investigated. In the pilot plant experiment, we also investigated the effect of pre-coagulation/sedimentation on the membrane fouling and the removal efficiency of natural dissolved organic matter. Coagulation/sedimentation prior to membrane filtration process controlled the membrane fouling and increased the removal efficiency of natural dissolved organic matter.


Abstract. The design of coastal protection measures and the quantification of coastal
risks at locations affected by tropical cyclones (TCs) are often based solely
on the analysis of historical cyclone tracks. Due to data scarcity and the
random nature of TCs, the assumption that a hypothetical TC could hit a
neighboring area with equal likelihood to past events can potentially lead
to over- and/or underestimations of extremes and associated risks. The
simulation of numerous synthetic TC tracks based on (historical) data can
overcome this limitation. In this paper, a new method for the generation of
synthetic TC tracks is proposed. The method has been implemented in the highly
flexible open-source Tropical Cyclone Wind Statistical Estimation Tool
(TCWiSE). TCWiSE uses an empirical track model based on Markov chains and can
simulate thousands of synthetic TC tracks and wind fields in any oceanic basin
based on any (historical) data source. Moreover, the tool can be used to
determine the wind extremes, and the output can be used for the reliable
assessment of coastal hazards. Validation results for the Gulf of Mexico show
that TC patterns and extreme wind speeds are well reproduced by TCWiSE.


Conventional accelerator structures are manufactured using axial stacks of cylindrical components which, when brazed together, form the accelerator cell structure. Splitting the accelerator structure into two sections along the beam axis allows for a significant reduction in part count and vacuum joint length [1]. The resultant single and coplanar vacuum joint between the two split sections allows for joining techniques such as electron beam welding or brazing of the parts to form the accelerator vacuum envelope. High precision alignment of the two sections is achieved through an elastic averaging interface coupling where improved accuracy is derived from the averaging of errors over a large number of relatively compliant contacting members. The monoblock split sections allow for highly optimized cooling configurations with enhanced heat removal in high heat flux regions, reducing vacuum wall thermal stresses and enabling higher power operation. This paper describes the engineering and manufacturing of four generations of brazed and electron beam welded Xband accelerator structures at both 9.3 GHz and 11.4 GHz frequencies.


BACKGROUND
The purpose of this study was to identify the relationships between leg muscle power and sprinting speed with changes of direction.

METHODS

EXPERIMENTAL DESIGN
the study was designed to describe relationships between physical qualities and a component of sports performance.

SETTING
testing was conducted in an indoor sports hall and a biomechanics laboratory.

PARTICIPANTS
15 male participants were required to be free of injury and have recent experience competing in sports involving sprints with changes of direction.

MEASURES
subjects were timed in 8 m sprints in a straight line and with various changes of direction. They were also tested for bilateral and unilateral leg extensor muscle concentric power output by an isokinetic squat and reactive strength by a drop jump.

RESULTS
The correlations between concentric power and straight sprinting speed were non-significant whereas the relationships between reactive strength and straight speed were statistically significant. Correlations between muscle power and speed while changing direction were generally low and non-significant for concentric leg power with some moderate and significant (p<0.05) coefficients found for reactive strength. The participants who turned faster to one side tended to have a reactive strength dominance in the leg responsible for the push-off action.

CONCLUSIONS
The relationships between leg muscle power and change-of-direction speed were not consistent. Reactive strength as measured by the drop jump appears to have some importance for lateral change-of-direction speed, possibly because of similar push-off actions. It was concluded that reactive strength of the leg extensor muscles has some importance in change-of-direction performance but the other technical and perceptual factors than influence agility performance should also be considered.


Levodopa and other dopaminergic medications drastically improve the motor symptoms and quality of life of patients with Parkinson's disease in the early stages of the disease. However, once the "honeymoon" period has waned, usually after a few years of dopaminergic therapy, patients become progressively more disabled despite an ever more complex combination of available antiparkinsonian treatments. Sooner or later, they suffer from "dopa‐resistant" motor symptoms (speech impairment, abnormal posture, gait and balance problems), "dopa‐resistant" nonmotor signs (autonomic dysfunction, mood and cognitive impairment, sleep problems, pain) and/or drug‐related side effects (especially psychosis, motor fluctuations, and dyskinesias). Therefore, the current antiparkinsonian therapy cannot be considered as ideal with regard to both efficacy and safety. Ann Neurol 2003;53 (suppl 3):S3–S15


response. Characterization of T cell profiles is relevant to the improved understanding of chronic HBV infection and the design of antiviral therapy. The aim of the present study is to determine the absolute CD4 counts in different phases of CHB infection. METHODS: 106 hepatitis B patients were included in the study. All CHB patients fulfilled the following criteria: positive HBsAg for at least 6 months, no other concomitant causes of liver disease (hepatitis A, E and C, HIV infection and alcohol consumption of more than 60 g/day, autoimmune hepatitis and metabolic liver disease). None of the patients were drug user or exposed to hepatotoxins. Liver function tests, blood urea and creatinine, Haemoglobin%, total leucocyte and lymphocyte counts, platelet count and INR were measured for all patients. CD4 counts were determined by flow cytometry. HIV antibody and HBV markers (HBsAg, HBsAb, HBeAg, HBeAb, HBcAb, and anti-HBcAb IgM) were detected by enzyme-linked immunosorbent assay. Serum HBV DNA load was assessed by quantitative real-time polymerase chain reaction. RESULTS: Absolute CD4 count and CD4% were normal in acute hepatitis B and 'immune tolerant' CHB. But CD4 declines from 'immune reactive' to 'HBeAg-negative' CHB. Average CD4 counts were below 500/lL in these two phases – 351.12 + 33.23 and 237.0 + 118.27 respectively. CD4 counts were below 350/lL in 72.72% and below 200/lL in 27.27% in these two phases. Such low levels of CD4 count are not proportionate to the total lymphocyte counts in these two phases. Absolute CD4 count rises to moderate level in 'inactive HBV carrier state' (754.4 + 174.87) and 'treatment-experienced' patients (734.5 + 204.57). Similarly CD4% were low in 'immune reactive' to 'HBeAg-negative' (<25%) in contrast to 'immune tolerant' and 'inactive HBV carrier state' (>35%) CHB. CONCLUSIONS: CD4 count gradually declines with progressive liver damage in 'immune reactive' and 'HBeAg-negative' CHB and it may be implicated in the design of the antiviral therapy. Interferon may be unsuitable for CHB with very low CD4 counts (<250/lL). Sequential therapy comprising oral anti viral followed by Peg-Interferon might be theoretically appropriate approach in this group of patients. On the other hand, those with higher CD4 are appropriate for Peg-Interferon first followed by oral anti viral.


ABSTRACT 'Trust in the System' is contentious, if not spurious for many Indigenous Internet users. 'Trust' signifies as a term that embodies (and disembodies) our experiences from over 200 years of colonisation. Research has shown that Indigenous people have typically been early adopters of digital technologies. Over the last decade or so, social media technologies have gradually become a central part of our everyday lives. These platforms offer opportunities to connect across vast distances and diverse populations. They provide a space to express one's identity, connect with community, learn, play, seek love, organise political action, find lost friends and family, search for employment, seek help in times of need – and much more. Indigenous people have made particular use of social media for agitating for social justice. Information can be distributed, events coordinated and alliances spontaneously forged across great distances largely outside of the surveillance and control of state actors. Assessing the actual impact of online activism is not a straightforward matter – any concept of 'trust in the system' demands that we begin to infiltrate that system in order to force 'it' to incorporate the views and experiences of Indigenous actors and activists online.


The harvested wood products (HWP) in use carbon pool plays a beneficial but frequently unrecognized role in climate change mitigation by storing carbon that has been removed from the atmosphere and providing services that can substitute for emission intensive products. Countries with a culture of building houses with wood use a majority of HWP for structural purposes and, due to the long-lived nature of houses, the structural HWP within these dwellings can last for a long time. Long-lived products have the potential to make a major contribution to the HWP in use pool and accurate quantification of this pool is an important topic worthy of detailed investigation. This study reviewed published HWP decay models and developed a "regression-aggregation-fit" methodology to accurately model the inverse sigmoidal decay patterns of houses at the national level. Using this method, the end-use half-lives of U.S. single-family and multi-family houses, U.S. mobile homes, Canadian residential houses and Norwegian residential houses were estimated to be 137 years, 44 years, 92 years and 146 years, respectively. For comparison, the default product half-lives recommended by the IPCC are 35 years for sawnwood and 25 years for wood-based panels. The direct application of these default product half-lives to quantify the HWP pool in houses is likely to result in substantial underestimation of this carbon pool. The Gamma distribution model was shown to be the most applicable generalized model for describing the country-specific decay pattern of houses. It adequately modelled housing data sets from three different countries and it was the best of the six models evaluated. This model was used to quantify the structural HWP pool in U.S. single-family and multi-family houses and in 2009 this pool was 668 Tg C, which was about 20% larger than published estimates. A constant mass input scenario indicated that this pool may act as a sink for about 750 years with a saturation value of about 1.2 Pg C. This methods developed in this thesis should improve the accuracy of national greenhouse gas inventory reporting for countries with extensive forests and a tradition of building with wood.


The article gives a classification of intensification the methods of heat- and mass transfer. There are examined some advantages and disadvantages of nozzle and poppet pin devices. The method of influence analysis of nozzle form and construction on heat-, mass transfer process is provided. There is also described the effect of different parameters on the choice of the design of the nozzle. In article there were compared the most common in industry types of bulk and regular nozzles. An alternative method of intensification of heat and mass transfer finally was proposed.


IN C.R. lxxx (1966), 323, Professor F. R. D. Goodyear writes as follows concerning my chapter on 'The Language of Lucretius' in Lucretius, edited by D. R. Dudley (1965): 'he seems to imply that, if we accept that there was an evolution of Latin hexameter poetry from Ennius to Lucretius to Virgil, this entails that Lucretius must be judged by Virgilian standards'. My basic theme, enunciated on p. 71 and argued at some length, was (naturally) that Lucretius must not be judged by such standards. I regret that some alleged lack of clarity on my part may have led the reviewer to such a preposterous conclusion; but my argument was apparently clear to Mr. David A. West, who wrote in J.R.S. lvi (1966), 275, 'W. S. Maguinness... delivers an attack upon the tendency to condemn Republican poets for failing to comply with Augustan standards.'


Background: Extensive literature indicates that aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) are associated with reduced cancer incidence and mortality. For ovarian cancer, a pooled analysis of 12 case-control studies recently demonstrated a significantly reduced risk for regular aspirin use and a similar but non-significant reduced risk for non-aspirin NSAID use. However, studies specifically evaluating NSAIDs and ovarian cancer survival are absent from the published literature. Purpose: To determine if aspirin and other NSAIDs are associated with ovarian cancer survival. Methods: Ovarian cancer cases were identified from de-identified electronic medical records (EMR) from the Vanderbilt University Medical Center. Ever use of aspirin or any NSAID was determined by MedEx, a natural language processing system designed to capture medication use from EMR. Linked tumor registry data was used to generate hazard ratios (HR) and confidence intervals (CI) for overall survival using Cox proportional hazards regression; covariates included age, race, stage of disease, histologic subtype, treatments received, and year of diagnosis. Results: The majority of 1,147 confirmed ovarian cancer cases were Caucasian (87.0%), had serous histologic subtypes (53.6%), and late stage (III/IV, 50.0%) or stage unknown (29.3%) disease. Ovarian cancer cases with any aspirin use (207, 18.1%) had significantly longer overall survival in both unadjusted (HR: 0.56, 95% CI: 0.45-0.70) and adjusted analyses (HR: 0.59, 95% CI: 0.46-0.74). Similarly, ovarian cancer cases with any non-aspirin NSAID use (248, 21.6%) had significantly longer overall survival in both unadjusted (HR: 0.60, 95% CI: 0.48-0.74) and adjusted analyses (HR: 0.69, 95% CI: 0.54-0.88). Associations between any aspirin or other NSAID use (360, 31.4%) and longer ovarian cancer survival did not significantly differ by stage of disease (P-interaction=0.650), histologic subtype (P-interaction=0.076), or treatment with a platinum-based agent (P-interaction=0.069). Conclusions: Indication of aspirin or non-aspirin NSAID use ascertained retrospectively from EMR was associated with improved overall ovarian cancer survival. Further evaluation, including timing and duration of use, are underway; replication of this association in additional study populations is needed. Citation Format: Alicia Beeghly-Fadiel, Gwendolyn Holman, Samantha P. Stansel, Gretchen Edwards, Edward Baeg, Hannah Berke, Ryan J. Delahanty, Dineo Khabele. Aspirin, NSAIDS, and ovarian cancer survival from electronic medical records [abstract]. In: Proceedings of the 10th Biennial Ovarian Cancer Research Symposium; Sep 8-9, 2014; Seattle, WA. Philadelphia (PA): AACR; Clin Cancer Res 2015;21(16 Suppl):Abstract nr POSTER-TECH-1103.


This is the first reported case of a kidney transplant patient in Korea who developed cytomegalovirus and Nocardia pulmonary coinfection simultaneously with cytomegalovirus nephropathy. The patient had a history of end stage renal disease on peritoneal dialysis, diabetes mellitus and pulmonary tuberculosis. He underwent unrelated living kidney transplantation in China. About 5 months after transplantation, he developed high fever and rising serum creatinine for which he was admitted to hospital. Chest CT revealed consolidation in the left upper lung field and lung biopsy showed CMV infected bronchiolitis obliterans with organizing pneumonia. Culture of lung biopsy tissue grew Nocardia farcinica. In addition, he was found to have CMV infection in kidney tissue with positive CMV antigen assay of blood. This case emphasizes that CMV infection, through its effect on systemic immunity, may increase the risk of other opportunistic infection.