Introduction: Iodine status of pregnant women and their newborns have not been studied in Jaffna District, Sri Lanka. This study was planned to assess the maternal iodine status and thyroid function at the third trimester of gestation and the thyrotrophin level of their neonate. Methods: Four hundred and seventy-seven pregnant women and their newborns were randomly selected among six Medical Officers of Health Divisions out of 12 in Jaffna District, Sri Lanka. Maternal thyroid stimulating hormone (TSH), free thyroxine (fT4), thyroglobulin (Tg), urinary iodine levels, and the neonatal thyrotrophin (nTSH) level were assessed. Results: In this study, mean age, weight, height, and gestational age of the mothers were 28.95 (±5.46) years, 63.02 (±11.56) kg, 154.39 (±6.00) cm, and 39.33 (±1.37) weeks, respectively. Maternal median urinary iodine concentration (UIC) was 140.0 μg/L (inter-quartile range 126.0–268.0 μg/L). Median values of the maternal serum TSH, fT4, and Tg were 1.9 mIU/L, 12.6 pmol/L, and 21.4 IU/L, respectively. Among the 477 newborns, 50.5% (n = 239) were males. Mean birth weight of newborn was 3.03 (±0.43) kg, while the mean length was 51.1 (±2.1) cm. Among the newborns, 18% (n = 86) had nTSH level > mIU/L and 37.7% (n = 180) within TSH level > mIU/L. nTSH level had positive but very weak correlations with maternal thyroid parameters, that is, UIC (r = 0.06, P = 0.13), fT4 (r = 0.01, P = 0.05), TSH (r = 0.09, P = 0.05), and Tg (r = 0.12, P = 0.03). Conclusion: On the basis of the World Health Organization criteria, the iodine status of pregnant women was inadequate in this region and also nTSH levels indicate moderate iodine deficiency during pregnancy. Therefore, the continuous education on adequate iodine intake during pregnancy and monitoring of iodine status are useful.


Purpose
While there exist many surveys on the use stochastic frontier analysis (SFA), many important issues and techniques in SFA were not well elaborated in the previous surveys, namely, regular models, copula modeling, nonparametric estimation by Grenander's method of sieves, empirical likelihood and causality issues in SFA using regression discontinuity design (RDD) (sharp and fuzzy RDD). The purpose of this paper is to encourage more research in these directions.

Design/methodology/approach
A literature survey.

Findings
While there are many useful applications of SFA to econometrics, there are also many important open problems.

Originality/value
This is the first survey of SFA in econometrics that emphasizes important issues and techniques such as copulas.


A chemotherapy regimen consisting of fluorouracil, epirubicin and intravenous cyclophosphamide, followed by pertuzumab, trastuzumab and paclitaxel, used as a neoadjuvant or adjuvant treatment for HER-2/neu-positive breast cancer.


As the title suggests, this essay is a feminist and postcolonial literary analysis of the main character Okonkwo ́s downfall and demise in acclaimed author Chinua Achebe ́s 1958 novel, Things Fall Apart. A recurrent theme within the narrative is the concept of gender differences and gender roles, in the strict traditional and patriarchal system which serves as the setting of the narrative. Okonkwo, who is a traditional and proud Igbo man, has an aversion toward what is considered to be weak and feminine. Okonkwo is therefore struck with depression when he finds himself in a weak and helpless position, as well as emasculated emotional state of mind. Furthermore, Okonkwo becomes a victim to colonialism in the latter part of the narrative, which consequently adds to his already helpless and emasculated state of mind. The purpose with this essay is therefore to investigate if feelings of emasculation are the cause for Okonkwo ́s final decision to end his own life. Based upon the analysis included in this essay, one of the conclusions that could be drawn was that the helplessness and feelings of emasculation Okonkwo experiences within the narrative are too much for him to cope with and therefore cause his downfall and demise.


We use a braided polyester suture in place of cerclage wire in tension band fixations. The objective of this study was to test the biomechanical properties of this technique. Sixteen cadaveric patellae were fractured and repaired by modified tension band fixation. Eight were fixed using eighteen gauge stainless steel wire as a tension band and eight using braided polyester. All specimens were subjected to tensile testing. Polyester was 75.0% as strong as wire. For dynamic testing, the patellae of seven cadaveric knees were fractured and then fixed with polyester tension bands. These were mounted in a device capable of extending the knees from 90 degrees to neutral against an applied force. None of the fixations failed. Three of the specimens fixed using 18 gauge stainless steel wire were compared with three fixed using polyester over 2000 cycles of knee flexion and extension. Polyester performed as well as wire. We conclude that polyester is an acceptable alternative to wire in tension band fixation.


Background: The precise aetiopathogenesis of morphoea is poorly understood. Importantly, the initiating genetic / molecular mechanisms remain unclear. Linear morphoea (LM) likely follows Blaschko's-lines and hence may represent epidermal mosaicism. This, along with insights from related fibrotic processes, support the key role of the epidermis in disease initiation and propagation. The goal of this thesis was to investigate the genetic aetiologic and pathogenic basis of morphoea, focusing specifically on epidermal genomic variation and differential epidermal and dermal transcriptomic expression profiles. LM provides a unique template for this work, by enabling intra-individual comparisons of clinically affected and contralateral site-matched unaffected skin, with background genetic homogeneity. Methodology: After clinical and histological validation of the LM cohort (n=133), paired skin biopsies were collected from 27 participants. Epidermis and dermis were isolated using a two-step separation protocol. Whole genome sequencing (WGS; n=4 epidermal; Illumina HiSeqX Ten System, 60-70×) and RNA-seq (n=5 epidermal, n=5 dermal; BGISEQ-500, 20 million reads-per-sample) were performed on isolated tissue pairs. Gene set enrichment, PANTHER enrichment testing and STRING pathway analyses were employed. RT-qPCR and whole-skin immunohistochemistry were used to validate key results. Results: Epidermal WGS confirmed no commonly affected gene or developmental somatic mutation. However potentially disease relevant protein coding pathogenic variants were seen in ADAMTSL1 and ADAMTS16; with known links to fibrosis and LM fibroblasts. Epidermal transcriptomic-profiling demonstrated a wounded, proliferative, inflammatory and profibrotic signature, with over-expression of TNF-α via NFkB, TGF-β, IL-6/JAKSTAT and IFN-signaling. Epidermal IFI27 was upregulated and its induction of IFNγ-related-apoptosis could act as an initiating 'damage' signal. IFI27 also negatively regulates NR4A1, which enables persistent TGF-β-signaling; NR4A1 was under-expressed in the dermis. Morphoea dermis demonstrated a strong B-cell and IFN-signature. Upregulation of morphogenic development genes such as WNT was also seen, with concordant dermal upregulation of the frizzled Wnt-receptor SFRP2. Wnt-signaling may facilitate epidermal-dermal communication. Dysregulation of HOX, SOX and PAX genes was present in both skin layers, potentially providing clues to dermal mosaic mechanisms in morphoea. Conclusion: Based on NGS of paired-skin biopsies, this thesis provides a possible genetic and molecular understanding of the underlying morphoea aetiopathogenesis which supports potential complex polygenic epidermal mosaicism and the presence of key potential inciting and disease driving epidermal mechanisms.


Comparative'phagocytic activity ofbuffalo blood neutrophils incubated simultaneodv with ~ure and mixed cultures of Escherichia cdi. Staphylococcus aureus, &d strep- crgtdudue was studied. Flmgo&iC activity for pure bacterial cultures of Staph. aureua, Strep. agahctiae and E. di were 90.8%, 86.4% and 76.246, respectively. The percent phagocytosis of neutrophils incubated with mixed bacterial cultures was similar to that with pure bacterial cuhres. However. with mixed bacterial cdtures. a maioritv of heutrophils showed preferential ihagocytosia of one species of ba-&ria: l%urc, neutrophds incubated with a mixed bacterial culture ofE. mli and Staph. am showed a significantly higher phagocytosis of Staph rrureus, with a per cent phagocytosia of approximately 40%. Neutrophils incubated with a mixed bacterial culture of E. coli and Strep. walactiue showed a significantly higher - - phagocyt~sia of Strep. ag&tiae, Gth apercent phagoqtnsi~of appmximat+ly 33%. These observations indicate that when buffalo neutrophils are exposed to a mixed bacterial culture the &ity for phagocytizingE. &li was much lees in the presence of Staph. aurells than in the presence of Strep. agalactiae. Key work Buffalo, mixed bacterial cultures, neutmphil, pha@xybsis.


Technogenic deposits are formed with the materials produced by the human activity and direct or indirect deposition of sediments resulting in artificial bodies with an own dynamic in each environment. Among the problems, the formation and expansion of the technogenic deposits in the Araguaina city, north of Tocantins state (Brazil), may be subject to the economic cycles and technogenic resources in the last decades. The present study aims at two main aspects, at first a short discussion about the technogenic deposits worldwide will be made and then our aim will be analyzing will be made about the different types of inorganic, chemical, organic and terrigenous deposits in different environments: terrestrial, fluvial and lagoon. The applied methodology was based on the review of the literature, characterization of the study area and urban expansion, identification of satellite images and the structural and morphologic characterization of the technogenic materials. The results point at the link between the types of materials and phases of urban expansion, which mean that the deposits have a higher concentration of organic material and dominance of inorganic materials. Due to the necessity of adjusting the relief and soil for the construction, some areas suffered severe topographic changes and great deposition of technogenic materials. The future perspectives, based on the present conditions, indicate an increasing number and variety of technogenic deposits in some study areas


On 22 June 22 2011 the Securities and Exchange Commission (''SEC'') published three new releases under the US Investment Advisers Act of 1940, as amended (the ''Advisers Act'') that implement Title IV of the Dodd-Frank Wall Street Reform and Consumer Protection Act (the ''Dodd-Frank Act''), which potentially will have a sweeping impact on non-US advisers. This article explains the key provisions of the new releases and the Dodd-Frank Act, as they relate to non-US advisers.


This review covers the general area of disease and problems such as malaria, bacterial and fungal infections, free radical damage and the decline in the immune system. After a brief history of ethnopharmacology, we discuss the scientific approaches that have been used in the screening of medicinal plants and identify some African medicinal plants that are used successfully in the treatment of these diseases. It is evident that African medicinal plants are continuously being screened for their pharmacological properties and many interesting results with crude extracts have occasionally been obtained through the isolation and identification of the active principles. However, as a source of new drugs, African medicinal plants are understudied, considering the high percentage of plants not yet screened for their biochemical composition or for their pharmacological properties.


Depletion forces in colloidal systems are known to be entirely attractive, as long as the background of macromolecules is small enough that an ideal gas approach is valid. At higher densities, however, structural correlation effects of the macromolecules which lead to additional repulsive parts in the depletion interaction, have to be taken into account. We have measured the depletion interaction between a single polystyrene sphere and a wall in the presence of non-ionic polymer coils. Although the polymer volume fraction is very small, our results clearly show the existence of repulsive parts, leading to a large over-estimation of correlation effects in a hard sphere liquid. The possible explanation of this discrepancy by additionally considering the role of van der Waals forces is discussed.


We studied the topography of contralateral connections of both prefrontal and premotor regions of the dog's frontal association cortex (FAC) by charting distributions of retrogradely labeled cells following unilateral HRP injections to various areas of this cortex. Generally, in the contralateral hemisphere the labeled cells were most numerous in the FAC areas localized homotopically to the injection sites, less numerous in FAC areas heterotopic to injections, and the least numerous in cortical areas situated outside the frontal lobe. The nonfrontal areas which project to the dorsal and ventral FAC differ from one another. Dorso-caudal parts of the cingular and insular areas, as well as the auditory, somatosensory and visual association cortices project to the dorsal FAC, while the ventro-rostral parts of the cingular and insular areas, together with the prepiriform and periamygdaloid areas of the olfactory cortex as well as the subcallosal area send their axons to the ventral FAC. Thus, the dorsal and ventral FAC areas are supplied by contralateral afferents originating from different cortical areas. Similar organization of ipsilateral FAC connections was described previously.


The sixties was an era of great social and cultural upheaval. It was a period of mass mobilization that attempted to redefine "America" by addressing issues of racial exclusion, sexual subordination and nationalism. Opposing a predominantly materialist interpretation of the American dream and its master narrative of American exceptionalism, the 1960s generation sought a number of ways to convey the Zeitgeist of the period. Rock music, radical activism, consciousness-raising groups, anti-disciplinary politics as well as alternative lifestyles that adopted willed poverty, communal living, drug experimentation and non-Western, non-Christian practices and beliefs created a powerful yet loosely organized cultural movement, known as the counterculture of the 1960s. While it is difficult to define a phenomenon which exhibited a variety of co-existing, and often conflicting, cultural practices, my focus in this paper is on the adversarial tendency of the sixties as it manifested itself in representative literary examples. I examine the fictional production of and about the sixties written during that turbulent period and the decades that succeeded it. Looking back in time and from the spatial (and cultural) distance of Europe, I argue that, while remaining critical with itself, countercultural fiction did not only run against the social mainstream of the day, it aimed a major blow at the discourse of American exceptionalism.


Introduction: Acute concomitant rupture of both anterior cruciate ligament (ACL) and patellar tendon is a rare injury. The diagnosis of either of the injuries may be missed on clinical examination in the emergency room. A high index of suspicion is necessary when active extension is absent, and necessary investigations like ultrasound or magnetic resonance imaging (MRI) should be done to confirm the diagnosis. There are no fixed treatment protocols in these injuries. The options include immediate repair of patellar tendon with either simultaneous or delayed reconstruction of ACL. Case Report: We present a case of 30-year-old man with simultaneous ACL and patellar tendon injury sustained in a RTA, riding pillion on a bike. The mechanism of injury was a direct blow on his flexed right knee followed by landing on the ground, on his foot with a twisting valgus thrust. Following clinical examination and radiographs, MRI was done which showed complete patellar tendon mid substance rupture and ACL tear. A staged procedure was planned, and the patient was taken up for immediate patellar tendon repair. This was followed by 5 weeks of cast immobilization. After 6 weeks, the knee was mobilized and ACL reconstruction was done using hamstring graft. At last, follow-up, the patient regained full knee extension and flexion up to 120° with normal gait. Conclusion: High-velocity knee injuries have to be carefully evaluated for such concomitant tears, as they may be missed. If suspected, an immediate ultrasound scan or MRI should be done to confirm the injuries, especially that of the patellar tendon. As of now, a staged procedure comprising immediate patellar tendon repair followed by ACL reconstruction at a later date seems to be the better option of treatment.


This study examined the reliability and validity of the Pediatric Quality of Life Inventory™ (PedsQL) Oral Health Scale, a 5-item measure of child self-reported and parent-proxy reported pediatric oral health. One hundred twenty-six families participated during Phase 1 of the study, and 34 during Phase 2. Internal consistency and agreement between parent and child reports were examined. The construct, criterion-related, and convergent validity of the measure was supported by the results of this study. Using the PedsQL Oral Health Scale and the PedsQL 4.0 Generic Core Scales provide a generic health-related quality of life assessment that captures the physical, emotional, social, school, and oral domains of health.


Two-dimensional beamforming can be a valuable technique for obtaining pure-mode signals in a multipath environment, if adequate resolution is available in both elevation and azimuth dimensions. Early simulations have shown that, for adequate signal/noise ratios and for selected signal and noise types, two sources separated by as little as .01 conventional beamwidth can be resolved. Thus, current arrays may still have adequate aperture for resolving such multipaths. The MUSIC algorithm and related eigenvalue/eigenvector analysis techniques appear to be the key to allowing the kind of superior performance which would eventually lead to an order-of-magnitude improvement in source-location accuracy.


Introduction: Renal functional impairment is linked to an increased risk of thromboembolic and bleeding events in patients with nonvalvular atrial fibrillation (NVAF) treated with warfarin and rivaroxaban. Anticoagulants such as warfarin and rivaroxaban are often recommended to reduce the risk of stroke in NVAF patients. The purpose of this study was to evaluate and compare thromboembolic and bleeding event rates for warfarin and rivaroxaban patients stratified by presence of chronic kidney disease (CKD). Methods: Claims from the IMS Health Real-World Data Adjudicated Claims database from 05/2011-6/2015 were analyzed. Adult patients with NVAF who had ≥6 months of baseline data prior to the first dispensing of warfarin or rivaroxaban after 11/2011 were included. Patients were followed until the end of index therapy or end of data availability/insurance coverage. Outcomes were stratified by presence of CKD for ischemic stroke, major bleeding, and a composite measure of thromboembolic events (ischemic stroke, myocardial infarction (MI) or venous thromboembolism (VTE)) and analyzed using hazard ratios (HRs). Adjustments for confounding were made with inverse probability of treatment weights (IPTW). Results: The analysis included 39,872 rivaroxaban (9.0% [3,572 of 39,872] with CKD) and 48,637 warfarin patients (16.9% [8,230 of 48,637] with CKD). As expected, thromboembolic and bleeding events were more common in patients with CKD than those without CKD. Rivaroxaban patients had significantly lower risk of ischemic stroke, both in the overall population (HR = 0.79 [0.68-0.90], p=0.0008) and for those with CKD (HR = 0.55 [0.40-0.77], p=0.0004). A composite of thromboembolic events were lower with rivaroxaban irrespective of CKD. Major bleeding rates were comparable across all groups. Table 1 reports incidence rates and HRs stratified by presence of CKD. Conclusions: This study suggests that, in an adult population with NVAF, rivaroxaban-treated patients had fewer ischemic strokes across all patients, including patients with renal impairment. Rivaroxaban-treated patients also had significantly better outcomes for the composite (VTE, MI, or stroke) measure across all groups. Bleeding rates were comparable across all groups.


Performance evaluations of software-based mutual exclusion algorithms must take into account the effects of architectures and systems. We demonstrate a framework for such evaluation, and use the framework as a basis for designing more efficient algorithms. We propose a comprehensive performance evaluation framework that examines the overhead patterns inherent in the mutual exclusion algorithms and in the architectures on which the algorithms run. We used this framework to evaluate several representative mutual exclusion algorithms on the BBN TC2000 and KSR-1. Our research with this framework has helped us determine the characteristics of efficient software mutual exclusion algorithms. Based on these characteristics, we've developed three mutual exclusion algorithms, two of which combine good features of two of the representative algorithms. Tests show that these new algorithms are fast and can be highly scalable.


Maple syrup urine disease (MSUD) is a rare heritable enzyme defect associated with mental retardation. A diet deficient in the branched-chain amino acids is essential for survival. Patients with MSUD are at risk of ketoacidotic metabolic crises brought on by catabolic states, including simple infection or fasting. Delayed diagnosis and therapy can predispose these patients to loss of the gag reflex, lethargy, seizures, and feeding problems. Ultimately, this may result in aspiration and respiratory arrest, which, in turn, can cause cerebral palsy. Of seven cases of MSUD reviewed at The Hospital for Sick Children, two developed spastic diplegic cerebral palsy because of these sequelae. These two patients are similar to other patients with cerebral palsy. Despite special diet, healing of surgical wounds and fractures in patients with MSUD is normal. Simple precautions allow uncomplicated surgery and recovery, even though catabolic states can easily trigger acute ketoacidotic metabolic crises in these patients. The patients with MSUD discussed did not have an increased risk of infection.


Closed static chambers are frequently adopted for estimating gas fluxes across environmental interfaces. In this study we assessed the effects of three gas sampling rates and two methods of chamber placement in fertirrigated soils for estimating nitrous oxide (N2O) emissions, using chambers with similar design and on-site gas chromatography. The soils under analysis were fertirrigated with (liquid) digested swine manure at three different doses. The results indicate that N2O flux estimates are firmly determined by the chosen sampling rate, chamber placement, chamber design, and the emission magnitude itself. N2O fluxes were best estimated by faster sampling rates while gently placing the chamber at the soil surface due to conspicuous N2O emissions and relatively small chamber volume. A generalized chamber accumulation model developed by normalizing the dataset was used to illustrate effects on expected "low unforced-chamber", "high unforced-chamber" and "high forced-chamber" fluxes. We concluded that it is possible to adopt simple design and low-disturbing chambers with sufficient volume, height, and surface area for determining gaseous emissions across soil-air interfaces. Nevertheless, critical on-site gas sampling rate adjustment (by gas chromatography or other as precise real-time measuring device) is critical to avoid estimation inaccuracies in emission estimates.


ABSTRACT Purpose: Ultra-widefield fundus autofluorescence (UW-FAF) allows the characterization of the peripheral retinal features of vitreoretinal diseases. The purpose of this study was to examine possible genotypic/phenotypic correlations of UW-FAF patterns in patients with a variety of retinal dystrophies and retinitis pigmentosa (RP). Methods: An IRB-approved retrospective consecutive case series study was performed of genetically characterized retinal dystrophy or RP patients who underwent UW-FAF imaging. UW-FAF was performed with the Optos 200Tx system. Clinical variables, genotypic analysis, and phenotypic characteristics were reviewed. Results: Seventeen patients were identified who had identified mutations in retinal dystrophy or RP genes and who also had undergone UW-FAF. Three patients had X-linked RP with RPGR mutations. Six patients had autosomal dominant RP (four with RHO mutations and one with a PRPF31 mutation, and one with RDS/PRPH2 mutation). Four patients had autosomal recessive RP (four with USH2A mutations). Three patients had Leber Congenital Amaurosis (LCA) with mutations including CRB1, CEP290, and RPGRIP1. Macular hyperautofluorescence was noted in all patients. A ring of hyperautofluorescence was clear in patients with RHO and USH2A mutations, and patients with USH2A mutations demonstrated a second ring of hyperautofluorescence. In the periphery, patients with RHO or RPGR mutations exhibited hyperautofluorescence with patchy areas of hypoautofluorescence. Patients with USH2A mutations had a distinctive pattern of diffuse and homogeneous peripheral hypoautofluorescence. Conclusion: UW-FAF may provide important information to facilitate diagnosis and further research is needed to better characterize this technology as an imaging biomarker for genotype association in retinal dystrophies and RP.


New therapies are needed for metastatic breast cancer patients. Oncolytic herpes simplex virus (oHSV) is an exciting therapy being developed for use against aggressive tumors and established metastases. Although oHSV have been demonstrated safe in clinical trials, a lack of sufficient potency has slowed the clinical application of this approach. We utilized histone deacetylase (HDAC) inhibitors, which have been noted to impair the innate antiviral response and improve gene transcription from viral vectors, to enhance the replication of oHSV in breast cancer cells. A panel of chemically diverse HDAC inhibitors were tested at three different doses (<,  = , and >LD50) for their ability to modulate the replication of oHSV in breast cancer cells. Several of the tested HDAC inhibitors enhanced oHSV replication at low multiplicity of infection (MOI) following pre-treatment of the metastatic breast cancer cell line MDA-MB-231 and the oHSV-resistant cell line 4T1, but not in the normal breast epithelial cell line MCF10A. Inhibitors of class I HDACs, including pan-selective compounds, were more effective for increasing oHSV replication compared to inhibitors that selectively target class II HDACs. These studies demonstrate that select HDAC inhibitors increase oHSV replication in breast cancer cells and provides support for pre-clinical evaluation of this combination strategy.


The range and the stopping Power in the air and argon gas of alpha particle emitted by various sources which contain three isotopes (241Am, 244Cm and 239Pu), using surface barrier silicon detectors in a small vacuum chamber at various pressures. The stopping power of this charged particle in the air and argon from Bethe- Bloch formula was found to increase extremely as distance or pressure is increased. The range for this alpha source at a pressure of 1bar was found to be 5.8±0.1 cm in air and 6.0±0.1 cm in argon respectively with the stopping powers also found to be 1142.5±47.5 KeV/cm in the air and 1014.1±34.3 KeV/cm in the argon. The measured values of range were compared with another empirical formula from literature, while the measured values of the stopping power were compared with other empirically calculated values from the literature.


The imprinting of the genes on human chromosome 11p15.5 is thought to be controlled by two imprinting control regions located in two differentially methylated CpG islands upstream of the H19 gene (H19 DMR) and in intron 10 of the KCNQ1 gene (KvDMR). We have examined sequences in the human 11p15.5 genomic imprinted region for the presence of insulators and silencers using a position- and enhancer-dependent stable transfection assay. We have confirmed the existence of insulators in H19 DMR and discovered two novel insulators in the IGF2 gene. We have also found two novel silencer sequences; one is located in KvDMR, a region that is thought to contain the promoter for the KCNQ1OT1 transcript, and another is in the CDKN1C gene. We have demonstrated binding of CTCF protein in vitro to all the insulator and silencer sequences that we have detected. We discuss the differences in the regulation of imprinting controlled by the two imprinting control regions in chromosome 11p.


We propose a compact and simple all-optical subcarrier-multiplexed (SCM) label-swapping system employing an integrated electroabsorption modulation laser and a semiconductor optical amplifier based Mach–Zehnder interferometer wavelength converter. The experiments demonstrated error-free all-optical label swapping for the 155-Mb/s label and 10-Gb/s payload over two optical label-switching network nodes with less than 0.7-dB power penalty on the payload. The majority of the components in this SCM label-swapping system can be realized on a semiconductor platform (e.g., InP), which implies a step toward possible monolithic or hybrid integration of the all-optical label-swapping system in the future.


In this study, we selected and characterized different pesticide-tolerant bacteria isolated from a biomixture of a biopurification system that had received continuous applications of a pesticides mixture. The amplicon analysis of biomixture reported that the phyla Proteobacteria, Firmicutes, Bacteroidetes and Actinobacteria were predominant. Six strains grew in the presence of chlorpyrifos and iprodione. Biochemical characterization showed that all isolates were positive for esterase, acid phosphatase, among others, and they were identified as Pseudomonas, Rhodococcus and Achromobacter based on molecular and proteomic analysis. Bacterial growth decreased as both pesticide concentrations increased from 10 to 100 mg L-1 in liquid culture. The Achromobacter sp. strain C1 showed the best chlorpyrifos removal rate of 0.072–0.147 d-1 a half-life of 4.7–9.7 d and a maximum metabolite concentration of 2.10 mg L-1 at 120 h. On the other hand, Pseudomonas sp. strain C9 showed the highest iprodione removal rate of 0.100–0.193 d-1 a half-life of 4–7 d and maximum metabolite concentration of 0.95 mg L-1 at 48 h. The Achromobacter and Pseudomonas strains showed a good potential as chlorpyrifos and iprodione-degrading bacteria.


The syntheses of a novel uridine diphosphate galactose (UDP-Gal) analog, (UDP-2,4,6tri-O-acetyl-3-S-acetyl-3-thio-a-D-galactopyranose) (11) and the thiolpyridine protected (Uridine 5'-[3-S-(2-S-pyridyl)-3-thio-a-D-galactopyranosyl diphosphate) analog (12) are described. The reported synthesis relies on the novel use of thiolpyridine to generate 12 which is a suitably protected intermediate for generating a UDP-thioGal derivative by reduction prior to enzyme transfer via b-1,4-galactosyltransferase.


BACKGROUND
Corneal neovascularization is a vision-threatening condition usually associated with inflammatory or infectious disorders of the ocular surface. One current treatment is photodynamic therapy, which uses a photosensitizer to occlude the vessel, is successfully produced microvascular thrombosis with minimal damage to surrounding normal tissue. The aim of this article is to quantitatively determine the percentage of regression of corneal neovascularization experienced by patients treated with photodynamic therapy with verteporfin.

METHODS
A before and after treatment; experimental, analytical, prospective and longitudinal.

RESULTS
Of the 25 new vessels analyzed, 8 glasses (32 %) had total occlusion one month after, 15 vessels (60 %) had a partial occlusion in the range of 15.3 to 85.1 %, and 2 vessels (8 %) worsening in corneal vascularization. The mean area of corneal neovascularization decreased significantly a 70 % from 0.147 ± 0.118 mm2 to 0.045 ± 0.046 mm2 (p < 0.0005) after photodynamic therapy. No side efects were reported.

CONCLUSIONS
Photodynamic therapy with verteporfin is a safe and effective method of reducing corneal neovascularization and can be used to inhibit angiogenesis in the cornea.


: To compare the results of fibrogastroscopic study and to determine the activity of hexokinase (HK) in gastric juice 113 persons were examined 89 of them having ulcerous disease. The control group comprised 24 healthy individuals. The data obtained indicated that in the control group the activity of HK was not found in any portion of the gastric juice. In patients with ulcerous disease the presence of the enzyme was noted in 36 of 89 subjects. In two of them malignant transformation of the ulcer was observed. Patients with gastric ulcer, who show HK activity in any gastric juice portion, seem to be assessed as gastric cancer high-risk group.


We present the demographics data for the space physics workforce which are compared with other space sciences fields, physics, plus science and engineering in general. We focus on the early stages of college, and draw some lessons from looking beyond the US by discussing this in the context of physics degrees awarded in different countries. We review some of the studies from the National Academies, extracting some relevant recommendations. Studies of the science, technology, engineering and mathematics (STEM) workforce, the physical sciences profession, and specifically the space sciences show that the "pinch point" where the demographics narrow down is at the high school to college stages. We considered the actions that could be made nationally by federal agencies, locally by an institution or individually to enhance and diversify the career pathway through the space sciences.


2505 Background: Ipilimumab is the first agent to demonstrate a survival benefit in patients with metastatic melanoma in a randomized phase III clinical trial. Immune-related adverse events (irAEs) are the most common side effects associated with ipilimumab. Grade III/IV irAEs occur in approximately 10-15% of patients, and colitis is the most common irAE within this group. Ipilimumab-associated colitis has been managed effectively with immunosuppressive medications in clinical trials. IL-17 is an important mediator of autoimmunity and inflammation that has been implicated in colitis. We evaluated serum IL-17 levels in patients treated with ipilimumab, comparing patients who developed colitis to those without irAEs.

METHODS
Patients with metastatic melanoma received 10 mg/kg of ipilimumab on an expanded access protocol (EAP) (CA184-045). We obtained serum samples from 52 serially accrued EAP patients. Samples were collected pre-treatment and at appointed intervals during treatment. The serum concentration of IL-17 at each time point was quantitated using the Meso Scale Discovery system. Patients were classified into three groups based upon clinical symptoms: (1) colitis, (2) no irAE, or (3) non-colitis irAE.

RESULTS
Pairwise comparison of serum IL-17 levels in patients with colitis (n=13) versus no irAEs (n=16) demonstrated significantly higher serum IL-17 levels in patients with colitis at week 7 (p=0.007) and week 12 (p=0.02). In individual patients, development and resolution of colitis symptoms temporally correlated with increases and decreases in serum IL-17, respectively. Upon resolution of clinical symptoms, IL-17 levels in patients with colitis decreased to levels comparable to patients without colitis. Pre-treatment IL-17 levels were not significantly different between patients with or without colitis or between patients and healthy donor controls. This pattern was unique when compared with several additional cytokines tested.

CONCLUSIONS
We report that the development and resolution of colitis is significantly associated with fluctuations in serum IL-17 in this subset of ipilimumab-treated patients, reinforcing the immune-based mechanism of the most common ipilimumab side effect.


Cities around the world are under constant change. Population growth is leading to an increasing demand for residential, commercial and traffic areas and thus leading to progressive surface sealing and urban densification. Adding on the existing and growing challenging situation, the Earth’s climate is undergoing dramatical changes. Globally affecting cities by altering local temperature patterns, enhancing the occurrence of dry periods and increasing the frequency of Excessive Heat Events (EHE) as well as tropical nights per year, urban planning is becoming increasingly demanding. These consequences put cities (citizens and infrastructure) at risk, amplifying urban heat and the Urban Heat Island (UHI) effect. To ensure anticipatory and holistic planning approaches to counteract the consequences of climate change, specific tools must be developed enabling consideration of different aspects and boundary conditions as well as analysis of crucial processes and complex relationships within the urban environments. Therefore, we introduce a simple and fast spatial GIS-based modelling approach to carry out fine-scale simulations for land surface temperature (LST), mean radiant temperature (MRT) and Universal Thermal Climate Index (UTCI) in a 2D urban environment. This modelling approach combines a fine-scale surface classification, comprised of eight different surface classes, thermal characteristics (global radiation, direct radiation and diffuse radiation), surface characteristics (Emissivity and Bowen-Ratio values) and meteorological input data. Based on this combined dataset and well-established physical relations in the model set-up, the model uses an adapted approach to first evaluate LST, followed by the MRT and finally the UTCI. A DEM (Digital Elevation Model), a CIR-Image (Coloured Infrared Image) and a vector layer depicting building geometry are required as model input datasets. The accuracy of the input datasets determines the accuracy of the output datasets including the three main indicators. To improve this modelling approach and to consider the effects of climate change, we combine this spatial GIS-approach with the capabilities of computational fluid dynamics (CFD). We use CFD software to simulate wind velocities as well as air temperatures based on certain input parameters. Simulation time strongly depends on the complexity of the urban form within the area of interest. Therefore, a specific urban area was selected and the building structure, as well as the tree structure, was approximated by a self-designed 3D model. An additional input data set containing LST is provided by the modelling approach described above. Temperature data of the building envelope was conducted using a thermal infrared camera, with on-site measurements in the study area carried out during the summer of 2020. Among other settings, an initial wind speed and air temperature define the boundary conditions. Transferring calculated wind speed and air temperature datasets for different heights across the study area using CFD into the GIS based approach, leads to improved spatial LST, MRT and UTCI calculations and results and thus enhanced urban micro- and bioclimatic modelling.


Observ. XV. illustrated by Schem. IX. Figur:1 (figure 1 of this paper) in Robert Hooke's Micrographia (1665)1 is a description of Kettering–stone 'which is brought from Kettering in Northampton–shire, and digg'd out of a Quarry, as I am inform'd'. As Curator of Experiments for the Royal Society from 1662, Hooke was charged by the Society to bring in at every meeting one microscopical observation at least. The minutes of the Society2 record that on 15 April 1663 'Mr Hooke showed the Company two Microscopicall Schemas; one representing the Pores of Cork … the other a Kettering Stone, appearing to be composed of Globules; and those hollow ones, each having 3 Coatings, sticking to one another, and so making up one entire firm stone'.


The possibility for independently evolving entities to form and persist in the absence of sexual recombination in eukaryotes has been questioned; nevertheless, there are organisms that are known to be asexual and that have apparently diversified into multiple species as recognized by taxonomists. These organisms have therefore been identified as an evolutionary paradox. We explore three alternative hypotheses attempting to solve the apparent paradox, focusing on bdelloid rotifers, the most studied group of organisms in which all species are considered asexual: (1) they may have some hidden form of sex; (2) species do not represent biological entities but simply convenient names; and (3) sex may not be a necessary requirement for speciation. We provide ample evidence against the first two hypotheses, reporting several studies supporting (1) bdelloids asexuality from different approaches, and (2) the existence of species from genetics, jaw morphology, ecology, and physiology. Thus, we (3) explore the role of sex in speciation comparing bdelloid and monogonont rotifers, and conclude with some caveats that could still change our understanding of bdelloid species.


This paper describes a software system to track the reoccurrences of objects in multi-camera visual surveillance. Specifically, it is designed for after-event tracking of people to aid in a typical investigation of events occurring in a certain location at a certain time. This is a nontrivial problem because of several aspects that influence the appearance of scenes and people, such as changes in viewpoints, lighting conditions, shadow, occlusion, and weather conditions. Another challenge, which is the focus of this paper, is to integrate different required components into a complete working system, namely (i) motion detection, (ii) object classification, (iii) object modeling and matching, and (iv) interactive retrieval and visualization. We have designed and implemented a robust system consisting of state-of-the-art technologies in each component. We performed experiments with the system on a real-life dataset gathered from 12 street surveillance cameras over two hours in a city area. The experiments showed promising results in retrieving the reoccurrences of four target subjects.


Routing is a critical operation in networks. In the context of data and sensor networks, routing strategies such as shortest-path, multi-path and potential-based ("all-path") routing have been developed. Based on the connection between routing and flow optimization in a network, in this paper we develop a unifying theoretical framework by considering flow optimization with mixed (weighted) L1/L2-norms. We obtain a surprising result: as we vary the trade-off parameter, the routing graphs induced by the optimal flow solutions span from shortest-path to multi-path to all-path routing - this entire sequence of routing graphs is referred to as the routing continuum. Our theory subsumes the earlier results showing the shortest path and all-path routing can be obtained from L1 and L2 flow optimization, respectively. We also develop an efficient iterative algorithm for computing the entire routing continuum. Several generalizations are also considered, with applications to traffic engineering and wireless sensor networks.


Proton/gamma and alpha/gamma response ratios have been measured for very fine powders of the thermoluminescent phosphors CaF 2 :Mn, CaF2:Dy and CaSO4:Tm. This has been done as part of an evaluation of these phosphors for use in a combined neutron/gamma thermoluminescent dosimeter which is made neutron sensitive by embedding the phosphor powder in an hydrogenous medium. The CaF2:Mn phosphor has been found to be marginally better than the other two for this purpose. Reduction in the measured proton/gamma response ratio with decreasing proton energy has been attributed primarily to relatively low response near the surfaces of the phosphor particles.


The present analysis contributes to the existing literature on religion and suicide in three interrelated ways: (1) providing an analysis of suicide completions whereas most research is based on non-lethal levels of suicidality; (2) assessing the relationship with concrete individual level data on completed suicides instead of aggregated data marked by the ecological fallacy issue; and (3) providing gender specific analyses to determine if the relationship is gendered. METHODS. Data come from the U.S. Public Health Service, National Mortality Followback Survey. They refer to 16,795 deaths including 1385 suicides. Significant others of the deceased were interviewed to measure all variables. The dependent variable is a binary variable where 1 = death by suicide and 0 = all other causes. The central independent variable is an index of religious activities. Controls are included for five categories of confounders (1) psychiatric morbidity; (2) help-seeking behavior; (3) Opportunity factors such as firearms; (4) social integration; and (5) demographics. RESULTS. Multivariate logistic regression analysis determined that controlling for 16 predictors of suicide, a one unit increase in religious activities reduced the odds of a suicide death by 17% for males and by 15% for females. The difference in coefficients is not significant (Z = 0.51). Other significant predictors of suicide deaths included suicide ideation (OR = 8.87, males, OR = 11.48, females) and firearm availability (OR = 4.21, males, OR = 2.83, females). DISCUSSION. Religious activities were found to lower suicide risk equally for both men and women. Further work is needed to assess pathways, including suicide ideation, between religious activities and lowered suicide risk. This is the first U.S. based study to test for a gendered association between religion and suicide at the individual level of analysis.


Response of 16 oilseed rape genotypes to B (boron) toxicity was analyzed by
 comparing the results of two experiments conducted in a glasshouse. In
 Experiment 1 plants were grown in standard nutrient solutions with 10 µMB
 (control) and 1000 µM B. Relative root and shoot growth varied from 20-120%
 and 31-117%, respectively. Variation in B concentration in shoots was also
 wide (206.5-441.7 µg B g-1 DW) as well as total B uptake by plant (62.3-281.2
 µg B g1). Four selected genotypes were grown in Experiment 2 in pots filled
 with high B soil (8 kg ha-1 B; B8). Shoot growth was not affected by B8
 treatment, while root and shoot B concentration was significantly increased
 compared to control. Genotypes Panther and Pronto which performed low
 relative root and shoot growth and high B accumulation in plants in
 Experiment 1, had good growth in B8 treatment. In Experiment 2 genotype
 NS-L-7 had significantly lower B concentration in shots under treatment B8,
 but also very high B accumulation in Experiment 1. In addition, cluster
 analyses classified genotypes in three groups according to traits contrasting
 in their significance for analyzing response to B toxicity. The first group
 included four varieties based on their shared characteristics that have small
 value for the relative growth of roots and shoots and large values of B
 concentration in shoot. In the second largest group were connected ten
 genotypes that are heterogeneous in traits and do not stand out on any
 characteristic. Genotypes NS-L-7 and Navajo were separated in the third group
 because they had big relative growth of root and shoot, but also a high
 concentration of B in the shoot, and high total B uptake. Results showed that
 none of tested genotypes could not be recommended for breeding process to
 tolerance for B toxicity. [Projekat Ministarstva nauke Republike Srbije, br.
 OI 173028]


To achieve different end-use properties of polymers, an industrial plant must produce several grades of the product through the same process under different operating conditions. As molecular weight distribution (MWD) is a crucial quality index of polymers, grade transition based on MWD is of great importance. Dynamic optimization of the grade transition process using MWD is a challenging task because of its large-scale nature. After analyzing the relationships among state variables during polymerization, a novel method is proposed to conduct the optimal grade transition using dynamic optimization with a small-scale moment model, combined with a steady-state calculation of the MWD. By avoiding expensive computation in dealing with dynamic MWD optimization, this technique greatly reduces the computational complexity of the process optimization. The theoretical equivalence of this simplification is also proved. Finally, an industrial high-density polyethylene slurry process is presented to demonstrate the efficiency and accuracy of the proposed strategy. © 2014 American Institute of Chemical Engineers AIChE J, 60: 2498–2512, 2014


Data have been presented on dynamic changes in plasma insulin concentrations in normal and pathologic states and the relationship between plasma insulin levels and insulin secretory rates has been considered. Hypoglycemia secondary to absolute or relative hyperinsulinism can follow stimulation by glucose or pharmacologic agents, abnormal sensitivity to leucine, uncontrolled secretion by insulinomas and exogenous insulin administration; hypoglycemianot associated with significant elevation of plasma insulin may occur with nonpancreatic neoplasms, fructose intolerance, idiopathic hypoglycemia of childhood and hepatic malfunction. The occasional failure of the body's counterregulatory mechanisms to alleviate hypoglycemia in the absence of significant hyperinsulinism may be attributable to different factors in individual cases and requires independent study.


A distinct type of cervical involvement by endometrial cancer is reported and termed cervical implantation metastasis. It is believed to result from implantation of endometrial cancer on the denuded endocervix after fractional dilatation and curettage (D & C). The histologic criteria for diagnosis are: (1) the cervical implantation metastasis must be imbedded in the endocervical epithelium or superficial stroma surrounded by an implantation site of inflammatory cells and granulation tissue (free‐floating cancer cells above the cervical mucosa are not acceptable as implantation tissue), (2) the histologic findings of the cervical implantation metastasis must be similar to those of the endometrial adenocarcinoma in the uterine corpus, (3) the cervical implantation metastasis must be separate from the primary tumor with no evidence of direct extension, and (4) the cervical implantation metastasis should be surrounded by nonneoplastic endocervical glands with no transition between the two. Of the 176 patients who underwent fractianal D & C before hysterectomy. nine (5%) were found to have cervical implantation metastasis. No patients had cervical implantation metastasis who did not undergo fractional D & C before hysterectomy. When stratified according to stage, grade, and myometrial invasion, there was no statistically significant difference in the recurrence rate between patients with or without cervical implantation metastasis. It appears that cervical implantation metastasis does not alter prognosis or require specific treatment.


Since last few decades, the environmental challenges have been garnering severe attention from all the masses around the globe and have affected the political, social, legal as well as economical aspects at a considerably large scale. The environmental threats such as biomedical waste, textile waste, food waste, etc. have been hampering and posing threats to the living beings. An error in segregating and dumping the biomedical waste can taint the groundwater resources and may also pollute the air we breathe in. Several atmospheric discharges such as Nitrogen and Sulphur Oxide from the furnaces of the textile mills pose a threat to the workers and the environment. Only few of us contemplate the role played by the food waste in imposing grievous damage to the environment by the Methane gas which is released after it decomposes. Apart from the individuals, the corporate organizations have also played a major role in endangering the natural resources as well as the environment. This paper showcases the disproportionate penalties paid by the huge corporate organizations in lieu of the actual damage caused to the environment. The plight of the environment has been relieved through various national laws, international laws and policies. In some parts of the world, the mitigating policies have been implemented at a rapid pace while the other part still struggles for justice and environment friendly policies. This paper aims to highlight the role of the legislature and the judiciary in the evolution of the laws and policies pertaining to the environment.


In high aspect ratio (HAR) dielectric plasma etching, dual-frequency capacitively coupled radio-frequency plasmas operated at low pressures of 1 Pa or less are used. Such plasma sources are often driven by a voltage waveform that includes a low-frequency component in the range of hundreds of kHz with a voltage amplitude of 10 kV and more to generate highly energetic vertical ion bombardment at the wafer. In such discharges, the energetic positive ions can overcome the repelling potential created by positive wall charges inside the etch features, which allows high aspect ratios to be reached. In order to increase the plasma density a high-frequency driving component at several 10 MHz is typically applied simultaneously. Under such discharge conditions, the boundary surfaces are bombarded by extremely energetic particles, of which the consequences are poorly understood. We investigate the charged particle dynamics and distribution functions in this strongly non-local regime in argon discharges by particle-in-cell simulations. By including a complex implementation of plasma-surface interactions, electron induced secondary electron emission (δ-electrons) is found to have a strong effect on the ionization dynamics and the plasma density. Due to the high ion energies at the electrodes, very high yields of the ion induced secondary electron emission (γ-electrons) are found. However, unlike in classical capacitive plasmas, these γ-electrons do not cause significant ionization directly, since upon acceleration in the high voltage sheaths, these electrons are too energetic to ionize the neutral gas efficiently. These γ- and δ-electrons as well as electrons created in the plasma bulk and accelerated towards the electrodes to high energies by reversed electric fields during the local sheath collapse are found to induce the emission of a high number of δ-electrons, when they hit boundary surfaces. This regime is understood fundamentally based on the following approach: first, dual-frequency discharges with identical electrode materials are studied at different pressures and high-frequency driving voltages. Second, the effects of using electrodes made of different materials and characterized by different secondary electron emission coefficients are studied. The electron dynamics and charged particle distribution functions at boundary surfaces are determined including discharge asymmetries generated by using different materials at the powered and grounded electrodes.


Large language models have recently achieved state of the art performance across a wide variety of natural language tasks. Meanwhile, the size of these models and their latency have significantly increased, which makes their usage costly, and raises an interesting question: do language models need to be large? We study this question through the lens of model compression. We present a novel, structured pruning approach based on low rank factorization and augmented Lagrangian L0 norm regularization. Our structured approach achieves significant inference speedups while matching or outperforming our unstructured pruning baseline at various sparsity levels. We apply our method to state of the art models on the enwiki8 dataset and obtain a 1.19 perplexity score with just 5M parameters, vastly outperforming a model of the same size trained from scratch. We also demonstrate that our method can be applied to language model fine-tuning by pruning the BERT model on several downstream classification benchmarks.


A novel pulse phase method for ultrasonic flow measurement in pipes under pressure is presented. It belongs to a group of direct time measurement methods. The difference in propagation (transit) time between two ultrasonic beams transmitted in upstream and downstream directions across the fluid flow is measured. With a goal to achieve an accuracy better than 1% each of the transit time intervals is decomposed into two intervals. The first interval, called 'coarse', points to an integer number of the ultrasonic signal periods during propagation time, and the second one, called 'fine', points to the rest of its periods. Fluid flow velocity and volume quantity are determined through involving the calibration function. The main metrological characteristics of the realised fluid flowmeter are determined using available working etalons. Experiments have shown that the total error of the flowmeter described herein is within the specified accuracy of 1%.


Four general medicine units were divided into two "firms" to improve patient outcomes and ensure continuity of care. All members remain part of their firm for as long as they are employed. The nurse case managers remain constant in both inpatient and outpatient settings and coordinate discharge planning.


Objective: In this study, the effect of short-term exposure to welding fumes emitted by different welding techniques on workers was investigated. Methods: In a 3-fold crossover study, six welders used three different welding techniques for 3 hours. Before and after welding, blood and urine samples were collected to perform biomonitoring of metals. Breath condensate was collected to assess inflammatory reactions, and lung function measurements were performed. Results: Welding led to a significant increase of chromium and nickel in blood and urine and of nitrate and nitrite in exhaled breath condensate. These increases were higher for manual metal arc welding with alloyed material (MAW-a). Several lung function parameters decreased after welding. This decrease was significantly higher after MAW-a. Conclusions: In respect to biological effects, MAW-a seems to be more important than other welding techniques.


A comterm map method permits machine computation of the probability of occurrence of the event associated with the output for each logic gate of a multistate logic tree. The method is general and applies to any tree configuration, except where feedback occurs from higher to lower gates. Any state of two or more mutually exclusive component states may be used one or more times as primary inputs to the logic gates. The method usually requires much less memory than a minterm or Karnaugh map method by providing map space for only those selected components called ``common.''


Nanoparticles (NP) are being increasingly explored as vehicles for targeted drug delivery because they can overcome free therapeutic limitations by drug encapsulation, thereby increasing solubility and transport across cell membranes. However, a translational gap exists from animal to human studies resulting in only several NP having FDA approval. Because of this, researchers have begun to turn toward physiologically based pharmacokinetic (PBPK) models to guide in vivo NP experimentation. However, typical PBPK models use an empirically derived framework that cannot be universally applied to varying NP constructs and experimental settings. The purpose of this study was to develop a physics-based multiscale PBPK compartmental model for determining continuous NP biodistribution. We successfully developed two versions of a physics-based compartmental model, models A and B, and validated the models with experimental data. The more physiologically relevant model (model B) had an output that more closely resembled experimental data as determined by normalized root mean squared deviation (NRMSD) analysis. A branched model was developed to enable the model to account for varying NP sizes. With the help of the branched model, we were able to show that branching in vasculature causes enhanced uptake of NP in the organ tissue. The models were solved using two of the most popular computational platforms, MATLAB and Julia. Our experimentation with the two suggests the highly optimized ODE solver package DifferentialEquations.jl in Julia outperforms MATLAB when solving a stiff system of ordinary differential equations (ODEs). We experimented with solving our PBPK model with a neural network using Julia's Flux.jl package. We were able to demonstrate that a neural network can learn to solve a system of ODEs when the system can be made non-stiff via quasi-steady-state approximation (QSSA). Our model incorporates modules that account for varying NP surface chemistries, multiscale vascular hydrodynamic effects, and effects of the immune system to create a more comprehensive and modular model for predicting NP biodistribution in a variety of NP constructs.


Background: People with schizophrenia tend to engage in less physical activity (PA) than the general population, and experience higher rates of cardiovascular disease and obesity. Symptoms of schizophrenia are heterogeneous, and categorized as Positive, Negative, or Cognitive. Negative symptoms (NS) – deficits in typical function – have been consistently associated with less PA among people with schizophrenia. Certain NS, specifically amotivation, may be more relevant to engaging in goal-directed activities than others. Associations between specific NS and PA have not been reported. A secondary analysis of reliability data for a Health Action Process Approach (HAPA) inventory for PA in schizophrenia examined relationships between symptomology, PA and sedentary behaviour.

 Methods: 26 participants with schizophrenia or schizoaffective disorder were assessed for symptoms using the Brief Psychiatric Rating Scale (BPRS), the Clinical Global Impression Severity scale (CGI), and the Apathy Evaluation Scale (AES). Participants reported moderate and vigorous PA and sitting time from the previous 7 days using the International Physical Activity Questionnaire, and PA Intentions from the HAPA inventory.

 Results: Pearson correlations revealed significant associations between high levels of amotivation (AES) and fewer weekly minutes of moderate PA ( r =-.41, p =.035) and PA intentions ( r =-.56, p =.003). Total BPRS ( r =-.56, p =.003), the NS factor of the BPRS ( r =.40, p =.045) and CGI scores ( r =-.54, p =.004) were also inversely related to PA intentions. Sitting time was related to total BPRS ( r =.43, p =.042) and CGI scores ( r =.45, p =.032); a similar trend emerged with the AES (r=.38, p=.08). Symptom scales did not significantly correlate with vigorous or moderate-to-vigorous PA.

 Conclusion: These findings suggest a central role for amotivation as a disease-related barrier to moderate PA in patients with schizophrenia. A larger sample size would allow for more specific analysis of symptomology correlates of PA, which may help tailor PA promotion to the heterogeneous needs of this population. Acknowledgments: This study was supported by a Canadian Institutes of Health Research (CIHR) operating grant #MOP-115709.


Temperature is among the most important factors limiting CPU performance. To ensure stable and reliable operation temperature has to be limited. In this paper we present a method for predicting temperature of a multi-core microprocessor based on it's high-level thermal model. Temperature prediction is then utilised in a Dynamic Thermal Management algorithm that can exploit performance optimisation opportunities while ensuring operation below temperature limit. The DTM algorithm uses frequency and voltage scaling of the CPU cores and task migration and was evaluated on a physical computer with a quad-core CPU.


This paper presents an in-depth investigation of frequency-domain super-resolution time-of-arrival (TOA) estimation with diversity techniques for indoor geolocation applications. A methodology for performance evaluation of super-resolution techniques based on the measurements of indoor radio propagation channels is presented. The performance of super-resolution techniques is compared with the performance of conventional TOA estimation techniques. The effects of diversity techniques on the performance of super-resolution techniques are evaluated. The measurement and simulation methods presented in this paper can be used to establish empirical performance bounds for real implementation of super-resolution indoor geolocation systems.


Abstract Molecular phylogenetic methods were used to examine a number of morphologically based hypotheses concerning the taxonomic relationships and origin of the grasshopper subfamily Melanoplinae. This paper focuses on several North American genera and their interrelationships and connections with taxa on other continents. Portions of four mitochondrial genes (coding for cytochrome b, cytochrome oxidase subunits I and II, and NADH dehydrogenase subunit II) were sequenced in 17 North American species representing 13 genera, along with five and eight species from South America and Eurasia, respectively. Phylogenetic trees were constructed using maximum parsimony, weighted parsimony, neighbor-joining, and maximum likelihood methods. Bootstrap replications provided levels of confidence for recovered associations. Maximum resolution was achieved using weighted parsimony and by treating all sequences, totaling 1716 bp, as a unit. In terms of taxonomic organization, our phylogenetic analysis demonstrated that an earlier division of Melanoplinae into two tribes, Melanoplini and Podismini, has merit. Monophyly of each tribe was supported statistically. There was, however, no support for various systems subdividing Podismini into subtribes or "groups." Neither eastern nor western North American podismines proved monophyletic. There was no support for the integrity of another proposed tribe, Dactylotini. All methods suggested South America as the place of origin for the subfamily, supporting previous molecular studies. Both tribes originated in North America, most probably in the southwest United States. With respect to Podismini, this is contrary to the prevailing view of a Eurasian origin for the tribe.


This study was carried out between April, 2002 and April, 2003 at four stations in Mamasin Dam Lake in the Central Part of Anatolian Region of Turkey. Sixty phytoplanktonic algal taxa were recorded at these stations. These were consisting of species belonging to divisions of Ochrophyta (=Bacillariophta), Chlorophyta, Charophyta, Cyanobacteria and Euglenozoa. Generally, members of Ochrophyta group were dominant in the lake. Some physical and chemical water quality parameters were determined and these were related with chlorophyll-a values.


Fruits are needed in our life as part of nutrition component and have many beneficial effects on human health, e.g. as the source of dietary antioxidants. In Malaysia, Sarawak is one of the states that is rich in many types of flora, e.g. Canarium odontophyllum, which have not been well investigated. This fruit is not well known because it was categorized as underutilized and indigenous species. As part of an investigation, knowledge on the physical properties of fruit is important as the basic information. Therefore, this study was conducted with the objective to determine the physical properties of C. odontophyllum (length, width and thickness, cm), shape (sphericity index, aspect ratio, %) and mass (whole, skin, flesh, kernel, g). The data were obtained from the measurements of physical properties of two different sizes of C. odontophyllum and were stated as mean ± SD for whole fruit and mass fractions (skin, flesh and kernel) of the fruit. Averaged values (mean±SD) of big and small fruits were determined for length (4.10±0.11; 3.74±0.08 cm), width (2.79±0.13; 2.40±0.07 cm), thickness (0.50±0.00; 0.40 ± 0.00 cm), sphericity index (67.37±4.32; 41.28±0.69%), aspect ratio (43.62±0.76; 65.79±2.26 %), whole fruit mass (18.28±1.59; 12.73±0.69 g), skin mass (1.02±0.19; 0.86 g), flesh mass (11.22±0.93; 7.81 g) and kernel mass (6.79 ± 0.81; 5.84 g). These findings can be used as baseline information for further nutritional and processing application of the fruit.


In this work, the properties of the class of parallel feedforward compensators to stabilize linear closed-loop systems are studied. The characteristic equation and its root locus behavior, including its asymptotes, are investigated to leave out the compensators that will not result in a stable closed-loop system. Even though there have been numerous studies relevant to parallel feedforward compensation that result in the optimal integration of squared errors (ISE), the broader view of all possible compensators has not been of much interest in the literature. Nevertheless, this study is important because, in the presence of noise and disturbance, an optimal ISE control design for the nominal plant may perform poorly while a finite ISE design may have a robust and efficient performance. One of such class compensators is parallel feedforward compensator with derivative effort (PFCD) that for a vast number of processes can have impressive properties such as no branch comebacks to the right half plane (RHP) of the root locus plot (LHP black hole effect). The example in this paper shows how effectively PFCD can contract the root locus branches into the LHP.


The Comer Brook - Glover Island region records the development of the internal domain of the Humber Zone and its relationship to the adjoining external domain and Dunnage Zone. The region preserves both the Laurentian margin basement-cover contact and the siliciclastic-carbonate transition within the cover sequence. Precambrian Grenville basement of the Comer Brook Lake Complex is the oldest lithostratigraphic unit and yielded a UIPb zircon age of 1510 + 6 Ma. Three main lithostratigraphic assemblages overlie basement: silicic and mafic igneous rocks of the Lady Slipper Pluton which yielded a UIPb zircon age of 555Z: Ma; siliciclastic lithologies which include the South Brook and Surnrnerside formations; and carbonate-dominated sequences with clastic incursions which include the Port au Port, St. George, and Table Head groups, and the Breeches Pond, Irishtown, and Pinchgut formations. Dunnage Zone units include plutonic ultramafic to mafic rocks of the Grand Lake Complex, dated by UIPb zircon from trondhjemite at 490 + 4 Ma, volcanic and epiclastic rocks of the Glover Island Formation, and the Matthews Brook Serpentinite, the latter restricted to fault slivers within the Humber Zone sequence. The deformed Glover Island Granodiorite intrudes the Dunnage Zone rocks on Glover Island and is dated by UlPb zircon and titanite at 440 + 2 Ma. Little deformed Carboniferous sedimentary rocks unconfonnably overlie both Humber Zone and Dunnage Zone rock units. Timing of regional deformation and peak amphibolite-facies metamorphism in the eastern Humber Zone is constrained by isotopic data to the Early Silurian. In the Dunnage Zone, shear zones and foliation development both pre- and postdate the age of the Glover Island Granodiorite, with the later possibly temporally equivalent to deformation in the Humber Zone. Final juxtaposition of the two zones occurred during Carboniferous movement of the Cabot Fault.


The 1915 Buddhist-Muslim riots in Ceylon are often attributed to religious animosity, but economic and political factors significantly influenced the environment in which the riots occurred and help to explain the drastic government reaction to the disorders. The Muslims involved, recent arrivals from India called Coast Moors, were primarily traders and moneylenders. Resentment against price increases and alleged profiteering developed among the Sinhalese Buddhists. Before 1915, communal tensions had grown, with many Sinhalese-language newspapers denouncing the Coast Moors for exploitation of the Ceylonese. A Buddhist temperence movement had become a channel for articulating nationalist sentiments and was viewed with suspicion by the colonial regime. Labor unrest and trade unionism had appeared in Colombo prior to the riots. There, the 1915 disorders were led by the most militant urban workers, particularly railway workers, and reflected working-class grievances over rising living costs and unemployment. Fear of German intrigue during the war, the spread of nationalism and terrorism from India, and urban working-class unrest led colonial officials to interpret the riots as a threat to British rule. The officials were divided on the severity of action required, but those favoring the most drastic measures prevailed.


We give an axiomatic foundation to the updating rule proposed by [Sarin, R. and Wakker, P. P. (1998). Revealed likelihood and knightian uncertainty. Journal of Risk and Uncertainty 16(3):223-250.] for CEU preferences. This rule is dynamically consistent but non-consequentialist, since forgone consequences are relevant for conditioning. Whereas it does not work universally, but only when counterfactuals outcomes are better and/or worse than the ones resulting on the conditioning event, the rule has many interesting features, since it is able to describe Ellsbergtype preferences together with a recursive structure of the criterion.


Frequency of extended lactations and their effect on milk and reproductive performance of cows from the active population of 11 891 Black and White cows with different proportions of Holstein Fresian inheritance were analysed. It was found that lactations longer than a 305-day standard lactation were quite common in the analysed population of Black-and-White cows improved with the Holstein-Friesian breed. The age of cows, the level of yield in a standard lactation and season of the year had a significant effect on the proportion of extended lactations. Lactation extension had a beneficial effect on milk yield in full lactation but was detrimental to fertility. The efficiency of lactation extension was found to increase with the increasing level of yield in the standard lactation.


Ninety-four urban and 54 rural respondents who had undergone hospitalisation in the previous three years were interviewed using a semistructured interview schedule to ascertain their experiences and opinion regarding ethical issues. The interview focussed particularly on patients' satisfaction and expectations about information pro vided by medical professionals on various aspects of their illness. Results revealed that both the groups were satisfied with the amount of information they had received during their hospitalisation. Rural respondents were comparatively less satisfied with the information they received regarding complications of illness, possible side effects/complications of treatment, and nature of investigations. A higher proportion of urban respondents required information about other available treatment options and possible outcome of illness if left untreated. A higher number of urban respondents felt that provision of information about illness may have harmful consequences to the patient, and more frequently reported that receiving information was the patient's right. These results suggest that although both urban and rural respondents were sensitive to ethical issues, the response of urban respondents from developing coun tries is more akin to that of their counterparts in the developed countries.


A small-signal analysis of a travelling-wave structure implemented by periodically loading a parallel-plate waveguide with either resonant tunnelling or QWITT diodes is presented. A small-signal equivalent circuit is used to determine the diode impedance as a function of frequency. The periodicity of the structure, i.e. the distance between adjacent diodes, determines the oscillation (resonant) frequency of the circuit. The analysis shows that change in the oscillation frequency through variation in the design width and thickness of the waveguide is minimal. The physical dimensions of the waveguide facilitate monolithic fabrication of the oscillator circuit.


This comparative research paper examines the protection of performers' rights in copyright law, focusing on the right to be identified as the performer and the right to object to derogatory treatment of performances. Through an analysis of legal provisions, treaties, and case law, this study provides a comprehensive understanding of the scope, limitations, and enforcement of these rights in various jurisdictions. The research explores historical development, international standards, and challenges in implementing and enforcing rights. The findings contribute valuable insights for policymakers, practitioners, and performers seeking to enhance the protection of performers' rights within copyright law. The study aims to foster a balanced framework that preserves performers' creative contributions and maintains a harmonized copyright ecosystem. Key Words: Right, Performer, Artistic, Copyright, Protection


Delusional paranoia has been associated with severe mental illness for over a century. Kraepelin introduced a disorder called "paranoid depression," but "paranoid" became linked to schizophrenia, not to mood disorders. Paranoid remains the most common subtype of schizophrenia, but some of these cases, as Kraepelin initially implied, may be unrecognized psychotic mood disorders, so the relationship of paranoid schizophrenia to psychotic bipolar disorder warrants reevaluation. To address whether paranoia associates more with schizophrenia or mood disorders, a selected literature is reviewed and 11 cases are summarized. Comparative clinical and recent molecular genetic data find phenotypic and genotypic commonalities between patients diagnosed with schizophrenia and psychotic bipolar disorder lending support to the idea that paranoid schizophrenia could be the same disorder as psychotic bipolar disorder. A selected clinical literature finds no symptom, course, or characteristic traditionally considered diagnostic of schizophrenia that cannot be accounted for by psychotic bipolar disorder patients. For example, it is hypothesized here that 2 common mood-based symptoms, grandiosity and guilt, may underlie functional paranoia. Mania explains paranoia when there are grandiose delusions that one's possessions are so valuable that others will kill for them. Similarly, depression explains paranoia when delusional guilt convinces patients that they deserve punishment. In both cases, fear becomes the overwhelming emotion but patient and physician focus on the paranoia rather than on underlying mood symptoms can cause misdiagnoses. This study uses a clinical, case-based, hypothesis generation approach that warrants follow-up with a larger representative sample of psychotic patients followed prospectively to determine the degree to which the clinical course observed herein is typical of all such patients. Differential diagnoses, nomenclature, and treatment implications are discussed because bipolar patients misdiagnosed with schizophrenia are severely misserved.


We consider iterative subspace Wiener filters for solving minimum mean-squared error (MMSE) and minimum variance unbiased estimation problems in low-dimensional subspaces. In this class of subspace filters, the conjugate direction and multistage Wiener filters comprise two large subclasses, and within these the conjugate gradient and orthogonal multistage Wiener filters are the most prominent. We establish very general equivalences between conjugate direction and multistage Wiener filters, wherein the direction vectors of a conjugate direction filter and the stagewise vectors of a multistage filter are related through a one-term autoregressive recursion. By virtue of this recursion, the expanding subspaces of the two filters are identical, even though their bases for them are different. As a consequence, their subspace filters, gradients, and MSEs are identical at each stage of the subspace iteration. If the conjugate direction filter is a conjugate gradient filter, then the equivalent stagewise filter is an orthogonal multistage filter, and vice-versa. If either the conjugate gradient filter or the orthogonal multistage filter is initialized at the cross-covariance vector between the signal and the measurement, then each of the subspace filters iteratively turns out a basis for a Krylov subspace.


Numerical and structural chromosome aberrations are recognised as
important diagnostic and prognostic indicators in human diseases,
including non-Hodgkin's lymphomas (NHL). Recently, fluorescence insitu
hybridization (FISH) has been used with increasing success to
identify and characterise many chromosomal aberrations, leading to the
development of multiple chromosome painting methods for simultaneous
dctection of multiple probes in metaphase target cells. In this study, we
have analysed 15 NHL biopsy samples and 5 human lymphoma cell
lines (Daudi. HS602, Raji, MC116 and Namalwa). Some of the cell
liiics were partially analysed cytogenetically in the early 1970s using
solid staining techniques, but no chromosome analysis has been
previously attempted on the HS602 cell line. The detection of
chromosome abnoimalities in malignant lymphoma patients and cell lines
by conventional cytogenetics is particularly problematic because of
difficulty in routineIy preparing metaphases spreads of sufficient quality
or quantity and the complex nature of many of chromosomal changes.
We completed cytogenetic analyses on all of the NHL samples and the
cell lines. We then followed a strategy of refining these preliminary
findings by applying multicolour FISH with whole chromosome
painting probes derived from flow sorted chromosome libraries, using
direct and indirect combinatorial labelling with two fluorochromes, to
detect up to five different chromosomes on the same target metaphase.
The application of multiple chromosome painting has enabled complex
rearrangements to be. characterised and made the identification of marker
chromosomes possible.


Hepatitis B virus (HBV) is one of many viruses transmitted through the blood or body fluids. This paper concentrates on a mathematical study of the survival rate of HBV. Using data which includes the survival time for individuals who were diagnosed as being affected by HBV and those who died from HBV, we fit non-linear models to study the survival time for people affected by the virus. Survival probabilities suggest an exponential curve for the survival time. We also consider a pure death process which is a stochastic model for the survival time of the individuals affected. Our results show that individuals who have been diagnosed as having HBV have an estimated life expectancy of approximately 625 days.


Acute respiratory infections (ARI) are the most common treatment case for outpatient medical care in the autumn and winter. There are more than 200 agents of respiratory infections. The possibility of using modern domestic immunе modulator Polyoxidonium in adults and children for the purpose of pre- vention and treatment of ARI and acute respiratory viral infections. In total 13 scientific papers were analyzed, which were attended by 2,616 patients aged 6 months to 90 years. It is intended to recommend the use of immunе modulators, and in particular Polyoxidonium for the prevention and treatment of acute respiratory diseases in order to increase the effectiveness of the therapy.


Section I: Diseases and Disorders Section II: Procedures and Techniques Section III: Differential Diagnosis Section IV: Laboratory Tests Section V: Clinical Algorithms Section VI: Drug Formulary Index


Besides the stress around Cu TSV's, also the stress induced by microbumps is a main contributor to transistor level stress. For complete and successful deployment of 3D IC all effects generating stress have to be addressed. Therefore, this work quantifies the stress and its effects associated with Cu microbumps and their interaction with underfill material in 3D stacks by using a combined experimental and theoretical approach. We report on the stress generated by backside microbumps affecting FETs through the thinned silicon die and the stress on the thin die caused by 3D stacking. We find that the FET current shifts reach over 40% due to the impact of stress. Additionaly, a FEM parametric study was performed to determine key stress reduction contributors in 3D stacks.


Background Large scale efforts to expand access to mental healthcare in low- and middle-income countries have focused on integrating mental health services into primary care settings using a task sharing approach delivered by non-specialist health workers. Given the link between mental disorders and risk of suicide mortality, treating common mental disorders using this approach may be a key strategy to reducing suicidality. Methods and findings The Programme for Improving Mental Health Care (PRIME) evaluated mental health services for common mental disorders delivered by non-specialist health workers at ten primary care facilities in Chitwan, Nepal from 2014 to 2016. In this paper, we present the indirect impact of treatment on suicidality, as measured by suicidal ideation, among treatment and comparison cohorts for depression and AUD using multilevel logistic regression. Patients in the treatment cohort for depression had a greater reduction in ideation relative to those in the comparison cohort from baseline to three months (OR = 0.16, 95% CI: 0.05–0.59; p = 0.01) and twelve months (OR = 0.31, 95% CI: 0.08–1.12; p = 0.07), with a significant effect of treatment over time (p = 0.02). Among the AUD cohorts, there were no significant differences between treatment and comparison cohorts in the change in ideation from baseline to three months (OR = 0.64, 95% CI: 0.07–6.26; p = 0.70) or twelve months (OR = 0.46, 95% CI: 0.06–3.27; p = 0.44), and there was no effect of treatment over time (p = 0.72). Conclusion The results provide evidence integrated mental health services for depression benefit patients by accelerating the rate at which suicidal ideation naturally abates over time. Integrated services do not appear to impact ideation among people with AUD, though baseline levels of ideation were much lower than for those with depression and may have led to floor effects. The findings highlight the importance of addressing suicidality as a specific target–rather than an indirect effect–of treatment in community-based mental healthcare programs.


Never has one disease caused so much fuss in the debate over the rights of the individual and the safety of the community. AIDS has managed to bring out the worst in our irrational fears about the unknown, as well as to crystallise all our bigotry and prejudices. Knowledge about AIDS and how it spreads are essential to combating it.


Author(s): Rosenberg, Jason Carl | Advisor(s): Reynolds, Roger | Abstract: L.O.S.T. is a 25-minute composition scored for a 16-part unaccompanied mixed choir. Related to the Renaissance practice of the paraphrase mass, the work is a compositional response, and potential companion piece, to Lamentations of Jeremiah by Thomas Tallis. L.O.S.T. is designed such that Tallis' work can be interleaved with it in performance. Both pieces are shaped by the Hebrew Bible's penitential "Book of Lamentations," which chronicles an attempt to understand and cope with a devastating loss -- in particular, the sacking of Jerusalem. The book is divided into 5 chapters. Each chapter consists of 22 lines of text or a multiple thereof, whereby each line begins with a different letter of the Hebrew alphabet. Likewise, the English language lyrics created for L.O.S.T. by the composer contain 22 lines, each beginning with a different letter of the English alphabet. The four letters omitted from the list are, in order: L, O, S, and T. Relating to the five distinct poems that comprise the "Book of Lamentations", as well as the five florid, melismatic passages that punctuate Tallis' musical setting, L.O.S.T. is divided into five movements. Each movement of the piece outlines one of the five stages of grief as hypothesized by Kubler-Ross: denial, anger, bargaining, depression, and acceptance. Within or against this emotional context for each movement of L.O.S.T., Tallis' melodic material is transformed and re-imagined, overtly and covertly, thereby creating a set of evocations, which in turn can interact with the text syntactically or abstractly.


Head and neck cancers rank sixth among the most common cancers today, and the survival rate has remained virtually unchanged over the past 25 years, due to late diagnosis and ineffective treatments. They have two main risk factors, tobacco and alcohol, and human papillomavirus infection is a secondary risk factor. These cancers affect areas of the body that are fundamental for the five senses. Therefore, it is necessary to treat them effectively and non-invasively as early as possible, in order to do not compromise vital functions, which is not always possible with conventional treatments (chemotherapy or radiotherapy). In this sense, nanomedicine plays a key role in the treatment and diagnosis of head and neck cancers. Nanomedicine involves using nanocarriers to deliver drugs to sites of action and reducing the necessary doses and possible side effects. The main purpose of this review is to give an overview of the applications of nanocarrier systems to the diagnosis and treatment of head and neck cancer. Herein, several types of delivery strategies, radiation enhancement, inside-out hyperthermia, and theragnostic approaches are addressed.


Perak Man, named after the state where the skeleton was found, was the most complete skeleton found in Southeast Asia. The funerary artefacts indicate that Perak Man was highly respected, as he was buried at the centre of the highest cave in Lenggong, and he was the only person buried there. A copy of the original skull was made using computed tomography (CT) and 3D printing. Based on the internal structure of the reconstructed skull, the estimated intracranial volume (ICV) is 1,204.91 mL. The hypothetical face of Perak Man was reconstructed according to established forensic methods. Based on his presumed status, Perak Man was likely a respected person in the group and, perhaps, a shaman and the most knowledgeable person in the group regarding survival, hunting, gathering and other aspects of Palaeolithic daily life.


Objective: To measure the current state of organizational and well-being factors in otolaryngology residency programs and associate these perceptions with demographics, pursuit of subspecialty fellowships, and performance on the Otolaryngology Training Examination (OTE). Materials and Methods: Anonymous mail and online survey study of otolaryngology residents from the Southern, Mid-Atlantic, and East South-Central Regions of the United States. Summary of Results: A total of 46 otolaryngology residents across 14 residency training programs (22% resident response rate) completed our survey. Residents who scored above the 80th percentile on the OTE perceived greater organizational support (median = 3.84) than residents who scored below the 40th percentile (median = 3.31), U = 48.00, P = .047, η2 = 0.14. Residents interested in fellowship reported less burnout (median = 2.44) compared to those who did not plan to pursue fellowship (median = 3.56), U = 105.00, P = .010, η2 = 0.05. Residents pursuing fellowship also reported less work–life strain (median = 2.56) than those forgoing fellowship (median = 2.89), U = 126.00, P = .044, η2 = 0.10. Residents with children reported greater work–life strain (median = 3.11) compared to those without (median = 2.56), U = 60.50, P = .008, η2 = 0.15. Conclusion: For otolaryngology residents in this survey sample, the perception of organizational support and well-being may influence resident performance (on OTE examinations) and ultimate career goals (fellowship applications). Program directors and coordinators can use this information to strengthen the perceptions of organizational support as well as improve the clinical learning environment to optimize training conditions for their residents. Residency program directors can also use the identified study measures to assess resident perceptions of the clinical learning environment and well-being for annual evaluation and improvement purposes.


At commencement exercises themes concerning the improvement of the medical profession are always appropriate. It is only through the aid of the well-trained young men now entering the profession that we may hope for greater progress in the future. That there is still plenty of room for improvement in the medical profession can scarcely be doubted. If, indeed, we consider the matter carefully we must reach the paradoxical conclusion that the medical profession of the United States ranks at the same time the highest and the lowest among the great civilized nations. In technical skill our leaders, especially in surgery, are probably the best in the world. On the other hand, owing to the low standards of medical education that have prevailed in this country during the past century, it must be frankly confessed that the rank and file of our medical practitioners average low in proficiency. As a single


BACKGROUND
Information technology (IT) is a critical but underused component of health care. Many factors contribute to the inconsistent adoption of IT.

OBJECTIVE
To review the literature to better elucidate barriers that are likely to affect the adoption of IT by pediatric professionals.

DATA SOURCES
Manuscripts were found using a MEDLINE search combining the terms medicine, information systems, and technology transfer. I also obtained references cited by relevant articles. Finally, I explored the Internet using http://www.google.com and http://www.northernlight.com.

STUDY SELECTION
Articles discussing barriers or factors affecting the adoption of IT were considered for inclusion. Articles unrelated to clinical IT were excluded.

DATA SYNTHESIS
A variety of barriers exist that affect the adoption of useful technologies. Situational barriers include challenges imposed by the current national health environment, financial and legal risks associated with technology purchasing and use, and access to technology. The most significant barrier is that pediatric health care practitioners may lack the knowledge or training to use IT effectively.

CONCLUSIONS
Although some barriers exist that may be challenging to overcome, other barriers, such as the lack of knowledge about the uses of IT, are imminently solvable. Efforts to overcome these barriers should begin in earnest and should include educating stakeholders in the care of children and adolescents, as well as improving the knowledge about various technologies available to support pediatric and adolescent health care.


Hereditary spherocytosis (HS) is the most common cause of inherited red cell membranopathy, due to mutations in genes encoding for membrane or cytoskeletal proteins, including band 3, ankyrin, spectrin, band 4.1 or band 4.2. Membrane instability results in membrane surface area loss and generation of spherocytic red cells with elevated MCHC, decreased cellular deformability and reduced red cell survival, due to splenic sequestration. Clinical management of the hemolytic anemia due to HS depends on the age of the patient and the severity of anemia. Splenectomy is indicated in children with symptomatic anemia. A classic diagnostic test for HS is the incubated osmotic fragility: this test highlights the crucial role that ATP content plays in maintenance of normal RBC function including membrane stability: it is generally believed that the increased fragility of HS is the result of abnormal ATP depletion over the 24hr incubation. We explored the hypothesis that pyruvate kinase activator, mitapivat, by modulating ATP content could have potential beneficial effects for HS RBCs in band 4.2-/- mice, a well-established model of HS (Peters LL et al JCI 103: 1527, 1999). 4.2-/- mice exhibit moderate anemia which recapitulates most of the features of typical human HS without showing the profound anemization seen in other mouse models. Oral AG-348 administration to band 4.2-/- mice at dosages of 200 mg/kg/day over 6 months resulted in (i) improvement of anemia with reduced reticulocyte count (Hb 11.6±0.035 g/dL, n=17 vs 13.104±0.09 g/dL, n=9; P<0.05; retics: 11.4±0.1%, n=16 vs 7.6±0.2%, n=7 % P<0.05) and decrease hemolytic indices (LDH, total bilirubin) with decreased spleen weight/mouse weight ratio (8.41±0.08 vs 6.53±0.06, n=8 P<0.05); (ii) reduced hepatic and splenic iron overload; (iii) reduction in the proportion of phosphatidylserine positive RBCs, measured with Annexin V binding (2.4±0.02 vs 1.5±0.06 % P<0.05); (iv) reduction of naturally occurring antibody (NAb) bound to band 4.2-/- RBC membrane. The decreased hemolysis was associated with reduction in serum erythropoietin (EPO: 1001.2±41.7 U/L vs 472 ± 12.5 U/L, n=7, P<0.05), supporting the beneficial effect of mitapivat on HS anemia. These data indicate that mitapivat ameliorates anemia of band 4.2-/- mice, reduces chronic hemolysis and improves band 4.2-/- mouse RBC features. Thus, mitapivat might represent an interesting therapeutic option for HS patients.

 Kung: Agios Pharmaceuticals: Current Employment, Current equity holder in publicly-traded company. Kosinski:Agios Pharmaceuticals Inc: Current Employment, Current equity holder in publicly-traded company. Dang:Agios Pharmaceuticals Inc.: Current Employment, Current equity holder in publicly-traded company. Brugnara:Sysmex America Inc.: Consultancy; American Journal of Hematology: Other.