This exhaust gas purification facility (1, 70) has: an adsorptive removal device (2) provided with a rotation-type adsorbent (6) capable of adsorbing/desorbing flammable hazardous components contained in exhaust gas; a combustion-type exhaust gas purification device (4) for burning, in a combustion chamber (16) provided with a burner (56), exhaust air containing flammable hazardous components and purifying the flammable hazardous components, the exhaust air being discharged from the adsorptive removal device; a blower (40) provided upstream of the combustion-type exhaust gas purification device, the amount of exhaust air discharged from the absorptive removal device and blown into the combustion-type exhaust gas purification device being variable; a temperature sensor (50, 52, 58) for measuring the temperature in the combustion-type exhaust gas purification device corresponding to the concentration of the flammable hazardous components in the exhaust air; and a controller(42) for controlling the amount of exhaust air blown by the blower and the rotation speed of the adsorbent on the basis of the measurement values obtained by the temperature sensors and controlling the concentration of the flammable hazardous components in the exhaust air fed from the absorptive removal device to the combustion-type exhaust gas purification device.


Among the practical problems mentioned as outstanding by G.J. Foschini and G. Vannucci (see ibid., vol. Lt-6, no.3, p.370-9, 1988) is that of optical power level uniformity requirements. Foschini and Vannucci suggest that this should not be an insurmountable problem, but the commentor claims there is important source of nonuniformity which they appear to have overlooked. In the discussion of star networks, the commenter argues that they dismiss the losses in the coupler as a mathematical inconvenience that would cancel in performance analyses. The commenter aims to show that this is not generally true. In replying, Foschini and Vannucci take issue with the commentor's arguments and with the conclusions of D.B. Mortimore (1985), which serve as the basis of the commentor's arguments. >


In this study, we used a survey to examine how urban residents in Ljubljana, Slovenia, value and use distinct urban public spaces. Specifically, we were interested to assess if urban public spaces in the city are used/perceived as restorative environments. To do this, we addressed the question: To what extent do restorative dimensions differ in nine selected urban public spaces, varying in size, design, amenities, number of visitors, and, most importantly, degree of naturalness? Results from survey allowed to determine to what extent the selected urban public spaces in Ljubljana differ in terms of their perceived degree of restoration. We hypothesized that urban public spaces with a higher degree of naturalness in the city have a higher restoration value than urban public spaces with a lower degree of naturalness. Surprisingly, the urban public space that was above average on most restorative dimensions was the Old Town. These results are somewhat at odds with the attentional restoration theory, which states that the combination of dimensions is most typical of natural environments. However, this could be an indicator of the effectiveness of the city's current policies to improve the quality of life for its citizens.


A collapse of the Antarctic Ice Sheets would raise the sea level by 5 meters and, depending on how quickly it occurred, would pose an enormous threat to global economy and ecology. How stable are these volumes of ice? In his Perspective, Bindschadler discusses recent efforts to model the behavior of the West Antarctic Ice Sheet on the basis of data on past ice-sheet movement, including results reported in the same issue by
 Wingham
 et al .
 Consideration of these past data suggests that the ice sheets will remain stable for the next 4000 to 7000 years, but an accurate assessment awaits more data on ice-sheet history and better understanding of ice-sheet dynamics.


EDrroR,-In patients with colorectal cancer, any measures that reduce the delay to diagnosis should, hopefully, improve surgical cure rates and reduce the need for adjuvant treatment. There is good evidence from studies2 3 and from epidemiological publications4 to suggest that better application of proved methodologies would improve the detection of colorectal cancer at an early and more favourable stage. We recently completed a study of the diagnostic delays for all colorectal cancers presenting to our institution in 1993. Ninety three new colorectal cancers were diagnosed during the year. Seventeen patients presented as emergencies. When these patients were excluded the median delays were: time from onset of symptoms to presentation to the general practitioner, 60 days; from dispatch of letter to hospital review, 16 days; and from hospital review to histological confirmation, 15 days. Diagnosis was established at rigid sigmoidoscopy performed at the hospital clinic in 33 cases. The initial delay of 60 days could have been reduced to almost zero in these 33 patients if sigmoidoscopy were performed in primary care or if rapid open access to sigmoidoscopic services were available. The presence or absence of rectal bleeding made no difference to the likelihood of sigmoidoscopic abnormality in this group of patients. The importance of rectal examination has been emphasised in a study of 178 patients from Finland, in which information on initial rectal examination was not found in the hospital notes


Abstract The impact of benzene vapor (0.35 mg/l) of low concentration on the contents of free GABA, Glu and Asp, as well as on the enzyme activities of GDC and GABA-T in mitochondrial fractions of different brain regions of adult male rats was investigated. The conclusion was put forward that GABA increase by means of "keeping" inhibition provided for nerve cells defense from extremal excitation, taking place under the chronic exposure to the benzene low concentration.


This paper presents an improved equivalent-inputdisturbance (IEID) approach for disturbance rejection. It can be used for both minimumand nonminimum-phase plants. First, a full-order generalized state observer (GSO) is employed in the construction of an IEID-based servo system to estimate an equivalent input disturbance. Then, a stability condition is derived and a GSO design algorithm is developed based on the stability condition and a pole placement algorithm. Finally, a numerical example demonstrates the validity of this method.


Oilseed rape is known to persist in arable fields because of its ability to develop secondary seed dormancy in certain agronomic and environmental conditions. If conditions change, rapeseeds are able to germinate up to 10 years later to build volunteers in ensuing crops. Extrapolations of experimental data acted on the assumption of persistence periods for more than 20 years after last harvest of rapeseed. Genetically-modified oilseed rape—cultivated widely in Northern America since 1996—is assumed not to differ from its conventional form in this property. Here, experimental data are reported from official monitoring activities that verify these assumptions. At two former field trial sites in Saxony-Anhalt genetically-modified herbicide-resistant oilseed rape volunteers are found up to fifteen years after harvest. Nevertheless, spatial dispersion or establishment of GM plants outside of the field sites was not observed within this period.


In 1964, E.H. Hammond proposed criteria for classifying and mapping physiographic regions of the United States. Hammond produced a map entitled "Classes of Land Surface Form in the Forty‐Eight States, USA", which is regarded as a pioneering and rigorous treatment of regional physiography. Several researchers automated Hammond?s model in GIS. However, these were local or regional in application, and resulted in inadequate characterization of tablelands. We used a global 250 m DEM to produce a new characterization of global Hammond landform regions. The improved algorithm we developed for the regional landform modeling: (1) incorporated a profile parameter for the delineation of tablelands; (2) accommodated negative elevation data values; (3) allowed neighborhood analysis window (NAW) size to vary between parameters; (4) more accurately bounded plains regions; and (5) mapped landform regions as opposed to discrete landform features. The new global Hammond landform regions product builds on an existing global Hammond landform features product developed by the U.S. Geological Survey, which, while globally comprehensive, did not include tablelands, used a fixed NAW size, and essentially classified pixels rather than regions. Our algorithm also permits the disaggregation of "mixed" Hammond types (e.g. plains with high mountains) into their component parts.


A new decentralized hierarchical control scheme is presented to improve power sharing of multidistributed energy resources microgrids including nonlinear and sensitive loads. In this systems, electronically coupled distributed energy resources are responsible to perform the compensation to reduce the voltage harmonics at the point-of-common coupling. The proposed control scheme adds a new virtual impedance scheme, power calculation unit, and also a complementary loop to improve small- and large-signal stability margins and includes detailed modeling for all hierarchical control levels (either for grid-connected or islanded modes). Compared to conventional virtual impedance methods that add only line current feedforward terms to the voltage reference, here, the line current and voltage at the point-of-common coupling regulate the virtual impedance at fundamental and harmonic frequencies, respectively. So, mismatches in the feeder and line impedances are compensated. Moreover, a power calculation method based on harmonic power flow is presented, which exploits the nonlinear mapping ability of radial basis function neural networks to solve harmonic power flow and obtain voltage harmonics and active and reactive powers. To show the effectiveness of the proposed control scheme, offline time-domain simulation studies have been done on a test microgrid by MATLAB/SIMULINK software and verified experimentally using OPAL-RT real-time digital simulator.


Background: PI3K-AKT-mTOR pathway activation in breast tumors is associated with poorer breast cancer disease-free survival and decreased responsiveness to tamoxifen and trastuzumab. However, the role of germline variation in this pathway and breast cancer outcomes has not been previously evaluated. We hypothesized that single nucleotide polymorphisms (SNPs) in candidate genes affecting the PI3K-AKT-mTOR signaling pathway may act as genetic modifiers of breast cancer specific outcomes in patients diagnosed with early stage disease. Methods: We genotyped 106 SNPs in 13 genes (ADIPOQ, IGF1, INS, IRS1, LEP, LEPR, LEPROT, PIK3CA, PIK3R5, PTEN, TSC1, TSC2, and AKT1) in the P13K-AKT-mTOR pathway in a sample of 1020 women with stages I-II breast cancer treated at the MD Anderson Cancer Center between 1985 and 1999 and for whom long term follow-up on recurrence and death were available. The relationship between SNPs and breast cancer disease free survival (DFS) was assessed using Cox regression analysis. After correcting for false discovery rate (0.10) SNPs significantly associated with DFS in any genetic model (additive, dominant or recessive) were included in multivariable analysis. Results: After adjusting for race, age at diagnosis, tumor stage and treatment, rs1063539 in ADIPOQ (Hazard ratio [HR] 0.40, 95% confidence interval [CI] 0.19 - 0.86), rs11585329 in LEPROT (HR 0.72, 95% CI 0.53 - 0.98), and rs2519757 in TSC1 (HR 0.29, 95% CI 0.09 - 0.91) were associated with improved DFS and rs1520220 in IGF1 (HR 1.56, 95% CI 1.21 - 2.00) and rs2677760 in PIK3CA (HR 1.43, 95% CI 1.70 - 1.92) were associated with worse DFS. The associations were not modified by type of systemic treatment received. The SNPs were not associated with tumor characteristics such as tumor size, lymph node status, nuclear grade, or hormone receptor status. Conclusion: In this study, germline allelic variation inthe PI3K-AKT-mTOR pathway appears to modify breast cancer patient outcomes. Future studies are needed to replicate our results and to evaluate the relationship between these polymorphisms and activation of the PI3K-AKT-mTOR pathway in breast tumors. Citation Format: Mala Pande, Melissa Bondy, Kim-Anh Do, Aysegul A. Sahin, Jun Ying, Gordon B. Mills, Patricia Thompson, Abenaa Brewster. The association between germline genetic variants in the PI3K-AKT-mTOR pathway and breast cancer disease free survival. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3271. doi:10.1158/1538-7445.AM2014-3271


Objectives: The aim of the present study is to evaluate the efficacy of septoplasty in relieving symptoms and problems attributed to septal deviation including: nasal obstruction, recurrent sinusitis, recurrent /or chronic pharyngitis, epistaxis and snoring. Methods: This case series included eighty four patients with septal deviation severe enough to necessitate surgical intervention (severe nasal obstruction not relieved by medical treatment). The study was carried out at Al-Jumhori Teaching Hospital from July 2009 to Oct. 2010. All patients were suffering from nasal obstruction. Twenty seven patients had recurrent sinusitis, seven recurrent or chronic pharyngitis, five recurrent epistaxis, and snoring was found in four patients. The mean follow-up was six months with a range of 3-15 months. Results: The mean age of our patients was 27.3 years with a range of 15-52 years. The study included 52 males (61.9%) and 32 females (38.1%) with a ratio of 1.62:1. Sixty eight patients (80.9%) reported good improvement in their nasal obstruction after surgery. Improvement in recurrent sinusitis, chronic pharyngitis, epistaxis and snoring was 55.5%, 28.5%, 80% and 25% respectively. Conclusion: We conclude that septoplasty is indicated mainly to relieve nasal obstruction resulting from moderate to severe nasal septal deviation. Other conditions which are commonly attributed to septal deviation including recurrent sinusitis, chronic pharyngitis, epistaxis and snoring are not necessarily cured by this surgery.


Abstract This paper outlines a hypothetical six-dimension doctrine for military intelligence-gathering in the Akashic domain. The Akashic records are described by esotericists and mystics as a permanent record of all thoughts, feelings, and actions, stored in a kind of cosmic memory bank outside of space and time. Psychics, clairvoyants, and other intuitives purport to read the records, suggesting that development of an operational strategy for accessing such information may be possible. Command oversight, however, would present significant moral challenges, as "hacking" into this information would be a personally intrusive invasion of privacy with serious repercussions for the operators and state sponsors.


In this paper the concept of prime L-fuzzy ideals and L-fuzzy prime ideals of an ADL A with truth values in a complete lattice L satisfying the infinite meet distributive law are introduced. All prime L-fuzzy ideals of a given ADL A are determined by establishing a one-toone correspondence between prime L-fuzzy ideals of an ADL A and the pairs (P,α), where P is a prime ideal of A and α is a prime element in L. Also, here minimal prime L-fuzzy ideals and L-fuzzy minimal prime ideals of an ADL A are introduced and characterized.


Chile is a country that depends on the extraction and export of its natural resources. This phenomenon has exacerbated different processes of transformation and disturbance of natural and human ecosystems. Land use change has become a key factor for the transformation of ecosystems, causing consequences for biodiversity conservation. In this study, current and future (2030, 2050 and 2080) land use categories were evaluated. Land use projections were analysed together with models of ecosystem distribution in Chile under different climate scenarios, to finally analyse different dynamics of land use change within the protected areas system. In all the scenarios evaluated, land use projections showed an increase in the areas of industrial forest plantations and urban areas and a decrease in natural and agricultural areas could be expected. In relation to ecosystem modeling, vegetational formations located in the center and south of the country could be expected to decrease, while vegetational formations in the north and center of the country could extend their surface area. Inside Chile's protected area network, anthropic disturbances are currently undergoing expansion, which could have consequences for ecosystems and protected areas located in the central and central–south zones of Chile.


Purpose The aim of this study was to evaluate whether indomethacin eye drops and intravitreal ranibizumab (IVR) injections would provide additional benefit over ranibizumab alone in the treatment of choroidal neovascularization (CNV). Participants and methods This was a randomized, prospective pilot study of eyes with new-onset CNV. Fifty-eight patients were randomized 1:1 into a ranibizumab monotherapy (RM) group and a ranibizumab plus indomethacin (RI) group. All patients received monthly 0.5 mg IVR injections for 3 months, followed by monthly injections administered as needed. RI group patients also self-administered one drop of 0.5% indomethacin three times a day for 12 months. All patients were followed up for 12 months. Results At 12 months, both groups showed significant improvement in best-corrected visual acuity (BCVA) and central retinal thickness (CRT). The mean BCVA change from baseline to 12 months was −0.12±0.04 LogMAR and −0.20±0.04 LogMAR in the RM and RI groups, respectively, with the degree of change being significantly different between the two groups (P=0.04). At 12 months, the mean CRT in the RM group (316±41.2 µm) was significantly higher than that in the RI group (287±31.5 µm; P=0.004). The mean required number of IVR injections was 7.38±0.78 and 6.34±0.67 in the RM and RI groups, respectively (P<0.001). Conclusion Compared to IVR monotherapy, combination therapy with indomethacin eye drops and IVR provides superior anatomical and visual outcomes in patients with naive CNV lesions. Moreover, topical indomethacin might reduce the frequency of IVR injections, which is very beneficial considering the chronic and expensive nature of IVR therapy.


Abstract This paper deals with the question, how an abstract practice like 'violence' can be measured. On a methodological level, there are two possibilities: On the one hand, a quantitative approach that tries to determine homicide rates allegedly allowing comparisons over regions and time. On the other hand, there is a qualitative approach that analyses key concepts like 'cruelty' in order to define the limits of acceptable violence. However, both approaches have clear shortcomings. This article proposes another perspective: Using the example of France in the later Middle Ages, it scrutinises contemporary ideas of violence as they were expressed in chronicles and treatises. By focussing on decidedly negative descriptions of violent acts, we can pinpoint several characteristics that show which cultural aspects were of special importance for the contemporaries, e. g. the social standing of the people involved, the context of the act itself as well as the physical integrity of the nobles' bodies.


Fiberoptic colonoscopy was performed on 15 patients between the ages of 1 1/2 years and 16 years. Ten patients were hospitalized and five were outpatients. Of 12 with frank or microscopic blood in stools, fiberoptic colonoscopy revealed single polyps in six patients, ulcerative colitis in two and negative results in four with prior nondiagnostic radiographic studies, colonoscopy revealed ulcerative colitis in one, granulomatous colitis in one and negative findings in one. Polypectomy through the colonoscope was accomplished in all six patients with polyps. Perforation of the sigmoid colon during polypectomy with the snare loop was the single complication encountered. Lower intestinal endoscopy should be selectively considered for diagnosis and therapy of unexplained bleeding or recurrent lower abdominal pain in children in whom proctosigmoidoscopic laboratory and radiographic examinations do not achieve a diagnosis.


Hybrid systems are an appropriate formalism to model embedded systems as they capture the theme of continuous dynamics with discrete control. A simple extension, a network of communicating hybrid automata, allows for modeling distributed embedded systems. Although it is possible to generate code from such models, it is difficult to provide formal guarantees in the code with respect to the model. One of the reasons for this is that, the model is set in continuous time and concurrent execution with instantaneous communication, whereas the generated code is set in discrete time with delayed communication. This can introduce semantic differences between the model and the code such as missed transitions, faulty transitions, and altered continuous behavior. The goal of faithful code generation is to minimize these differences.In this paper, we propose a relaxed criteria of faithfulness, coined relative faithful implementation. Based on this criteria, we propose dynamically adjusting the guard at runtime using estimates of errors for preventing faulty transitions. We also identify a sufficient condition to ensure no missed transitions in the code.


Immunosensors are devices that exploit immobilized antibodies to promote the binding of specific analytes related to diseases of medical importance, such as cancer or cardiac dysfunctions. Label-free immunosensors have an important role, due to their simplicity and fast read-out. Here, the proof of concept for an immunosensor based on a 2-D photonic crystal silicon nitride membrane is presented. The device has been fabricated by means of a well-tuned nanofabrication protocol, achieving a high-quality photonic pattern on a large-area membrane (1 mm 1 mm), and it has been tested for the detection of interleukin-6, getting protein detection at pg/mL concentrations.


Purpose of reviewHigh infectious risk donors (HRDs) fall into a behavioral category thought to increase risk of infectious transmission through transplantation; despite controversy surrounding their use, they comprise almost 9% of donors in which at least one organ is recovered. This review seeks to describe national patterns in utilization, attitudes toward HRDs, and strategies to minimize and quantify infectious risks. Recent findingsHRD organs are discarded at a higher rate than non-HRDs, and many surgeons have decreased the use of HRDs in response to a recent widely publicized case of HIV and hepatitis C virus (HCV) transmission. Special informed consent use can mitigate legal risk and might increase provider comfort with HRD utilization. Nucleic acid testing (NAT) mitigates infectious risk by decreasing the window period, particularly for HCV in which the risk of undetected window period infection decreases by an order of magnitude. Estimated risk of undetected window period HIV infection varies by HRD behavior category (range 0.035–4.9 per 10 000 donors when NAT is used), HCV risk is higher (range 0.027–32.4 per 10 000). SummaryGiven long waiting times and high waitlist mortality, organs from HRDs can be used to expand the organ supply. Estimates of HRD infectious risk can be used to guide patient and provider decision making.


Process flow of Ta/Ti/Al/Mo/Au ohmic contacts formation to AlGaN/GaN heterostructures was developed. Correlation between Al thickness and optimal ohmic contact annealing temperature was obtained. Optimal Ta:Ti:Al:Mo:Au metal ratio was obtained for two different types of AlGaN/GaN heterostructures. Ohmic contacts fabricated in developed process flow show good surface morphology and contact resistance less than 0.5 Ohm/mm.


BACKGROUND
Iron balance is critical for adequate erythropoiesis, but its optimal therapeutic regimen remains to be defined. Continuous maintenance therapy with iron has been proposed for dialysis patients on recombinant human erythropoietin (rHuEpo) in the hope that the regimen is adequate and safe.

METHODS
We determined serum ferritin, transferrin, transferrin saturation (TSAT), serum transferrin receptors, albumin and C-reactive protein (CRP) in a 3-year prospective study in 30 chronic haemodialysis patients on dialysis treatment for 132+/-111 months (18 males, 12 females; mean age 56+/-14 years). Beginning in the year 2000, they regularly received low-dose maintenance iron supplementation (i.v. iron gluconate 31.25 mg/week) for 12 months (Period 1 or first treatment phase), followed by a 6-month withdrawal (Period 2 or stop phase) and then by continuous maintenance iron therapy (i.v. iron gluconate 31.25 mg/week) for another 9 months (Period 3 or re-challenge phase).

RESULTS
A significant increase in serum ferritin and TSAT was observed, with values exceeding 500 ng/ml and 50% in 10/30 (33%) and 7/30 (23%) of subjects, respectively, in Period 1, and in 11 and 5% in Period 3. A significant decrease in serum transferrin was documented during Period 1, followed by an increase in Period 2 and a decrease in Period 3. Serum albumin remained stable. Serum transferrin was always negatively correlated with ferritin (r = -0.41, P<0.001) and weakly correlated with serum transferrin receptors (r = 0.178, P<0.05), but was not correlated with serum albumin or CRP. Regression equations based on pre-treatment serum ferritin values were developed for predicting the value of serum ferritin at any time following the beginning of continuous iron supplementation. They fitted a linear relationship for males (y = 81 + 21.5 x time) and for females (y = 65 + 22 x time). Percentile charts for quantitative tracking of serum ferritin increases and decreases in patients have also been developed from values measured at different times. These charts show box-plot distributions of expected ferritin against time.

CONCLUSIONS
Even continuous low-dose maintenance iron therapy, with only 31.25 mg weekly over 1 year, cannot prevent the risk of iron overload in patients with moderate anaemia. Furthermore, this treatment is responsible for decreases in serum transferrin, unrelated to changes in serum albumin, possibly of concern for hypo-transferrinaemia as an independent risk factor for iron toxicity.


The design of efficient and scalable routing protocols is a fundamental challenge in wireless ad-hoc networks. Compare to topology-based routing protocol, position-based routing is regarded as having better scalability and lower control overhead, since hosts do not need to maintain the routes to their destinations and periodically broadcast the routing control messages. Location service is the most important part of the position-based routing protocol. Before sending packets, the source node needs to obtain the location of the destination node via a location service scheme. With this reliable location information, packets can be sent to the correct target. In this paper we present Spatial Aware Virtual Home Region (SAVHR) - a multi-home region scheme that selects different update and query strategies by using the host's location as the spatial information. We show that SAVHR shortens the lengths of the update, query and reply paths and also reduces the overall network overhead. The simulation results show that the performance of SAVHR is comparably fast and stable.


In a pediatric inpatient setting, an interdisciplinary team designed and implemented an online journal club to discuss current nursing trends and research and to foster evidence-based practice. This article is Part I of a two-part series in which the process will be described.


The non-invasive, in vivo measurement of microvascular blood flow has the potential to enhance breast cancer therapy monitoring. Here, longitudinal blood flow of 4T1 murine breast cancer (N=125) under chemotherapy was quantified with diffuse correlation spectroscopy based on layer models. Six different treatment regimens involving doxorubicin, cyclophosphamide, and paclitaxel at clinically relevant doses were investigated. Treatments with cyclophosphamide increased blood flow as early as 3 days after administration, whereas paclitaxel induced a transient blood flow decrease at 1 day after administration. Early blood flow changes correlated strongly with the treatment outcome and distinguished treated from untreated mice individually for effective treatments.


BACKGROUND
The role of lateral retroperitoneoscopic adrenalectomy (LRA) for complicated tumor with large diameter remains controversial, this study aimed to evaluate the effectiveness of this procedure on the management of tumor larger than 5cm in diameter.

METHODS
A retrospective comparison was conducted of 67 patients with large complicated adrenal tumor (>5cm). 41 patients received LRA, and 26 received open adrenalectomy (OA) in our hospital between January 2011 and June 2015. Basic characteristics regarding mean age, gender, body mass index (BMI), tumor size, tumor side, previous abdominal surgery, resection method, pathology were preferentially analyzed. Operative indicators regarding operation time, estimated blood loss (EBL), conversion to ICU, complications, post-operative hospitalization, duration of drain, time to first oral intake and ambulation were compared between groups.

RESULTS
There were no significant differences between the two groups in the basic characteristics. The mean operation time for LRA was shorter than OA (98.7±32.3 min vs 152.7±72.3 min, P = 0.001). EBL was 31.9±20.0 ml for LRA and 590.0±1181.1 ml for OA (P = 0.03). There was no complication in LRA group and one patient in OA group had complications, but this difference was not significant (P = NS). The post-operative hospitalization in LRA was 7.4±2.8 days, and shorter than 9.8±2.7 days in OA group (P = 0.00). The time to first oral intake and ambulation for LRA was shorter than OA (first oral intake, 1.9±0.8 days vs 3.1±1.3 days, P = 0.00; time to ambulation, 2.6±1.4 days vs 4.2±1.6 days, P = 0.00). While the difference between groups were not significant in terms of ICU conversion (3/41 vs 4/26, P = NS) and duration of drain (3.9±2.2 days vs 4.7±1.9 days, P = NS).

CONCLUSION
Our study shows that LRA can be performed safely and effectively for complicated adrenal tumors larger than 5 cm in diameter, but it remains technically demanding.


Optical properties of generalized dielectric Fibonacci multilayer generated by the rule Sl+1 = Sn l S m l−1 with a pair of positive integers m and n were studied. The initial generations S1 and S2 are taken as S1 = H and S2 = L where H and L are two elementary layers with refractive indices nL = 1.45 and nH = 2.3, respectively. In the following numerical investigation, we chose SiO2 (L) and TiO2 (H) as two elementary layers. We use the so-called "antitrace" map to determine the transmission spectra of the structures. Based on the representation of the transmittance spectra in the visible range an analysis depending on the pair (n,m) is presented. We show that the whole structure Sn l S m l−1 has an interesting application for well selection pairs (m,n) values.


Growth and moisture distribution assessments of sorghum intercropped with Parkia, Leucaena and Gmelina on plinthustalf in the Southern Guinea Savanna Zone of Nigeria were carried out over four growing seasons. Compared to sole crop, reduced sorghum height (15 and 30 %) due to Gmelina was observed in the second and third growing seasons respectively. However, the presence of Gmelina was beneficial to sorghum height growth during the fourth growing season leading to 60 % above the sole crop. Moisture build-up reached peaks in sorghum root, stem and leaf at 90 days after sowing, Legume's beneficial effect on moisture distribution in root, stem and leaf of sorghum was in the order: Leucaena>Parkia > no legume in year IV. Sorghum intercropped with Gmelina in year IV contained significantly higher moisture content than sorghum without it. Suggestions to enhance the performance of sorghum while in intercropping with the investigated trees were proffered.  Keywords: Intercropping, simultaneous intercropping, sequential intercropping, agri-silviculture, pruning, thinning.


Background: To evaluate a service reconfiguration of pain rehabilitation programmes for chronic back pain using three programmes of differing intensity and duration and a clinical algorithm. This study describes the outcomes for each programme for three consecutive cohorts. Method: Non randomised observational study of 120 consecutive patients with chronic pain treated by a Physiotherapy Department of a Specialist Orthopaedic and Rehabilitation hospital. Three different pain rehabilitation programmes each comprising of multidisciplinary rehabilitation with varying intensity and duration of content were compared for clinical and cost efficacy. The main outcomes used were Oswestry Disability Index (ODI), Pain visual analogue score (VAS), pain catastrophising scale (PCS), pain self efficacy questionnaire (PSEQ), Tampa scale for kinesiophobia (TSK) and physical tests of timed sit to stand and 5 minute walk test. Results: Analysis of changes within groups was by Wilcoxon signed rank tests and found patients attending the 'gold standard' Functional Restoration Programme showed statistically and clinically significant improvements in mean change scores for VAS, PCS, TSK, PSEQ, sit to stand and 5 minute walk test - p<0.001; with effect sizes for the different outcomes ranging from 0.2-1.19. For the shorter Active Rehabilitation Programme there were significant improvements all outcomes except TSK and sit to stand (p0.004), with effect sizes varying from 0.48-0.81. For the Short Management Programme there were significant improvements all outcomes with effect sizes ranging from 0.18-1.14. Conclusion: This research uses a novel approach where an existing service was redesigned adhering to key principles but varying intensity and duration and using a clinical algorithm to determine treatment allocation in order to translate research based findings into clinical practice.


This paper analyzes container transportation network equilibrium considering draft of vessels. Concept of load factor (λ) of ship is included in the model. Three players are considered, i.e. port administrator, ship companies (carriers), and shippers. Interaction of these players leads to Nash equilibrium problem. The result of the model calculation indicates that Hong Kong and Singapore port dominates container throughput in the world and the big vessel (3000 6000 TEU) is dominant in these ports. Conversely, the smaller port with depth less than 15 m dominated by 1000 TEU vessels. The result is inline with the reality. The other finding from the study is 6000 TEU vessels can enter port with depth less than 15 m such as port of Shanghai. Again, it is inline with reality. Validation of the model shows that coefficient of determination (R) is 0.95. It indicates the model provides good accuracy.


The investigation of power system disturbances is critical for ensuring the supply's dependability and security. Phasor Measurement Unit (PMU) is an important device of our power network, installed on system to enable the power system monitoring and control. By giving synchronised measurements at high sample rates, Phasor Measurement Units have the potential to record quick transients with high precision. PMUs are gradually being integrated into power systems because they give important phasor information for power system protection and control in both normal and abnormal situations. Placement of PMU on every bus of the network is not easy to implement, either because of expense or because communication facilities in some portions of the system are limited. Different ways for placing PMUs have been researched to improve the robustness of state estimate. The paper proposes unique phasor measurement unit optimal placement methodologies. With full network observability, the suggested methods will assure optimal PMU placement. The proposed algorithm will be thoroughly tested using IEEE 7, 9, 14, and 24 standard test systems, with the results compared to existing approaches.


Abstract Systemic sclerosis (SSc) is a multisystemic, complex, and rare disease of connective tissue, with high morbidity and mortality, and without specific treatment. The disease is characterized by three main principles: vascular disease, autoantibody production and inflammation, and fibrosis. Since it is well defined that SSc is characterized by elevated production of TGF-β, IL-6, and IL-1, all of them cytokines related to Th17 differentiation, the hypothesis is that this disease may be strongly related to a polarization of the immune response towards the Th17 pathway. Considering the importance of a better understanding of the pathophysiology of Th17 pathway in SSc, this article aims to propose an update for a better understanding of current knowledge on main cytokines secreted by the Th17 cells (IL-17 A, IL-21, and IL-22) and the future prospects in the current disease.


Deep learning algorithms have been widely used in remote sensing image classification and recognition. Due to the difference in parameters such as spectral response functions of different sensors, a single sensor sample dataset cannot meet the needs of other sensors. Constructing sample datasets for different sensors will seriously increase the workload. To solve this problem, this paper proposes a multi-spectral data simulation method based on hyper spectral data and analyzes the accuracy of simulated data from typical surface spectrum curves, gray histograms and pixel errors. The results show that the simulation data is in good agreement with the original data, and the overall accuracy reaches 94.6%, which can solve the problem of deep learning sample dataset requirements. Keywords: Data simulation, hyperspectral data, sample dataset Cite this Article X. Yang. Multi-spectral Data Simulation Method Based on Hyperspectral Data. Journal of Remote Sensing & GIS. 2019; 10(2): 43–51p.


At Hirosaki University, there has been insufficient discussion regarding laboratory medicine education, why medical students learn about laboratory tests, why clinical laboratory physicians teach, and to what degree these contribute to medical education. In order to answer these questions, it is essential to develop the philosophy of laboratory medicine. Our teaching philosophy is to foster physicians who can identify and judge "uncertainties" in laboratory tests and then act to minimize them. In order to embrace this philosophy, educators, i.e., clinical laboratory physicians, themselves, must be innovators and always strive to propose new concepts and knowledge to overcome uncertainties in laboratory tests. We hope that active discussion among many educators involved in laboratory medicine will lead to a consensus regarding the above mentioned questions, thus further stabilizing and expanding laboratory medicine at medical universities (schools of medicine), including our university. We hope that the discussion held at the present symposium will serve as a catalyst.


In his early work, the philosopher Stanley Cavell offers a sustained engagement with the threat of epistemological scepticism, shaped by the intuition that although (as the late Wittgenstein shows) ordinary language use is the practice within which alone meaning is possible (and which can thus not be further analysed or rationalised), it is also a basic human inclination to wish to escape the limitations of the 'ordinary'. This, for Cavell, is the root of scepticism. Scepticism, on this view, thus appears not primarily as an epistemological but as an (injurious) moral stance, which cannot be refuted but must be continually confronted and overcome. Vis-a-vis scepticism, 'acknowledgement' is the practice-based recognition of the world and other people in their continuing elusiveness, which ineluctably involves risk, but just so is the only way of knowing that is appropriate to and honours the (finite) human condition. One problematic aspect of this (very fertile) approach is that Cavell's secular viewpoint makes it difficult for him to say both why the desire for a 'beyond' arises in the first place, and why its expression as denial is morally wrong (rather than merely misguided). His approach thus invites a theological 'supplementation' which grounds the human condition in an original and real relation to God that is meant to draw the believer, through Christ, into the divine life itself. Such a reinterpretation both elucidates the concepts of scepticism and acknowledgement, and makes these concepts available for a theological outlook that is able to accommodate Cavell's profound insights into 'the human'.


Introduction: Colorectal cancer survival rate has increased due to the advances in this disease treatment in the recent years. Therefore, this study aimed to investigate the survival rate for colorectal cancer patients from 2001 to 2011 in Yazd . Methods: In this retrospective cohort study, 604 patients with colorectal cancer were studied who were admitted to the cancer registry of Yazd province from 2001 to 2011. Their death time was determined by the death registry center or their families. Those who died due to other reasons rather than this cancer were omitted. The data were analyzed by Kaplan-Meier method and x2. Results: The mean age of these patients was 58.9±19.99 years and the median age was 62 years. Their survival rates in one, five and ten years were respectively 72.2 %, 50.1% and 39.8% regardless of their sex and age. The survival mean and median were 0.23±6.47 and 0.71±5 years. In this study there was a significant relationship between age and survival rate, though no significant relationship was observed between sex and survival. Moreover, the survival rate in patients younger than 50 years was significantly more than those older than 50 years . Conclusions: Despite advances in colorectal cancer treatment in Iran and around the world, in this study, the long-term survival rate was reported less than that of developed countries .


This paper describes an active vision system based reverse engineering approach to extract the 3D geometric information from dental cast/teeth and transfer this information into computer-aided design/computer-aided manufacture (CAM) systems to improve the accuracy of the constructed units for patient care. The benefits of our approach are a non-contact measurement, low cost, and capturing all the surface data at the same time. Our system involves the development of a vision rig prototype accommodating up to three charged couple device cameras, image processing, and shape recovery from a series of convex profile (2D) images of complex objects morphology (e.g. incisor or sunflower seed). The rig is designed using engineering design methods such as a concept selection matrix and a weighted objectives evaluation chart. The rig concept design is based on the human/stereo vision principles in computer vision. The occluding boundary technique and its derived method, the slicing method, are described and employed by the vision system to generate (3D) models of two typical teeth using a dental cast. Comparison of the vision system and the Renishaw Triclone dental system is demonstrated on these two models with one of them being manufactured using CAM technology. The results have shown that our vision system is capable of supporting the advanced reverse design applications in restorative dentistry. It is concluded that the new system could encode the shape of small complex objects and the device could be useful in the characterization of natural materials as a basis for biology-based design.


The liver has dual blood supply from the portal vein and hepatic artery. Computed tomographic findings of hepatic neoplasms are greatly influenced by hepatic blood flow, and abnormal portal and hepatic arterial blood flow needs to be examined separately by CT arteriography (CTA) and CT during arterial portography (CTAP). Both CTA and CTAP have advantages over conventional CT in that they can provide greater contrast enhancement of hepatic tumors by injecting contrast material directly into the hepatic or superior mesenteric arteries. The methods of CTA and CTAP are described. CTA and CTAP were useful in the detection of small hepatic lesions, evaluation of changes in hepatic parenchymal blood flow, and evaluation of portal flow in hepatocellular carcinoma, which contribute to the classification of HCC. In conclusion, CTA and CTAP were indispensable in selecting a therapeutic approach.


The clinical implications of hypertension in addition to a high prevalence of both uncontrolled blood pressure and medication nonadherence promote interest in developing device-based approaches to hypertension treatment. The expansion of device-based therapies and ongoing clinical trials underscores the need for consistency in trial design, conduct, and definitions of clinical study elements to permit trial comparability and data poolability. Standardizing methods of blood pressure assessment, effectiveness measures beyond blood pressure alone, and safety outcomes are paramount. The Hypertension Academic Research Consortium (HARC) document represents an integration of evolving evidence and consensus opinion among leading experts in cardiovascular medicine and hypertension research with regulatory perspectives on clinical trial design and methodology. The HARC document integrates the collective information among device-based therapies for hypertension to better address existing challenges and identify unmet needs for technologies proposed to treat the world's leading cause of death and disability. Consistent with the Academic Research Consortium charter, this document proposes pragmatic consensus clinical design principles and outcomes definitions for studies aimed at evaluating device-based hypertension therapies.


Dihydroxycoprostane and trihydroxycoprostane, intermediates in normal bile acid synthesis in the liver, enhanced the rate of porphyrin synthesis in cultured liver cells by induction of δ-aminolevulinate synthetase, the rate-limiting enzyme for this pathway. Other 5β-cholestane derivatives and cholest-5-ene derivatives were ineffective. The selectivity of the induction may indicate that the above-mentioned coprostanes have a physiological role in porphyrin synthesis.


The lignification of the leaf vein bundle sheath (BS) has been observed in many species and would reduce conductance from xylem to mesophyll. We hypothesized that lignification of the BS in lower-order veins would provide benefits for water delivery through the vein hierarchy but that the lignification of higher-order veins would limit transport capacity from xylem to mesophyll and leaf hydraulic conductance (Kleaf ). We further hypothesized that BS lignification would mediate the relationship of Kleaf to vein length per area. We analysed the dependence of Kleaf , and its light response, on the lignification of the BS across vein orders for 11 angiosperm tree species. Eight of 11 species had lignin deposits in the BS of the midrib, and two species additionally only in their secondary veins, and for six species up to their minor veins. Species with lignification of minor veins had a lower hydraulic conductance of xylem and outside-xylem pathways and lower Kleaf . Kleaf could be strongly predicted by vein length per area and highest lignified vein order (R2  = .69). The light-response of Kleaf was statistically independent of BS lignification. The lignification of the BS is an important determinant of species variation in leaf and thus whole plant water transport.


In this paper, we propose an auto-decision system KMCD, which helps remote students choose their majors. The system is based on knowledge of students who want to choose majors and students who have finished their studies. KMCD is a first-order reasoning system equipped with an uncertain reasoning function. A description of KMCD is given in details. The whole decision procedure is comprehensively discussed, which shows the effectiveness and the reasonableness of the system. Examples in the paper illustrate how KMCD can help remote students make their decisions in major-choosing.


Sulphasalazine is a "disease modifying" drug that is now widely used in rheumatoid arthritis, having fewer and milder side effects than gold or penicillamine.' One potential side effect, which is easily missed and may become life threatening, is macrocytic anaemia. This occurs in 2-3% of prising and possibly to "reflect the brittle state of folate metabolism in rheumatoid arthritis." Since then the development of macrocytic anaemia during treatment with sulphasalazine has been mentioned in reports but has drawn little attention. Recently it was suggested that sulphasalazine does not cause folate deficiency in rheumatoid arthritis at a dose below 2 g/day,5 but the number of patients and duration of the study do not allow a definite conclusion to be reached. Certainly, folic acid deficiency is more likely to occur when additional causes of it are present and when sulphasalazine is given in higher dosage. It is an important complication as it is potentially serious, easily treated, and not an indication for stopping sulphasalazine.


This article explores the challenges of implementing UN Security Council Resolution 1540 through the prism of the "tragedy of the commons." Because implementing 1540 requires a significant investment of time and resources, the decision by states not to implement the resolution is a rational inaction for each individual state driven by self-interest to maximize private gains. However, this ultimately leads to collective irrationality and the destruction of the public good, i.e., common security, leaving every state worse off.


Background: As variation in normal discourse is well acknowledged in the sociolinguistic literature (Labov, 1972), it is logical that it must be inherent in the discourse of heterogeneous clinical populations. Yet, variation is rarely discussed in the aphasiology discourse literature. This is despite the fact that speech pathologists are constantly required to make judgements about the normalcy or otherwise of the discourse of their clients on clinical tasks - a difficult endeavour given the paucity of data available on the range of discourse styles evidenced in the non-brain-damaged population on these same tasks. Aims: The study aims to examine linguistic differences observed in the performances of nonbrain-damaged speakers on a recount task in order to address the potential for variation in clinical populations when undertaking a similar task. Methods & Procedures: Twelve adult non-brain-damaged speakers were required to produce a recount of an illness they had experienced. Analysis of the texts was then undertaken using Halliday's (1994) analysis of clause complexes, which examines logical relationships existing between clauses. Outcomes & Results: In the heterogeneous group studied, five different patterns of recounts were observed, each pattern having a different semantic impact on the text. Some texts focused on the chronological ordering of events, whereas others focused more on detailed descriptions of participants and circumstances, causal factors involved, or a combination thereof. In addition, considerable variation in text length and clause complex length was observed. Conclusions: The study demonstrates the stylistic variation that can exist among speakers within a genre that is generally considered to be relatively homogeneous. Speakers may achieve the same text macrostructure and yet do this in different ways through different patterns of microstructure. Length of both the overall text and the clause complexes it contains may vary, as may the nature of the logical relations represented, all producing variations of the same text type or genre. Such variation in non-brain-damaged speakers is important for clinicians to consider when making judgements of "normalcy" on the discourse of clinical populations.


A variable cohesive gel form stabilizing implant is disclosed for augmentation or reconstruction of the breast. The prosthesis of this invention comprises an implantable shell or envelope (not limited to a single shell or envelope), filled with a biocompatible gel, or gels, having alterations in gel cohesiveness to maintain stable form, shape, and dimension after surgical implantation. The gel cohesiveness may increase, with increased volume or dimension of the prosthesis. The variable cohesiveness of the gel filler material may be altered by any means (i.e. chemical, fabrication, etc.). The variable cohesive gel form stabilizing implant has shape retention characteristics to maintain its form, thereby reducing or eliminating the undesirable effects of shell wrinkling, knuckling, scalloping or deformation, which can occur at the upper or lower pole of the prostheses, along the perimeter of the shell or at the base, post-implantation. Finally, the variable cohesive gel form stabilizing implant provides new control and possibilities for achieving and preserving the most natural breast shape.


Intravascular devices (IVDs) are widely used for vascular access but are associated with a substantial risk of IVD-related bloodstream infection (BSI). The development of novel technologies based on our understanding of pathogenesis promises a quantum reduction in IVD-related infections in an era of growing nursing shortage. Infections of long-term IVDs (most are in place for > or =10 days), including cuffed and tunneled central venous catheters (CVCs), implanted subcutaneous central venous ports, and peripherally inserted central catheters (PICCs), are primarily due to microorganisms that gain access to the catheter hub and lumen. Novel securement devices and antibiotic lock solutions have been shown to reduce the risk of IVD-related BSI in prospective randomized trials. The challenge for the future will be to identify new preventative technologies and to begin to more-widely adapt those technologies that have already been shown to be efficacious and cost effective.


Effluents from the slaughterhouses, meat and poultry industries are heavily polluted and contain a high concentration of biodegradable organic materials. Therefore, the pollution capacity of these industries is high. Most of these industries discharge their effluents to a sewer or a watercourse.In order to comply with water pollution control standards and to reduce costs on sewer surcharges, these industries have to apply an adequate treatment of their effluents.Physical and chemical treatment methods as well as the conventional biological treatment processes are frequently applied in the treatment of these effluents. A combination of the methods are required where the effluent is to be discharged to surface waters, since no single treatment method will provide sufficient effluent.In the last decade, the high rate anaerobic wastewater treatment systems have become a good alternative for conventional aerobic as well as anaerobic biological treatment methods. The high rate anaerobic treatment systems were initially developed for the treatment of highly soluble low and medium strength wastewaters. These systems provided only a partial treatment of complex wastewaters containing a high fraction of suspended solids such as slaughterhouse wastewater.Investigations have shifted towards the application of high rate systems like the upflow anaerobic sludge blanket (UASB) for the complete treatment of agro-industrial wastewaters which are more difficult to handle, because they contain relatively high concentrations of suspended solids, i.e. complex wastewaters.Presently, the UASB system is the most widely applied high rate anaerobic system for complete treatment of such complex wastes.This thesis focuses on the question whether, and under which operationa conditions and environmental circumstances a one stage UASB mesophilic anaerobic treatment system is suitable for a complete treatment of slaughterhouse wastewater in practice.The feasibility of using the upflow flocculent anaerobic sludge blanket (UASB) process for a one stage anaerobic treatment of unsettled complex slaughterhouse wastewater, which contains approximately 50% of coarse insoluble COD, was investigated (Chapter 2). The continuous experiments were performed in a 25.3 m 3 UASB pilot-plant which was operated under semi-continuous conditions, viz. with a varying organic load over day and nighttime (i.e. high organic load during the daytime and with low organic load at night) and with weekend feed interruptions. The UASB pilot-plant was operated at a temperature of 30° C. In order to assess the feasibility of the process under conditions of lower temperatures the temperature was reduced to 20°C, 20 weeks after the start-up of the reactor.The data indicated that the system can satisfactorily handle organic loads up to 3.5 kg COD m -3 day -1 at a liquid retention time of 8 h at temperatures as low as 20°C. Temporary shock loads up to 7.5 kg COD m -3 day -1 during the day time at a liquid retention time of 5 h were accommodated satisfactorily provided such a shock load was followed by a period of low loading, e.g. at night.A significant discrepancy was found between the treatment efficiency in terms of COD reduction and to the lower calculated percentage of supplied COD total converted into methane-COD. This difference indicated that a significant portion of the achieved COD reduction was due to the accumulation of non- or slowly biodegradable substrate ingredients in the reactor. No differentiations could be made between the different types of substrate ingredients that accummulated in the reactor because the accumulated sludge was not characterized. However, a part of the accumulated substrate was converted to CH 4 in periods of feed interruptions.In Chapter 3 the feasibility of the upflow granular anaerobic sludge blanket process for a one-stage anaerobic treatment of slaughterhouse wastewater was investigated. The experiments were performed under semi-continuous operational conditions viz. continuous feeding at a constant organic load (24 h day) during the working days but with weekend feed interruptions, and process temperatures of 30°C and 20°C. Under a stable operation of the system, i.e. at a maximum COD reduction and a high conversion of COD into methane, the optimal loading rates that could be applied were 11 kg COD m -3 day -1 and 7 kg COD m -3 day -1 at 30°C and at 20°C respectively.The system was less effective in the removal of coarse suspended solids, compared to the removal of the colloidal and soluble fractions from the slaughterhouse wastewater.The data obtained in these investigations indicate that imposed prolonged loadings exceed the optimal loading rates, lead to deterioration of the specific methanogenic activity of the sludge, due to the accumulation of colloidal and soluble fractions of the wastewater in the sludge bed. Therefore, it was concluded that the system stability strongly depends on the processes involved in the removal of the colloidal and soluble compounds from the wastewater and their conversion into methane. As the predominant - non-biological-mechanisms underlying the elimination of these wastewaters pollutants were considered the entrapment and the adsorption mechanisms. The effect of these mechanisms on the rate of the liquefaction of the accumulated substrate - which is the required first step in their conversion into methane - were discussed.The different pollutant fractions of the wastewater, viz. the coarse suspended solids, the colloidal and the soluble compounds affect the performance of the UASB reactors because of the different mechanisms involved in the removal of these substrate ingredients and their subsequent conversion into methane. Therefore, these mechanisms were investigated in more detail. The results of these investigations are presented in Chapter 4. The experiments were performed in a one-stage flocculent sludge UASB-reactor under continuous operational conditions viz. continuous feeding at a constant organic load during 24 h a day and 7 days a week.The COD removal efficiency of the UASB reactor exceeded the COD removal efficiency as expected from the observed CH 4 production, indicating once again that non-biological mechanisms are involved. Two different non-biological mechanisms were distinguished in the removal of substrate ingredients from the wastewater. The entrapment mechanism prevailed in the elimination of coarse suspended solids, while mainly adsorption mechanisms are involved in the removal of colloidal and the soluble fractions of the wastewater.A continued accumulation of substrate ingredients in the reactor ultimately will become detrimental for the stability of the anaerobic treatment process, as it leads to sludge flotation and consequently could result in a complete loss of the active biomass from the reactor.After having demonstrated the principle feasibility of the upflow anaerobic sludge blanket (UASB) process for a one-stage anaerobic treatment of the slaughterhouse wastewater, we decided to assess the maximum possible extent of anaerobic degradation of the soluble, colloidal and coarse suspended solids fractions of the slaughterhouse wastewater (Chapter 5). In this way we intended to get a better insight in the real limitations of the system. All the experiments were performed at process temperatures of 30°C and 20°C, using membrane filtered wastewater (wastewater mf ), paper filtered wastewater (wastewater pf ) and total wastewater. The experiments were performed in a recirculated batch digester system with granular sludge. The experiments with the coarse suspended solids separated from the wastewater were performed with granular sludge as well as with flocculent sludge using conventional batch-fed stirred digesters. The maximum biodegrability percentages (i.e. conversion into methane) found at 30°C were 75% for wastewater mf , 61% for wastewater pf and 67% for wastewater total while at 20°C these values were 72%, 49% and 51% respectively. The maximum biodegrability of the coarse suspended solids fraction of the waste amounts to 50% at 30°C and 45% at 20°C.The mechanisms involved in the removal of the soluble and colloidal fractions of the slaughterhouse wastewater were thoroughly studied and elucidated. The data obtained in these experiments indicate that the prevailing mechanism in the removal of the soluble but especially also the colloidal fraction of the wastewater is an adsorption mechanism. The relatively high degree of adsorption of the colloidal fraction of the wastewater to the surface of the sludge, in combination with its high fat content, will deteriorate the specific methanogenic activity of the sludge. The adsorption of the colloidal materials will ultimately result in an enclosure of the granular sludge bacterial matter with a film of increasing thickness, and perhaps also density, which increasingly will hamper the supply of substrate to the bacteria present in the grains. The deterioration effect of fats towards the methanogenic activity of the sludge was explained on the basis of the inhibitory effect of the long-chain fatty acids of the neutral fats.As the extent of adsorption is very similar at lower and higher temperatures, but the rate of liquefaction of adsorbed compounds drops significantly at decreasing temperatures, it will be evident that the process can withstand considerably lower loading rates at 20°C as compared to 30°C.Therefore, it is concluded that the rate of liquefaction of the adsorbed insoluble colloidal fraction of the wastewater is the controlling factor with respect to loading potentials of the process and consequently that the temperature is the factor of predominant importance.


Blunt traumatic diaphragmatic rupture (BTDR) is a life-threatening condition with an incidence from 0,8%–1,6% in blunt trauma, mostly located on the left side. The main prognostic factors are severe side injuries and the delay of diagnosis. We present a rare case of a 68-year-old female, with an isolated right diaphragm rupture. The diagnosis was done with a delay of 4 days by thoracic radiographs, which showed a herniation of small bowel into the right thoracic cavity. A reposition of the small bowel and a closure of the diaphragmatic defect by running suture were carried out laparoscopicly. Although large prospective studies concerning the outcome of laparoscopic approach to right BTDR are still missing, we could show, that laparoscopy can be performed safely in right traumatic diaphragm rupture.


This paper studies the sensor activity of carboxyl-modified single-walled carbon nanotubes (zig-zag, armchair type) to atoms and ions of alkali metals Na, Li, K. The mechanism of the carboxyl binding to the open border of the semi-infinite carbon nanotube is investigated. Calculations of the interaction processes between the sensor and sample alkali atoms and alkaline ions are performed. The process of scanning a sample surface site with atoms of metals under consideration is modeled and the functional carboxyl group chemical activity is defined. The research is performed by the MNDO method within the framework of the molecular cluster model and DFT method.


In type 1 diabetes, autoimmune β-cell destruction may be favored by neoantigens harboring posttranslational modifications (PTMs) such as citrullination. We studied the recognition of native and citrullinated glucose-regulated protein (GRP)78 peptides by CD8+ T cells. Citrullination modulated T-cell recognition and, to a lesser extent, HLA-A2 binding. GRP78-reactive CD8+ T cells circulated at similar frequencies in healthy donors and donors with type 1 diabetes and preferentially recognized either native or citrullinated versions, without cross-reactivity. Rather, the preference for native GRP78 epitopes was associated with CD8+ T cells cross-reactive with bacterial mimotopes. In the pancreas, a dominant GRP78 peptide was instead preferentially recognized when citrullinated. To further clarify these recognition patterns, we considered the possibility of citrullination in the thymus. Citrullinating peptidylarginine deiminase (Padi) enzymes were expressed in murine and human medullary epithelial cells (mTECs), with citrullinated proteins detected in murine mTECs. However, Padi2 and Padi4 expression was diminished in mature mTECs from NOD mice versus C57BL/6 mice. We conclude that, on one hand, the CD8+ T cell preference for native GRP78 peptides may be shaped by cross-reactivity with bacterial mimotopes. On the other hand, PTMs may not invariably favor loss of tolerance because thymic citrullination, although impaired in NOD mice, may drive deletion of citrulline-reactive T cells.


Background: Bachelor of Medicine and Bachelor of Surgery (MBSS) students are the largest group of international students. Due to the breakout of COVID-19, most international students have returned to their home countries. From March 2020, the MBBS undergraduate students of Yangzhou University were taught online since March 2020. For MBBS students,the effect of online teaching remains unknown. Methods: This study was conducted in Yangzhou University in June 2021, including 295 MBBS international undergraduate students. The objective conditions, environment, teacher factors, personal factors, advantages, and disadvantages of online teaching were evaluated for each student by using a self-completed structured anonymous questionnaire. At the same time, Pearson chi-square analysis was conducted to evaluate the factors affecting online teaching satisfaction (teaching attitude, teacher-student interaction, teacher evaluation, learning effect, online teaching management). Results: Most students' hardware was well equipped and their network could meet the need of online learning (240 of 280, 85.71%). Most students (263 of 280, 93.93%) had a quiet environment during online teaching. With respect to factors conducive to online teaching, students rated the importance of teachers from the aspects of knowledge level, teaching methods, class attitude, interaction with students, English proficiency, homework correction and pre-class guidance. In terms of students' attention, 76.78% students' attention was concentrated and 85.36% students had a positive attitude towards online teaching. Four factors (teaching attitude, teacher-student interaction, learning effect and management of online teaching) appeared to be associated with teaching effect satisfaction. Conclusion: This study investigates the various factors involved in conducting online education during the pandemic and provides suggestions for improving the quality and effectiveness of online education for MBBS students.


Summary Sialolithiasis is the most common disorder of major salivary glands. The main site of salivary stones' formation is submandibular gland, followed by parotid and sublingual gland. The aim of this article was to present current diagnostic imaging modalities carried out in patients suspected with salivary stones on the basis of own material and review of literature. Current diagnostic imaging tools used in the imaging of salivary stones were described and illustrated in this paper. These are: conventional radiography, sialography, ultrasonography, computed tomography, magnetic resonance sialography and sialoendoscopy. Digital subtraction sialography and ultrasonography are the methods of choice in the imaging of salivary gland calculi. Although sialography is a very old diagnostic method, still it is the best diagnostic tool in the imaging of subtle anatomy of salivary gland duct system. Digital subtraction sialography can show the exact location of salivary stone and enables imaging of salivary ducts' pathology (e.g. stenoses), which is especially important when sialoendoscopy is planned. Sialography is also used as the treatment method, i.e. interventional sialography. Nonenhanced computed tomography is recommended when multiple and tiny salivary stones are suspected. Magnetic resonance imaging is the evolving alternative diagnostic method. In this diagnostic modality there is no need for salivary ducts' cannulation and administration of contrast material. Thus magnetic resonance sialography can also be carried out in the acute sialoadenitis. In the future, sialoendoscopy may become one of the main diagnostic and treatment procedures for salivary duct disorders, especially in salivary stone cases.


Along with topical and systemic therapy, phototherapy is one of the three fundamental treatment options for managing psoriasis. The use of UVB continues to be one of the most important therapeutic interventions for mild to moderate psoriasis. An advance in UVB phototherapy has been the introduction of narrowband UVB lamps (311 nm). UVB lamps are superior to conventional broadband UVB in clearing psoriasis. PUVA is very effective therapy and is still the most effective form of phototherapy for severe, extensive form od the disease. There has been a trend towards whole-body PUVA-bath. Advantages of PUVA bath are lack of gastrointestinal side effects and no need for post-treatment eye photoprotection because there is no systemic photosensitization. UVB and PUVA can be administered in combination with a variety of topical and systemic treatments to achieve more effective results more quickly. The most recent form of phototherapy, 308-nm excimer laser, holds promise for becoming a useful tool in the treatment of stable, localized psoriasis.


The fusion process of Ca induced reactions is studied with the two-step model. In this model, the fusion process is devided into two stages: first, the sticking stage where projectile and target come to the touching point over the Coulomb barrier from infinite distance, and second, the formation stage where the di-nucleus formed with projectile and target evolve to form the spherical compound nucleus from the touching point. By the use of the statistical evaporation model, the residue cross sections for different neutron evaporation channels are analyzed. From the results, optimum reactions are given to synthesize Z = 117 element with Ca induced reactions.


The use of synthetic self-similar traffic in computer networks simulation is of vital importance for the capturing and reproducing of actual Internet data traffic behavior. A commonly used technique for generating selfsimilar traffic is achieved by aggregating On/Off sources where the active (On) and idle (Off) periods exhibit heavy tailed distributions. This work analyzes the balance between accuracy and computational efficiency in generating self-similar traffic and presents important results that can be useful to parameterize existing heavy tailed distributions such as Pareto, Weibull and Lognormal in a simulation analysis. Our results were obtained through the simulation of various scenarios and were evaluated by estimating the Hurst (H) parameter, which measures the self-similarity level, using several methods.


Aircrafts and wind turbine blades often get hit by lightning strikes due to their operating locations. With increasing incidents of lightning flashes every year due to global warming, damage assessment of CFRP structures after lightning strike to aircrafts and wind turbine blades is getting increasingly important. Many researchers are involved in designing better and more resilient lighting strike protection materials and often utilize non-destructuve evaluation (NDE) methods such as ultrasonic testing (UT), high-speed digital videograpgy, and high-speed IR thermography. In particular, UT is widely used due to its cost-effectiveness compared to other methods. Using UT imaging can obtain any potential damaged locations caused by lightning strike through the thickness of the composite specimens. Traditional UT and visual inspections only display the damage in units area, when in fact the UT data is volumetric. This study optimized the UT data to measure and display the volumetric damage after artificial lightning strike and is compared to the standardized visual inspection.


Abstract The persistence and severity of the gap between black and white wealth, and the role of housing discrimination in creating and sustaining this gap are both well documented. But given the chronological and spatial limits of national data sets, we have little direct empirical evidence about the local mechanisms shaping race, housing and wealth in the era when most of the damage was done. We employ the newly available 1940 full count census and the archival records of the St. Louis Assessors office to traced housing values, tenure, and disposition for a sample of 1940 owners and addresses. We show that sustained residential segregation carved the City into zones with very different trajectories of housing opportunity, and trapped African-American homeowners into long tenures of ownership in distressed and depreciating neighbourhoods.


Since 1999, Pathfinder International has worked in some of India's poorest states to advance the reproductive health needs of vulnerable and underserved populations. Recently, Pathfinder expanded these activities to include programs addressing the longstanding problem of unsafe abortion. Under India's 1971 Medical Termination of Pregnancy (MTP) Act, a woman in India can legally obtain an abortion if her pregnancy carries the risk of grave physical injury, endangers her mental health, is the result of contraceptive failure (for married women only) or rape, or is likely to produce a child with physical or mental abnormalities. Public knowledge of the law and access to safe services are still sorely lacking.


The detection of left ventricle metastases is highly relevant because of the risk of severe adverse outcomes such as ventricular arrhythmia. We report herein the case of a 68-year-old man who presented with a ventricular tachycardia due to a myocardial metastasis from a renal cell carcinoma. The metastasis was embedded within the left ventricular lateral wall. It was identified on the basis of persistent F-FDG focal uptake following the ingestion of a high-fat, low-carbohydrate preparation.


Genome-wide analysis indicate that alternative splicing of mRNA precursors (premRNAs) affects the vast majority of human genes. Alternative splicing provides a fundamental mechanism to increase transcriptome complexity, allowing the production of two or more mRNA variants that often encode proteins with different, sometimes opposite functions. Its importance is underscored by the observation that misregulated alternative splicing can lead to human diseases. Pre-mRNA splicing has long been known to be regulated by cis-acting sequence elements and trans-acting protein factors. In higher eukaryotes, it mostly occurs co-transcriptionally so that it is not surprising that a role for chromatin and epigenetic factors in the regulation of exon inclusion is now emerging. In this review, we will discuss the most recent findings on the roles played by chromatin structure on the modulation of the cotranscriptional splicing reactions. In particular, we will focus our attention on how the modulation of the transcribing RNA polymerase II, the changes in nucleosome architecture and the presence of different histone modifications contribute to the regulation of the splicing process.  Corresponding author: Silvia M.L. Barabino, Department of Biotechnology and Biosciences, University of Milano-Bicocca, Piazza della Scienza, 2, I-20126 Milano, Italy, Phone: +39-02-6448 3352, Fax: +39-02-6448 3569, E-mail: email@example.com. No part of this digital document may be reproduced, stored in a retrieval system or transmitted commercially in any form or by any means. The publisher has taken reasonable care in the preparation of this digital document, but makes no expressed or implied warranty of any kind and assumes no responsibility for any errors or omissions. No liability is assumed for incidental or consequential damages in connection with or arising out of information contained herein. This digital document is sold with the clear understanding that the publisher is not engaged in rendering legal, medical or any other professional services. Gabriele A. Fontana, Aurora Rigamonti and Silvia M. L. Barabino 70


Periodontal disease is common in dogs and is initiated by gingival plaque composed of several hundred bacterial species. Some of these species have specifically been pointed out as potential periodontal pathogens, such as Treponema spp. Treponema spp. are difficult to culture and therefore the majority have been detected by culture-independent methods, such as PCR (Polymerase Chain Reaction). This leaves many Treponema spp. uncharacterized and unnamed. In this study, treponemes were investigated in gingival plaque from dogs with varying degree of periodontal disease with the aim to describe their occurrence and diversity in dogs. The methods used were culture, phase-contrast microscopy, PCR targeting the 16SrRNA-tRNAIle intergenic spacer region (ISR2), sequencing of the ISR2 and phylogenetic analysis. Treponema spp. were detected in samples from 10 out of 11 dogs and isolates were obtained from six dogs. Both healthy and periodontitis affected dogs were Treponema positive. Phylogenetic analysis, based on ISR2 sequences, revealed a large diversity of treponemes in the study population that were found to be distributed mainly in two groups, corresponding to the human oral treponeme phylogroups II (Treponema denticola) and IV (Treponema maltophilum) genetic groups. They were generally more distantly related to other treponemes in these groups. Treponemes from dogs with periodontitis and dogs with mild gingivitis without periodontitis did not differ in any obvious way. The results indicate that several phylotypes of oral treponemes are common in dogs regardless of periodontal status.


The monitoring and the management of smart grid require an advanced communication infrastructure. The time synchronization is among the most important services such an infrastructure should offer. Several solutions are available to disseminate the time information in a distributed system; for instance, most of the times a global positioning system (GPS) receiver is used to recover accurate time information. However, GPS receivers need a clear view of the sky. Other solutions, like the use of a network-based synchronization mechanism, require a dedicated communication infrastructure, which is not always feasible for economical reason. Thus, the use of the power grid itself to disseminate a time signal is extremely interesting. The aim of this article is to investigate the possibility to distribute a time signal over a medium voltage (MV) grid using a chirp-based modulation. The timing data are coded using IRIG-B time code. Such an approach does not require the installation of a dedicated infrastructure, and it is noninvasive, because the signal is transmitted on a different band with the respect to power line communication (PLC). The effectiveness of the approach has been experimentally evaluated on a test MV line available in a laboratory. Although the tested chirp-based symbol has a limited frequency bandwidth (80 kHz), the jitter in the identification of the start of frame is on the order of 7.5 $\mu \text{s}$ , fulfilling the requirements of the most smart grid applications.


Abstract 1639 Introduction: Maintenance using interferon-α (IFN) had previously been shown to be effective in indolent lymphoma (Solal-Celigny et al., NEJM 1993, Hagenbeek et al., JCO 1998). However, data on the impact of IFN in lymphoplasmacytic lymphoma (LPL) and after immuno-chemotherapy are rare. In two GLSG first-line trials which included LPL patients, IFN-maintenance was intended in all patients responding to induction therapy and not assigned to high-dose therapy. We performed a retrospective analysis to compare the clinical outcome in LPL patients who received IFN-maintenance versus no consolidation or maintenance. We adjusted for potential confounders that might have influenced the decision not to start IFN-maintenance. Methods: In the GLSG first-line trials "CHOP vs. MCP" and "CHOP vs. R-CHOP" patients younger than 60 years had been randomized between consolidating high-dose radio-chemotherapy followed by autologous stem cell transplantation (ASCT) and IFN-maintenance. IFN-maintenance was also intended in all responding patients older than 60 years. Patients with LPL achieving a partial or complete remission after MCP, CHOP, or R-CHOP and who did not start ASCT were included in the current analysis. We compared patients in which IFN-maintenance was not started to patients with IFN-maintenance. We investigated patient and treatment characteristics of these groups in order to detect possible reasons why IFN-maintenance was not started. Outcome parameters were remission duration (RD) and overall survival (OS). RD, calculated from the end of induction to relapse or death, was censored at the latest follow-up date in patients without event, but also when a new antilymphoma therapy was initiated without any sign of progression. No censoring was done for any form of dose reduction or stopping of IFN, which was recommended in the trials if inacceptable side effects were observed. RD and OS were analysed by Kaplan-Meier curves and log rank test and we adjusted for potential confounders in multiple Cox-Regression. In order to assess the impact of IFN-maintenance after R-containing induction, we performed a subgroup analysis of R-CHOP treated patients. Results: IFN-maintenance was started in 56 (75%) of 75 responding LPL patients not treated with high-dose therapy. Patients with IFN-maintenance were younger (60 vs. 69 years, p=0.001), but other baseline characteristics (ECOG performance status, haemoglobin, LDH, platelets, β2-microglobulin, IgM) were comparable, as well as the percentage of patients with R-CHOP induction (64% vs. 63%). More patients treated with IFN had achieved a CR (18% vs. 0%). Patients with IFN-maintenance had significantly longer RD (hazard ratio, HR, 0.27, 95% CI 0.12 to 0.59, p=0.001) and OS (HR 0.19, 95% CI, 0.06 to 0.58, p=0.004) which was similarly seen after adjustment for age (RD: 0.32, 95% CI 0.14 to 0.78, p=0.012, OS: 0.30, 95% CI 0.08 to 1.04, p=0.058), or the achievement of a CR. Of 48 patients responding to R-CHOP, IFN-maintenance was started in 36 (75%). RD after 3 years was 87% vs. 41% (p Conclusions: Although this is a non-randomized comparison based on a relatively small patient number, our results suggest that IFN-maintenance is effective in LPL also in the era of immuno-chemotherapy. It seems relevant to keep in mind that interferon-a may be a therapeutic option when other strategies are not possible. It may also be relevant for future investigations in lymphoma therapy. Disclosures: Hoster:Roche: Honoraria. Off Label Use: Interferon-alpha in lymphoplasmacytic lymphoma. Pfreundschuh:Roche: Membership on an entity9s Board of Directors or advisory committees, Research Funding. Dreyling:Roche: Honoraria, Membership on an entity9s Board of Directors or advisory committees, Research Funding. Hiddemann:Roche: Research Funding.


Recently, Leung et al. (2002) have identified a pan‐cultural set of five dimensions tapping beliefs about the world in which each individual functions. These general axioms may be conceptualized as individual assessments of the social context constraining one's behavioural choices. As such, we hypothesize that these beliefs about the world may be combined with measures of motivation to predict an individual's actions. To test this model, the present research examined the usefulness of these social axioms as predictors of behavioural tendencies in conjunction with four comprehensive dimensions of values (Schwartz, 1992). Hierarchical regression analyses showed that social axioms added moderate predictive power over and above that provided by values to vocational choices, methods of conflict resolution, and coping styles. Specifically, reward for application was related to preference for conventional jobs and accommodation in conflict resolution; religiosity was related to accommodation and to competition in conflict resolution; social cynicism was related negatively to collaboration and to compromise in conflict resolution, and positively to wishful thinking in coping; fate control was related positively to wishful thinking and distancing in coping; and social complexity was related to compromise and to collaboration in conflict resolution, and to problem‐solving as a coping strategy. It thus seems as if measures of respondents' beliefs about the external, social world supplement measures of their internal motivations to achieve various goals. Copyright © 2004 John Wiley & Sons, Ltd.


A new mutation of transthyretin (TTR) has been identified in a patient with late-onset familial amyloidotic polyneuropathy (FAP) of Japanese origin. Peptide mapping by reverse-phase high performance liquid chromatography to compare the patient's TTR with normal TTR showed the presence of an abnormal peptide. Amino acid sequence analysis of the peptide (residues 49-61) showed a lysine-for-glutamic acid substitution at position 61. This substitution, verified by direct DNA sequencing, was the result of a guanine to adenine change on exon 3 of the TTR gene. A polymerase chain reaction-induced mutation restriction analysis (PCR-IMRA) system was established to rapidly detect the missense mutation. TTR-Lys61 is the first variant TTR with a replacement of the acidic with basic amino acid to be found in the amyloid precursor proteins of FAP.