Reflective practice is widely taught within higher education and is regarded as beneficial to developing graduates' ability to practise effectively within professional environments. In spite of widespread acceptance of the merits of reflective practice, a comprehensive understanding of teaching reflective practice remains incomplete and contested. This paper reports on a study undertaken to explore physiotherapy students' experiences and perceptions of learning reflective practice in order to critically and meaningfully inform current teaching practice. The findings identified that students and graduates conceptualised reflective practice in terms of the challenges they faced in the concrete tasks of daily novice practice. They used methods of reflection that were embedded in the context of their daily practice with particular emphasis on using social and collective opportunities for reflection. The preferred methods of reflective practice used by students and graduates contrasted with traditional approaches to teaching reflective practice. This study supports rethinking approaches for teaching reflective practice to incorporate approaches that are embedded within real and daily practice experiences.


Background. The quality assessments of food products often involve evaluating their electrical properties, including impedance, permittivity and dielectric loss factor. The measurements of food electrical characteristics provide an interesting alternative to time-consuming and expensive methods based on chemical parameter measurements. This report describes investigations into the effects of frequency on the electrical properties of honey. Specifically, honey electrical properties were tested under an electromagnetic field with frequency ranging from 1 kHz to 1 MHz. Results and conclusion. Both experimental and numerical methods were used in this study. Double verification yielded identical results, which confirmed that the numerical method applied and the computational conditions were selected appropriately. The most important feature and the most significant advantage of the numerical approach is the possibility to predict the behavior of the actual object based on its mathematical model. It is much easier and faster to perform computer simulations than to perform the corresponding measurements under real-life conditions. Numerical simulations are also extremely useful when experiments are too dangerous to perform, i.e. when the electromagnetic field being studied can pose a threat to the health or life of a tested subject. The main drawbacks of computer simulations are the restraints of computing resources and the long duration of calculations.


For restaurants, the wine list is a mean of communication and increasing resources. It allows to position the brand. The restaurant owner must offer a wide range of wines to meet customer demands. The vineyards of the Midi-Pyrenees regions (southwest of France) products all types of wines. This exploratory study focuses on the wine lists of Toulouse low and medium-level full service restaurants. The total number of references and the percentage of Midi-Pyrenees wines and foreign wines have been calculated. It appears that assortment policies of Toulouse restaurants are varied. The wine lists of restaurants that offers local cuisine or cuisine from a wine producing area include more Midi-Pyrenees wines as do entry-level restaurants


The generalization of the geometric phase to the realm of mixed states is known as Uhlmann phase. Recently, applications of this concept to the field of topological insulators have been made and an experimental observation of a characteristic critical temperature at which the topological Uhlmann phase disappears has also been reported. Surprisingly, to our knowledge, the Uhlmann phase of such a paradigmatic system as the spin-j particle in presence of a slowly rotating magnetic field has not been reported to date. Here we study the case of such a system in a thermal ensemble. We find that the Uhlmann phase is given by the argument of a complex valued second kind Chebyshev polynomial of order 2j. Correspondingly, the Uhlmann phase displays 2j singularities, occurying at the roots of such polynomials which define critical temperatures at which the system undergoes topological order transitions. Appealing to the argument principle of complex analysis each topological order is characterized by a winding number, which happen to be 2j for the ground state and decrease by unity each time increasing temperature passes through a critical value. We hope this study encourages experimental verification of this phenomenon of thermal control of topological properties, as has already been done for the spin-1/2 particle.


This study was carried out to evaluate the respective safety of standard introduction of the umbilical trocar after insuflation of the abdomen through a veress needle, direct trocar insertion, and the open laparoscopy approach. Abdominal adhesion were induced by standardized peritoneal trauma in 60 New Zeland white female rabbits. Three weeks later, the animals were randomly assigned to one of three techniques: group 1: standard approach; group 2: direct trocar insertion; group 3: open laparoscopy. Twenty-four bowel injuries occurred in group 1, thirty nine in group 2, and six in group 3. The differences between groups were statistically significant (group 1 vs group 2: p = 0.03; group 3 vs group 1: p = 0.004; group 3 vs group 2: p = 0.0001). These findings favor the use of the open laparoscopy approach when abdominal adhesions are suspected. The standard approach is safer than the technique without pneumoperitoneum, but would require an endoscopic visualization of the umbilical trocar insertion to reduce the complication rate.


This paper begins with a selective review of theories relevant to the state–society relationship. The review focuses on the mode by which competing theories are constructed. Three factors which affect theory-building are considered: Assumptions about the intention of the state; the function and capacity of the state; and the forms of alliance, allegiance, and conflict. It is argued that each of these competing theories is valid under specific circumstances and it is suggested that they are not necessarily mutually exclusive but can be complementary at a given point in time. With these reflections on theory and theory-building as background, Klak's comment on an earlier paper is evaluated.


A simple, reliable, and non-destructive approach based on contact angle measurements is described for predicting the activity of catalyst supports in carbon nanotube (CNT) carpet growth. The basic component of the surface free energy of different alumina supports - determined from the van Oss-Good-Chaudhury model and the Young-Dupré equation - was found to correlate with the activity of Fe catalyst during water-assisted CVD growth of CNT carpets.


Building scalable and highly available geo-replicated file systems is hard. These systems need to resolve conflicts that emerge in concurrent operations in a way that maintains file system invariants, is meaningful to the user, and does not depart from the traditional file system interface. Conflict resolution in existing systems often leads to unexpected or inconsistent results. This paper introduces ElmerFS, a geo-replicated, truly concurrent file system designed with the aim of addressing these challenges. ElmerFS is based on two key ideas: (1) the use of Conflict-Free Replicated Data Types (CRDTs) for representing file system structures, which ensures that replicas converge to a correct state, and (2) conflict resolution rules, which are determined by the choice of CRDT types and their composition, are designed with the principle of being intuitive to the user. We argue that if the state of the file system after resolving a conflict conveys to the user the resolved conflict in an intuitive way, the user can complement or reverse it using traditional file system operations. We discuss the challenges in the design of geo-replicated weakly consistent file systems, and present the design of ElmerFS.


The recognition of the various forms of neurosyphilis has, during recent years, become relatively easy. This is due to a better understanding of the underlying pathologic process as well as to the standardization of the Wassermann test and the addition of the Kahn test. A thorough neurologic examination as well as a serologic study usually leads to the correct diagnosis. Failure to diagnose neurosyphilis correctly is due to error of omission rather than of commission. The therapy of these disorders has also become more or less standardized. The different arsphenamine preparations, mercury, bismuth, tryparsamide, and malaria inoculation, selected to suit each particular case, comprise a fairly effectual group of remedies in the treatment for these diseases. The following two cases are reported because of their unusual clinical picture, their striking diagnostic difficulties and therapeutic problems, and the interesting pathologic observations in one of them. REPORT OF CASES Case 1.—History. —A.


Hollow core photonic crystal fiber (HC-PCF), fabricated according to a nominally non-birefringent design, shows a degree of un-controlled birefringence or polarization mode dispersion far in excess of conventional non polarization maintaining fibers. This can degrade the output pulse in many applications, and places emphasis on the development of polarization maintaining (PM) HC-PCF. The polarization cross-coupling characteristics of PM HC-PCF are very different from those of conventional PM fibers. The former fibers have the advantage of suffering far less from stressfield fluctuations, but the disadvantage of a higher loss figure and the presence of interface roughness induced modecoupling which increases in strength as birefringence reduces. Close to mode anti-crossing events of one polarization mode, the PM HC-PCF is characterized by high birefringence, a high polarization dependent loss and an increased overlap between the polarization modes at the glass interfaces. The interplay between these effects leads to a wavelength for optimum polarization maintenance, λPM, which is detuned from the wavelength of highest birefringence. By a suitable fiber design involving antiresonance of the core-surround geometry, λPM may coincide with a low-loss wavelength for the signal carrying polarization mode.


Background: COVID-19 pandemic has brought significant challenges in the life of children with ASD and their families. Restrictive containment measures and the ensuing disruption to daily routines is a particular source of concern in these vulnerable children, resulted in lifestyle, behavioral and psychosocial implications. Limited access to essential services such as speech and occupational therapy which are difficult to deliver through telehealth may contribute to regression of autism symptoms. Identifying perceived needs, dimensions of impact and strategies to cope is critical to accommodate the negative sequalae of the pandemic on children with ASD. Aim: This review aims to generate important insights into the anticipated challenges faced by children with autism and their families as a result of COVID-19 restrictions. The secondary aim is to propose comprehensive, resilient, multi-component coping strategies that support children with autism and their families. Methods: A systematic literature search was conducted on PubMed, ScienceDirect, Medline and Scopus from inception to 14 March 2021. The current report is an executive summary of data regarding challenges and coping strategies during COVID-19 pandemic for children with autism and their families. Results: The literature reviewed indicates that the ongoing COVID-19 pandemic has undoubtedly led to shifting social situations and disruption of behavioral, mental, physical and social domains which have impacted individuals with ASD and their families. To mitigate the effect of the pandemic on this vulnerable population, implementation of structured multi-level and multi-component child/parent-centered interventions are of paramount importance and will assist in translating perceived negative impacts into opportunities to adapt and cope. Conclusion: Children with ASD are uniquely vulnerable to the disruption caused by COVID-19 pandemic. Transition into in-home behavioral and learning interventions is particularly challenging time for those children and their families. Barriers to essential services such as speech and occupational therapies, combined with loss of routine and predictability has widened the gap between needs and provided care. Parents, teachers and health care should aim to work collectively for a broadened approach that is child/parent centered to compensate for most of disrupted vital support and services. Practical evidence-based resources that support and guide ASD caregivers is likely to reduce anxiety and restore a sense of routine during the pandemic. Ongoing care is essential for those children in order to maintain behavior and prevent symptoms regression that contribute to better prognosis and lowered health care costs.


Immunosuppressive drugs and biological agents may represent a potential risk of lymphoma development in patients with rheumatoid arthritis. But most cases are diffuse, large B-cell lymphomas. Primary cutaneous CD4+ small/medium-sized pleomorphic T-cell lymphoma, a provisional entity in the 2005 WHO-EORTC classification of cutaneous lymphomas, is only described in a limited number of reports. To our knowledge, our case is a rare instance of primary cutaneous CD4+ small/medium-sized pleomorphic T-cell lymphoma, after associated treatment with methotrexate and etanercept, in a patient with moderate rheumatoid arthritis who had undergone an orchidectomy incorrectly.


Thirty-four cases of rupture of the bladder due to blunt trauma of the abdomen are reviewed. Intraperitoneal rupture occurred in 41% of the patients: extraperitoneal rupture occurred in 59% of them. Thirty-five per cent of the patients with extraperitoneal bladder rupture sustained concomitant intraperitoneal visceral injuries. While repairing the extraperitoneal bladder rupture a routine laparotomy through a small incision over the linea semicircularis was helpful in discovering intraperitoneal injuries in patients previously assessed by the general surgery service and considered to be free of intraperitoneal pathology.


Entomology (Abstract) The Virginia Integrated Pest Management Expert for Wheat was designed to combine the best available information regarding wheat pest management of disease pathogens, weeds, and insects into a decision support system that would provide potential outbreak risk and pest control information to the Comprehensive Resource Planning System (CROPS). In addition, the system stands alone as an educational tool for farmers and Extension personnel. This is a rule-based system developed on the Microsoft Windows platform. Knowledge about crops and pest management is represented in the form of IF/THEN rules, demons, and " when-changed " methods. The inference engine analyzes specific crop system information entered by the user to determine potential risks of outbreak for wheat crop pests common to Virginia. These potential outbreak risks are presented as low, medium, and high levels of risk and are presented for each of 15 pests of wheat in Virginia. iii The system was evaluated using thirty random cropping system scenarios. By comparing expert system output with output from human experts, it was shown that the expert system agreed with human expert opinions in 84 percent of the decisions made. Statistical analysis of the insect pest data showed that there was no significant statistical difference between the distribution of the human expert predictions and the expert system predictions. Statistical analysis of the disease pest data showed that there were some significant statistical differences between the distribution of the human expert predictions and the expert system predictions. who served as experts and gave their time and insight to this project. I thank Marion Reynolds and Pamela Norris for their help with the statistical analysis of my data.


When used with 14C records, an accurate reconstruction of the 13C/12C changes of atmospheric CO2 may be a key constraint to determining the historic activity of the biosphere as CO2 source or sink. We recently detailed the derivation of an atmospheric δ13C record for 1930–1979 from Arizona juniper tree rings (Leavitt and Long, 1983). Each tree was close to a weather station, allowing us to account for the effects of climate on the tree-ring δ13C records. The resulting atmospheric δ13C trend shows an overall decrease of ca 1.3‰, but instead of decreasing exponentially over the whole 50-year period, the best-fit curve decreases exponentially to ca 1960 and then flattens out. The drop from 1956 to 1978 was ca 0.55‰, still very similar to the measured atmospheric drop over that period of 0.65 ± 0.13‰ (Keeling, Mook, and Tans, 1979).


Proceedings: AACR 106th Annual Meeting 2015; April 18-22, 2015; Philadelphia, PA

Anaplastic large cell lymphoma (ALCL), a type of T/null-cell lymphoma, represents about 20-30% of paediatric lymphomas and has an aggressive clinical course with frequent relapse. Recently, high-level expression of CSF1R on malignant cells in ALCL has been linked to shorter progression free survival, providing a rationale to test adoptive C28ζ-mediated T-cell therapy. This approach encompasses the genetic modification of T-cells to express a chimeric antigen receptor (CAR) named C28ζ, a fusion receptor coupling the recognition of CSF1R on the tumour cell surface to the delivery of tailored T-cell activation signal provided by a fused CD28+CD3ζ endodomain. To optimize this approach for human translation, the C28ζ CAR was co-expressed with the chimeric cytokine receptor 4αβ (combination termed "C4"), which allows for selective expansion and enrichment of CAR-transduced T-cells using IL-4. PBMCs of healthy donors were isolated and activated using anti-CD3/CD28 beads. Following retroviral T-cell transduction and 14 days expansion of C4+ T-cells in the presence of IL-4, co-cultures with a panel of ALCL cell lines (2 ALK positive and 2 ALK negative ALCL cell lines) were set up to test C4 efficacy in vitro. Successful re-targeting of C4+ T-cells was confirmed by monitoring target cell destruction. Conditioned media was collected and analysed for IFN-γ and IL-2 production. Cytotoxicity, cytokine release and T-cell proliferation data demonstrated Ag-specific activation of the C4+ cells, which contrasted with T-cells expressing a control CAR with truncated endodomain. This data provides for the first time the basis for successful application of CAR-based immunotherapy against CSF1R-expressing malignancies.

Citation Format: Daniela Achkova, James Spicer, John Maher. Development of immunotherapy for anaplastic large cell lymphoma (ALCL) using CSF1R retargeted human T lymphocytes. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 3144. doi:10.1158/1538-7445.AM2015-3144


Scientific evidence suggests that rising levels of anthropogenic underwater sound ("ocean noise") produced by industrial activities are causing a range of injuries to marine animals—in particular, whales. These developments have forced states and development proponents into acknowledging ocean noise as a threat to marine economic activity. This paper delivers a Gramsci-inspired critique of the modernizations of ocean noise regulation being wrought by science, state and politics. Gramsci was acutely interested in the dynamic and social nature of scientific research, and his writings affirm science's powers and ambitions. At the same time, he was keen to observe how science participates in the process he called hegemony. Using examples drawn from Canada's West Coast, I suggest that capital is engaging ocean noise not only as a regulatory problem issuing from legal duties and legitimacy concerns, but opportunities linked to the commercialization of ocean science.


Herzberg, Mausner and Synderman (1959) have classified job characteristicsas either self-actualizing factors (motivators) or physical job features (hygienes). A sample of 42 professional and 46 non-professional men and women reported their order of preference for 10 job characteristics (5 motivators and 5 hygienes) and also indicated their perception of the importance of these job traits for male and female co-workers. Both sexes regarded motivators as personally more important than hygienes but non-professional respondents were significantly more concerned about hygienes than the professional group. Females, both professional and non-professional, did not perceive any significant differences between themselves and their male and female co-workers, while males rated themselves as significantly more influenced by motivators than they believed their female co-workers to be. Male and female non-professionals rated their male colleagues as more interested in the self-actualizing factors thantheir female co-workers. These results are discussed in terms of the possible negative consequences of the image of the less committed female worker.


Collisions between two objects are classified into three groups : Linear Central Impacts, Oblique Central Impacts and Eccentric Impacts. In this paper, the effects of all three types of impacts by motor vehicles are studied using the theory of impulse and momentum. The loss of energy caused by impacts is defined by the Coefficient of Restitution \lq\lq e''. Accordingly, Elastic, Elastoplastic and Plastic Collisions occur in all 3 types of impact. Oblique Central Impact is observed more often than Linear Central Impact, and Eccentric Collisions are observed more often than the other two types in highway collisions. Cases of these types of collision are examined, and examples of all 3 types of collision adapted to vehicle collisions are illustrated.


T cells are stimulated by the engagement of antigen, cytokine, pathogen, and hormone receptors. While research performed over many years has focused on deciphering the molecular components of these pathways, recent data underscore the importance of the metabolic environment in conditioning responses to receptor engagement. The ability of T cells to undergo a massive proliferation and cytokine secretion in response to receptor signals requires alterations to their bioenergetic homeostasis, allowing them to meet new energetic and biosynthetic demands. The metabolic reprogramming of activated T cells is regulated not only by changes in intracellular nutrient uptake and utilization but also by nutrient and oxygen concentrations in the extracellular environment. Notably, the extracellular environment can be profoundly altered by pathological conditions such as infections and tumors, thereby perturbing the metabolism and function of antigen‐specific T lymphocytes. This review highlights the interplay between diverse metabolic networks and the transcriptional/epigenetic states that condition T‐cell differentiation, comparing the metabolic features of T lymphocytes with other immune cells. We further address recent discoveries in the metabolic pathways that govern T‐cell function in physiological and pathological conditions.


Objective: To investigate the prognostic value of induced monomorphic ventricular tachycardia (VT) and ventricular flutter or fibrillation (VF) during programmed electrical stimulation in patients with a high risk for sudden arrhythmogenic cardiac death. Design: Prospective cohort study. Patients: 102 patients at high risk for arrhythmogenic sudden cardiac death who received an automated implantable cardioverter-defibrillator (AICD) were evaluated. 56 patients received the AICD for primary prevention and 46 for secondary prevention. 58 patients had induction of a monomorphic VT (VT group) and 44 had induction of a polymorphic VT, ventricular flutter, or ventricular fibrillation (VF group) during programmed electrical stimulation. Average follow up was 20 months in both groups. Main outcome measures: Appropriate AICD protocol. Results: In patients who received the AICD for primary prevention, 16 of 32 patients in the VT group, compared with only four of 24 patients in the VF group, received an appropriate AICD protocol (p = 0.02). In the entire study population, 479 appropriate AICD protocols were recorded in 28 (48%) patients in the VT group and 28 appropriate protocols in 11 (25%) patients in the VF group. Cumulative Kaplan-Meier event-free survival curves were significantly different (p = 0.02). Conclusion: Induction of VF during programmed electrical stimulation is of no prognostic value even in high risk patients without previously documented ventricular fibrillation.


The proper balance of gene expression is essential for cellular health, organismal development, and maintaining homeostasis. In response to complex internal and external signals, the cell needs to modulate gene expression to maintain proteostasis and establish cellular identity within its niche. On a genome level, single-celled prokaryotic microbes display clustering of co-expressed genes that are regulated as a polycistronic RNA. This phenomenon is largely absent from eukaryotic microbes, although there is extensive clustering of co-expressed genes as functional pairs spread throughout the genome in Saccharomyces cerevisiae. While initial analysis demonstrated conservation of clustering in divergent fungal lineages, a comprehensive analysis has yet to be performed. Here we report on the prevalence, conservation, and significance of the functional clustering of co-regulated genes within the opportunistic human pathogen, Candida albicans. Our analysis reveals that there is extensive clustering within this organism—although the identity of the gene pairs is unique compared with those found in S. cerevisiae—indicating that this genomic arrangement evolved after these microbes diverged evolutionarily, rather than being the result of an ancestral arrangement. We report a clustered arrangement in gene families that participate in diverse molecular functions and are not the result of a divergent orientation with a shared promoter. This arrangement coordinates the transcription of the clustered genes to their neighboring genes, with the clusters congregating to genomic loci that are conducive to transcriptional regulation at a distance.


In a conventional calibration service, clients send their instruments to a laboratory for routine calibration, during which the clients are not able to use their instruments due to downtime. Some of their instruments are huge and heavy such as power source transformer which is difficult to be transported. A solution to these problems is to send an engineer together with measurement instrument to a client site to perform the calibrations. Another way of solving the problem is to send only the measurement instrument to a client site where the instrument and the unit under test are controlled by a computer that links with the laboratory computer over the Internet. The calibration engineer can monitor the calibration progress remotely from his laboratory without going to the site. This can improve the calibration service and bring satisfaction to the clients. The research conducted here is to develop a calibration system that allows the client instruments to be calibrated at the remote location. The existing Internet facility and its advancement pave the way for development of Internet calibration system. The methodology of internet calibration is based on the technology of client-server applications. It is distinguished by the connected online calibration service that it provides. Customers from various industries and services will benefit from this implementation. Their instruments performances are directly traceable to national laboratory. Experts from national laboratory can share their skills and knowledge with the customers.


Background MRI is increasingly used to objectively assess disease activity and damage in patients with rheumatoid arthritis (RA), especially in clinical trials. The preferred scoring method is the RAMRIS, which implies the use of gadolinium, an intravenous contrast agent, to assess synovitis. Objectives We evaluated in a small preliminary study if the fusion of MRI and US Power Doppler (PD) images could avoid gadolinium. Methods 12 patients (10 women) affected by RA, with at least one involved wrist, were studied. Mean age was 58.8±9.1 years and mean disease duration was 54.5±56.1 months. Disease activity (DAS 28-CRP) was evaluated on the day of the examinations. MRI was performed on a extremity-dedicated machine (Oscan 0.3 T, Esaote, Genova Italy) and US by MyLab Twice ultrasound scanner with a virtual navigator software (Esaote, Genova, Italy). T3Dt1 sequences were used in the fusion images (parameters: TR/TE/NEX 38/16/1, matrix 192*192*39, FOV 160*160*60, thickness 0.6 mm). US scans were performed sagittally on the radio-lunate joint and axially on the proximal carpal bones of the dorsal wrist with B-mode and PD (PRF 500–750Hz; WF: 3; maximum gain with probe's calibration in air). Magnetic position sensor linked to the US transducer (13 MHz) and low magnetic field transmitters were used to allowed fusion images. MRI synovitis was scored by the RAMRIS and with the contrast-enhanced dynamic method resulting in rate of early enhancement (REE) and relative enhancement, (RE). The US score was the Global OMERACT-EULAR Synovitis Score (GLOESS) and its individual parts. Results Inter-reader agreement for PD by weighted kappa was 0.75 (75%CI 0.53–0.96) for the sagittal and 1 (75%CI 1–1) for the axial view. It was 0.85 (75%CI 0.69–0.98) for MRI synovitis. There was a correlation between DAS28 and the MRI synovits score (r=0.59, p=0.04), REE (r=0.60, p=0.04), and RE (r=0.58, p=0.05), US Doppler in the long (r=0.75, p=0.005) and in the axial axes (r=0.86, p=0.01), but not with B-mode synovial effusion (r=0.56, p=0.056). The GLOESS correlated with DAS28 (r=0.66, p=0.019), but not with RAMRIS synovitis, erosions or BME nor with REE. The MRI wrist synovitis score did not correlate with the Doppler score on the sagittal and axial views, nor with US B mode score. This was true also for the three individual MRI slices of the wrist, the REE and the RE. The figure shows from the left the pre-contrast axial MRI image, the post-contrast and the fusion images. Conclusions Although both MRI and Doppler are good indicators of disease activity in RA, they seem not to be interchangeable. This may be due to the fact that MRI and US show different features of synovitis or, alternatively, that MRI comprised the whole wrist whereas US visualized only its dorsal area. Although our preliminary data do not support the use of fusion images, these should be investigated on larger number of patients with a more extended PD approach. Disclosure of Interest None declared


BACKGROUND
There have been very few small studies or case reports in the literature considering noninvasive postmortem imaging as supplement to autopsy, especially in fetuses with skeletal dysplasias. Apert syndrome accounts for 4.5% of all patients with craniosynostotic syndromes. It is classically characterized by the triad of coronal craniosynostosis, midfacial hypoplasia, and symmetric bony syndactyly of the hands and feet.

PURPOSE
Illustrate the accuracy of a postmortem computed tomography compared with a conventional autopsy as well as review common imaging findings in a case of prenatally diagnosed Apert syndrome.

CASE
A 31-year-old woman was seen for a routine prenatal ultrasound. A craniofacial syndrome was suspected by prenatal ultrasound, and the anomalies raised the suspicion of Apert syndrome. After genetic counseling, it was chosen to terminate the pregnancy. A postmortem computed tomographic scan was performed, followed by a conventional autopsy that confirmed the findings.

DISCUSSION
Computed tomography provides many advantages in postmortem assessment. Postmortem imaging cannot replace conventional autopsy but is superior in axial and appendicular skeleton assessment. These studies provide supplemental information that may guide the autopsy. In situations where the parents wish not to pursue an autopsy, postmortem imaging can provide useful clinical information.


Introduction Antimicrobial resistance has become a major public threat. Resistance to commonly used antibiotics has increased in Pakistan. Cephalosporins and ciprofloxacin resistance in E.coli have been reported in the range of 70% and 80%. Increasing resistance to ceftriaxone and Ciprofloxacin have also been reported among hemodialysis patients for Klebsiella bacteremia from our center. There is no data about antibiotic susceptibility among common gram negatives from renal transplant recipients from our country which are vulnerable population due to immunosuppressive drugs. This study is conducted to find the trends in antimicrobial resistance pattern among common gram negatives over a 9-year period in renal transplant recipients. The aim is to guide the physicians regarding decision over empirical antimicrobial choices. Methods Our institute is a 700-bedded tertiary care hospital in a developing country where more than 5500 patients have been received transplant till now. A retrospective computerized data review of blood cultures collected from renal transplant recipients admitted in transplant unit over alternate years i.e. 2008, 2010, 2012, 2014, 2016 was conducted. Data on E.coli and Klebsiella was taken as they are the major causative microorganism identified. The resistance pattern of ceftriaxone, piperacillin-tazobactam, ciprofloxacin, amikacin and imipenem were compared over the 9 years period. Results Of 13,736 blood cultures, 1799 (13%) had at least one identified pathogen. E. coli (22%) and Klebsiella (6.28%) are most common pathogen among gram negatives. Ceftriaxone resistance is increased in E. coli (from 48% to 70.5%) and in Klebsiella upto 81%, whereas Ciprofloxacin resistance in both organism is in the range of 60-70%. Carbapenem resistance is also started increasing for both organism. Trends in resistance to E. coli and Klebsiella is shown in figure1 and figure 2 respectively. Conclusion Resistance to broad spectrum antimicrobials has been increased significantly with a five-fold increase in imipenem resistance over the last 9 years. We need a robust stewardship program for judicious use of antimicrobials and better infection control measures to contain increasing resistance.


Over the past two decades quantum engineering has made significant advances in our ability to create genuine quantum many-body systems using ultracold atoms. In particular, some prototypical exactly solvable Yang–Baxter systems have been successfully realized allowing us to confront elegant and sophisticated exact solutions of these systems with their experimental counterparts. The new experimental developments show a variety of fundamental one-dimensional (1D) phenomena, ranging from the generalized hydrodynamics to dynamical fermionization, Tomonaga–Luttinger liquids, collective excitations, fractional exclusion statistics, quantum holonomy, spin-charge separation, competing orders with high spin symmetry and quantum impurity problems. This article briefly reviews these developments and provides rigorous understanding of those observed phenomena based on the exact solutions while highlighting the uniqueness of 1D quantum physics. The precision of atomic physics realizations of integrable many-body problems continues to inspire significant developments in mathematics and physics while at the same time offering the prospect to contribute to future quantum technology.


In order to perform data acquisition and avoid unwanted over-current damage to the power supply, a convenient and real-time method of experimentally investigating repetitive nanosecond-pulse breakdown in polymer dielectric samples is presented. The measurement-acquisition and control system not only records breakdown voltage and current, and time-to-breakdown duration, but also provides a real-time power-off protection for the power supply. Furthermore, the number of applied pulses can be calculated by the product of the time-to-breakdown duration and repetition rate. When the measured time-to-breakdown duration error is taken into account, the repetition rate of applied nanosecond-pulses should be below 40 kHz. In addition, some experimental data on repetitive nanosecond-pulse breakdown of polymer films are presented and discussed.


Gradient-based optimisation relies on the response Jacobian whose evaluation constitutes a major computational overhead in full-wave numerical analysis. Adjoint-based techniques may offer numerically efficient solutions, but their implementation is too involved in the case of full-wave computations. A simple approach that uses the self-adjoint sensitivity analysis and Broyden's update is proposed. The overhead of the Jacobian computation is greatly reduced because an adjoint system analysis is not needed and because Broyden's update is used to compute the system matrix derivatives. To improve the robustness of the Broyden update in the sensitivity analysis, we propose a switching criterion between the Broyden and the finite-difference estimation of the system matrix derivatives. We illustrate and validate the proposed method using full-wave commercial electromagnetic solvers based on the finite-element method as well as on the method of moments. Different gradient-based optimisation algorithms are exploited in the examples where efficiency is compared in terms of CPU time savings.


Consumers want to use their digital content in the same way they have always used analog content. Consumer associations and governments are starting to request and even impose interoperability between DRM vendors' products. Therefore, interoperability has become a hot topic among content creators and distributors. Digital music providers and even authors are starting to refute the idea thatDRM is an ideal solution for protecting their rights. This is partly due to Apple and Microsoft not making their solutions interoperate.


This reference design uses inductive and hall-effect sensing technologies to provide a human-machine interface. The inductive sensing devices create eight different touch buttons on a seamless surface while the hall-effect sensor is used to create a magnetic dial that can rotate and be used as an additional button. Using an inductive sensing touch button provides a robust solution that uses the force of the press to determine a button press. This allows for touch buttons that can be used with gloves on while also ignoring environmental factors like dirt or damages to the button surface. The hall sensor dial creates a contact-less rotation that has improved wear and tear over traditional contact-based implementations such as potentiometers or rotary encoders.


We study the desirability of limits on the public debt and of political turnover in an economy where incumbents have an incentive to set public expenditures above the socially optimal level due to rent-seeking motives. Parties alternate in office and cannot commit to future policies, but they can forge a political compromise where each party curbs excessive spending when in office if it expects future governments to do the same. In contrast to the received literature, we find that strict limits on government borrowing can exacerbate political economy distortions by making a political compromise unsustainable. This tends to happen when political turnover is limited. Conversely, a tight limit on the public debt fosters a compromise that yields the efficient outcome if political turnover is vigorous. Our analysis thus suggests that to sustain good economic policies, a society needs to restrict either the extent of political turnover or the ability of governments to issue debt, but not both.


COVID-19, the disease and ''lockdown'', the preventive measure, can be termed as major watershed of our times as never before in human history human lives and activities have been halted to such a huge level as combat measure against any disease. Under this unprecedented situation, an online survey was conceptualised to see the situation of students' households during lock down period.Objective: On the basis of that data, feasibility of adherence regarding public health aspects (like washing hands, physical distances, and restricted movement outside house) are discussed through this study. Moreover, the awareness, capability and feasibility of households to abide by the prescribed norms are numerically measured through related social variable and logical insight.Method: Though this cross sectional survey data collected during May 15 to May 31st 2020, three separate indices regarding three major points of guideline e.g. Frequent hand washing, keeping physical distance and staying inside home are devised and finally a composite normalised index is created to judge the overall status of the households.Results: This composite index is robust and sensitive enough. It is found to related with the level of living of the households, household size and some other social parameters.Conclusion: Respondent households being mostly from Kolkata nearby areas (Howrah, Hooghly, 24 PGS (N) &(S)) of Hindu, General and largely (two-thirds) belonging to 'lower-middle class' (family income per month 15000 or less) can be very well assumed as a representative sample of whole west Bengal. With the help of this composite index we may identify the status of any household in the spectrum of plausibility to adhere the guidelines and public health educative measures can be taken for those households in the long run.


Field experiments were planned and conducted during kharif 2017-18 and 2018-19 to evaluate the "Influence of organic formulations and inorganic fertilizations on soil properties and nutrient uptake by tomato", at the research farm, College of Agriculture, Golegaon, Vasantrao Naik Marathwada Krishi Vidyapeeth, Parbhani. The experiments were laid out in randomized block design with three replications. There were twelve treatments comprising of organic formulations and inorganic fertilizers. The finding emerged out indicated that conjoint use of RDF + Beejamruth + Jeevamruth + Panchagavya significantly enhanced in nutrient uptake in tomato. Among the different applications widely applying with RDF + Beejamruth + Jeevamruth + Panchagavya followed by RDF + Beejamruth + Panchagavya to nutrient uptake. It can be concluded from these experiment that the balanced use of organic formulations with inorganic fertilizations affect the nutrients uptake on tomato plants.


The adaptations to low environmental temperatures exhibited in mammalian hibernation are many and varied, and involve molecular and cellular mechanisms as well as the systematic physiology of the whole organism. Natural torpidity is characterised by a profound reduction in body temperature and other functions lasting from a few hours to several weeks. Controlled reduction of heart rate, respiration and oxygen consumption is followed by the fall in body temperature. However, thermoregulation persists such that a decrease in ambient temperature below dangerous levels typically triggers arousal, and shivering and non-shivering thermogenesis from brown fat provide the heat to restore body temperature to normal levels. Many of the cellular mechanisms for survival are similar to those brought into play during medium-term storage of organs destined for transplantation. For example maintenance of ionic regulation and membrane fluxes is fundamental to cell survival and function at low body temperatures. Differences between hibernating and non-hibernating species are marked by differences in Na+/K+ transport and Ca++pumps. These in turn are probably associated with alterations in the lipoproteins of the plasma membrane and inner mitochondrial membrane. We have accordingly conducted a series of pilot studies in captured Richardson's ground squirrels kept in laboratory conditions as a model for hypothermic organ preservation. Tissue function was compared during the summer (non-hibernating season) with that in the winter when the animals could be: (i) in deep hibernation in a cold chamber at 4 degree C; (ii) maintained in an ambient temperature of 4 degree C but active and awake; or (iii) active at an ambient temperature of 22 degree C. The studies involved: whole animal monitoring of standard physiological parameters; whole organ (kidney) storage and transplantation for viability assessment; storage and functional assessment on an ex vivo test circuit with capacity for perfusion at normothermic and hypothermic temperatures; measurement of thyroid function; measurements of total nucleotides (ATP, ADP and AMP)and ratios by standard techniques after freeze-clamping of organs; similar nucleotide and pH measurements using31P-NMR as a non-invasive whole animal technique; and measurement of O2 uptake and gluconeogenesis using isolated renal tubules and isolated hepatocytes. Marked differences in cold tolerance were demonstrated between organs taken from hibernating versus non-hibernating individuals. In particular kidneys transplanted from animals in deep hibernation were capable of withstanding up to 72 hours of cold storage as compared with up to 24 hours in non-hibernating squirrels or in comparable sized rats. Adaptations which might provide valuable clues in our attempts to better preserve human organs for transplantation are explored in some depth in this report.


In this essay, Pauline Kleingeld notes that Kant's Principle of Autonomy, which played a central role in both the Groundwork for the Metaphysics of Morals and the Critique of Practical Reason, disappeared by the time of the Metaphysics of Morals. She argues that its disappearance is due to significant changes in Kant's political philosophy. The Principle of Autonomy states that one ought to act as if one were giving universal laws through one's maxims. The criterion of just legislation that Kant accepted in the mid-1780s does not require any actual consent on the part of the citizens—genuine universality is sufficient for a law to be just. Hence, at that time, Kant could indeed explicate the criterion governing the moral permissibility of one's maxims by drawing an analogy with the criterion governing the justice of political laws. In the Metaphysics of Morals and in other works in the 1790s, however, he added the further condition that laws must be given with the consent of the citizens. With this further condition, the moral criterion was no longer fully analogous to the criterion for political laws being just. Accordingly, Kleingeld argues, Kant dropped the Principle of Autonomy, which was firmly based on that analogy.


The pelvic exenteration procedure must be considered a multimodal therapeutic concept from a humanistic-medical point of view. Careful patient selection, radical resection of all tumor-infiltrated organs, complete interdisciplinary organ reconstruction, and optimal perioperative management including full psychosomatic rehabilitation are mandatory. This concept should only be realized in medical centers with highly sophisticated infrastructures.


Abstract First reported in 1896, psorosis was the first citrus disease proven to be graft transmissible and also the first for which eradication and budwood certification programs were launched to prevent its economic damage. For many years psorosis etiology remained elusive and only in 1986 it was associated with the presence of virus-like particles in infected plants. However, in the last two decades a virus with unusual morphology (Citrus psorosis virus, CPsV) was characterized and closely associated with psorosis disease as previously defined by field symptoms and by biological indexing in sensitive indicator plants. With a tripartite, negative-sense, RNA genome and a ~48 kDa coat protein, CPsV, the presumed causal agent of psorosis, is the type member of the genus Ophiovirus, within the new family Ophioviridae. Availability of the complete genomic sequence of two CPsV isolates and partial sequences of many others has enabled i) setting up rapid and sensitive RNA-based detection methods, ii) testing different citrus and relatives for resistance to CPsV, iii) identification of the two components (psorosis A and psorosis B) traditionally associated with non-scaled and scaled bark inoculum, respectively, from psorosis-infected plants and study their interactions, iv) analysis of genetic variation and evolutionary forces shaping the CPsV populations, v) preliminary studies on the interactions between virus and host factors and vi) development of transgenic citrus plants expressing variable degrees of resistance to CPsV. In summary, 120 years after the first report on psorosis we start seeing a pale light at the end of the tunnel.


In order to realize efficient nitrogen removal and N2O emission reduction, air lift circulation bioreactors were applied to study the relationship between activated sludge aggregation state and N2O emission characters on the basis of high nitrogen removal performance. The nitrification/denitrification activity of different microbial aggregates was evaluated by key enzyme action ratio method. Combined with correlative theoretical analysis, the optimal aggregation state with efficient nitrogen removal and N2O emission reduction was selected. According to the results, different activated sludge aggregation state in SND would lead to significant difference of N2O emission amount (> or = 40%). The smaller aggregates (< or = 0.9 mm) with moderate compactness could keep high SND efficiency (> or = 70%) and achieved N2O emission reduction. In experimental defined system, the optimal diameter of aggregates was in the range of 0.45-0.9 mm, which could obtain higher nitrification activity [ammonia-oxidizing bacteria activity was 0.17 mg x (g x min) (-1), nitrite-oxidizing bacteria activity was 0.74 mg x (g x min) (-1)] and denitrification activity [NO3(-) -N consumption rate was 0.47 mg x (g x min) (-1), NO2(-) -N consumption rate was 0.22 mg x (g x min) (-1)]. Compared to the control group, N2O accumulated emission amount in the reactor with aggregates of 0.45-0.9 mm could be realized reduction more than 32.55%.


This paper reviews and summarizes the progress in research on high-Tc superconducting infrared bolometers since the discovery of high-temperature superconductor (HTSC) materials. After mentioning previous review articles and their particular themes in the introduction, we recall bolometer basics in section 2, where key parameters are presented and design principles summarized. The latter include incident radiation to HTSC thermometer coupling techniques (absorber and antenna approaches) and the thermal balance inside the active region. Section 3 (which forms the largest part of the article) is devoted to medium and near-infrared transition edge bolometers (0.8-20 µm wavelength range), covering both monolithic and composite (absorber coupled) devices. The main landmarks and state-of-the-art devices are described in the order of the increasing degree of technological complexity (thick substrates, thinned or suspended substrates, micromachined silicon-based structures), while keeping in mind the sensitivity versus time response compromise and the aimed competitiveness with photon detectors. The last section treats far-infrared (antenna coupled) hot electron bolometers (HEBs), whose emergence has benefited from newly developed superconducting nanostructures and which are promising candidates for terahertz heterodyne detection. Finally, recent results on both HTSC and (more mature) low-Tc HEBs are given.


In this paper, we study K-user multiple-input multiple-output (MIMO) interference channels (IC) in the presence of antenna correlations. Although interference alignment (IA) achieves the maximum multiplexing gain, i.e., degrees of freedom (DOF), the actual performance is degraded due to ill-conditioned channels caused by the antenna correlations. To enhance the overall system performance, we thus consider a transmission mode selection scheme which adaptively determines the number of data streams at each transmitter-receiver pair in a distributed fashion using local channel state information (CSI). A filter update process is exploited in order to estimate the performance regarding each transmission mode successively by considering the actual channel conditions as well as signal-to-noise ratio (SNR). Simulation results show that our mode selection scheme enhances the sum rate performance compared to the conventional full data stream transmissions in spatially correlated MIMO IC.


This paper focuses on the evidentiary aspects of the precautionary principle. Three points are highlighted: (i) the difference between association and causation; (ii) how the strength of scientific evidence can be considered; and (iii) the reasons why regulatory regimes tend to err in the direction of false negatives rather than false positives. The point is made that because obtaining evidence of causation can take many decades of research, the precautionary principle can be invoked to justify action when evidence of causation is not available, but there is good scientific evidence of an association between exposures and impacts. It is argued that the appropriate level of proof is context dependent, as "appropriateness" is based on value judgements about the acceptability of the costs, about the distribution of the costs, and about the consequences of being wrong. A complementary approach to evaluating the strength of scientific evidence is to focus on the level of uncertainty. If decision makers are made aware of the limitations of the knowledge base, they can compensate by adopting measures aimed at providing early warnings of un-anticipated effects and mitigating their impacts. The point is made that it is often disregarded that the Bradford Hill criteria for evaluating evidence are asymmetrical, in that the applicability of a criterion increases the strength of evidence on the presence of an effect, but the inapplicability of a criterion does not increase the strength of evidence on the absence of an effect. The paper discusses the reason why there are so many examples of regulatory "false negatives" as opposed to "false positives". Two main reasons are put forward: (i) the methodological bias within the health and environmental sciences; and (ii) the dominance within decision-making of short term economic and political interests. Sixteen features of methods and culture in the environmental and health sciences are presented. Of these, only three features tend to generate "false positives". It is concluded that although the different features of scientific methods and culture produce robust science, they can lead to poor regulatory decisions on hazard prevention.


Background Ageing is a growing issue for people from UK black, Asian and minority ethnic (BAME) groups. The health experiences of these groups are recognised as a 'tracer' to measure success in end of life patient-preferred outcomes that includes place of death (PoD). Aim To examine patterns in PoD among BAME groups who died of cancer. Material and Methods Mortality data for 93,375 cancer deaths of those aged ≥65 years in London from 2001–2010 were obtained from the UK Office for National Statistics (ONS). Decedent's country of birth was used as a proxy for ethnicity. Linear regression examined trends in place of death across the eight ethnic groups and Poisson regression examined the association between country of birth and place of death. Results 76% decedents were born in the UK, followed by Ireland (5.9%), Europe(5.4%) and Caribbean(4.3%). Most deaths(52.5%) occurred in hospital, followed by home(18.7%). During the study period, deaths in hospital declined with an increase in home deaths; trend for time analysis for those born in UK(0.50%/yr[0.36–0.64%]p<0.001), Europe (1.00%/yr[0.64–1.30%]p<0.001), Asia(1.09%/yr[0.94–1.20%]p<0.001) and Caribbean(1.03%/yr[0.72–1.30%]p<0.001). However, time consistent gaps across the geographical groups remained. Following adjustment hospital deaths were more likely for those born in Asia(Proportion ratio(PR)1.12[95%CI1.08–1.15]p<0.001) and Africa(PR 1.11[95%CI1.07–1.16]p<0.001). Hospice deaths were less likely for those born in Asia(PR 0.73 [0.68–0.80] p<0.001), Africa (PR 0.83[95%CI0.74–0.93]p<0.001), and 'other' geographical regions (PR0.90[95% 0.82–0.98]p<0.001). Home deaths were less likely for those born in the Caribbean(PR0.91[95%CI 0.85–0.98]p<0.001). Conclusions Location of death varies by country of birth. BAME groups are more likely to die in a hospital and less likely to die at home or in a hospice. Further investigation is needed to determine whether these differences result from patient-centred preferences, or other environment or service-related factors. This knowledge will enable strategies to be developed to improve access to relevant palliative care and related services, where necessary.


This study investigates the response of the semidiurnal tide (SDT) to the 2013 major sudden stratospheric warming (SSW) event using meteor radar wind observations and mechanistic tidal model simulations. In the model, the background atmosphere is constrained to meteorological fields from the Navy Global Environmental Model—High Altitude analysis system. The solar (thermal) and lunar (gravitational) SDT components are forced by incorporating hourly temperature tendency fields from the ERA5 forecast model, and by specifying the M2 and N2 lunar gravitational potentials, respectively. The simulated SDT response is compared against meteor wind observations from the CMOR (43.3°N, 80.8°W), Collm (51.3°N, 13.0°E), and Kiruna (67.5°N, 20.1°E) radars, showing close agreement with the observed amplitude and phase variability. Numerical experiments investigate the individual roles of the solar and lunar SDT components in shaping the net SDT response. Further experiments isolate the impact of changing propagation conditions through the zonal mean background atmosphere, non‐linear wave‐wave interactions, and the SSW‐induced stratospheric ozone redistribution. Results indicate that between 80 and 97 km altitude in the northern hemisphere mid‐to‐high latitudes the net SDT response is driven by the solar SDT component, which itself is shaped by changing propagation conditions through the zonal mean background atmosphere and by non‐linear wave‐wave interactions. In addition, it is demonstrated that as a result of the rapidly varying solar SDT during the SSW the contribution of the lunar SDT to the total measured tidal field can be significantly overestimated.


Abstract Carbamylation is a nonenzymatic post-translational modification observed during the reaction between cyanate and amino acids and/or proteins that may occur during some pathologies such as chronic kidney disease. Evidence suggests that carbamylation may interfere with the quantification of some analytes measured using immunoturbidimetric assays. C-reactive protein (CRP) is an inflammatory response protein that is commonly quantified through immunoturbidimetry in clinical laboratories. Because the presence of modified proteins in serum can lead to impaired quantification, this study aimed to verify the impact of in vitro carbamylation on the measurement of CRP in a CRP standard solution and serum pool. The samples were incubated with 150 nM, 150 µM, or 150 mM potassium cyanate (KOCN) or 20, 100, or 500 mg/dL urea at 37 °C for 24 h. CRP concentrations were measured using an immunoturbidimetric assay. The results showed a 61%–72% decrease in the CRP detection rate after incubation with KOCN. Incubation with urea resulted in a 0.7%–8% lower CRP detection rate. The results of this study indicate that high concentrations of cyanate can lead to falsely decreased CRP levels, as measured by immunoturbidimetry.


Abstract The Gillberga quarry in northern Öland provides a c. 16 m thick sequence through middle Volkhov to upper Kunda (mid-Arenig to early Llanvirn) beds. The section has been sampled for conodonts and its temporal faunal changes have been investigated on the basis of fiftynine samples yielding over 300,000 conodont elements. Conodont zones earlier recognized in south-central Sweden and ranging from the middle of the Baltoniodus navis Zone to the middle or upper part of the Microzarkodina ozarkodella Subzone of the Eoplacognathus pseudoplanus Zone were encountered at Gillberga. The temporal changes in relative frequencies of the most abundant conodont genera were calculated throughout the sequence and are presented in frequency diagrams. A new species, Microzarkodina bella, from the lower Kunda has been identified and is described.


A well-known organic host, tris-o-phenylenedioxycyclotriphosphazene, exists in two polymorphic guest-free forms: the thermodynamic nonporous high-density phase and the kinetic nanoporous low-density phase. Simple pressurization of the high density phase with CO(2) brings a solid-state transformation to the low density phase, resulting in significant expansion of the crystal volume by 23%.


It is not every year that we cross the threshold of a New Millennium! For reasons unknown, governments around the World decided that when midnight struck on the last day of 1999 we would move through this mystical timewarp. The Royal Greenwich Observatory would have preferred us to wait another year. Whichever, such an occasion does provide an opportunity for looking back in time and for trying to look ahead. Inevitably, reminiscences are personal. However, the more I explored my thoughts the more I became aware that my most acute memories are not just personal, but are inextricably interwoven with apparently disparate events in the history of Scottish Geology. These have a bearing on local heroes, the path of the Industrial Revolution, Scottish lighthouses, a weather station on Ben Nevis, the Geological Society of Glasgow, Professors of Geology, Geological Survey maps, and concerns about climate change. 'The events in our lives happen in a sequence in time, but in their significance to ourselves they find their own order'. Eudora Welty's words are profoundly relevant. It is the interconnectedness of events with each other and with my most vivid personal recollections, that forms the basis for this Millennium article. Like the history of the Earth, the story of these events is written in rock. Initially, in a small piece of non-descript brownish-black rock picked up by a casual prospector 150 years ago in a field some 2 miles east of Armadale, West Lothian. This was originally thought to be coal . . .


www.school-nursing.co.uk www.internurse.com � Emma Croghan (Consultant Editor) Independent Public Health Consultant Yinglen Butt Nurse Consultant, Department of Health, London Richard Cotton School Charge Nurse, Stoke-on-Trent Gill Coverdale Lecturer in Public Health and Primary Care, University of Leeds Elizabeth Cox Paediatric Continence Nurse Specialist (retired) Stephen Hackney Specialist Community Public Health Nurse (School Health, Deputy Team Leader), Cheshire Kath Lancaster Independent Nurse Consultant Liz Plastow Independent Consultant and Professional Adviser to the Association for Nurse Prescribing Catherine Powell Consultant Nurse Safeguarding Children, Portsmouth City Teaching PCT Helen Ross Locality Team Leader for Children's Services Barbara RichardsonTodd School Nurse Co-ordinator and Practice Teacher, Suffolk PCT Sarah Sherwin Course Leader, SCHPN School Nursing, University of Wolverhampton Frances Weston Accredited Counsellor and Psychotherapist, Uttoxeter Sharon White UK Professional Officer, School and Public Health Nurses Association Barbara Young Independent Nurse Adviser, Children and Young People's Public Health, Kent Consultant Editor Editor Sales Director Classified Sales Production Manager Publisher Associate Publisher Design Executive Medical Illustrator Managing Director Emma Croghan Caroline Voogd Roger Allen Rachel McElhinney Jon Redmayne Matt Cianfarani Alice Hall Peter Constantine HFS Imaging Mark Allen


To explore the potential functions and clinical significances of peroxisomes during lung cancer development and progression, we investigated the expressional profiles of peroxisome pathway genes and their correlations with clinical features in non-small cell lung cancer (NSCLC). The RNA-seq data of NSCLC including lung squamous carcinoma (LUSC) and lung adenocarcinoma (LUAD) patients with their clinical information were downloaded from The Cancer Genome Atlas (TCGA). Gene expression comparisons between tumor and normal samples were performed with edgeR package in R software and the results of the 83 peroxisome pathway genes were extracted. Through Venn diagram analysis, 38 common differentially expressed peroxisome pathway genes (C-DEPGs) in NSCLC were identified. Principal components analysis (PCA) was performed and the 38 C-DEPGs could discriminate NSCLC tumors from the non-tumor controls well. Through Kaplan-Meier survival and Cox regression analyses, 11 of the C-DEPGs were shown to have prognostic effects on NSCLC overall survival (OS) and were considered as key C-DEPGs (K-DEPGs). Through Oncomine, Human Protein Atlas (HPA) and the Clinical Proteomic Tumor Analysis Consortium (CPTAC), three K-DEPGs (HSD17B4, ACAA1, and PXMP4) were confirmed to be down-regulated in NSCLC at both mRNA and protein level. Their dy-regulation mechanisms were revealed through their correlations with their copy number variations and methylation status. Their potential functions in NSCLC were explored through their NSCLC-specific co-expression network analysis, their correlations with immune infiltrations, immunomodulator gene expressions, MKI67 expression and their associations with anti-cancer drug sensitivity. Our findings suggested that HSD17B4, ACAA1, and PXMP4 might be new markers for NSCLC diagnosis and prognosis and might provide new clues for NSCLC treatment.


Surgical specimens from 111 patients with Stage I endometrial cancer were reviewed for the presence of lymph‐vascular space invasion by tumor cells. Lymph‐vascular space invasion was noted in 16 cases, and occurred most frequently in poorly differentiated tumors with deep myometrial penetration. Tumor recurrence developed in 44% of patients whose tumors demonstrated lymph‐vascular space invasion as opposed to only 2% of patients without this finding (p < 0.001). Of seven patients with lymph‐vascular space invasion who experienced tumor recurrence, five developed extra‐pelvic metastases. Discriminant function analysis of these data revealed a statistically significant correlation between lymph‐vascular space invasion and tumor recurrence, independent of histologic differentiation of myometrial penetration. These findings suggest that lymph‐vascular space invasion by tumor cells is an important prognostic variable in Stage I endometrial cancer which should be considered in treatment planning.


Variation in colouration has rarely been related to sexual selection in anuran amphibians, even though such a relationship has been proven for many other vertebrate taxa. Male and female Moor Frogs (Rana arvalis )h ave ac ryptic brown colour pattern, but males develop a conspicuous blue nuptial colouration during the reproductive season. To investigate the possibility that colouration plays a role in sexual selection in this species, we studied the temporal variation in blue colouration, determined if body size or body temperature affected blueness and investigated if blueness of males could be related to their mating success. Results confirmed previous observations that males develop and maintain blue colouration for only a very few nights during peak reproductive activity. Colouration of males was unrelated to body size, but males exhibiting higher body temperatures were somewhat bluer than males with lower body temperatures. Further, males in amplexus had higher body temperatures than non-mated males. Finally, mating success was positively related to blueness in small males, whereas in large males no such relationship was detected. While our results align with the hypothesis that the bright blue colouration of males may be a target of sexual selection, alternative explanations are also discussed.


In the context of RF and high-speed circuits, systems on chip with analog and mixed signal (SOC-AMS) interconnects has becoming a dominant factor in determining circuit performance and reliability in deep submicron designs. Transmission line properties of on-chip wiring need to be taken into account due to the great lengths and fast rise times encountered. Coupling noise between adjacent interconnects can also cause catastrophic effects on the logical functionality and long-term reliability of a VLSI circuit. With these trends, the electrical phenomena that have to be investigated are governed by the electromagnetic theory. However, it is impossible to proceed to a complete SOC-AMS analysis with a full wave electromagnetic numerical tool, due to the large scale integration. As interconnects are typically of very large size and high-order, model-order reduction becomes necessary for efficient SOC modeling, simulation, design and optimization. In this communication, a new method based on numerical inversion of the Laplace transform and on a discrete model-reduction technique is presented for simulating peak crosstalk noise problems found in high speed digital circuits and SOC-AMS. The method, particularly efficient and easy to be implemented in a program, is useful for an electromagnetic simulation of a complete system.


On the Vega gas condensate and oil field in the Norwegian North Sea, two high temperature, high pressure (HTHP) gas condensate wells on one subsea template in 370 m water depth were acid and scale inhibitor treated in order to improve productivity by acid scale removal and prevent future scaling. Significant amount of work was undertaken on design and qualification of the treatment fluids. In order to reduce operation time and increase efficiency, a novel one-time connection concept was utilized. During the operations, wells were kicked off after energizing with gas bullheaded from the neighbouring well. The treatment fluids were designed to reduce consequences for the host facility due to H2S generated during the operation - this required optimization after understanding of the H2S source as witnessed in prior treatments.
 The new concept with one-time connection was successfully employed and allowed for three subsequent well treatments in a row, thus saving at least two days vessel operations time. The gas injection from the neighbouring well - the one not treated at the moment - allowed for an efficient start-up of the treated well without need for larger nitrogen injection which would have led to contamination and potentially to flaring due to off-spec gas. The introduction of a batch with pH neutralizer and H2S scavenger batch into the treatment design to be placed into the production pipeline reduced H2S liberation and production to the host facilities, thus limiting the operational stress on the platform. Productivity of well A1 showed an immediately significant increase after the operations, whereas productivity of well A2 required a longer clean-up than originally anticipated.


Background The head-to-head AMPLE (Abatacept versus Adalimumab Comparison In Biologic-Naïve RA Subjects With Background Methotrexate) study demonstrated comparable efficacy for SC abatacept and adalimumab in patients with RA.1 Anti-citrullinated protein antibodies (ACPA) are a known biomarker for RA and disease progression,2,3 but their predictive value for treatment outcomes is not well understood. Such information may serve as a predictor of treatment response in RA. Objectives To examine the effect of abatacept and adalimumab on patient-reported outcomes (PROs) in patients grouped by baseline quartiles of anti-cyclic citrullinated peptide-2 (anti-CCP2; a surrogate for ACPA) antibody titre. Methods The AMPLE study has been described.1 In this post hoc analysis of the AMPLE study, anti-CCP2–immunoglobulin (Ig) G titres in patient samples collected at baseline were determined by anti-CCP2 ELISA.4 PROs were assessed in anti-CCP2-positive patients divided into quartiles 1–4 based on increasing baseline titres. PROs analysed included: Patient Global Assessment (PGA), pain, fatigue, and SF-36 physical (PCS) and mental component summary (MCS) scores. Mean change from baseline was calculated with adjustment by analysis of covariance, with treatment as a factor; baseline values and DAS28 (CRP) stratification were covariates. Results There were 97 patients per quartile. Quartile limits were (AU/mL): Q1=28–235; Q2=236–609; Q3=613–1046; Q4=1060–4894. The number of patients per treatment group in each quartile were (abatacept, adalimumab): Q1=42, 55; Q2=51, 46; Q3=46, 51; Q4=46, 51. Higher anti-CCP2 antibody titre at baseline was associated with numerically better treatment response, as assessed by PGA, pain and SF-36 PCS for abatacept: mean changes from baseline were greater for Q4 than Q1–3 in patients receiving abatacept; such differences were not as pronounced with adalimumab. No consistent differences were evident in fatigue and SF-36 MCS based on quartile for abatacept; however, lower baseline anti-CCP2 titre (Q1) was associated with better responses in the adalimumab group for these PROs. Conclusions A pattern of more robust improvement was observed for patients receiving abatacept, but not adalimumab, among the highest anti-CCP2 quartiles with respect to several PROs: PGA, pain, and SF-36 PCS scores. These findings are consistent with those on clinical parameters, where greater changes in DAS28 (CRP) and HAQ-DI scores were observed for patients in the highest anti-CCP2 titre quartile receiving abatacept but not adalimumab. References Schiff M, et al. Ann Rheum Dis 2014;73:86–94. Verpoort KN, et al. Arthritis Rheum 2006;54:3799–808. van der Woude D, et al. Ann Rheum Dis 2010;69:1554–61 Anti-CCP2 ELISA, Euro Diagnostica. http://www.eurodiagnostica.com/upload/files/fileLibrary/ProductSheet_CCPlus_Screen120504.pdf. Accessed 15 Jan 2015 Disclosure of Interest J. Sokolove Grant/research support from: Bristol-Myers Squibb, M. Schiff Grant/research support from: UCB, Consultant for: AbbVie, Amgen, Antares, Bristol-Myers Squibb, Eli Lilly, Horizon, Johnson and Johnson, Novartis, Novo Nordisk, Pfizer, Roche, UCB, Speakers bureau: AbbVie, R. Fleischmann Grant/research support from: AbbVie, Amgen, Astellas, AstraZeneca, Bristol-Myers Squibb, Celgene, Dynavax, Genzyme, Janssen, Eli Lilly, Merck, Novartis, Pfizer, Roche, sanofi-aventis, UCB, Xoma, Consultant for: AbbVie, Amgen, AstraZeneca, Bristol-Myers Squibb, Celgene, Janssen, Eli Lilly, Pfizer, Roche, sanofi-aventis, UCB, M. E. Weinblatt Grant/research support from: Bristol-Myers Squibb, Crescendo Bioscience, UCB, Consultant for: Bristol-Myers Squibb, Crescendo Bioscience, UCB, AbbVie, Roche, Janssen, Pfizer, Lilly, Amgen, V. Strand: None declared, S. E. Connolly Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, M. A. Maldonado Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, S. Patel Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, E. Alemao Shareholder of: Bristol-Myers Squibb, Employee of: Bristol-Myers Squibb, W. H. Robinson: None declared


1 The concentrations of some organochlorine pesticides and polychlorobiphenyl compounds have been determined in 102 samples of human milk collected between January 1979 and September 1980. 2 Comparison of the results with those from a limited study undertaken in 1963-4 shows a decline in residues' levels. 3 The concentrations of organochlorine pesticides and polychlorobiphenyls in human milk samples from residents in Great Britain compare favourably with data obtained in other countries.


It is evident for a reviewer of scientific literature that quality of argumentation in some areas of medical and biological research has deteriorated during the last decades. Publication series defending questionable scientific concepts have been continued without referring to the published criticism. Another tendency that has become remarkable last time is that drugs and dietary supplements without proven effects as well as questionable treatment methods have been advertised, and corresponding products marketed in the guise of evidence-based medicine. Scientific publications are needed to register such drugs and treatments to obtain permissions for their use; accordingly, the publications have been prepared, sometimes being obviously fabricated in a rough-and-ready manner. The author of this book firmly believes that such deviations are temporary in their nature, that science has a self-purifying capacity, and that scientific truth will win through sooner or later.


The impact of future climate change on streamflow is assessed in the Haihe River basin (HRB) by the Variable Infiltration Capacity (VIC) model, using the outputs from 18 general circulation models (GCMs) of the Coupled Model Inter-comparison Project Phase 5 (CMIP5). Three Representative Concentration Pathway (RCP) scenarios have been used, including RCP2.6, RCP4.5, and RCP8.5. Based on the model parameters calibration in six catchments in the HRB and parameter regionalization, the hydrological simulation for the whole HRB denotes good performance of the VIC model. Taking the period 1961–1990 as a baseline period, the outputs from the GCMs indicate that the HRB will become warmer and wetter in the 21st century (2010–2099). There might be an increasing trend for the streamflow in the HRB under future climate change scenarios. For example, in the 2050s (2040–2069), the streamflow may increase by 12%, 28%, and 24% under the RCP2.6, RCP4.5, and RCP8.5 scenarios, respectively. Monthly, the highest and lowest increase in streamflow is in dry and wet seasons, respectively. Spatially, the increasing trend for streamflow in the north HRB is higher than that in the south HRB. The uncertainty from the GCMs and climatic scenarios should be further focused.


Electrochemical properties of terbutaline sulfate (TBS) at the glassy carbon electrode modified with multi-walled carbon nanotubes (MWNTs) were explored by cyclic voltammetry (CV) and differential pulse voltammetry (DPV). The response was evaluated with respect to pH, scan rate and other variables. Some electrochemical parameters, such as the charge number and proton number, were calculated. The results indicated that TBS underwent irreversible oxidation at the modified electrode, which was an adsorption-controlled process with two protons and two electrons. The reductive peak current of TBS significantly increased and the peak potential shifted negatively at the modified electrode, thus resulting in an electrode for TBS. The current was proportional to the concentration of TBS over 1.12 and 141 μM with a detection limit of 0.34 μM (at S/N = 3). The modified electrode showed good sensitivity, selectivity and stability for the determination of TBS in pork sample.


AIM
To determine the incidence of variations of maxillary sinus pneumatization especially when it is extensive and the associated anomalies.

STUDY DESIGN
Two hundred consecutive direct coronal paranasal sinus computed tomography (CT) scans were reviewed retrospectively. Extensive maxillary sinus pneumatization (EMSP) was defined as one in which the largest horizontal and/or vertical dimension of the maxillary sinus equalled or exceeded 90% of the corresponding diameter of the orbit. Further subtype I, II & III were defined depending on whether the pneumatization was extensive in one dimension (horizontal or vertical), two dimensions (horizontal & vertical) and by the presence of sphenomaxillary plate, intermaxillary plate or extension into frontal recess.

RESULTS
EMSP was found in 8%, of these 7% were bilateral and 1% was unilateral. (Subtype I, II and III constituting 1%, 3% & 4% respectively).

CONCLUSION
EMSP has been defined as a group and a classification proposed. EMSP will result in an atypical clinical picture, has a role in the pathogenesis of frontal sinusitis in some cases and may predispose injury to the orbit during endoscopic sinus surgery (ESS).


Background: Anaemia is a global public health issue in India with anaemia prevalence of 56% among adolescent girls. While it affects all age groups, pregnant women and children are reported to be at risk. The study aims to understand the underlying factors of anaemia among adolescents.
Methods: The systematic review has included all studies from the time period, 2000 to 2020 which had anaemia prevalence among adolescent girls (10 to 19 years of age). Scopus and Web of Science databases were used to browse relevant articles within April-June, 2020. Study design, sample size, anaemia prevalence, and the method of Haemoglobin estimation, were some of the information recorded.
Results: A total of 88 articles were selected, out of which 20 were retained as per the inclusion criteria. Study from the east zone reported an anaemia prevalence of 36.4% and a significant association between serum ferreting levels and the severity of anaemia. The anaemia prevalence of different studies from the north, west and south zones ranged from 50-70%, 80-90%, and 30-79% respectively. Socio economic status, education of parents, prevalence of vitamin B12 deficiency was some of the important factors contributing to the prevalence were highlighted.
Conclusion: Anaemia prevails across and within the different zones, it is not comparable. However, strengthening of the existing level of effort is necessary to address the issue of anaemia among adolescents in India.


This paper examines how macroeconomic policies can be managed to accommodate a large inflow of foreign aid to combat the HIV/AIDS epidemic and still maintain macroeconomic stability. Because of the daunting scale of this epidemic, funds need to be disbursed urgently in order to contain its spread, yet some economists worry that rapidly scaling up foreign assistance for this purpose will cause inflation and appreciation of the real exchange rate. If such effects occur, they could impair a country's international competitiveness and endanger its growth prospects. However, this paper maintains that such effects can be minimized if governments and central banks coordinate fiscal, monetary and exchange rate policies. If they do, they should be able to both 'spend' aid in order to finance larger government programmes and 'absorb' aid in order to import more real resources. Often, governments that receive foreign aid neither spend nor absorb it fully, defeating the basic purpose of development assistance. Because governments fear inflation, they are reluctant to finance a significant increase in spending on HIV/AIDS programmes even when the funding is available. Central banks are reluctant to sell the foreign currency they receive from HIV/AID related aid because they fear


A social state of welfare that procures a variety of economic and social policies for all to grasp some minimal standards of living, needs to inaugurate winning recruitment strategies for effectively tackling the obstacles of employment that thwart steady economic growth. Certain incentives are currently offered by the government for employers to pick, involving some tax exclusions and relief in workers' social security obligations, in an effort to help creation of new job opportunities, lowering the risk of unemployment and an increase in tendency among youngsters and women toward joining the workforce. These incentives also serve some greater goals such as channelling investments, boosting throughput, forging business owners to achieve better in competition and thereby augmenting the overall competitive power of the country on the international arena, and perseverance of R&D efforts for technological advancement. The incentives pursued in both industrial states and developing countries on employment for economic and social purposes have been transposed to the government practice in Turkey, as well, as part of the ongoing struggle against problems of employment. This study puts the magnifying glass on the current range of tax and insurance incentives for private employers as secured by the Turkish Laws in effect, in the hope of helping a rise in employment rates. It is expected to contribute to the international scholarly literature, in that it encapsulates the legal grounds, scope, durations and conditions of availability of the legislated incentives.


Magnetic resonance imaging (MRI) and positron emission tomography (PET) have gained a great importance in the last thirty years in medicinal diagnostics as imaging techniques with a superior spatial resolution and contrast. MRI has assumed a critical role in medicinal diagnosis and applications of contrast agents (CAs), mostly based on Gd(III) complexes. For this purpose, specific CAs have been developed, changing relaxivity after cleavage of some bonds sensitive to the presence of specific ions or metabolites. For PET applications, a new isotope 68Ga(III) has been proposed. In view of utilization of toxic ions, the crucial condition for their applications in vivo is their complexation in stable species. In this review, the ligand types and structures of their complexes as well as their physicochemical parameters are discussed.


Some species of Euphorbia have been used as medicinal plants to treat wounds, and skin diseases, around the world. The solvents n-hexane, ethyl acetate, and methanol were used successively to prepare extracts of the aerial parts of E. characias subsp. wulfenii, E. helioscopia, E. macroclada, E. seguieriana subsp. seguieriana, and E. virgata. Linear incision, circular excision wound models and the hydroxyproline assay method were used to assess the wound-healing activity. The inhibition of the increase in capillary permeability induced by acetic acid was used to assay the anti-inflammatory activity. The methanol extract of the aerial parts of E. characias subsp. wulfenii showed statistically significant wound-healing activity with 43.03% tensile strength for the linear incision wound model and a 65.24% reduction in the area of the wound by day 10 for the circular excision model. The tissue treated with this extract was found to contain 35.47 μg/mg of hydroxyproline. The methanol extract of E. characias subsp. wulfenii inhibited inflammation induced by acetic acid with a value of 34.74%. The results showed that the aerial parts of E. characias subsp. wulfenii possess wound-healing and anti-inflammatory activities on different models.


OBJECTIVE
To study the relationship between in vitro chemosensitivity of human breast cancer to MDR related drugs and expression of mdr-1 gene.

METHODS
We measured the chemosensitivity of 56 human breast cancers to MDR related drugs by MTT assay in vitro and level of mdr-1 mRNA in these samples by RT-PCR technique.

RESULTS
The expression of mdr-1 gene in the breast cancer resistant to drugs in vitro was increased significantly. The level of mdr-1 mRNA was not correlated with Imax%, but correlated with IC50 statistically.

CONCLUSION
These results support that the increased expression of mdr-1 gene is a major cause of resistance to MDR related drugs.


This article updates the literature analyzing the charitable deduction associated with live-burn donations. This deduction has been the subject of multiple recent Tax and appellate Court rulings, all of which have disallowed the deduction. The article examines and reconciles the resulting live-burn donation line of cases. It agrees with prior scholarship finding that the courts' treatment of the deduction has rendered it ineffective as a tax planning tool, but proposes a theoretical sequence of analysis to gauge the state of the law and determine whether any avenue remains which leads to deduction. Scholarly response to the disallowance of the live-burn donation has been generally negative. In contrast to these positions in the literature, this article finds that denial of a deduction for live-burn donations is consistent with and reconcilable on grounds of traditional tax policy notions of equity and fairness. Despite the live-burn donation's initial acceptance on the basis of public benefit, the doctrine is fundamentally vulnerable on multiple fronts: it pushes the bounds of vertical equity, it disproportionately favors the wealthy, it undermines traditional concepts of charitable intent, and it provides an excessive private benefit in exchange for a public benefit which is too difficult to measure or quantify.


We derive the conditions for a non-equatorial eccentric bound orbit to exist around a Kerr black hole in two-parameter spaces: the energy, angular momentum of the test particle, spin of the black hole, and Carter's constant space ($E$, $L$, $a$, $Q$), and eccentricity, inverse-latus rectum space ($e$, $\mu$, $a$, $Q$). These conditions distribute various kinds of bound orbits in different regions of the ($E$, $L$) and ($e$, $\mu$) planes, depending on which pair of roots of the effective potential forms a bound orbit. We provide a prescription to select these parameters for bound orbits, which are useful inputs to study bound trajectory evolution in various astrophysical applications like simulations of gravitational wave emission from extreme-mass ratio inspirals, relativistic precession around black holes, and the study of gyroscope precession as a test of general relativity.


During the period 1957-1962, the Committee on Maternal and Child Care of the California Medical Association and the State Department of Public Health studied 551 deaths of women who died during or within 90 days of termination of pregnancy. Of the 356 deaths from obstetric causes, 109 were attributed to abortion. Of the 195 deaths from non-obstetric causes, about one-half were considered by review committees to have been related to pregnancy.


The increasing power levels handled by electric vehicle (EV) dc fast chargers will impose additional challenges to the switching devices in order to cope with the efficiency requirements. A cost-effective alternative to achieve highly efficient power conversion is through the partial-power conversion concept. This article validates the advantages of a step-down Type II partial-power converter (PPC), based on the phase-shifted full-bridge converter, for EV fast chargers. By exploiting the reduced voltage range of an EV battery pack along with the reduced power ratio for a Type II PPC, an extremely efficient charging process can be achieved. The concept is validated with the development of a 7-kW demonstrator, and hence, realistic efficiency measurements are obtained. Results indicate the effectiveness of charging a battery by merely handling 13.32% of the power provided to it, with a peak efficiency of 99.11%.


BACKGROUND
Probiotics have been evaluated in multiple clinical trials on irritable bowel syndrome (IBS). However, in real-life long-term compliance could be low. Our study is single-center, observational and prospective, aiming both to evaluate the adherence to prescription of probiotic therapy in real-life and to identify factors able to influence adherence to therapy.

METHODS
Fifty patients diagnosed with IBS according to Rome IV and receiving a clinical prescription of a multistrain probiotic preparation (VSL#3® manufactured by Nutrilinea Srl and marketed in Italy by Ferring S.p.A.) have been enrolled and 49 completed the follow-up. Two months after baseline a second visit was made to assess adherence and eventual reasons for discontinuation.

RESULTS
Sixty percent of patients took all the prescribed probiotic therapy in real-life setting, with perceived benefits in more than 60% of cases. Among the 20 patients with reduced adherence, 5 took less than 50%, 12 took 50% and 2 took more than 50% but less than 80% of the prescribed doses. Principal reasons of not complete adherence among the 20 patients were: price of the product (8/20), mild adverse events (AEs) (6/20) and poor appreciation of flavour (3/20).

CONCLUSIONS
This study suggested that the adherence to probiotic therapy is affected by different factors in patients with IBS in a real-life setting. The main reason for lack of adherence was the price of the product. Other reasons are mild AEs (mainly bloating) and low palatability.


Flow maps allow users to perceive not only the location where interactions take place, but also the direction and volume of events. Previous studies have proposed numerous methods to produce flow maps. However, how to evaluate the usability of flow maps has not been well documented. In this study, we combined eye-tracking and questionnaire methods to evaluate the usability of flow maps through comparisons between (a) straight lines and curves and (b) line thicknesses and color gradients. The results show that curved flows are more effective than straight flows. Maps with curved flows have more correct answers, fixations, and percentages of fixations in areas of interest. Furthermore, we find that the curved flows require longer finish times but exhibit smaller times to first fixation than straight flows. In addition, we find that using color gradients to indicate the flow volume is significantly more effective than the application of different line thicknesses, which is mainly reflected by the presence of more correct answers in the color-gradient group. These empirical studies could help improve the usability of flow maps employed to visualize geo-data.


In this paper, the RF breakdown power threshold in arbitrary complex components based on rectangular waveguide technology is investigated. In particular, multipactor (in vacuum) and corona discharge (close to the Paschen curve minimum) are analyzed. The objective has been to predict the RF breakdown threshold for space applications. The simulation results have been validated with many experimental tests also performed within the frame of this work. The good agreement achieved shows the validity of the approach followed


Bentonite is often proposed as an engineered-buffer material in high-level radionuclide waste-management systems. For effective design of the barrier that will provide protection over the long time periods required, the physical/thermal/chemical processes taking place in the barrier material must be understood thoroughly. These processes, which interact, include the flow of water and gas, the flow of heat, and the transport and reaction of chemical constituents. The purpose of this study was to better understand the processes that occurred in a small-scale experiment within a confined bentonite space. A conceptual and mathematical model (FADES-CHEM) was built in order to simulate the results of an experiment conducted in 2000, and thereby to gain a better understanding of the controlling processes. In that experiment, a block of compacted bentonite was placed in an air-tight cell and subjected, for 6 months, to simultaneous heating and hydration from opposite sides. The bentonite block was then sliced into five sections each of which was then analyzed in order to obtain a series of physicochemical parameters illustrating the changes that had occurred. Before modeling, the chemical composition of the bentonite pore waters was restored in order to account for different processes such as gas outgassing and cell cooling. Modeling indicated that gas-pressure build up was a relevant process when computing the saturation of bentonite, and the computations in the present study suggested that evaporation/condensation processes played a crucial role in the final distribution of the water content. Gas pressure and evaporation/ condensation also affected the geochemical system, and the numerical model developed gives results that were consistent with the experimental values and trends observed. The model reproduced the results obtained and enable use at the repository scale and over longer time frames, provided that adequate data are available.


This contribute aims to explore 3D modelling and its practical applications investigating scales of representation and scales of contents from architecture to landscape. The goal of this approach is to test the flexibility of modelling tools to different fields of application and to draw shared methods, even if they are applied in so different context. Changing the scale, is obvious, the language changes - because it is necessary to recompose symbolic and iconographic elements - themes and scales of representation change. So is possible to pave the way to strictly disciplinary thinking on outcomes and on instrumental and methodological guidelines for further research. The topic focuses on developing guidelines and creating a simple three-dimensional model designed to represent both the complexity of the "cultural heritage" morphology, as well as the need to manage the process of restoration in all its phases: from first findings to the restored final output