Incremental sheet metal forming process is an advanced flexible manufacturing process to produce various 3D products without using dedicated tool as in conventional metal forming. There are a lot of process parameters that have effect on this process, studying the effect of some parameters on the strain distributions of the product over the length of deformation is the aim of this study.
In order to achieve this goal, three factors (tool forming shape, feed rate and incremental step size) are examined depending on three levels on the strain distributions over the wall of the product. Strain measurement was accomplished by using image processing technique using MATALB program. The significance of the control factors are explored using two statistical methods:  analysis of variance (ANOVA) and main effect plot (MEP). All experiments were carried out on a sheet of Aluminum alloy (Al1050) with thickness 0.9 mm by using 3 axes CNC machine to produce frustum pyramid product. The result showed that the feed rate is a parameter that has large effect on the values of the effective strain percentage contribution of (42.86% and 51.42%), respectively, and is followed by step size (25.1% and 30.60%) percentage contributions and finally the tool shape with (21.79% and 10.54%) on the (55° and 45°) wall angle, respectively. The maximum and minimum average effective strain computed on the 55◦ forming angle were (0.580 and 0.399), respectively. Finally, the maximum and minimum average effective strain computed on the 45◦ forming angle were equal to (0.412 and 0.324), respectively.


ABSTRACT Reported medication errors in an ICU at an academic teaching hospital raised concerns about adherence to safety protocols, including barcode scanning before medication administration. A group of nurse leaders, bedside nurses, and pharmacists formed a medication safety task force to increase compliance with barcode scanning and reduce reported medication errors in which failure to scan was a contributing factor. Three task force members observed nurses' workflow in ICU medication administration. The members observed three nurses administer medications before scanning the barcode and three other nurses scan medications in a location where they were unable to see alerts on the computer. After the observations, the task force implemented three interventions: medication tables to provide a surface in front of the computer where medications could be placed when scanning; standardized workflow; and nursing staff education. Task force members then conducted postimplementation observations to evaluate improvement in barcode scanning compliance. In the postintervention observations, all medications were scanned in front of the computer before administration, an increase of 27.3 percentage points (from 72.7% preintervention) in the barcode scanning compliance rate. The ICU also went 17 months in the postintervention period without a reported medication administration error in which failure to scan was a contributing factor. The task force's observation of medication administration led to interventions that made it easier for nurses to adhere to best practice. Medication tables were a simple, sustainable intervention that used human factors principles to increase barcode scanning compliance. A nurse-led initiative reduces medication errors by increasing adherence to safety protocols, including compliance with barcode scanning before medication administration.


The term "dhatuvada" (j. kitai-setsu) was invented by Dr. Shiro Matsumoto in order to develop his critical examination of Buddhist thought in general. In this paper, I would like to claim that Shinran's view of buddhakaya is not applicable to the notion of Matsumoto's "dhatuvada". For that purpose, I classified the view of buddhakaya from three standpoints, i. e., 1) buddhakaya as the ultimate reality, 2) Buddha's saving work as manifested in Buddha's Name and Buddha-body, 3) buddhakaya as immanent in all beings. In Shinran's view of buddhakaya, the second standpoint is most prominent, the first being mentioned only in relation to the second, and the third standpoint is totally ignored.Matsumoto does not admit the second standpoint, but identifies it with the first or third one. Shinran's view of buddhakaya, however, is mainly based on it. Especially the notion of sambhogakaya, or Amida Buddha as the fulfillment of his causal Vow, is crucial. This sambhogakaya is not such a Buddha-body transformed tentatively from dharmakaya, as Matsumoto states, but rather a manifestation of Amida's saving work on all sentient beings.Concerning the third standpoint stated above, Buddha-nature is not that which beings originally possess, but is endowed to them through Other Power of Amida.


Although rubber components are extensively used in mechanic parts. There are still a lot of difficulties in designing the rubber components applied in complex shapes and preloaded states because of the complicated material properties. One of the most important parameters for more detailed and accurate mechanical analysis during the development stages is the dynamic characteristics of the rubber components. It is well known that the dynamic properties of rubber are dependent on frequency as well as static preload. Consequently, a large number of experiments have to be conducted to identify the dynamic stiffness of a rubber bush considering the various applied conditions. In this paper, an efficient experimental method is suggested, which estimates the dynamic stiffness of a rubber bush using rubber material test and static stiffness of the bush. This method is capable of predicting the dynamic stiffness of a rubber bush under various load conditions from minimized test data.


Semi-supervised semantic segmentation learns a model for classifying pixels into specific classes using a few labeled samples and numerous unlabeled images. The recent leading approach is consistency regularization by selftraining with pseudo-labeling pixels having high confidences for unlabeled images. However, using only highconfidence pixels for self-training may result in losing much of the information in the unlabeled datasets due to poor confidence calibration of modern deep learning networks. In this paper, we propose a class-adaptive semisupervision framework for semi-supervised semantic segmentation (CAFS) to cope with the loss of most information that occurs in existing high-confidence-based pseudolabeling methods. Unlike existing semi-supervised semantic segmentation frameworks, CAFS constructs a validation set on a labeled dataset, to leverage the calibration performance for each class. On this basis, we propose a calibration aware class-wise adaptive thresholding and classwise adaptive oversampling using the analysis results from the validation set. Our proposed CAFS achieves state-ofthe-art performance on the full data partition of the base PASCAL VOC 2012 dataset and on the 1/4 data partition of the Cityscapes dataset with significant margins of 83.0% and 80.4%, respectively. The code is available at https://github.com/cjf8899/CAFS.


The bioavailability of the thiazide diuretic bemetizide from a tablet containing 25 mg of this drug and 50 mg of the chemically unrelated diuretic triamterene was lower than, and significantly different (p less than 0.01) from that from a tablet containing 25 mg bemetizide alone. The mean peak plasma level of bemetizide after administration of the combination tablet (68.3 ng ml-1) was lower than that after administration of bemetizide alone (87.9 ng ml-1), although the times of occurrence of the peak levels were similar. The bioavailability of triamterene from the combination tablet was greater than, but not significantly different from that after administration of a capsule containing 50 mg triamterene alone. The mean peak plasma level of triamterene after administration of the combination tablet (44.6 ng ml-1) was higher than and significantly different (p less than 0.001) from that after administration of triamterene alone (15.7 ng ml-1). Although bemetizide is unstable in urine, measurement of the apparent excretion of unchanged drug in the 24 h post-dose urine (less than 4 per cent of the dose) agreed with the estimate of drug bioavailability from the plasma level data. Less than 2 per cent of the dose of triamterene was excreted unchanged in the 24 h post-dose urine, but the urinary excretion data also agreed with the bioavailability estimates from the plasma level data. The results of this study and those reported in the literature suggest that because of their physicochemical properties, the bioavailability of some thiazides and triamterene needs to be evaluated when new formulations of these drugs are produced. However, with respect to the combination formulation reported in this paper, the difference in bioavailability of the thiazide component did not detectably effect the diuretic activity of the formulation.


The message which we wish to convey here may someday be looked on as a quaint survival into the latter part of the twentieth century of a medical philosophy which vanished with the home delivery and the two dollar office call. It would certainly have no place in the streamlined tax-paid medical mill of a welfare state. It is incompatible with three minute per patient sessions at the home or office. It will be economically indefensible when the bills, made out in quintuplicate, are paid from the public till and the patient consults his general practitioner as a routing station on his way to receive that acme of medical care which is his just due—the services of a specialist, alleged, assumed or actual. When every sprain requires the services of an orthopedist, when every headache is neurological in domain and when every bleeding hemorrhoid is the sacred sphere of the


The broadband noise field of a ship of opportunity often exhibits environment dependent striation structure in the frequency-range plane. For the soft-layered sediment environment studied in this paper, the striation structure is critically determined by sub-bottom sound speed (Cbot), sediment thickness (H) and sediment sound speed (Csed). Numerical simulations demonstrate that striations in different frequency bands have different sensitivities to the three critical parameters. The sensitivity differences are used here to progressively estimate the Cbot, H and Csed. We first use low-frequency striation structure to estimate the Cbot, then obtain a preliminary estimation of the H and Csed with a set of low-frequency striations, and finally find the best-fit solutions from previous estimates using high frequency striation structure. We processed passive ship run data collected in Mediterranean Sea in 2007. The good agreement between our results with active inversion methods demonstrates the accuracy of the method for ocean bottom geoacoustic characterization.


Background: Renal urolithiasis is the third most common disease of the urinary tract of dogs. In humans, staghorn lithiasis affects 1 to 1.5% of the population, often women over 50 years old. In veterinary medicine, this type of lithiasis has been little reported, and there are few descriptions of treatment, both in small and large animals. The objective of this work is to report a rare case of renal staghorn stones treated by laparoscopic nephrotomy. Case: A six-year-old female schnauzer with 6 kg body weight was evaluated clinically in order to spay. According to the owner, the animal showed polydipsia. Additional tests such as blood count, serum biochemistry, radiography and abdominal ultrasound were done, showing hematological examinations within the standards for the species. After the ultrasound we noticed an asymmetric kidneys with the right kidney with preserved cortical layer and hyperechoic line corticomedullary interface, with posterior acoustic shadow and left kidney with relative/corticomedullary differentiation and pelvis preserved without alteration; this evocative image of kidney stones in kidney right. In abdominal radiographs was possible to visualize radiopaque mass in the right kidney compatible with renal staghorn stones. Excretory urography was done, which demonstrated evident excretion of contrast material in the left kidney and the right kidney doubtful. Based on these findings, we opted for exploratory laparoscopy followed by laparoscopic nephrectomy or nephrotomy for removal of urolithiasis, depending of the lesions visualized during the procedure. All procedure were performed using a minimally invasive approach without the need for conversion to open or videoassisted procedures. The most complex and delicate step was the nephrorrafy, due the little time for suturing to avoid renal ischemia. Eight months after the surgery, the owner is contacted, and it said that the animal was well, without clinical signs of kidney disease. After returning and performing ultrasound and excretory urography revealed that the right kidney had atrophied, but there was still draining contrast shown by excretory urography. Discussion: Although the use of laparoscopy is increasing worldwide is still considered an underexplored approach to renal calculi in veterinary medicine. Our choice in this case was due the numerous potential advantages that have minimally invasive compared to open technique, as demonstrated in medicine and veterinary medicine studies. At the beginning of laparoscopy was possible to elect the procedure (nephrectomy or nephrotomy) to be performed; the anatomic changes present as renal artery patency /coloring kidney and wrist, observed by laparoscopic visualization, with amplification, showed the possibly of renal preservation. This is an advantage associated with videosurgical access. Laparoscopic view allowed to discard residual gallstones as well as to promote the correct synthesis of renal tissue. All steps of the nephrotomy were performed by minimally invasive access. It was not possible to directly correlate with the histological analysis technique renal disorder before and after the surgery, because the kidney was already reduced in size in the first operation and biopsy was not done in that occasion. The present report demonstrates that laparoscopic surgery can be considered viable for the management of renal staghorn stones in dogs.


A simple solvent extraction and spectrophotometric method for the determination of trace amounts of thiocyanate is described. Thiocyanate is selectively separated from other ions by reaction with mercury(II). The excess of mercury(II) is determined using N-phenylbenzohydroxamic acid (PBHA) at pH 6.8 and the thiocyanate concentration calculated. Mercury(II) complexes rapidly with PBHA in ethanol and is further extracted into chloroform. Beer's law is obeyed for thiocyanate in the range 0–10 p.p.m. at 550 nm for a fixed amount, 20 p.p.m., of mercury(II). The method has been applied to the determination of thiocyanate in human blood serum, urine and some organoisothiocyanate samples.


Ireland is known to be a photogenic country. Yet it seems that verdant Ireland and its rugged coastlines have been turned into cliches and dominant visual stereotypes which are deemed to represent the only true and authentic landscapes of Ireland. Basing our study on three photographic series by the authors, we shall explore landscape as a form of language in which the notion of framing reflects an aesthetic and a scientific choice. While the photographer tries to capture his perception of the landscape, the geographer develops an analytical description. Here, the Irish landscape is treated as a testing ground for both views. This paper will move from individual observations towards a diversified approach to the plurality of aesthetic readings.


ABSTRACT Extreme response style (ERS) has the potential to bias the measurement of intra-individual variability in psychological constructs. This paper explores such bias through a multilevel extension of a latent trait model for modeling response styles applied to repeated measures rating scale data. Modeling responses to multi-item scales of positive and negative affect collected from smokers at clinic visits following a smoking cessation attempt revealed considerable ERS bias in the intra-individual sum score variances. In addition, simulation studies suggest the magnitude and direction of bias due to ERS is heavily dependent on the mean affect level, supporting a model-based approach to the study and control of ERS effects. Application of the proposed model-based adjustment is found to improve intra-individual variability as a predictor of smoking cessation.


Introduction Colorectal cancer (CRC) is the 3rd most common cause of cancer death. Colonoscopy is the 'gold standard' for CRC screening and early diagnosis but still sometimes misses lesions. Our aim was to identify potential factors that might influence CRC miss rates on colonoscopy. Methods Data on all new CRC diagnoses during a 3 year period (1 st September 2014 – 31 st August 2017) were collected retrospectively from the electronic records of a UK teaching hospital. A CRC miss was defined as a case where CRC was missed on 'initial' colonoscopy and identified within 3 years upon subsequent 'diagnostic' colonoscopy. We analysed demographic data, and features of the 'initial' and 'diagnostic' colonoscopies. Results 691 new CRC cases were identified during the 3 year period. 12 of these were CRC misses (1.74%). Missed CRC cases had an average age of 65.25 years (29–80) and M:F ratio of 1:3. All 12 cases were adenocarcinomas with various histopathological and endoscopic features (table 1). 'Initial' colonoscopy identified polyps in 8 cases. In 4/8 (50%) cases the polyp location was identical to the cancer later identified on 'diagnostic' colonoscopy. Interestingly, adjusting for volume of colonoscopies performed by each endoscopist type, trainees and surgeons were 2.5 and 5 times respectively, more likely to miss CRC than physician endoscopists (table 2). Finally, 4 out of 12 (33.33%) cases had the 'initial' colonoscopy that missed CRC on a Saturday morning. This translates to a 4-fold increased risk of missing CRC on a Saturday morning service list compared to any weekday morning (n=4) or afternoon (n=4) session. Conclusions Despite a small missed CRC cohort, our results suggest that risk of missing CRC on colonoscopy might be higher in female patients and the miss rate might be linked to scope operator with trainee and surgical endoscopists perhaps more likely to miss CRC than physician endoscopists. It was common for 'initial' colonoscopy to identify a polyp which in ½ of cases was at the same anatomical site as the cancer identified later. The risk of colonoscopy missing CRC was higher on a Saturday service list than a normal working day session. Overall, our findings suggest discrepancies that warrant further investigation in larger more cohorts with more statistical power in order to improve CRC screening.Abstract PTU-039 Table 1 Diagnostic colonoscopy histopathological and endoscopic characteristics in missed CRC cohort Anatomical site in colorectum (% total) Sigmoid 3 (25%) Splenic flexure 1 (8.33%) Transverse 3 (25%) Hepatic flexure 2 (16.67%) Ascending 2 (16.67%) Caecum 1 (8.33%) Dysplasia (% total) Low grade 11 (91.67%) High grade 1 (8.33%) Abstract PTU-039 Table 2 CRC misses by endoscopist type Scope operator CRC misses (% total) Endoscopist miss rate (misses/total colonoscopies) Trainee endoscopist 3/12 (25%) 0.004 (3/750) Surgical Endoscopist 2/12 (16.67%) 0.008 (2/250) Physician Endoscopist 7/12 (58.33%) 0.00159 (7/4400)


Incorporating an electric propulsion system into conventional vehicle electronic architecture makes electromagnetic compatibility (EMC) become one of the most important issues during electric vehicle design. Electromagnetic shielding is one of the compulsory preventions to protect electronic circuits against electromagnetic interference (EMI). However, apertures of the shielding enclosure reduce shielding effectiveness (SE) by permitting EMI leakage to affect the electronic circuits. When the dimensions of the enclosure remain fixed and the aperture has a particular area, studies such as optimization of the aperture dimensions or changing the enclosure material are essential. In this study, a genetic algorithm (GA) is designed initially, which improves SE by determining aperture dimensions on the front surface of the shielding enclosure. Then, obtained aperture dimensions are used in a numerical model in which the inner surfaces of the enclosure are coated with graphene sheets. It is observed that SE simulation results are in good agreement with measurement ones.


Nanoparticles as drug delivery carriers have benefited diseases, including cancer, since the 1990s, and more recently, their promise to quickly and efficiently be mobilized to fight against global diseases such as in the COVID-19 pandemic have been proven. Despite these success stories, there are limited nanomedicine efforts for chronic kidney diseases (CKDs), which affect 844 million people worldwide and can be linked to a variety of genetic kidney diseases. In this Perspective, we provide a brief overview of the clinical status of genetic kidney diseases, background on kidney physiology and a summary of nanoparticle design that enable kidney access and targeting, and emerging technological strategies that can be applied for genetic kidney diseases, including rare and congenital kidney diseases. Finally, we conclude by discussing gaps in knowledge remaining in both genetic kidney diseases and kidney nanomedicine and collective efforts that are needed to bring together stakeholders from diverse expertise and industries to enable the development of the most relevant drug delivery strategies that can make an impact in the clinic.


PURPOSE
To evaluate clinical and radiographic outcomes of indirect pulp treatment (IPT) in primary molars after long-term function (up to 60 months).

METHODS
Teeth with deep carious lesions without signs and symptoms of irreversible pulpitis were divided by random allocation into two groups, according to the capping material utilized over demineralized dentin: experimental group (1): self-etching adhesive system (Clearfil SE Bond); and control group (2): calcium hydroxide liner (Dycal). Both groups were filled with resin composite (Z250) and submitted to a clinical and radiographic monitoring period until exfoliation.

RESULTS
After the follow-up period (up to 60 months), no statistical difference was found between groups (P= 0.514). The overall success rate reached 78%. The failures occurred after the first year period recall.


The application motivating this work is related to the identification of deposits inside nuclear power plant steam generators using eddy-current probes. We consider a realistic experimental process that relies on the scan of a domain by sweeping along a tube axis a probe made out of coils, playing the role of the sources/receivers. Solving the inverse shape problem associated with these measurements using a least squares method requires solutions to the eddy-current and the adjoint problems for a large number of right-hand sides at each gradient-descent iteration. Additional cost in the forward solver comes from the use of a potential formulation of the problem that has the advantage of being independent from the topology of the conductive media (that may vary during iterations). We use a level-set approach to avoid remeshing and handle unknown topologies. The crucial ingredient in our algorithm is an optimized way of handling high numbers of right-hand sides for iterative solvers of large-scale problems. We first benchmark various block Krylov methods, block GMRES and block BGCRODR, to test their effectiveness compared to their standard counterpart, i.e., GMRES and GCRODR. Then, we propose for BGCRODR a new implementation for recycling information from previously generated Krylov bases that scales better than traditional approaches. This part is independent from the practical inverse problem at hand. The efficiency of the overall inversion procedure is finally demonstrated on realistic synthetic 3D examples.


Resignation (tawakkal) means surrendering all affairs only to God and believe everything that happens has been appointed since the time of Azali. However. attitude of resignation can not simply be interpreted as act of submission to God's dealings with businesses annulled. In this article, the author tries to explore the attitude of resignation that is not solely based on a passive stance (not doing anything) into the meaning of resignation is active through the study were taken from the point of view of some scholars'. positive resignation (active) in this article does not mean not recognize the omnipotence of God. Positive resignation still acknowledge the intervention of God in all his success, but only make a positive resignation attitude surrendered (resignation) as an entity of its business. To know about the concept of active resignation in this article, the resignation was discussed in section Tawhid and resignation; a signification, Depth resignation, barrier resignation, and Active resignation; Applicable Tauhid expression, which later would give a conclusion a fter trying, one must surrender to God about the outcome, because "results" are Lord region.


Developmental increases of the activity of choline acetyltransferase (ChAT) were examined in the brains of fetuses and offspring from parent rats continuously exposed to a 500 mG, 60 Hz circularly polarized (CP) magnetic field (MF) prior to pregnancy, and further, during pregnancy and lactation. In developing rats between 12 days and 20 days of embryogenesis that were housed in a control unit, i.e., nonexposed to MF, the specific activity of ChAT in whole brain specimens increased from 2.4% to 6.9% of adult activity, while specific activity of ChAT in rat brain specimens between 12 days of embryogenesis and 10 days of postpartum increased from 2.4% to 21.6% of adult activity. On the other hand, the specific activity of ChAT in whole brain specimens from rats under housed MF exposure conditions was found to increase from 2.6% to 6.7% of adult activity between 12 days and 20 days of embryogenesis and from 2.6% to 21.6% of adult activity between 12 days of embryogenesis and 10 days postpartum. Furthermore, the effect of the same test magnetic environment on the specific activity of ChAT in the brains of parental rats was examined in order to determine whether magnetic field exposure of parental rats might reflect onto the development of fetal brain. It was observed that continuous exposure of parental rats to a 500 mG, 60 Hz CP MF did not show any significant changes in the specific activity of ChAT in the septodiagonal band complex, dorsal and ventral hippocampus, striatum, and frontoparietal cerebral cortex, as compared with the same brain regions of control subjects.(ABSTRACT TRUNCATED AT 250 WORDS)


Various methods of cerebral protection have been used during such aortic arch operations as the Norwood Procedure and operations on the interrupted aortic arch in neonates and infants. Deep hypothermia with circulatory arrest is the most common technique, but has a limited safe period for circulatory arrest. Antegrade cerebral perfusion has been introduced to prolong this safe period. We reviewed our experience with antegrade cerebral perfusion during surgical repair, in a patient with hypoplastic left heart syndrom in stage 1 palliation.


The electrochemical characteristics of various kinds of multilayers of gold nanoclusters (GNCs) were investigated. Two types of gold nanoclusters, one covered by self-assembled monolayers (SAMs) of mercaptoundecanoic acid (MUA), hexanethiol (C6SH), and ferrocenylhexanethiol (FcC6SH), MHF-GNC, and the other with MUA and C6SH, MH-GNC, were used. The multilayers were constructed on a Au(111) surface based on a carboxylate/metal cation (Cu++)/carboxylate or carboxylate/cationic polymer (poly(allylamine hydrochloride):PAH)/carboxylate electrostatic interaction. While the multilayers constructed by the former method were stable only in nonaqueous solutions, those constructed by the latter method were stable even in aqueous solutions. Electrochemical measurements of the multilayers of MHF-GNCs showed a pair of waves corresponding to the redox of the ferrocene group around 350-480 mV and the charge of these peaks, i.e., the amount of adsorbed GNC, increased linearly with the construction cycle up to 6 cycles in the former and to 18 cycles in the latter. A rather reversible redox response of the ferrocene moiety was observed even at the gold electrodes with five GNC layers of two different sequences in which MHF-GNC exists as the layer closest to the gold electrode, ie., the first layer, or as the outermost layer with MH-GNC in the other layers. These results show the facile transfer of electrons and ions through the multilayers of the SAM-covered GNCs and electron transfer between the ferrocene moiety and the Au(111) electrode takes place through the GNC cores by hopping.


Purpose To validate the modified World Health Organization (WHO) classification in pregnant women with congenital and acquired heart diseases. Patients and methods The database of pregnant women with heart disease, who delivered at Songklanagarind Hospital between January 1995 and December 2016, was retrieved from the Statistical Unit, Department of Obstetrics and Gynecology, along with the Hospital Information System of Songklanagarind Hospital, Faculty of Medicine, Prince of Songkla University. Each patient was retrospectively classified according to the modified WHO classification of maternal cardiovascular risk. Comparison of maternal and fetal outcomes among the modified WHO classes were analyzed using the chi-square test or Fisher's exact test and one-way ANOVA test. A p-value of <0.05 was considered statistically significant. Results A total of 331 cases were studied: 157 cases with congenital heart disease and 174 cases with acquired heart disease. There were 48, 173, 32 and 78 cases in the modified WHO class I, II, III and IV, respectively. Congestive heart failure was the most common complication. The overall maternal mortality rate was 3.6%, all of which were in the modified WHO class IV. Maternal cardiovascular events occurred in 24.2% of cases, increasing rates with higher modified WHO class: 4.2%, 15.0%, 25.0% and 56.4% in class I, II, III and IV, respectively (p<0.001). Adverse fetal outcomes including preterm delivery, low birth weight, small for gestational age and neonatal intensive care unit admission were also significantly increased in class III and IV (p<0.05). Conclusion The modified WHO classification is useful not only for obtaining a cardiovascular risk assessment in pregnant women with heart disease but also for predicting adverse fetal outcomes. It must, therefore, be implemented into routine care service at all levels of health care systems.


Diagnostic enzymes like aspartate aminotransferase
(AST), alanine aminotransferase (ALT) and alkaline phosphatase
(ALP) were determined as indices of heavy metal pollution in Tilapia
guinensis. Three different sets of fishes treated with lead (Pb), iron
(Fe) and copper (Cu) were used for the study while a fourth group
with no heavy metal served as a control. Fishes in each of the groups
were exposed to 2.65mg/l of Pb, 0.85mg/l of Fe and 0.35 mg/l of Cu
in aerated aquaria for 96 hours. Tissue fractionation of the liver
tissues was carried out and the three diagnostic enzymes (AST, ALT,
and ALP) were estimated. Serum levels of the same diagnostic
enzymes were also measured. The mean values of the serum enzyme
activity for ALP in each experimental group were 19.5±1.62,
29.67±2.17 and 1.15±0.27 IU/L for Pb, Fe and Cu groups compared
with 9.99±1.34 IU/L enzyme activity in the control. This result
showed that Pb and Fe caused increased release of the enzyme into
the blood circulation indicating increased tissue damage while Cu
caused a reduction in the serum level as compared with the level in
the control group. The mean values of enzyme activity obtained in
the liver were 102.14±6.12, 140.17±2.06 and 168.23±3.52 IU/L for
Pb, Fe and Cu groups, respectively compared to 91.20±9.42 IU/L
enzyme activity for the control group. The serum and liver AST and
ALT activities obtained in Pb, Fe, Cu and control groups are
reported. It was generally noted that the presence of the heavy metal
caused liver tissues damage and consequent increased level of the
diagnostic enzymes in the serum.


We report the high-pressure high-temperature synthesis of the germanium-based framework compounds BaGe6 (P = 15 GPa, T = 1073 K) and BaGe(6-x) (P = 10 GPa, T = 1073 K) which are metastable at ambient conditions. In BaGe(6-x), partial fragmentation of the BaGe6 network involves incommensurate modulations of both atomic positions and site occupancy. Bonding analysis in direct space reveals that the defect formation in BaGe(6-x) is associated with the establishment of free electron pairs around the defects. In accordance with the electron precise composition of BaGe(6-x) for x = 0.5, physical measurements evidence semiconducting electron transport properties which are combined with low thermal conductivity.


Use of recombinant human erythropoietin has been advocated for therapy in anemic patients with end-stage renal disease and to enhance the harvesting of autologous red blood cells from healthy patients scheduled for elective orthopedic surgery. The authors report the case of a diabetic patient with moderate chronic renal failure and cholelithiasis but whose religious beliefs forbade the use of transfusion therapy. She underwent successful cholecystectomy only after treatment with recombinant human erythropoietin.


Open-loop rear-wheel-steering (RWS) control can be enhanced by modifying the open-loop gain table that adapts to changes in vehicle dynamics parameters, such as front and rear cornering compliances. These changes can be caused by tire deflation/inflation, tire wear, loading change and suspension aging, etc. The vehicle parameters can be estimated by using a real-time vehicle parameter estimation technique. The open-loop gain table is modified based on three different strategies: yaw-rate gain matching, lateral-velocity gain matching, and lateral-velocity to yaw-rate ratio matching strategies. The three strategies are investigated using linear analysis. The yaw-rate gain matching strategy does recover yaw-rate gain in the presence of vehicle cornering compliance changes. However it has undesired effect on lateral-velocity response. The other two strategies are both very effective in reducing lateral-velocity although the lateral-velocity to yaw-rate ratio matching strategy is preferred due to its simplicity. When the only change in vehicle dynamics parameters is the rear cornering compliance, the three proposed strategies are found to be equivalent. An adaptive open-loop RWS control structure is then proposed and analyzed with simulation studies. The simulation result shows the effectiveness of the adaptive open-loop control.


Islet β-cell failure is mostly progressive in type 2 diabetes, resulting in the need for serial escalations in glucose-lowering therapies for many patients with this condition (1–4). This failure is a consequence of impaired β-cell function and loss of β-cell mass, with varying contributions of each likely to relate to the heterogeneity in causative factors from patient to patient (1–5). It is a commonly held view that impaired proinsulin synthesis contributes to the β-cell dysfunction aspect of β-cell failure (1,2). This can be a consequence of the endoplasmic reticulum (ER) stress response that inhibits protein synthesis (including proinsulin) and/or β-cell de-differentiation in which the expression of the essential elements required for a mature β-cell function, including the transcription of the insulin gene, are reduced or absent (1,2).

In this issue of Diabetes , however, Alarcon et al. (6) convincingly show that islet β-cell proinsulin synthesis is increased rather than decreased in two obese mouse models of type 2 diabetes. They do find severe depletion in the number of mature insulin granules in the β-cells of these obese diabetic mice, but the evidence is that this results from accelerated, dysfunctional proinsulin processing and trafficking rather than the consequence of deficient proinsulin synthesis (6). Furthermore, these defects can be rapidly reversed by a short period of β-cell rest, at least in vitro (6). These findings are important, as reversibility of this form of islet β-cell dysfunction, if better understood, may lead to improved approaches for the prevention of progressive β-cell failure in affected patients with type 2 diabetes.

Alarcon et al. (6) used the C57BL/6J db/db and the C57BLKS/J db/db obese diabetic mouse models (referred to hereon as 6J db/db and KS db/db ), the difference between …


Considering the problem that the performance of algorithms based on conventional second order cyclic statistics degrades in the impulsive non-Gaussian noise which exists widely in practical environments,the signal samples contaminated by impulsive noise are taken as outliers and W statistics for Gauss test based on robust statistics theory is adopted to adaptively trim the impulsive samples,and then a new estimated cyclic correlation expression is formulated.Consequently,a novel robust DOA(direction of arrival) estimation is obtained.The proposed algorithm needs no any prior knowledge of the noise probability density function and can be applied to all types of non-Gaussian noise model situations.Computer simulations are presented to illustrate the superior efficiency of the novel approach to the existed robust algorithms under different nonGaussian noise environments.


We have previously proposed the ReceiptLog, which stores user's purchase histories from daily receipts for value-added consumer services. As a practical application of the ReceiptLog, we design and implement a shopping support service, called "Sma-Sho", in this paper. Sma-sho is designed to cope with two typical problems in daily shopping: duplicate purchase and forgotten purchase. The duplicate purchase is that a user mistakenly buys a product although there is sufficient stock of the same product at home. The forgotten purchase is that a user forgets to buy a product although the product is out of stock. Using the ReceiptLog APIs extensively, Sma-Sho provides useful purchase histories for the user with a mobile terminal, to prevent the above two problems. We also conduct an experimental evaluation with 8 subjects, to show the effectiveness of the proposed method.


As an attempt to disclose environmental degradation of the Niger Delta and the suffering of its residents since the oil exploration in 1957, Kaine Agary with her novel Yellow-Yellow (2006) represents the effects of the ecological destruction that socially and environmentally impact a marginalized group of Nigerian people as well as the natural surrounding of the Niger Delta. Employing the literary approach of agential realism with its new material turn, this paper investigates the ways in which Yellow-Yellow (2006) re-imagines the concept of agency through the struggling of female human protagonist, named Zilayefa, and nonhuman actors against the forces of oil exploitation. In doing so, the paper reveals the representation of an environmental ethics in forms of an unbroken bond of multiple agents among which are humans and nonhumans that need to be considered and sustained. This paper aims to become an example of how environmental literature could inspire and urge for environmental preservation and conservation in the reality.


Histiocytic necrotizing lymphadenitis is a rare, benign entity described independently both by Kikuchi and Fujimoto et al. This disease, which has a broad morphologic spectrum, can readily be mistaken for malignant lym-phoma. Our report on the morphologic features in 10 selected cases of this disease highlights those features that mimicked lymphoma and those that helped us to make an accurate diagnosis. The distinctive features were (a) pathologic areas, which are pale and do not occupy the entire lymph node; (b) preserved sinuses in the uninvolved areas; (c) prominent mottling by histiocytes or transformed lymphoid cells in the nonpathologic areas; (d) frequent absence of overt necrosis; (e) presence of benign histiocytes with moderate to marked nuclear irregularities and scanty to moderate cytoplasm that resembled cleaved cells; (f) variable amounts of nuclear debris, usually extracellular; (g) presence of so-called plasmacytoid T cells at the periphery of or immediately outside the pathologic areas; (h) moderate numbers of mitotic figures and transformed lymphoid cells of medium and large size (immunoblasts); and (i) absence of inflammatory and granulomatous reaction. Because overt necrosis is often absent and histiocytes resemble cleaved cells, we support the suggestion that this entity should be called "Kikuchi-Fujimoto disease" rather than "histiocytic necrotizing lymphadenitis."


In Reply. —Clinical manifestations of pulmonary vasculitis and emboli are rarely, if ever, seen in patients with temporal arteritis. In fact, our search of the literature uncovered no such relationship. On occasion, however, pulmonary arteritis has been reported in the larger autopsy series. There are increasing reports in the literature of vasculopathy in patients with temporal arteritis affecting major vessels other than the temporal artery, such as the major branches of the aorta. It is well known that patients with systemic lupus erythematosus often develop vasculitis that will affect any vessel. Thus, it would appear not unusual that Dr Brentlinger's patient was demonstrated to have pulmonary vasculitis. I agree with Dr Brentlinger that pulmonary vasculitis may explain the episodes of supposed pulmonary emboli in our patients. I would think that embolization would be the more common occurrence. Unfortunately, pulmonary arteriography was not done on our patients. However, our patients have


This research raises the issue of the importance of empowering Kelurahan in improving community services. On this occasion, the researcher used a qualitative design with a literature study method using theories and existing journals as reference materials. Empowerment is the strengthening of the development process, independence, self-empowerment, and the negotiating position of the lower classes against the oppressed forces of all levels of society. According to Law Number 25 of 2009 concerning Public Services, public services are defined as activities or series of activities in the context of meeting service needs in accordance with the laws and regulations for every citizen and resident for goods, services and / or administrative services provided by service providers. public. To improve services at the kelurahan level, the Kelurahan needs to be empowered by referring to aspects, in the form of; freedom of mobility, the ability to buy small commodities, the ability to buy large commodities, to be involved in making household decisions, the relative freedom from family domination, legal and political awareness, involvement in campaigns and protests, economic security and contributions to the family.


Rice is the most important staple food for a large part of the world's population. Its production needs increase to meet the predicted demands of increasing population. Biotechnology provides a novel approach for rice improvement through transformation technique. Studies related to the In-vitro culture of plant require a basic protocol for callus induction and subsequent plant regeneration. Efficient callus induction and plant regeneration are pre-requisite for transformation. In the present study, an efficient callus induction and regeneration system was established for basmati rice varieties viz. Basmati-370, Pusa Sugandha-4, Vallabh Basmati-22 and Taroari. A number of factors such as media composition, different concentrations and combinations of hormones were studied. MS media supplemented with 2.0 mg/l of 2, 4-D produced the most desired calli. The callus induction frequency was found to be highest for Pusa Sugandha-4 while Basmati-370 showed the highest regeneration frequency on MS medium supplemented with 2.0 mg/l BAP and 1mg/l of NAA.


The pathogenesis of RA is a complex and ever-changing landscape but amid the chaos of the disease process we have found effective treatment regimes. However, our current therapeutics, although targeting various components of both the innate and adaptive immune response, do not result in disease remission. Protein kinase inhibitors are attractive targets due to their ability to influence downstream signalling and their oral bioavailability. Fostamatinib (R788) inhibits spleen tyrosine kinase (Syk) and has been in clinical trials involving both MTX inadequate responders (MTX-IRs) and biologic inadequate responders. Studies on the MTX-IR population revealed ACR20 responses of 67-72% at higher doses (150 mg bd and 100 mg bd), ACR50 responses of 43-57% and ACR70 responses of 28-40%. The trial in the biologic non-responder population showed no efficacy, however, post hoc analyses of the data suggested that a further trial in this population is warranted. The most common adverse events included gastrointestinal effects, hypertension, neutropenia and transaminitis. Many adverse effects were dose responsive and hypertension was amenable to treatment. Upper respiratory tract infections were more likely at higher doses, but no serious infections with tuberculosis, fungi or opportunistic infections were reported. The oral availability of these agents makes them attractive treatment options for our patients, although the literature from the oncology field suggests that patients will only choose the oral route if efficacy is equivalent. Long-term follow-up studies are ongoing and will be critical for rare side effects. The role of these agents in our current arsenal is unclear and economic analyses are awaited.


Background One of the principal findings of genome wide association studies in autoimmune diseases has been the substantial overlap of genetic susceptibility loci identified. This has underpinned fine mapping initiatives such as the Immunochip (IC) project in which custom chips were designed to fine-map regions of associations common to a number of autoimmune diseases. Samples from patients with rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA) and psoriatic arthritis (PsA) have been genotyped using IC; given that all are types of inflammatory arthritis (IA) which exhibit common pathology and some overlap of associated loci, the data emerging from IC provides a unique opportunity to identify novel overlapping regions and determine whether the causal variants within overlapping loci are the same or different for each disease. Objectives To investigate IC fine mapping data to identify genetic regions which are associated with susceptibility to more than one type of IA. Methods As part of the IC project, genotyping, quality control and association analysis was performed for RA (14056 cases and 9583 controls), JIA (1614 polygoarticular and oligoarticular JIA cases and 7153 controls) and PsA (929 cases and 4537 controls). Some controls were shared between cohorts. For this analysis all common SNPs (MAF>0.05) with p<10-3 in any of the 3 diseases were first selected. IC regions were defined as including all SNPs from the 1000 Genomes Project CEU population (September 2009 release) that were in 0.1-cM (HapMap3 CEU) recombination blocks around each GWAS region lead marker. IC Regions which contained SNPs associated with more than one type of IA were considered overlapping. Results 26 regions showed association at p<10-3 with more than one type of IA, of these, in RA and JIA two loci (PTPN22 and STAT4) reached genome wide significance (5×10-8), with a further 8 associated at p<10-4in both diseases. Interestingly 2 of these loci are also associated with PsA at p<10-3 (RUNX1 and PTPN2). 4 of these loci have been previously associated with both RA and JIA (PTPN22, STAT4, PTPN2, and IL2RA) whilst 6 are novel overlapping regions (ANKRD55, RUNX1, IL2RB, DNASE1L3, UBE2L3 and COG6). For the PTPN22, STAT4, ANKRD55, DNASE1L3, PTPN2 and UBE2L3 regions the RA and JIA associated SNPs are either identical or highly correlated (r2>0.8), the direction of effect is the same in both diseases and odds ratios similar. For RUNX1 and COG6 the associated SNPs are different and weakly correlated (r2>0.4<0.8) but the direction of effect is similar for each disease. An interesting finding is that for IL2RA and IL2RB the pattern of association in the region is completely different. Conclusions These findings add to the body of evidence that there are shared susceptibility genes for inflammatory arthritis. Further investigation is required to fully explore whether the regions contain the same or different causal effect, including functional studies to determine whether, in overlapping loci with the same causal variant, the variant predisposes to disease by the same mechanism. Disclosure of Interest None Declared


Purpose

Cities across the globe, particularly those of the less developed world, face long-term challenges associated with floods which impact negatively on the resilience of city systems and their inhabitants. In the city of Maroua, most urban management stakeholders have been unable to integrate flood resilience research into urban development issues. It is against this background that the purpose of this paper is to evaluate the governance issues constraining the deployment of flood resilience strategies implemented by residents in flood-prone zones and those used by the government via administrative authorities and institutions charged with urban development to flood-related risks in the city of Maroua, Far North Region of Cameroon.

Design/methodology/approach

Field surveys, participant observations, interviews, and on-the-spot appraisals were carried out with residents in flood-prone neighbourhoods and municipal authorities on the state of recurrent floods including mitigating strategies being implemented.

Findings

The results revealed that Maroua has a fragile ecological setting which has increased the vulnerability of the town to flood-related risks. This is further aggravated by the fact that municipal authorities are yet to have a thorough mastery of such recurrent flood incidences due to their limited planning horizons, rendering the urban poor disproportionately susceptible to flood-related stresses. This exposes them to unavoidable flood associated hazards such as water borne diseases (typhoid and cholera) as they are bogged down by physical and financial limitations. Besides, decision-making processes in relation to managing urban systems are not guided by good governance as efforts to enhance and integrate the local population for flood resilience are neither participatory nor inclusive, ushering the urban environment of Maroua into a frivolous path to profligacy.

Originality/value

For resilience to be deeply entrenched, the paper proffers for the mainstreaming of flood resilience strategies into urban development plans through multi-stakeholder involvement across different sectors and departments, as well as the setting up of a practical time table for monitoring the progress of these measures through geospatial technologies such as remote sensing and geographical information systems.


Uncertain delays in the absorption, distribution, and utilization of insulin can cause model inconsistencies and poor glycemic control performance. To address this problem, an adaptive system identification approach able to handle the variable delays in the insulin pharmacokinetics is integrated in this work with a predictive control formulation to explicitly consider the plasma insulin concentration, which facilitates the designed controller to constrain the insulin concentration in the bloodstream. Adaptive models and the estimation of the insulin absorption and utilization rates improve the model predictions and control performance, and the efficacy of the proposed model predictive control algorithm handling the uncertain delays in insulin action is demonstrated using simulation case studies.


The relationships between air and ground surface temperatures across North America are examined in the historical and future projection simulations from 32 general circulation models (GCMs) included in the fifth phase of the Coupled Model Intercomparison Project (CMIP5). The difference between surface air (2 m) and ground surface (10 cm) temperatures is affected by simulated snow cover, vegetation cover, and precipitation by means of changes in soil moisture and soil properties. In winter, the differences between air and ground surface temperatures, for all CMIP5 simulations, are related to the insulating effect of snow cover and soil freezing phenomena. In summer, large leaf area index and large precipitation rates correspond to smaller differences between air and ground temperatures for the majority of simulations, likely due to induced changes in latent and sensible heat fluxes at the ground surface. Our results show that the representation of air‐ground coupling, analyzed using the difference between ground and air surface temperatures as metric, differs from observations, the North American Regional Reanalysis product and among the CMIP5 GCM simulations, by amounts that depend on the employed land surface model. The large variability among GCMs and the marked dependence of the results on the choice of the land surface model illustrate the need for improving the representation of processes controlling the coupling of the lower atmosphere and the land surface in GCMs as a mean of reducing the variability in their representation of weather and climate phenomena.


Open pneumothorax is the complete, sudden collapse of the lung which inevitably occurs when an operation requires the wide opening of the chest wall, in the absence of adhesions between visceral and costal or diaphragmatic pleura, or when an attempt is made to drain the chest after the method employed in other parts of the body. The importance of preventing this physical phenomenon was fully realized by Dr. Matas more than twenty years ago, when, as one of the pioneers in the field of thoracic surgery in America, he had his assistant, Dr. Parham of New Orleans, excise a tumor of the chest wall with the help of a differential pressure apparatus, the Fell-O'Dwyer combination, as modified by Matas. Ever since that time, open pneumothorax has been a topic for discussion. Our association considered it, at the second annual meeting, in 1919, when the president's address, which dwelt on the


Running amok is considered a rare culture-bound syndrome by current psychiatric classification systems, but there is evidence that it occurs frequently in modern industrialized societies. The historical origins of running amok as a psychiatric condition are reviewed in this article, and its relevance to modern day episodes of violent behavior is discussed. Psychotic illnesses, personality disorders, and mood disorders are all possible causes of amok, and the identification and treatment of patients who are at risk for manifesting violent behavior are discussed.


Fludarabine has shown a definite clinical activity in B-cell chronic lymphocytic leukemia (B-CLL). Recently it has been demonstrated that loxoribine, a guanine ribonucleotide derivative, is able to increase the cytotoxicity of fludarabine in B-CLL cells, in vitro. We have here extended these findings by testing the activity of loxoribine in combination with fludarabine and mafosfamide. As we have previously demonstrated, loxoribine enhances the activity of fludarabine at all concentrations, while only lower doses of mafosfamide seem to be positively affected by loxoribine. The combination of fludarabine and mafosfamide is synergistic on CLL cells, and the cytotoxic activity is increased by the addition of loxoribine. We have also evaluated the pro-apoptotic activity of each drug, both alone and in combination; these results are concordant with the cytotoxicity data, thus demonstrating that, even though loxoribine is more active in combination with fludarabine than with mafosfamide, the efficacy of the triple combination is higher than that obtained with any other agent alone or in double combination.


Background: Inflammation, where vascular endothelial cells are activated by cytokines, recruits circulating leukocytes such as neutrophils into the tissues. Mononuclear phagocytes as well as tissue cells activated by these stimuli produce these chemokines. In this study, thr effects of IL-1 and LPS on the expression of CXC chemokines such as GRO-, IL-8 and ENA-78 in vascular endothelial cells and the neutrophil adhesion effects of ENA-78 and GRO- was investigated. Methods: Human umbilical vein endothelial cells were cultured and stimulated with various concentrations of IL-1 and LPS. The concentrations of the GRO-, IL-8 and ENA-78 secreted were measured using enzymelinked immunosorbent assay. The effects of ENA-78 and GRO- on neutrophil adhesion to the endothelial cells were also investigated. Results: The addition of IL-1 and LPS to the vascular endothelial cells induced GRO- IL-8 and ENA-78 secretion in a time- and dose-dependent manner. The neutrophil adhesion was also increased by induction of ENA-78 and GRO- to the vascular endothelial cells in a dose-dependent manner. Conclusion: CXC chemokines such as GRO-, IL-8 and ENA-78 secreted by the vascular endothelial cells play an important role in the acute inflammatory responses by stimulating neutrophil adhesion to the vascular endothelial cells, raising the possibility that the CXC chemokines are one of the targets in the clinical application of acute inflammation.


Exemplary agricultural research supported by good government policies has ensured food security in India. It is the right time to focus on micronutrient malnutrition in the country. Recently, Zn deficiency in diet especially of young children below 5 years of age has received global attention. Zn deficiency diseases in infants and children include diarrhoea, pneumonia, stunted growth, weak immune system and retarded mental growth. Zn deficiency in pregnant women can lead to these problems and even mortality in infants. Over 450 thousand infant deaths in the world during 2004 were ascribed to Zn deficiency. Although Zn deficiency to some extent can be cured by Zn supplementation and improvement in dietary composition, it is better to increase the Zn content in cereals, the staple food in India and as a matter of fact in the entire south and southeast Asia. This can be achieved by biofortification of foodgrains either by developing crop cultivars with high concentration of Zn in grains or by adequate Zn fertilization of crops grown on Zn-deficient soils. Animals also suffer from Zn malnutrition.


The development OF knowledge-building or leaning communities is a complex, multifacered task By examining users Like David, we came to understand that our goals for a learning community would not be addressed by any "magic bullet" technology solution. Instead, we undertook a lengthy design process that started with self-examination and self-definition and still continues today with community support, assessment, and evaluation. The challenges we faced are similar to those in other community-building efforts, and we have attempted to extract the intrinsic types of work required to engineer technologies to support an online community. Many of these areas of inquiry would exist even if we were not using technology to support our users, bur they are all the more important when we consider designing software to support their needs. By now, the reader has probably. noticed the wide variety of skills to be brought to the problem, from computer science and design to management and grassroots community building to social science research. To be successful at supporting learning communities, we need to address all the questions here in a multidisciplinary way that not only involves research on existing practices and definit~ono f the goals for the community but also supports design and implementation with community support, technologies that map to the users' needs, and reflection on community and individual outcomes.


Introduction These experiments were performed to measure choroidal blood volume and blood flow in albino rabbits breathing room air; 100% oxygen; 10% carbon dioxide, 90% oxygen; and 10% carbon dioxide, 21% oxygen, 69% nitrogen gas. The simultaneous measurement of the orbital arterial blood pressure during the determination of blood flow allows comparison of the vasomotor tone of the choroidal bed as the respiratory gases were changed. Kety et al 1 devised the nitrous oxide technique to study changes in the average cerebral blood flow in human subjects. This work focused attention upon changes in regional blood flow with changes in the respiratory gas mixtures. In a group of normal human subjects breathing gases with elevated oxygen tensions, Kety demonstrated a decrease in the average cerebral blood flow from 52 to 45 ml/100 gm/min. This was accompanied by an increase in vascular resistance from 1.7 to 2.2 units. Further studies documented


The rescreening of negative cervical/vaginal smears is one of the potential areas of utilization of the systems for computer-assisted cytology diagnosis. In the Imola cytology laboratory, a random sample of 1309 conventionally prepared smears that had been originally reported as negative was rescreened with the PAPNET System (Neuromedical Systems, Inc., Suffern, NY). Smears with a PAPNET diagnosis other than negative were further and independently evaluated by the staff of the laboratory and classified according to the majority report. The PAPNET rescreening confirmed the original negative diagnosis for 1188 smears (907.6/1000) and led to the detection of 46 ASCUS/LGSIL cases (35.1/1000) and 2 AGUS/HGSIL cases (1.5/1000). Seventy-three smears (55.8/1000) were interpreted as unsatisfactory. The majority report confirmed the original negative diagnosis for 42 (91%) of the 46 PAPNET diagnoses of ASCUS/LGSIL and 50 (68%) of the 73 smears interpreted as unsatisfactory. The 2 cases of AGUS/HGSIL diagnosed by PAPNET were confirmed. The detection rate of ASCUS/LGSIL decreased from 35.1/1000 to 3.1/1000 (rate ratio 0.09, 95% confidence interval [95% CI] 0.02-0.22). The rate of unsatisfactory smears decreased from 55.8/1000 to 17.6/1000 (rate ratio 0.31, 95% CI 0.20-0.47). The rate of negative smears increased from 907.6/1000 to 977.9/1000 (rate ratio 1.08, 95% CI 1.02-1.14). In conclusion, the PAPNET rescreening of negative smears brought about a low detection rate of severe cellular changes. Though greater, the detection rate of low grade changes was substantially and significantly reduced by the majority reports. At our laboratory, the PAPNET rescreening does not appear to improve the performance of conventional cytodiagnosis.


The mechanism of laser-induced damage to thin films is described in this paper, and a definition of laser breakdown threshold to thin film, optical breakdown threshold is presented. The new definition is clearer than the existing one. The measurement results and comparison for various samples are given on the basis of the two above-mentioned definitions.


Metric embeddings have become a frequent tool in the design of algorithms. The applicability is often dependent on how high the embedding's distortion is. For example embedding into ultrametrics (or arbitrary trees) requires linear distortion. Using probabilistic metric embeddings, the bound reduces to O(log nlog logn). Yet, the lower bound is still logarithmic.We make a step further in the direction of bypassing this difficulty. We define "multi-embeddings" of metric spaces where a point is mapped onto a set of points, while keeping the target metric being of polynomial size and preserving the distortion of paths. The distortion obtained with such multi-embeddings into ultrametrics is at most O(log Δ log log Δ) where Δ is the (normalized) diameter, and probabilistically O(log n log log log n). In particular, for expander graphs, we are able to obtain constant distortions embeddings into trees vs. the Ω(logn) lower bound for all previous notions of embeddings.We demonstrate the algorithmic application of the new embeddings by obtaining improvements for two well-known problems: group Steiner tree and metrical task systems.


Solid dielectric material characterization is commonly performed through measurement of dielectric frequency response. A technique, called arbitrary waveform impedance spectroscopy (AWIS), has been developed as one of its modified versions. It is capable, among other features, of obtaining a broad dielectric response spectrum from one single measurement, provided the applied test voltage is rich in harmonic components. As AWIS is a technique, rather than an instrument, it can be optimized to reach signal to noise ratio in the 106 range. However, both the electrode arrangements as well as the accuracy of the measurement setup limit the precision of the characterization. An air reference method and a contact-free electrode arrangement are presented in this paper for enhancing the dielectric characterization accuracy through avoiding problems introduced by electrode contacts. It is shown that by performing a calibration with electrode gap filled with air under the same conditions as the material is tested, the air reference method can improve the measurement accuracy substantially. This type of approach also eliminates the need for a detailed model of the analog measurement circuit. In conjunction with the contact-free measurements and harmonic-rich waveforms, the approach allows for avoiding complicated and time-consuming sample preparation procedures. Both the measurement methodology as well as the electrode arrangement are presented and evaluated by comparing results obtained with different instruments.


Abstract Research on vegetable-based protein sources has grown as a result of the European Union ban on the inclusion of meat and bone meal in diets of agricultural livestock. This together with recent concern over genetically modified soybeans, the protein source of choice for monogastric diets, has sparked research into the identification of some alternative protein sources. The objective of this study was to evaluate the effect of raw or extruded pea (RP and EP), faba beans (RFb and EFb) or lupin (RL and EL) in partial substitution of soybean meal and other starch sources in broiler diets. A total of 462-d-old male Ross chicks, Marek vaccinated, were randomly assigned to seven dietary treatments (3 pens/treatment). Chicks were floor housed, ad libitum fed isocaloric and isonitrogenous diets and had free access to water. Artificial light was provided 10 h/d. The amount of alternative proteins used as fed basis and for 1-10 d-old and 11-42 d-old growing periods were: RP and EP: 350 g/kg for all diets; RFb: 480 and 500 g/kg; EFb: 240 and 250 g/kg; RL: 360 and 300 g/kg; EL: 180 and 150 g/kg. Feeds were analyzed for tannins, polyphenol, genisteine, and daidzeine contents and the in vitro alpha-amilase starch digestibility was measured. At the end of the trial performance parameters were calculated, animals were processed and percentage yields (one per pen) of breast meat and leg quarters were quantified. The polyphenol concentrations and antitrypsin activity were reduced and the alpha-amylase digestibility increased in EP and EFb. The feed conversion ratio was not significantly affected, however, the feed intake was reduced (P<0.01) in EL diet compared to the control group and to the RL diet. The RP group had lower dressing percentage (P<0.05), whereas groups fed faba bean had higher breast yield (P<0.01) independent of processing. There were no statistical differences in percent yield of the leg quarters. Data support the utilization of these alternative proteins sources into broilers diets as a viable solution to counteract the current constraints of soybean meal. Partial improvement was seen with EFb and EP, which was not seen however for the lupin based diets.


The pedagogy used to teach computer security to students new to the field is usually handled by a one- or two-course augmentation to an existing curriculum. Furthermore, the courses tend to be technology-centric and often do not uncover the underlying processes that students can transfer to new situations. In this article, we look more closely at determining an appropriate scope and sequence for information assurance (IA) and briefly describe a project whose goal is the articulation of an IA curriculum.


In recent decades, interest in and application of behavioral insights to conservation theory and practice have expanded significantly. Yet the growth of integrated strategies to adapt and guide human behavior in service of conservation outcomes has included limited engagement with questions of equity and power. Here we examine the use of behavioral approaches in conservation efforts, emphasizing potential misapplications that may result from omitting equity and power considerations. Such omission may lead to an overemphasis on the role of individual behaviors relative to system‐level drivers of biodiversity loss, result in misalignment between behavioral interventions and the actual drivers of behavior in situ, and incur unanticipated negative social welfare and distributional costs, all of which may undermine conservation success. We offer recommendations for centering equity when applying behavioral insights to conservation, including strategies for high‐level agenda setters (scholars, advocates, funders and programmatic leaders) as well as conservation practitioners. The urgent need for biodiversity conservation is insufficient reason to side‐step equity and power considerations; we contend that centering equity is consistent with this urgency and key for developing sustainable conservation theory and practice.


One hundred seventy-seven isolates of serotype b Haemophilus influenzae recovered largely from children with invasive disease in the United States were characterized by the electrophoretic mobilities of 16 metabolic enzymes, the NaDodSO4/PAGE pattern of outer-membrane proteins (OMP), and biotype. Thirty-two distinctive multilocus genotypes (electrophoretic types, ETs) were distinguished on the basis of allele profiles at the enzyme loci. Twenty-eight OMP types and five biotypes were identified, but only 55 distinctive combinations of ET, OMP type, and biotype were represented. The strong nonrandom associations of characters and the recovery of isolates with identical properties in widely separated geographic regions and over a 40-year period suggest that the population structure of H. influenzae is basically clonal. Examination of nonserotype b isolates indicated that clones of serotype b are a restricted subset of the genotypes in the species as a whole. Currently, most of the invasive H. influenzae disease in the United States is caused by serotype b strains of two related ETs, and, more specifically, much of it is attributable to two subclones marked by OMP type. There is evidence that the frequency of the ET-1/OMP 1H/biotype I subclone has increased dramatically in the United States since the 1939-1954 period. The hypothesis that populations of H. influenzae are subject to marked temporal variation in clonal composition is supported by evidence of major differences in the genetic structure of populations in the United States and the Netherlands.


In this article, we introduce the Sharma-Mittal entropy of a graph, which is a generalization of the existing idea of the von-Neumann entropy. The well-known R{e}nyi, Thallis, and von-Neumann entropies can be expressed as limiting cases of Sharma-Mittal entropy. We have explicitly calculated them for cycle, path, and complete graphs. Also, we have proposed a number of bounds for these entropies. In addition, we have also discussed the entropy of product graphs, such as Cartesian, Kronecker, Lexicographic, Strong, and Corona products. The change in entropy can also be utilized in the analysis of growing network models (Corona graphs), useful in generating complex networks.


The psoas muscle is a long, powerful muscle which, in spite of its virtual continuous activity when a person is sitting and walking, is never subject to direct violence and is rarely indirectly traumatized. Strandell1recently reviewed the literature and cited 13 cases of subcutaneous rupture of the iliopsoas muscle, in 8 of which the rupture occurred in a normal muscle. Haldeman and Soto-Hall2reported 2 cases of trauma to the psoas muscle in a series of 104 injuries to muscles and tendons. Trauma to the psoas muscle may produce fibrillar, partial or complete rupture of the muscle bundles. The clinical picture depends on the degree of rupture, the site and size of the secondary hemorrhage, the irritation of contiguous nerves and structures and such complications as formation of a cyst, calcification and infection. Strandell has shown that a definite diagnostic picture is obtained, consisting of sudden acute


The problem of optimum sparse array configuration to maximize the beamformer output signal-to-interference plus noise ratio (MaxSINR) in the presence of multiple sources of interest (SOI) has been recently addressed in the literature. In this paper, we consider a shared aperture system where optimum sparse subarrays are allocated to individual SOIs and collectively span the entire full array receiver aperture. Each subarray may have its own antenna type and can comprise a different number of antennas. The optimum joint sparse subarray design for shared aperture based on maximizing the sum of the subarray beamformer SINRs is considered with and without SINR threshold constraints. We utilize Taylor series approximation and sequential convex programming techniques to render the initial nonconvex optimization a convex problem. The simulation results validate the shared aperture design solutions for MaxSINR for both cases where the number of sparse subarray antennas is predefined or left to constitute an optimization variable.


The plasma stored energy as a function of input power follows an off-set linear law during ion-cyclotron resonance heating in the JET Tokamak. The behaviour of the experimentally obtained incremental confinement time tau inc of centrally heated ICRH discharges is understood in terms of a local heat transport model, where chi 0 varies as Ip-1/2 and ( chi ) increases as the size of the q=1 surface is increased at higher Ip/Bt or lower qa due to the presence of the sawtooth instability, where Ip is the plasma current, Bt is the toroidal field and qa is the Tokamak safety factor at the plasma edge. With the transient stabilization of sawteeth by central ICRF heating in JET, the authors are also able to assess the effect of sawteeth on confinement and determine the plasma current scaling of tau inc without mixing its dependence on the safety factor. The same model is also used to explain the degradation of tau inc when ICRH power is deposited off-axis.


This research is aimed at establishing how teaching culture has been transformed by the implementation of online teaching and learning during the COVID-19 pandemic crisis. In particular, the study seeks to establish how this paradigmatic shift towards online learning in the approach to teaching has impacted the teaching culture of Hong Kong from the perspective of teachers working in higher education who have moved to teaching online as a result of the COVID-19 crisis. How is online teaching affecting the experience and well-being of students? How may any negative impacts may be offset? In what ways can benefits be maximised and enhanced by the implementation of digital devices in teaching? These questions are explored in this study through the undertaking of both primary and secondary research. The study introduces the contextual background to the topic in light of the implementation of online teaching in the wake of the COVID-19 pandemic from both a global perspective and that of higher education in Hong Kong. The primary data admitted to this study for analysis consists of both questionnaire and interview data derived from teachers of English Language teaching online at higher education institutions across Hong Kong. This variety of primary questionnaire and interview data should allow for both quantitative and qualitative analysis of data, allowing for some triangulation of findings from either source.


The major purpose for conducting this study was to determine whether certain instructional strategies were superior to others in teaching high school chemistry students problem solving. The effectiveness of four instructional strategies for teaching problem solving to students of various proportional reasoning ability, verbal and visual preference, and mathematics anxiety were compared in this aptitude by treatment interaction study. The strategies used were the factor-label method, analogies, diagrams, and proportionality. Six hundred and nine high school students in eight schools were randomly assigned to one of four teaching strategies within each classroom. Students used programmed booklets to study the mole concept, the gas laws, stoichiometry, and molarity. Problem-solving ability was measured by a series of immediate posttests, delayed posttests and the ACS-NSTA Examination in High School Chemistry. Results showed that mathematics anxiety is negatively correlated with science achievement and that problem solving is dependent on students' proportional reasoning ability. The factor-label method was found to be the most desirable method and proportionality the least desirable method for teaching the mole concept. However, the proportionality method was best for teaching the gas laws. Several second-order interactions were found to be significant when mathematics anxiety was one of the aptitudes involved.


An infinite elastic medium is initially at rest in a prestressed state of plane- or anti-plane strain. At time t = 0 a plane crack comes into existence which occupies a strip parallel to the y axis and whose width varies in time. Assuming that the components of the traction are known on the crack surface it is possible to set up an integral equation on the area of the crack for the relative displacement across the crack. Although the kernel of this integral equation is non-integrable a method is found for discretizing it and a numerical method of solution is carried out. The results, which in some cases are the solutions of diffraction problems, are presented graphically.


A 5MHz bandwidth switched-capacitor bandpass filter system with 100Msample/s input sampling is designed to provide both baseband operation at 37.5MHz center frequency and sub-sampling operation at 137.5MHz center frequency. It employs parallelism and decimation and achieves linear phase response, accurate center frequency and better than 40dB of inband image rejection. Implemented in a 0.8µm CMOS technology, it dissipates 125mW drawn from a 5V supply and occupies 10.25 mm2of die area.


Study of the systemic and regional blood pressure in various parts of the maxillofacial area and of microcirculation in tissues and fundus oculi in patients with maxillofacial injuries showed that such traumas involve brain injuries in 100% of cases and are therefore combined. The authors emphasize that this patient population is to be treated for brain injuries.


The electrically evoked auditory brainstem response (EABR) and stapedius reflex threshold (ESRT) are routinely recorded during implant surgery with the Nucleus 22 channel cochlear implant in the Nottingham Paediatric Cochlear Implant Programme and are extremely valuable in the management of young implanted children. These intraoperative tests were carried out in a young child on the occasion of the first implantation and then after re-implantation 17 months later following malfunction of the first device. The surgical experiences of the first implantation and the re-implantation were both straightforward. Recordings of the intraoperative EABR and ESRT were typical of the expected pattern of responses on both occasions and there was only a small reduction in threshold sensitivity after re-implantation. These investigations provide valuable objective information to support and assist with the management of re-implantation in a young child.


In present study, two enriched biochar-based fertilizers were prepared having fertilizer grade of 6-6-4 N-P2O5-K2O by intercalation of NPK fertilizers mixture solution as EB-1 and additional humic acid and seaweed extract as EB-2. In laboratory, batch experiment were done to compare nutrients (NH4+, NO3−, P and K+) release patterns of developed fertilizers along with conventional fertilizers. Enriched biochar fertilizers (EB) demonstrated much slower release pattern of NH4+, P and K+, however NO3− release was similar over conventional fertilizers. The cumulative release of N in EB fertilizers was similar to conventional fertilizer, however significantly less of P and K were released during the period of 72 hrs. The field response study of enriched fertilizers EB-2 revealed 29.5, 11.5 and 22.9% higher apparent use efficiency than conventional fertilizer. The slow nutrients release behaviour of EB fertilizers implies reduced losses and enhanced NUE as reflected by higher apparent recovery of N, P and K.


In this paper, we investigate the impact of channel estimation on the performance of bit-interleaved coded modulation (BICM-OFDM) systems with iterative decoding. Pilot-aided and iterative channel estimation techniques are evaluated with Gray labeling and symbol mappings optimized for iterative decoding by means of numerical simulations. We show that after several turbo iterations, pilot-aided channel estimation provides the best performance in terms of bit error rate (BER) while the iterative estimation approach achieves a better frame error rate (FER) performance.


Hydrostatic coupling has recently been reported as a means to improve the versatility and safety of electromechanical actuators based on dielectric elastomers (DEs). Hydrostatically coupled DE actuators rely on an incompressible fluid that mechanically couples a DE-based active part to a passive part interfaced to the load. The work reported here was aimed at developing millimetre-scale bubble-like versions of such transducers. Silicone-made oil-filled actuators were manufactured as both single units and arrays of parallel elements. Bubbles had a base diameter of 6 mm and were driven up to a voltage of 2.25 kV, applied across a silicone film with a thickness of 42 µm. Active relative displacements and stresses up to 18% and 2.2 kPa, respectively, were recorded with static driving. Dynamic investigations reported a −3 dB bandwidth of the order of 100 Hz and a resonance frequency of about 250 Hz. Millimetre-scale hydrostatically coupled DE actuators might play a useful role in several fields of application. Among them, we are currently exploring novel tactile displays and cutaneous stimulators, made of wearable, distributed and flexible devices. Although further miniaturization is required for high-resolution uses, this technology holds promise to properly combine performance with safe and compliant interfaces with users, low specific weight, no acoustic noise and low cost. Copyright © 2009 Society of Chemical Industry


Exact structured inference with neural network scoring functions is computationally challenging but several methods have been proposed for approximating inference. One approach is to perform gradient descent with respect to the output structure directly (Belanger and McCallum, 2016). Another approach, proposed recently, is to train a neural network (an "inference network") to perform inference (Tu and Gimpel, 2018). In this paper, we compare these two families of inference methods on three sequence labeling datasets. We choose sequence labeling because it permits us to use exact inference as a benchmark in terms of speed, accuracy, and search error. Across datasets, we demonstrate that inference networks achieve a better speed/accuracy/search error trade-off than gradient descent, while also being faster than exact inference at similar accuracy levels. We find further benefit by combining inference networks and gradient descent, using the former to provide a warm start for the latter.


The growth of marine renewable energy and marine protected areas in France leads to an increased need for animal population knowledge at sea. Offshore energy generator projects (wind turbines for example) must obey these regulations and show their harmlessness to the environment, particularly to the wildlife and to protected species, which are vulnerable and threatened. The work presented in this paper is part of a project whose goal is to propose a system of sea surface survey by plane, using numerical HD photography. Data will be recorded in daylight with a flight plan allowing to cover all of the sea surface to be studied. This paper introduces a solution to use these images to detect and classify the objects present on the sea surface, near this surface or in the air column under the plane: birds, marine mammals, turtles and sharks (near the surface), ships, other mankind objects (waste).


This piece is a personal response to the articles in this special issue of the Journal of Psychosocial Studies. It identifies three themes that seem to unite the articles: children's emotional labour; repair and generativity; and après-coup or Nachträglichkeit. It is also suggested that there is an absence – the shadow of envy, competition and rivalry, which also tends to run through the matrix of so many mother–daughter and supervisor–supervisee relations. Further, it is suggested that any future iterations of these relationships would be enriched by integrating contributions on the ways in which not only collusion, competition and oedipal struggles, but also hierarchy and asymmetry are especially problematic sources of psychic pain when women supervise women.


Passwords act as a first line of defense against any malicious or unauthorized access to one's personal information. With the increasing digitization, it has now become even more important to choose strong passwords. In this paper, the authors analyze a 100 million Email-Password Database to perform Exploratory Data Analysis. The analysis provides valuable insights on statistics about the most common passwords being used, character set of passwords, most common domains, average length, password strength, frequencies of letters, numbers, symbols (special characters), most common letter, most common number, most common symbol, the ratio of letters, numbers, symbols in passwords which highlights the general trend that users follow while creating passwords. Using the results of this paper, users can make intelligent decisions while creating passwords for themselves, i.e., not opting for the most common features that will help them create robust and less vulnerable passwords.


Background: Excessive production of oxygen free radicals and imbalance in the mechanisms responsible for antioxidant protection may result in the onset of many diseases including breast cancer. Objective: To evaluate antiproliferative and antioxidant activity of an ethylacetate fraction (EAF) of Picria fel-terrae Lour. Herbs in the T47D cell line. Methods: Phenolic and total flavonoid contents in EAF were determined. EAF was tested for cytotoxicity and effects on the cell cycle and apoptosis, as well as antioxidant activity. Results: EAF was found to contain high levels of phenolic agents (92.88 ± 0.50 mg GAE/g), total flavonoid (84.39 ± 0.07 mg QE/g). The EAF of Picria fel-terrae Lour. herbs was found to have an IC50 of 62.98µg/mL, caused accumulation in G0-G1 and S phase and increased early and late apoptosis. Antioxidant activity in DPPH assays gave an IC50 of 166.90 ± 0.10 µg/mL. Conclusions: The results reveal that EAF of Picria fel-terrae Lour. herbs has antiproliferative activity and strong antioxidant potential. Further studies are now needed to isolate the responsible antiproliferative and antioxidant components.


High-temperature (HT) applications have witnessed real growth during the last years. Several instrumentation and measurement applications require electronic circuits functioning reliably in HT. The analog-to-digital converter (ADC) and the operational amplifier (op-amp) are essential parts of measurement systems and circuits. They are the major parts of the analog front end of a conditioning signal circuit. Modeling HT electronic (HTE) components is a challenging task. The motivation of this paper is to describe an appropriate choice of the ADC and op-amp modeling approaches for HT ranges. The context of HTE systems is briefly described here and allows us to understand the challenges of such modeling. Comparing most known techniques enables us to make a suitable modeling choice for the HT. An appropriate methodology for modeling is presented. Some temperature-dependent models of ideal and nonideal ADC and op-amp are developed. The comparison of the simulation and experimental results is described to validate our approach choice.


An integral geometric curvature is defined as the index expectation K(x) = E[i(x)] if a probability measure m is given on vector fields on a Riemannian manifold or on a finite simple graph. Such curvatures are local, satisfy Gauss-Bonnet and are independent of any embedding in an ambient space. While realizing constant Gauss-Bonnet-Chern curvature is not possible in general already for 4-manifolds, we prove that for compact connected manifolds, constant curvature K_m can always be realized with m supported on Morse gradient fields. We give examples of finite simple graphs which do not allow for any constant m-curvature and prove that for one-dimensional connected graphs, there is a convex set of constant curvature configurations with dimension of the first Betti number of the graph. In particular, there is always a unique constant curvature solution for trees.


OBJECTIVES
The purpose of this study was to evaluate the efficacy of education modules in preparing staff before the implementation of a pediatric delirium screening protocol.

METHODS
After consenting participants began phase 1 of the study, which covered general information on pediatric delirium. It comprised a 21-question assessment administered as a pretest followed by an education module and then the same 21-question assessment administered as a posttest. After completing phase 1, participants proceeded to phase 2, which focused on use of the Cornell Assessment of Pediatric Delirium (CAPD) tool. It comprised an education module and a 14-question postassessment. Participants completed these phases at their convenience via provided instruction documents. Assessments were delivered through the online service SurveyMonkey. Education modules were available online as invisible YouTube videos.

RESULTS
A total of 50 nurses and pharmacists gave consent, and 37 of these participants initiated phase 1. All 37 participants completed the phase 1 preassessment, averaging a score of 46% (range, 29%-71%). A total of 27 participants completed the phase 1 postassessment, with an average score of approximately 76% (range, 48%-95%). A total of 20 participants, with no prior training on the CAPD, completed the phase 2 postassessment, averaging a score of 88% (range, 43%-100%).

CONCLUSIONS
Both the pediatric delirium general education module and the CAPD use education module resulted in participant learning, as evidenced by the assessment score averages.


Background Anifrolumab is a fully human IgG1 monoclonal antibody directed against subunit 1 of the type I interferon–α receptor (IFNAR1). It is in development for treatment of SLE. Objectives To support dosage selection for pivotal anifrolumab studies, using an E−R model. Methods In the Phase IIb MUSE study (NCT01438489),1 adult pts with moderate to severe SLE, who had inadequate responses to standard-of-care (SOC) medications, were randomized 1:1:1 to intravenous anifrolumab 300 or 1,000 mg or placebo every 4 weeks (Q4W), in addition to SOC medications, for 48 weeks. Pts were stratified by type I interferon gene signature (IFNGS) test status (high or low) using a validated 4-gene expression assay, oral corticosteroid dosage (<10 or ≥10 mg/day of prednisone or equivalent), and SLE disease activity index−2K score (<10 or ≥10) at screening. A mechanistic target-mediated drug disposition model2 was used to describe the pharmacokinetics (PK) of anifrolumab. The dichotomous efficacy endpoint, SLE responder index [SRI (4)], was modeled using logistic regression. A dropout hazard function was used to describe voluntary withdrawals during treatment. Clinical simulations were conducted to assess dosing scenarios in virtual SLE pts. Results There was no PK difference between type I IFNGS test–high or –low pts (mean [standard deviation] Ctrough (Day 169): 17.0 [11.5] μg/mL and 23.3 [16.0] μg/mL, respectively). SRI (4) modeling demonstrated no anifrolumab treatment effect in type I IFNGS test–low pts compared with placebo; interpretation of this result may be limited by small sample size. In type I IFNGS test–high pts, a log-linear logistic model was used to describe the treatment effect of anifrolumab. Pt dropouts were more likely in nonresponders. Clinical simulations demonstrated dosages <300 mg would result in inadequate PK exposure and suboptimal efficacy in some pts with SLE. In contrast, simulations indicated minimal efficacy improvement for dosages >300 mg, consistent with the Phase IIb MUSE study outcomes. Conclusions Based on E−R analyses and overall risk assessment, a 300 mg Q4W, intravenous dosage regimen is recommended for pivotal anifrolumab studies in pts with SLE. References Furie R, et al. Arthritis Rheumatol. 2017;69:376–86. Wang B, et al. Clin Pharmacol Ther. 2013;93:483−92. Acknowledgements Funded by MedImmune. Medical writing support: R. Plant, QXV Comms, an Ashfield company, funded by MedImmune. Disclosure of Interest L. Santiago Shareholder of: AstraZeneca, Employee of: MedImmune LLC, B. Wang Shareholder of: AstraZeneca, Employee of: MedImmune LLC, P. Brohawn Shareholder of: AstraZeneca, Employee of: MedImmune LLC, L. Wang Employee of: MedImmune LLC, G. Illei Shareholder of: AstraZeneca, Employee of: MedImmune LLC, L. Roskos Shareholder of: AstraZeneca, Employee of: AstraZeneca


Objective To describe the lived experience of nursing staff and nurse leaders working in COVID-19 devoted units (intensive care or medical unit) prior to vaccine availability. Research Design Qualitative phenomenological design with a focus group approach. Methods The study team recruited a convenience sample of nursing staff (nurses, and nursing assistants/nurse technicians) and nurse leaders (managers, assistant nurse managers, clinical nurse specialists, and nurse educators) at an academic medical center in the midwestern United States. Focus groups and individual interviews were conducted to encourage participants to describe their (1) experiences as nursing professionals, (2) coping strategies, and (3) perspectives about supportive resources. Moral distress was measured with the moral distress thermometer and qualitative data were analyzed with Giorgi-style phenomenology. Results We conducted 10 in-person focus groups and five one-on-one interviews (n  =  44). Seven themes emerged: (1) the reality of COVID-19: we are sprinting in a marathon; (2) acute/critical care nurse leaders experience unique burdens; (3) acute/critical care staff nurses experience unique burdens; (4) meaning of our lived experience; (5) what helped us during the pandemic; (6) what hurt us during the pandemic; and (7) we are not okay. Participants reported a moderate level of moral distress (M  =  5.26 SD  =  2.31). They emphasized that peer support was preferred over other types of support offered by the healthcare organization. Participants expressed positive feedback about the focus group experience and commented that group processing validated their experiences and helped them "feel heard." Conclusion These findings affirm the need for trauma-informed care and grief support for nurses, interventions that increase meaning in work, and efforts to enhance primary palliative communication skills. Study findings can inform efforts to tailor existing interventions and develop new, more comprehensive resources to meet the psychosocial needs of nursing staff and nurse leaders practicing during a pandemic.


The purpose of the present paper is to examine the efficiency of Indonesian rice production conducted in Aceh Province, by using agricultural census data 2013 with a sample of 1,029 characteristics of farm households. The analysis model used is stochastic frontier analysis (SFA)) approach and the estimation result obtained that rice production factors such as wages of farm workers, harvested area, fertilizer, and seeds have not been technically efficient. Furthermore, the economical scale of rice production in Aceh Province is decreasing return to scale that coherent with the results of the efficiency test. Keywords: efficiency, farmer household, stochastic frontier analysis, economic scale.


A BSTRACT . This paper is concerned with the numerical treatment of second kind Volterra integral equations whose integrands present diagonal and/or endpoint algebraic singularities. A projection method based on an optimal interpolating operator is developed in the spaces of weighted continuous functions endowed with the supremum norm. In such spaces, the uniqueness of the solution is discussed and suitable conditions are determined to assure the stability and the convergence of the method. Several numerical tests are presented to show the efficiency of the method and the agreement with the theoretical estimates.