Imaging dose from megavoltage cone beam computed tomography (MVCBCT) can be significantly reduced without loss of image quality by using an imaging beam line (IBL), with no flattening filter and a carbon, rather than tungsten, electron target. The IBL produces a greater keV-range x-ray fluence than the treatment beam line (TBL), which results in a more optimal detector response. The IBL imaging dose is not necessarily negligible, however. In this work an IBL was dosimetrically modeled with the Philips Pinnacle3 treatment planning system (TPS), verified experimentally, and applied to clinical cases. The IBL acquisition dose for a 200 degrees gantry rotation was verified in a customized acrylic cylindrical phantom at multiple imaging field sizes with 196 ion chamber measurements. Agreement between the measured and calculated IBL dose was quantified with the 3D gamma index. Representative IBL and TBL imaging dose distributions were calculated for head and neck and prostate patients and included in treatment plans using the imaging dose incorporation (IDI) method. Surface dose was measured for the TBL and IBL for four head and neck cancer patients with MOSFETs. The IBL model, when compared to the percentage depth dose and profile measurements, had 97% passing gamma indices for dosimetric and distance acceptance criteria of 3%, 3 mm, and 100% passed for 5.2%, 5.2 mm. For the ion chamber measurements of phantom image acquisition dose, the IBL model had 93% passing gamma indices for acceptance criteria of 3%, 3 mm, and 100% passed for 4%, 4 mm. Differences between the IBL- and TBL-based IMRT treatment plans created with the IDI method were dosimetrically insignificant for both the prostate and head and neck cases. For IBL and TBL beams with monitor unit values that would result in the delivery of the same dose to the depth of maximum dose under standard calibration conditions, the IBL imaging surface dose was higher than the TBL imaging surface dose by an average of 18%, with a standard deviation of 8% (p = 2 x 10(-6)). The IBL can be modeled with acceptable accuracy using a standard TPS, and accounting for IBL dose in treatment plans with the IDI method is straightforward. The resulting composite dose distributions, assuming similar imaging doses, are negligibly different from those of the TBL. The increased IBL surface dose relative to the TBL is likely clinically insignificant.


The present work was performed to investigate the phenolic composition of P. lentiscus L. distilled leaves (PDL) and examine its potential against certain key enzymes related to skin aging. High-pressure liquid chromatography coupled to mass spectrometry (HPLC-MS) and various separation procedures combined with nuclear magnetic resonance (NMR) and MS analysis were performed to isolate and identify compounds present in the ethyl acetate extract (EAE) of PDL. A high amount of flavonol glycoside was detected in EAE. Indeed, quercetin-3-O-rhamnoside (FC), myricetin-3-O-rhamnoside (FM2), and kaempferol-3-O-rhamnoside (FB2) were isolated from EAE, and are present in high quantities of 10.47 ± 0.26, 12.17 ± 0.74, and 4.53 ± 0.59 mg/g dry weight, respectively. A transdermal diffusion study was carried out to determine the EAE-molecules that may transmit the cutaneous barrier and showed that FM2 transmits the membrane barrier with a high amount followed by FC. EAE, FM2, and FC were tested against tyrosinase and elastase enzymes. Moreover, intracellular tyrosinase inhibition and cytotoxicity on skin melanoma cells (B16) were evaluated. The results indicated that EAE, FC, and FM2 have important inhibitory activities compared to the well-known standards, at non-cytotoxic concentrations. Therefore, they could be excellent agents for treating skin pigmentation and elasticity problems.


The transfer impedance between conducting coils is evaluated to estimate the down-hole dielectric properties that can contribute to more effective exploration and production of gas/oil reservoirs. The earth formation with a borehole-mud filtrate invasion is simulated by concentric zones of variable dielectric properties to account for rocks saturated by different fluids. We have imposed analytical restrictions to allow only magnetic-dipole coupling between logging coils and to limit logging source frequencies from 10 to 30 MHz for typical coil spacings. Depending on the depth of invasion front, guided waves may exist in the invaded formation. When guided waves do not exist, rapidly converging branch-cut integrations are used to evaluate the transfer impedance. When the invasion front begins to support guided waves, the numerical converence becomes somewhat slower using spatial-bandlimited integrations. Both types of integration are used to produce inversion charts from which dielectric properties and invasion-front radii can be estimated from downhole-measurable transfer impedances. Ambiguity in parameter inversion is also demonstrated to provide insight for developing a future inverse process based on array processing of adequately sampled data.


The financing patterns of corporations have changed over the last fifteen years. Bond financing has superseded bank loans. In addition, the deeper integration of worldwide financial markets has diffused risk assessment mechanisms, which were previously restricted to industrialized countries. In this context, credit ratings issued by rating agencies such as Standard & Poor's and Moody's play an important role in the procurement of financing. A rating is referred to as "… an opinion about an issuer's future capability, legal responsibility, and willingness to meet the payment of the principal and interest of a specific bond…" (MOODY'S 1999a, p.5).This paper aims to verify whether or not it is possible to predict corporate ratings based on a set of financial indicators. We study the case of Repsol-YPF, a world-renowned Argentine oil company. The ordered logit model was used as estimation method, as it yields better results than the more commonly used least squares and probit models. From a small set of financial indicators, the most relevant appear to be earnings (EBITDA) and short term debt over total debt (STD/TD). This small number of financial indicators was able to reasonably predict Repsol-YPF corporate ratings, suggesting than ratings may not have information in addition to that publicly available.


Total pressure measurements for ammonia + methanol were made at 10 °C and 20 °C. The liquid and vapor compositions were derived by iteration from the material balance and the Martin-Hou equation of state.


A new method of ground vehicle shock absorber characterization using lumped acceleration excitation is presented. By using a triangular waveform and lumping the acceleration at the beginning and end of travel, this method produces a 27% larger mapping on the phase plane than traditional harmonic (sinusoidal waveform) excitation characterization. Force response surfaces are created based on the lumped acceleration and on harmonic excitation data. A difference surface is created between the common regions of both force response surfaces. A correlation is made between the response of the lumped acceleration force response surface to harmonic inputs and observed data. Hysteresis effects are noted using the lumped acceleration force response surface at low frequencies. A standard materials testing machine is used to characterize the shock absorber.


Neuroanatomical tract tracers (NaTTs) have been used for neural circuit tracing for decades and now find recent applications in disease diagnosis and drug and gene delivery. In this Review, first the different subclasses of NaTTs including nonviral and viral types and their unique properties are discussed. The focus then is shifted to recent developments in improving the design and performance of NaTTs for neural circuit mapping, their role in disease diagnostics, and the emerging applications in drug and gene delivery targeted to the nervous system. In contrast to most molecular and biologic drugs that do not pass through the blood-brain barrier, NaTTs, including certain types of plant lectins, bacterial toxins, and some viruses, are readily taken up by nerve endings in mammalian muscle and efficiently transported within the central nervous system to the brain. Incorporating NaTTs into nanomedicines to bypass biological barriers and to deliver drugs to specific neurons thus presents an exciting direction and offers many possibilities for drug delivery. We hope that this Review will catalyze further discussions and collaborations among neuroscientists, biomedical researchers, and nanotechnologists that lead to innovative therapeutic options for treating neurological diseases.


The membrane-restricted photoactivatable carbene generator 3-(trifluoromethyl)-3-(m-[125I]-iodophenyl)diazirine [Brunner, J., & Semenza, G. (1981) Biochemistry 20, 7174-7182] was used to label the subunits of the membrane attack complex of complement (C5b-9). C5b-9 complexes either were assembled from serum on erythrocyte membranes or were reconstituted from purified components on liposomes. After irradiation, most of the probe is bound to C9 independent of the membrane system used, indicating that the wall of the transmembrane channel is predominantly composed of C9. No difference was observed whether polymerized C9 was in the tubular or nontubular form [Podack, E. R., & Tschopp, J. (1983) J. Biol. Chem. 257, 15204-15212], showing that tubule closure is not essential for successful lipid insertion. The same label distribution between the two forms of polymerized C9 was obtained by analyzing zinc-polymerized C9 in the absence of C5b-8. Since the photoreactive probe reacted with at least two distinct polypeptide segments within C9, lipid interaction does not occur via a single segment of hydrophobic amino acids.


UNLABELLED
Tumor necrosis factor alpha (TNF-alpha) plays a central role in pathogenesis of many inflammatory diseases including asthma and allergic rhinitis. Its capability for cell activation, chemotaxis and upregulation of adhesion molecule expression on surface of inflammatory cells suggests that TNF-alpha may be responsible for bronchial hyperresponsiveness (BHR) and clinical symptoms of atopic diseases.

THE AIM
Relationships between serum concentration of TNF-alpha and clinical course as well as nonspecific BHR in patients with isolated seasonal rhinitis (SR) and seasonal bronchial asthma (SA) were assessed.

MATERIAL AND METHODS
The study was performed in 19 subjects with SR and 26 subjects with asthma sensitized to pollens, with measurable BHR during symptomatic phase of disease. Control group consists of 16 healthy volunteers. Serum concentration of TNF-alpha, ventilatory parameters, BHR to methacholine, asthma and seasonal rhinitis score were assessed two times--during and outside pollen season.

RESULTS
Nonspecific BHR was find in 10 (21%) patients with SR and 18 (69%) patients with asthma symptoms out of season. In both groups postseasonal mean geometric values of PC20M were significant higher than during season. There were no marked changes in ventilatory parameters accompanied the increase in BHR. TNF-alpha concentration in serum in both groups of patients was significant higher than in healthy subjects. Further increase of its activity about 50-70% compared to baseline values was observed during pollen season. There was no correlation between serum concentration of TNF-alpha, BHR and symptom score. There is increased serum concentration of TNF-alpha in patients with seasonal airway allergy even in asymptomatic period of disease.

CONCLUSIONS
Natural exposure to allergens causes significant increase of TNF-alpha concentration in patients with rhinitis and asthma. Although level of BHR and intensification of clinical symptoms coexist with changes in TNF-alpha concentration there is no correlation between them.


Recent studies carried out at national and international levels indicate that ICT use in the Italian school system is lagging in a number of ways. Observation of the situation in lower secondary schools has prompted us to conduct an investigation focusing on three different areas: teachers' knowledge and use of technology, sharing of contents and processes, and the adoption of collaborative strategies for learning and teaching. This paper combines the quantitative data collected from different research studies into digital technologies in the Italian school system with the results of a survey we conducted into the professional profile of teachers in the Liguria region. The aim is to reveal the actual level of technology usage and to bring to light critical issues involved. This ultimate goal of this undertaking is to support the sharing and uptake of innovative practices through teacher-centred professional development that promotes inclusive education.


ABSTRACT Recent techno-functional studies of the lithic assemblage of Layer C3 in Late Acheulian Revadim (Israel) have demonstrated the variability in tool production and use in this layer. Here we present the results of a techno-functional and residue analysis of two central categories of artifacts found in Layer C3: side-scrapers and cortical flakes. We investigate the assumed functional link between side-scrapers and scraping activities and examine the question of whether cortical flakes were considered by the Revadim hominins as simple waste products or as useful tools. Our study applies an integrative and multidisciplinary methodology combining experimental archaeology, use-wear and residue analysis, and spectroscopic measurements. Our results show that side-scrapers were used for scraping and mixed activities, mostly on soft-medium and medium materials, while cortical flakes were occasionally used, mostly for cutting. Tool function reconstruction was supported by the morphological, elemental, and chemical characterization of extraordinarily well-preserved residues of animal origin, suggesting their use in butchery. .


Drinking that occurs under special permits in Canada, such as at weddings, private receptions and parties, is a neglected aspect of alcohol research. These permits are issued for many different occasions and are most common in the provinces with the highest per capita alcohol consumption. Special permit drinking is becoming a social and alcohol-control issue but information on the problems it creates is sparse. Specific problem areas such as excessive drinking and drinking by minors have not been studied, but because such drinking is rarely monitored they may be substantial. Further study of special permit drinking is recommended.


Eighteen morphometric and five meristic characters of the yellow seahorse, Hippocampus kuda inhabiting the coastal waters of Ratnagiri, central west coast of India, were studied. Morphometric/numerical analysis confirmed the identity of the species from Ratnagiri coastal waters as Hippocampus Kuda Bleeker, 1852. A negative allometric relationship was observed in both genders of H. kuda. The estimated weight-length relationships  (WLR) for male and female specimens, respectively were, W=0.0034 SL2.8533 and W=0.0078 SL2.5253 (r2>0.95). The biological information on morphometric and meristic characters, WLR and length-length relationship (LLR) provided in this study would be helpful for conservation and management of this vulnerable seahorse species.


We combine Hubble Space Telescope (HST)/Wide Field Camera3 (WFC3) imaging and G141 grism observations from the Cosmic Assembly Near-infrared Deep Extragalactic Legacy Survey (CANDELS) and 3D-HST surveys to produce a catalog of grism spectroscopic redshifts for galaxies in the CANDELS/GOODS-South field. The WFC3/G141 grism spectra cover a wavelength range of 1.1 ≤ λ ≤ 1.7 ?> μm with a resolving power of R ∼ 130 ?> for point sources, thus providing rest-frame optical spectra for galaxies out to z ∼ 3.5 ?> . The catalog is selected in the H-band (F160W) and includes both galaxies with and without previously published spectroscopic redshifts. Grism spectra are extracted for all H-band detected galaxies with H ≤ ?> 24 and a CANDELS photometric redshift z phot ≥ 0.6 ?> . The resulting spectra are visually inspected to identify emission lines, and redshifts are determined using cross-correlation with empirical spectral templates. To establish the accuracy of our redshifts, we compare our results against high-quality spectroscopic redshifts from the literature. Using a sample of 411 control galaxies, this analysis yields a precision of &sgr; NMAD = 0.0028 ?> for the grism-derived redshifts, which is consistent with the accuracy reported by the 3D-HST team. Our final catalog covers an area of 153 arcmin2 and contains 1019 redshifts for galaxies in GOODS-S. Roughly 60% (608/1019) of these redshifts are for galaxies with no previously published spectroscopic redshift. These new redshifts span a range of 0.677 ≤ z ≤ 3.456 ?> and have a median redshift of z = 1.282. The catalog contains a total of 234 new redshifts for galaxies at z > 1.5 ?> . In addition, we present 20 galaxy pair candidates identified for the first time using the grism redshifts in our catalog, including four new galaxy pairs at z ∼ 2 ?> , nearly doubling the number of such pairs previously identified.


Photography is a very broad communication style used in our society and it is a way of communicating as in visual style of expression to touch others in various ways. This is a process of creation, activity and art creating something for others to value and appreciate the captured image of photography. The Shari'ah of Islam has not permitted creating pictures of living things or even taking pictures of them. The objectives of this research is to explore the ideation of Islamic geometric patterns and to be experimenting with the geometric Islamic patterns style into art photography. This study also examines the possibilities of creating art photographic influences with the geometric Islamic patterns. Experimental approach in terms of using adobe Photoshop was used to conduct the study. The photography images produce for this research is only scope on modern architecture. It is to understand the Islamic geometric pattern and implement its characteristic into photography to create symmetry patterns in art photography. The result gathered from this research contributes towards of enhancement and creating new art photography with modern architecture and Islamic art approach, creating pattern variation and innovation.


The accumulation of monoclonal chronic lymphocytic leukemia B (B-CLL) cells may be due to excessive proliferation and longevity. Clinical progression may thus come from a constitutive but altered expression of a number of genes that results in extended B-CLL cells life span, increased proliferative capacity and diminished cell death. B-CLL cells express a number of surface markers that characterise the normal B-cells phenotype. However, B-CLL cells are CD5 positive and most of them also express CD6, surface receptors that are present in just a small subset of normal B-cells. When exploring CD6 function, we found out that cross-linking of CD6 protected B-CLL from anti-IgM-induced apoptosis. CD6 activation blocked anti-IgM- induced Bax(alpha) up-regulation and, by doing so, corrected an imbalance in the Bcl-2/Bax ratio that accompanies apoptosis. Here, we review all surface receptors and cytokines that have been described as participating in the induction or protection of B-CLL apoptosis together with data on chemosensitivity and gene modulation, data on the Fas receptor/Fas ligand system, and the implications of all the latter for B-CLL cell survival.


Introduction New roles are being introduced within the NHS to utilise knowledge and skills to offer value for money services. Assistant Practitioners were introduced into the endoscopy unit and an innovative service was set up to improve the patient management for pre surveillance colonoscopy screening. Methods A telephone assessment was implemented by an Assistant Practitioner (band 4) to ascertain whether this could be offered as an alternative to the current pre endoscopy clinic led by a band 5 to ensure the patient was safe to proceed with bowel preparation and investigation. Results 68 patients were booked onto the Assistant Practitioner (AP) telephone clinic over a 10-week period. Out of these 20 DNA'd the appointment and 48 were assessed via the telephone consultation. Out of the 48 patients assessed the AP was able to decide if the patient was fit to proceed without seeking further advice. Forty-one patients were deemed suitable to advance to colonoscopy and agreed a date to attend. Seven patients chose to be discharged. Conclusion Hospital attendance is not always required to adequately assess the suitability for bowel preparation and colonoscopy. For a cohort of patients this can be done by a telephone consultation. This has advantages both for the user, in that they are not required to attend with all the difficulties associated with hospital visits, and the provider for adequate use of resource and capacity available. It is acknowledged that there may be a proportion of patients identified that require a face to face assessment at a higher level and those can be given a date to attend a nurse led clinic at the time of telephone consultation. This method is more cost effective due to the higher numbers of consultations on a telephone assessment clinic compared to face to face clinic and the associated salaries of the band of the practitioner undertaking the session. Competing interests None declared.


Introduction Colorectal cancer, the second leading cause of cancer death in the United States, is also among the most preventable cancers. However, Latino men are less likely than non-Latino men to engage in preventive screening. Compared with 60% of non-Latino white men and women, only 42% of Latino men are up to date with colorectal cancer screening guidelines, which may result in diagnosis at advanced disease stages and increased deaths. We evaluated the literature on colorectal cancer screening interventions among Latino men to characterize intervention components effective in increasing colorectal cancer screening.


Cycle time for a product is one of the key performance indicators in semiconductor manufacturing. Reduction of cycle time will shorten product time to market, increase throughput, reduce operational cost and develop customer trust. Semiconductor manufacturing that process 40,000 to 50,000 work-in-progresses (WIP), usually takes 50 to 70 days, 300 to 400 equipments and 300 to 900 steps to complete. Thus, any task related to manual data collection to make indices reports or analysis usually needs high resources requirements to spend for manual work and risk for mistake. In the modern facility of semiconductor fabrication, a system like Manufacturing Execution Systems (MES) was implemented to ease the process and operation traceability. The information is well kept in the appropriate databases. Many applications then are integrated with MES database to perform indices reports. In this paper, the improve method for data collection related to cycle time improvement is introduced. In this approach, the automated systems was developed using existing Advance Productivity Family (APF) programming platform to collecting the data. The system is integrated between MES and APF to have the real time data collection and analysis. In the systems, manual data collection is replaced with respective automated data transfer from real situation in the manufacturing environment. This program then able to shows real root caused with proper relational charting to display real problem for engineering to prioritize and resolve respectively. As a result, 39% reduction of cycle time gained by implementing this technique. The system has successfully implemented and supports the cycle time reduction.


This work investigates the promising multi-modal luminescence (upconversion (UC), downshifting (DS) and quantum cutting (QC)) properties of RE3+ (Tm3+, Yb3+) and Bi3+ activated GdNbO4 phosphors synthesized using the well-known solid state reaction method. Structural characterization using x-ray diffraction measurements confirms the formation of the pure phase of the GdNbO4 host with no impurities. The optical band gap (Eg) of GdNbO4 (with and without RE3+ ions) calculated from UV–Vis–near-infrared (NIR) measurements was found to be the same ~4.44 eV which indicates that GdNbO4 is a wide band gap material. Further, Bi3+ doping presents an interesting Eg tuning of the GdNbO4 phosphor, i.e. Eg increases up to 5.38 eV. In terms of luminescence, this material produces intense blue and NIR emission via multi-modal optical processes. On NIR excitation (λexc  =  980 nm), Gd0.94Tm0.01Yb0.05NbO4 produces intense upconverted blue and NIR and relatively weak red emission. In addition to the UC process, Gd0.94Tm0.01Yb0.05NbO4 also exhibits pump power dependent variation in fluorescence intensity ratio for I472/I477 showing the applicability of this material as an optical heater. On UV excitation (λexc  =  265 nm), Gd0.99Tm0.01NbO4 produces intense DS blue emission due to the Tm3+ ion, overlapped with the emission of the (NbO4)3− ion through strong energy transfer (ET) from (NbO4)3− to Tm3+ ions. Interestingly, NIR QC has also been successfully observed in Gd0.9Yb0.1NbO4, Gd0.89Bi0.01Yb0.1NbO4 and Gd0.79Tm0.01Yb0.2NbO4 phosphors through cooperative ET from the (NbO4)3− group to the Yb3+ ion, Bi(6s)–Nb(4d) to the Yb3+ ion and the Tm3+ ion to the Yb3+ ion, respectively. The mechanisms involved in these processes are explained in detail in this work. The QC efficiency in this work has been found to be ~177%. Thus, the multi-modal luminescence (UC, DS and QC) property of this material makes it a promising candidate for display devices, spectral converters for enhancing the efficiency of silicon solar cells, etc.


It has been repeatedly shown that universities and public research institutes contribute to local innovation generation and facilitation. The mechanisms behind this contribution are well discussed in the literature. However, detailed empirical examinations are missing. We analyse the impact of universities and public research on regional innovation output. Thereby we analyse separately 19 technologies and distinguish whether university education and public research are rather innovation generators or innovation facilitators. All analyses are conducted on German data.


In this paper, we prove some invariant curve theorems for the planar almost periodic reversible mappings. As an application, we will discuss the existence of almost periodic solutions and the boundedness of all solutions for the nonlinear oscillator x′′ + g(x)x′ +̟2x+ φ(x) = f(t) with f(t) almost periodic.


The antimicrobial activity of 15 antibiotics against 73 Vibrio cholerae 01 strains ogawa type, El Tor biotype was determined using the disc diffusion method. Most of the isolates (91.8%) were resistant to trimethoprim/ sulphamethoxazole, 82.2% to streptomycin, 61.6% to furazolidone, 57.5% to tetracycline, 54.8% to rifampicin, 39.7% to erythromycin, and 27.4% to ampicillin. Less than or equal to 3% were resistant to gentamicin, chloramphenicol, and neomycin. All were sensitive to ciprofloxacin, ofloxacin, nalidixic acid, norfioxacin, and tobramycin.


The effect of dietary supplement containing cabbage on cadmium ‐ induced toxicity was studied in wistar rats. The effect of cadmium was investigated in 3 animals groups. Group A, rats were fed normal basal diet only. Group B rats were placed on normal basal, mixed with cadmium chloride (3 mg/kg body weight daily) while group C rats were fed with basal diet mixed with Cadmium chloride (3 mg/kg body weight) and 0.5 kg dry cabbage pellets daily. Rats were monitored for 28 days. At the end of the treatment, the animals were sacrificed using chloroform vapor. Oral rat LD50 for Cadmium Chloride, Anhydrous is 88 mg/kg. The effect of cadmium treatment alone and combined cadmium-cabbage treatment on lipid peroxidation, as measured by malondialdehyde levels in testes and kidney, serum activities of acid phosphatase (ACP) and prostatic acid phosphatase (PAP) and alkaline phosphatase (ALP) were investigated alongside testicular and kidney organ weight and assessment of some hematological indices. The result showed that cadmium induced a significant increase in both testicular and kidney malondialdeyhde (MDA); but dietary cabbage seem to have a beneficial effect on lipid peroxidation. Cadmium also induced a 75% increase in ACP, 98% in PAP and 22% increase in ALP, but cabbage supplementation tended to produce a reduction in the activities of these enzymes (p = 0.001). Result of organ weight analysis in Cd ‐exposed rats showed a decrease in testes and kidney weight. Comparatively rats whose diet contained cadmium with cabbage supplementation showed an increase in organ weight. Administration of combined treatments of cadmium and cabbage may provide beneficial effects against cadmium-induced changes on the testicular and kidney weight, malondialdeyhde, liver enzymes; alkaline phosphatase, acid phosphatase and prostatic acid phosphatase levels by reducing cadmium ‐associated oxidative stress.


The American Medical Education Foundation established in 1951 has had a slow but steady growth. During the year 1953 the growth was much more encouraging. In 1951 the campaign was started. The American Medical Association gave a half million dollars and has made this same gift each year. The Association has now appropriated a total of 2 million dollars towards the support of our medical schools. In addition the Association has appropriated additional funds to pay the administrative overhead of the A. M. E. F., so that every dollar contributed goes to the medical schools. During the first year of its operation, 1951, there were only 1,876 individual contributors to the Foundation. In 1952, this number had increased by 287% to 7,259. In 1953, however, the number of individual contributors had grown to 17,809, or another increase over 1952 of 149%. As to the actual amounts contributed by individual physicians,


Acute abdominal pain is a common complaint in children. We came across several unusual causes of acute abdomen including jejunal haematoma, perforation and abdominal abscess following hydrostatic intussusception reduction, twisting of mesenteric cyst, perforation of sigmoid colon and Meckel's diverticulum presenting with intussusception. In this article, we aim to present imaging features of these entities so that paediatric surgeons, radiologists and other health-care providers are aware of these unusual manifestations of acute abdomen.


In the study presented here, transplants of normal and pathological skin were done on 9 patients with active psoriasis. The transplantation of skin lesions from one site to another on individual patients has been done in the past to study dermatological problems. Haxthausen2mentioned in a paper entitled, "Studies on Pathogenesis of Morphea, Vitiligo and Acrodermatitis Atrophicans by Means of Transplantation Experiments," the fact that he performed "some" such studies on psoriasis. He stated, "As a rule, psoriasis transplanted to normal skin preserves its pathological character and sometimes extends, and normal skin placed in a psoriatic lesion becomes involved with psoriasis." He notes that there are irregularities seen and that any conclusions will have to await further study. He made no mention here of the number of cases or of control procedures in his study. Subjects Nine patients with psoriasis were selected for the transplant procedure. Seven were white


This study investigated the extent to which social trust affects consumers' food safety opinions. Additionally, it examined the determinants of social trust in governmental agencies and advocacy groups responsible for food safety. It also examined relationships between trust and food safety opinions. The data came from a social survey administered by mail to 289 adults in the Minneapolis/Minnesota metropolitan area. The results show support for a conceptual distinction between food safety worry and concern, which, respectively, reflect emotional and cognitive consumer risk assessments. Social trust significantly affected worry, but not concern. Environmentalism and social-demographic variables had significant total effects, but not significant direct effects, on trust, worry, and concern.


Abstract This paper assesses the functioning of law and legal institutions in Palestine/Israel through the lens of settler colonialism by analysing two thematically interconnected decisions issued by the Supreme Court of Israel, the first involving the starvation of besieged Palestinian civilians and the second involving the force-feeding of Palestinian prisoners. Following a discussion regarding the role of law in settler colonialism, it proceeds to argue that the Court enabled, legitimised and legalised state-sanctioned violence that targeted the native Palestinian population by and through a jurisprudence of elimination in order to facilitate the attainment of Israeli settler-colonial objectives. By so doing, the paper provides further evidence in support of the appropriateness of settler colonialism as a theoretical framework for the case of Israel, including in legal matters.


Binding and internalization of [125I]angiotensin II (AII) were studied by morphological and biochemical methods in rats in vivo. Light microscope radioautography demonstrated that [125I]AII binds specifically to adrenal zona glomerulosa (ZG) cells. Ultrastructural radioautographic analysis revealed that [125I]AII binds to the cell surface, clusters in coated pits, is internalized in coated vesicles, and is transported by receptosomes to lysosomes in less than 20 min. Biochemical analysis revealed that as much as 40% of the adrenal radioactive uptake behaves as native [125I]AII as shown by electrophoresis, immunoprecipitation and radioligand binding studies. These results indicate that the effects of AII on the secretion of aldosterone by ZG cells are mediated by cell surface phenomena and not by binding to intracellular organelles involved in steroidogenesis. They also indicate that the half-life of AII bound to receptors and internalized seems to be much longer (min) than in the systemic circulation (sec).


This essay examines the conflation of blood stains, blots and blemishes, and graphic allusions in William Shakespeare's The Rape of Lucrece (1594) and Thomas Middleton's The Ghost of Lucrece (1600), to suggest that both poets embrace the material, and particularly the staining, qualities of blood in their versions of the Lucretia narrative. It interrogates the role that Lucrece's tainted and staining blood performs in exposing her rape; by translating the stain in Lucrece's blood into the typographic marks of blots and stains, Shakespeare challenges the representational limitations of both. It will suggest that Lucrece's blotting and staining blood crosses the borders between the animate, medicalised body and the written text. By reading Lucrece's contamination as 'infection' (907, Lt. infectus, inficere, to corrupt, dye, stain, imbue), it draws humoral interpretations of Lucrece into conversation with the poem's rich matrix of textual and typographic images. Indeed, in sixteenth century usage, to distain and, in its aphetic form, to stain is always both to colour and discolour: to mark, blemish and defile (OED 4.a), but also to remove or deprive of colour (OED 1.a, †2). In this sense, Lucrece's stained and staining blood is simultaneously destructive and creative. In addition to being blot, blemish and stain, Lucrece's blood provides 'testament' (1183) and 'excuse' (1316); whilst blood is cause and symptom, it is also always readable and articulate. Accordingly, Lucrece's bloody suicide makes public her internal, sanguineous stain - reading Lucrece and Lucrece, we undertake a diagnostic reading of blood. Finally, it examines Thomas Middleton's The Ghost of Lucrece, and the way in which Shakespeare's contemporary appropriates and amplifies the image of the bloody, graphic stain.


Despite considerable progress that has been made in the diagnosis, treatment and prevention of respiratory tract infections, community-acquired pneumonia (CAP) remains a fairly common disease [1-3] that continues to have the status of the leading infectious cause of death in modern humans and claims more lives each year than tuberculosis, meningitis, AIDS and infective endocarditis taken all together [4]. In this case, it is evident that clinical guidelines stating, among other things, approaches to the rational empirical antibacterial therapy (ABT) of the disease are the most effective measures in achieving better outcomes of CAP [5–8]. However, the issue of determining the optimal duration of ABT remains a subject of lively discussions (Table. 1). It is important to note here that the clinical stability of patients with EP can be achieved in most cases during the first 3–5 days of empirical ABT, and it is a rare occasion when the need for long-term prescription of antibiotics arises [12].


Abstract This paper examines the impact of relative humidity on jades by enclosing the samples under constant relative humidity (RH) of 32, 49, 61.5, and 81.7% at the same temperature of 40 ± 0.1°C for 160 days. The simulated samples were pure and dense tremolite jade and serpentine jade, impure tremolite jade and serpentine jade containing some calcite, and serpentinized calcite, which are all common materials of ancient jade found in archaeological excavations. All samples were characterized through particle-induced X-ray emission and a glossmeter. The degree of deterioration proved to be greater in impure materials than in pure ones. The best RH to conserve various kinds of materials differs: for pure tremolite and serpentine, all of the RH levels are equal; for impure tremolite with some calcite, 61.5 and 81.7% were superior; for impure serpentine with some calcite, the highest RH (81.7%) was best; and as to the serpentinized calcite, there is no clear conclusion as yet and further research is needed.


Despite a clear benefit of anticoagulation in patients with atrial fibrillation for the prevention of stroke, treatment rates are disappointingly low in clinical practice in the industrialized countries. This survey demonstrates similar rates in a Brazilian tertiary outpatient clinic, with only 55% of patients at high risk receiving dose-adjusted warfarin. Poor patient education and health care system limitations are considered important barriers. Strategies to improve treatment rates should target specific problems at each location.


A relation among the form factors of $ $ at $q^2 \to 0$ is derived. It is verified to lowest order in both the $1/M_c$ expansion and the expansion in number of derivatives using the effective lagrangian that incorporates the heavy quark symmetries for the b and c quarks, and the chiral symmetry for the u, d, s quarks. % (Contributed note to the Proceedings of the "Workshop on B Physics at Hadron Accelerators", Snowmass, Colorado (USA)).


Achieving food self-sufficiency has always been the primary objective of agricultural policy in India. Driven by rising population, growing economy, increasing urbanization and changing tastes and preferences, the demand for food is continuously growing in the country. This study has attempted to answer questions like will India be able to produce enough to meet its growing food demand or will it open for imports of food commodities over the next two decades (2010-2030)? What would be the likely trends for future demand of various food commodities? Will the supply of key food commodities continue to keep pace with their demand? These are the questions, which need to be answered to evolve appropriate strategy and meet the future demand of food commodities in India. This study is an attempt to project demand for and supply of key food commodities by 2020 and 2030, and assesses their demand-supply gap. Such information will be useful to evolve appropriate medium- and long-term strategies in the food sector.


Drawing on literature from India and key contributions from social science, this paper asks and attempts to answer the question 'who is to blame for treatment failures in TB'? Some key lessons emerge: effective tuberculosis control cannot be achieved so long as the disease is considered in isolation from the social processes that maintain it, create the conditions facilitating its spread and act as barriers to care. Insights into the economic and social burdens incurred with a diagnosis of TB are essential to understand why many patients, especially the most disadvantaged, are unable to comply with treatment regimens. TB and health care interventions need to be appropriate to the health service contexts in which they are applied, and sensitive to the competing demands, needs and priorities of people's lives. The paper argues for the need to reorient TB control programmes towards enabling patients to obtain care. The problem of access emerges as central to people's ability to obtain and maintain appropriate therapy. Examples and characteristics of successful non-governmental projects, from which policy makers, programmers and practitioners could learn, are outlined and contrasted with more rigid directly observed treatment approaches. We conclude that treatment failures are not patient failures, and that TB control programmes need to address the social dimensions of TB, and adhere to the principles of good TB care, with the same commitment that is devoted to ensuring patients follow treatment guidelines. We suggest a paradigm shift away from a focus on diseased patients towards enabling health in the community.


A simple tandem mass spectrometry method for differentiating isomeric monoglycosyl flavonols, flavones, and flavanones using manganese complexation is reported. Dissociation of the [Mn(II) (L) (L - H)]+ and [Mn(II) (L)2 (L - H)]+ species provides unique fragment ions that allow the identification of the saccharide moiety as glucose, galactose, arabinose, or xylose. The glycosylation site of the flavonoid can also be determined by the fragmentation pathways of the Mn complexes. The Mn complexation method was adapted for on-line liquid chromatography-mass spectrometry analysis and tested using flavonoid extracts from Fuji apples (Malus domestica Borkh. cv. Fuji) and red onions (Allium cepa L.). Using fragmentation data obtained from collisional activated dissociation of the deprotonated flavonoid glycosides and their Mn complexes, the major flavonoid species in these extracts were identified.


In modern Western philosophy and aesthetics subjectivity is gradually turning to intersubjectivity. In ancient China philosophy and aesthetics were originally intersubjective. After subjectivity was confirmed in 1980s, Chinese literary theory should turn its attention to intersubjectivity. The intersubjective theory goes beyond the limitation of epistemology. Instead of regarding literary creation as the activities in which subject realizes and conquers object, it considers literary creation as the interaction between different subjects, the dialogue and communication between self-subject and world-subject, the identification of each other between self and others and thus as the free existence style and the experience with meaning of being.


Obesity is characterized by changes in the metabolism of zinc and thyroid hormones. Studies have also shown the role of zinc in the function and metabolism of thyroid. The present study aimed to evaluate the relationship between serum concentrations of thyroid hormones, dietary zinc intake and zinc distribution in obese women. A case-control study was conducted enrolling 98 women aged between 20 and 50 years old who were divided into case group (BMI ≥ 35 kg/m2) and control group (BMI = 18.5-24.9 kg/m2). Patients underwent anthropometric measurements and analysis of dietary zinc intake, which was performed by a three-day food record. Zinc concentrations in plasma and erythrocytes were determined by inductively coupled plasma optical emission spectrometry. Serum concentrations of thyroid hormones and antibodies were determined by chemiluminescence. Mean values of dietary zinc intake were higher than recommended (10.37 ± 3.12 mg/day and 11.37 ± 4.36 mg/day for control and obeses, respectively). Obese women had reduced plasma (67.22 ± 5.96 μg/dL) and erythrocyte (37.16 ± 3.64 μg Zn/gHb) zinc concentrations when compared to the control group (plasma: 89.71 ± 13.33 μg/dL; erythrocyte: 42.68 ± 3.73 μg Zn/gHb) (p < 0.001). Serum TSH (control: 2.62 ± 1.29 μIU/mL; obeses: 3.08 ± 1.13 μIU/mL), Free T3 (control: 2.19 ± 0.63 pg/dL; obeses: 2.09 ± 0.34 pg/dL), and Free T4 (control: 1.12 ± 0.31 ng/dL; obeses: 1.09 ± 0.19 ng/dL) concentrations were within the normal range in both groups, without significant difference between them (p > 0.05). There was no correlation between thyroid hormone concentrations and zinc parameters (p > 0.05). Although obese women presented hypozincemia, they had normal levels of thyroid hormones and no correlation was found between the studied parameters.


BACKGROUND
The pattern of AIDS-defining diseases in adults and adolescents in Spain from 1988-1993 has been described.

METHODS
Twenty-two thousand two hundred thirty-nine cases (CDC, 1987) diagnosed in patients over the age of 12 years from 1988 to 1993 were taken from the National AIDS Registry. The percentage of cases which each of the indicative diseases on registry was evaluated and the differences based on the category of HIV transmission, sex and age were identified.

RESULTS
The most frequent AIDS indicative diseases were extrapulmonary tuberculosis (29.7%), Pneumocystis carinii (28.2%) and invasive candidiasis (24.8%). The percentage of cases with extrapulmonary tuberculosis was higher among the intravenous drug users and Kaposi's sarcoma, non Hodgkin's lymphoma (NHL) and cytomegalovirus disease (CMV) among the homosexual males. The disease pattern has demonstrated some differences between sexes on adjustment by transmission category and age. Herpes simplex disease, retinitis by CMV and cerebral toxoplasmosis appeared were more frequent in women and extrapulmonary tuberculosis and NHL in males. On adjustment by transmission category and sex, extrapulmonary tuberculosis was observed with a higher frequency in patients under the age of 30 years while wasting syndrome and progressive multifocal leukoencephalopathy were more often observed in those over the age of 30 years.

CONCLUSIONS
The category of HIV transmission plays and important role in the pattern of AIDS-defining diseases. Sex and age also play a role although to in a lesser degree.


In the final years before the USSR imploded Mikhail Gorbachev spoke
about a 'coming century of peace', characterised by increased cooperation
amongst great powers, the growing significance of multilateralism
and the increasing illegitimacy of military force. Distinctly different
from the militaristic power politics that characterised the Cold War,
this order would be defined by the global spread of democracy, accord
through institutional cooperation and the declining incidence of war
and conflict. However, since the collapse of the USSR in 1991 and the
subsequent ending of the Cold War, varying degrees of political, economic
and social chaos have plagued the post-Soviet space. In fact,
this space has arguably been defined by the war and conflict that has
taken place there. Whereas the high-profile conflicts that took place in
Rwanda and the former Yugoslavia were identified as being representative
of what post-Cold War conflict would most likely continue to look
like, wars in the former Soviet space, especially those in Chechnya and
Georgia, have also challenged the way we think about war and conflict.
With this in mind, one is therefore moved to ask whether there has been
a change in the nature and character of war. If so, how significant is this
change?

These questions have particular relevance to the former Soviet geopolitical
space. Indeed, the former USSR serves as a microcosm for
the changes that characterise the post-Cold War order: new forms of
religious and ethnic secessionist violence; identity politics; and nontraditional
security threats that the new Russian state has responded
to in an arguably non-traditional manner. The wars in Chechnya serve
as a case in point. Conversely, the 2008 Russo-Georgian conflict bears
many of the hallmarks of so-called traditional warfare. Thus, while
a discussion on the changing nature of conflict and warfare can certainly
be framed in a broader, global context, the geopolitical significance
of the former Soviet space makes a focus on this arena especially
pertinent.


In this paper, we apply locally linear embedding method to large-scale communication network traffic analysis at flow-level. With the method, we can separate normal behavior from abnormal behavior by search k nearest neighbors. Compare with PCA, the method provide a nonlinear dimensionality reduction method for network traffic analysis and display more nonlinear information about data.


Background Multiple sclerosis (MS) is the quintessential neurologic disorder from which one can gain insights into the principles of afferent and efferent neuro-ophthalmology. The popularity of eye movements as an experimental tool can be partly attributed to the fact that they can be conveniently and accurately measured and analyzed, and also because much is known about their neural substrate. It is therefore no surprise that eye movements have been commonly applied to better understand the visual and motor disorders in patients with MS. Objectives The aim of this study was to demonstrate the vast ocular motor abnormalities that occur in this disease using videonystagmography as our tool of description and determine the relationship with Expanded Disability Status Scale (EDSS) and MRI findings. Materials and methods The current study included 76 patients who were divided into two groups. Group I comprised 54 patients with relapsing-remitting multiple sclerosis who fulfilled the Revised Mcdonald′s criteria for diagnosis of MS. The age of the patients in group I ranged from 20 to 68 years, with a mean of 35.13 ± 9.42 SD (23 men and 31 women). Group II comprised 22 healthy age-matched and sex-matched individuals who were recruited from the general population and were not relatives of the patients. Their ages ranged from 19 to 54 years, with a mean of 33.81 years ± 10.07 SD (11 men and 11 women). Video-nystagmography, saccadic tracking, random horizontal saccades, optokinetic tracking (at 20, 40, and 60΀/s), smooth pursuit (0.2, 0.3, 0.4, 0.5, 0.6, and 0.7 Hz), and gaze-evoked nystagmus were examined in both groups. Group I, in addition, was subjected to a thorough neurological history and neurological examination, EDSS assessment, ophthalmologic examination (visual acuity and ocular motility), and radiological assessment by MRI with and without contrast. Results The eye movement disorders most commonly noted are saccadic dysmetria, followed by gaze-evoked nystagmus and pendular nystagmus. They are caused by disease affecting the brain stem and cerebellar circuits. Reduced pursuit gain and saccadic pursuit were also noted. A strong correlation between brainstem and cerebellar MRI lesions and the affection of the ocular motor system was well noted. A high EDSS score was well correlated with abnormal ocular motor test findings. Conclusion Ocular motor system tests are more sensitive than conventional clinical examinations in identifying abnormalities in MS.


The determination of the ratio of live female fetuses compared to the total number of live fetuses present in the uterus. The measurement may be expressed as a fraction or percentage.


Open Education gained more visibility as a result of the emergence of Open Educational Resources (OER) and Massive Open Online Courses (MOOCs). This article discusses whether MOOCs should be considered as OER. Open Education and OER can be treated as two strands with different historical roots even though, in theory, OER are an aspect of Open Education. Different OER definitions and typologies are analyzed in relation to their dimensions and categorizations. Furthermore, the four conditions and two original categories of MOOCs are discussed, leading to a debate on their quality. It turns out that there are two perspectives on MOOCs: from an OER perspective, MOOCs as a product can be called OER. From an Open Education perspective, MOOCs are going beyond OER as enablers of Open Education and are understood as an innovative way of changing education. These perspectives are reflected by the OpenEd Quality Framework. The short answer to our leading question is: sometimes, and it depends on your perspective.


Dendrimers are unique class of polymers which play an important role in emerging nanotechnology. Novel drug delivery is one of the most attractive potential applications of dendrimers. Dendrimers are macromolecules having highly branched, 3D structure, nanoscale architecture with monodispersity and high functionality. Dendrimers are dominated by the functional groups on the molecular surface for example; a dendrimer can be water soluble when its end groups like a carboxylic group. These features make it attractive candidates as drug carrier for controlled release or targeted delivery. Dendrimer is a smart polymer having various applicability in pharmaceutics, industry and diagnosis.


The paper is focused on investigation and comparison of two chemical processes occurring in water solutions treated by DC diaphragm discharge - hydrogen peroxide generation and degradation of organic compounds dissolved in water. Concentration of hydrogen peroxide produced by the discharge depends on the discharge conditions (polarity and magnitude of the applied voltage etc.) and it is determined by photometry using a specic titanium reagent. Organic dyes in solid phase and dissolved in water are chosen as model compounds for the degradation processes. Their concentration is determined by photometry, too.


The aim of the research is to aquire an appropriate plating technique on leather product accessories made from metal without lessening the wonderful appearance of the accessories, to maintain the shade and to keep the rust away from the accessories that avoid or diminish defects on the leather. The plating was carried out by spraying using spraying-gun one, two, and three times, and repeated three times for each treatment to chrome plated metal, gold plated metal and roasted metal. The smaples were then pinned on a piece of chrome tanning leather and vegetable tanned leather, whereas the test carried out was wet and dry rub fastness. Data from completely randomized design are analyzed by factorial pattern according to Gasperz (1991), showed that there was not significant effect on plating neither metal on chrome and vegetable tanned leather having been stored for one, two, or three months, neither on similar things having not been stored yet. However there was significant difference on accessories having been do treated as the stated above and set on a piece of vegetable tanned leather stored for three months. Conclusion could be drawn from the research that the use of acrylate using spray system for plating metal accessories was able to maintain its beautiful appearance, kept the rust away, that was not create defects neither on chrome nor vegetable tanned leather. Keywords : plating, leather product, metal accessories, acrylate.


Cross-coupled planar microwave filters were fabricated using YBa/sub 2/Cu/sub 3/O/sub 7-/spl delta// superconducting thin films deposited on both sides of a LaAlO/sub 3/ single crystal substrate by pulsed laser deposition. The hairpin resonator geometry allows one to miniaturize the 3-GHz filters by compacting the entire filter onto a substrate with dimensions 0.5 cm /spl times/ 1 cm. By adjusting the relative spacing among the resonators to establish adequate couplings, filters with very sharp rejection skirt and extremely small insertion loss in passband were obtained.


Introduction: Imperforate anus (IA) is a congenital abnormality in which the baby cannot excrete feces normally. The infant is born without a normal rectal opening. This disorder is the most common pediatric surgical problem. Since imperforate anus patients are operated in the first few days of infancy, diagnosis of other congenital anomalies is of vital importance. The present study was aimed to determine the prevalence of congenital heart disease in patients with imperforate anus. Methods: This retrospective-descriptive study was held on 97 patients with imperforate anus who were referred to Dr. Sheikh Pediatric hospital for surgery and were undergone echocardiography (2004-2009). Information about congenital heart anomalies and its type, infant's gender, and age of mothers were recorded. Finally, overall prevalence of heart disease risk and affliction to its different types were measured and reported. Data were analyzed by SPSS statistical software version 14. In order to compare mothers' age in cardiac and non-cardiac infants, T-test was used. And chi-square test was performed to compare the infants' gender in two groups. Results: No cardiac dysfunction was observed in 68 infants (70) while 29 (30) of them had congenital heart anomalies. 16 infants (55) were male and 13 infants (45) were female. The highest prevalence rate of congenital heart anomalies was in the Northern Khorasan. The most common congenital heart diseases were respectively: Atrial septal defect (45), ventricular septal defect (27.5), ventricular septal defect with patent ductus arteriosus (10/3), and ventricular septal defect with atrial septal defect (7), and patent ductus arteriosus with atrial septal defect (3.4), patent ductus arteriosus with ventricular septal defect and atrial septal defect (3.4) and tetralogy of fallot (3.4). Conclusion: This study confirms an increased risk of congenital heart disease among infants with imperforate anus.


In 2013, the European Union (EU) initiated negotiations for regional trade agreements (RTAs) with the United States (US) and Japan, key trading partners and two of the largest economies in the world. Both countries have strong offensive interests in audio-visual services, a sector that is a sensitive defensive interest to the EU. In this article, it is argued that, besides the likelihood of it being unacceptable to the US and Japan, the 'cultural exception' for audio-visual services as applied in EU trade policy is ill-fitting for its purposes. First, it is too narrow at a cross-sectoral level and, second, it is too wide at the sectoral level. Therefore, it is claimed that the EU should reassess its negotiation strategy vis-à-vis audio-visual services. For inspiration in doing so, this article analyses four cases in which the US and Japan have negotiated bilaterally on audio-visual services with counterparties with defensive interests somewhat similar to the EU's, i.e., Canada, Korea, Switzerland, and India. It concludes that whilst the Canadian approach, i.e., exclusion, is unlikely to be acceptable to the EU's negotiating partners, the Korean, Swiss and, to a lesser extent Indian, approaches provide ample guidance for the EU to rethink its negotiation strategy for audio-visual services.


IntroductIon Firms and organizations are increasingly exploiting electronic channels to reach their customers and create new business opportunities. To this end, electronic shops have been developed, either offering products from a single firm or encompassing multiple individual electronic stores, comprising thus electronic shopping malls. Besides development activities, electronic shopping has attracted the attention of researchers, who have studied various perspectives, including user attitude, Two main concerns for e-commerce are personalization and enhancement of user experience. Personalization addresses the ability to offer content tailored to the preferences of each user (Anupam, Hull, & Kumar, 2001) or user group (Wang et al., 2003). Preferences may be explicitly declared by the user, or derived by the system through inspecting user interaction; if the system dynamically reacts to changes of visitor behavior, it is termed as adaptive. Personaliza-tion allows customers to focus on the items they are interested in, and enables electronic shops to make targeted suggestions and send promotions to customers (Lekakos & Giaglis, 2005). Enhancement of user experience is another major issue in e-commerce, given that 2D images and texts on the screen are not sufficient to provide information on product aspects such as physical dimensions, textures, and manipulation feedback (Park & Woohun, 2004). Major e-commerce categories that could benefit from giving a more accurate and/or complete view of the products include real estate brokers who could present detailed models of properties, furniture stores that could allow their customers to view how certain pieces would fit in the target place (Hughes, Brusilovsky, & Lewis, 2002), and clothing shops that could provide a virtual fitting room with customizable avatars (Compucloz Corporation , 2003). Multimedia presentations can also be used as a means for " information acceleration " 347 Adaptive Virtual Reality Shopping Malls for promoting " really new " products (Urban et al., 1997). Enhancement of user experience may finally compensate for the loss of the pleasure associated with a visit to a shopping mall (Laskaridis, Vassilakis, Lepouras, & Rouvas, 2001). Nowadays, the technological potential of Internet systems provides adequate means for building online multimedia applications that can help e-commerce sites attract e-shoppers. Applications can be built to adapt to the user's profile and provide the user with a suitable set of information in the most efficient way. Virtual reality (VR) technologies are also now mature enough to be used for the wide public, offering vivid and highly interactive environments, allowing users to …


An accurate and fully automatic method for detecting and quantifying emphysema in CT-images is presented. The method is based on an image preprocessing step followed by a neural network classifier trained to separate true emphysema from artifacts. The proposed approach is shown to be superior to an established method when applied on real patient data.


The current study explores the attitudes and knowledge of Greek health professionals (nurses and doctors) in the management of pain. Quantitative non-experimental methodology was implemented based on McCaffery's questionnaire with regards nurses attitudes of pain management to conduct the study. The study was carried out in Greece at the city of Ioannina in the laboratory of Medical Psychology of the University of Ioannina. The data collection commenced in January 2006 and lasted until July 2006. A total of 422 doctors and nurses all of Greek background constituted the sample. The results of the survey revealed that the Greek health professionals demonstrated insufficient knowledge of pain management, which consequently influenced their attitude of effectively treating pain. Hence, leading to ineffective pain management and consequently indicating the need for continuous professional development and knowledge enhancement of Greek health professionals with regards the management of pain.


Hepatocellular carcinoma (HCCa) is a primary malignancy of the liver. Many different proteins are involved in HCCa including insulin growth factor (IGF) II , signal transducers and activators of transcription (STAT) 3, STAT4, mothers against decapentaplegic homolog 4 (SMAD 4), fragile histidine triad (FHIT) and selective internal radiation therapy (SIRT) etc. The present study is based on the bioinformatics analysis of FHIT protein in order to understand the proteomics aspect and improvement of the diagnosis of the disease based on the protein. Different information related to protein were gathered from different databases, including National Centre for Biotechnology Information (NCBI) Gene, Protein and Online Mendelian Inheritance in Man (OMIM) databases, Uniprot database, String database and Kyoto Encyclopedia of Genes and Genomes (KEGG) database. Moreover, the structure of the protein and evaluation of the quality of the structure were included from Easy modeler programme. Hence, this analysis not only helped to gather information related to the protein at one place, but also analysed the structure and quality of the protein to conclude that the protein has a role in carcinoma.


The aim of this study is to develop a non-invasive method based on quantitative ultrasound image analysis for the evaluation of muscle injury. The method needs to be sufficiently sensitive to detect possible changes in the muscle in order to monitor muscle injury repair and assist in gauging efficacy of treatment modalities. The gastrocnemius muscle was used to develop the method as this muscle constitutes a typical site for muscle injury. A three dimensional ultrasound sweep was performed on the gastrocnemius muscle of 25 healthy subjects and 5 patients with injured muscle using a 3D linear array transducer. Four slices were extracted from the 3D data set from the middle part of the muscle at different sites. Texture parameters include gray level, variance, skewness, kurtosis, co-occurrence matrix; run length matrix, gradient, autoregressive (AR) model and wavelet transform were extracted from the images. The coefficient of variation (CV) and intra-class correlation coefficient (ICC) were calculated for each texture parameter and used to test repeatability and reproducibility. The effect of varying the gain and the dynamic range setting on the texture features were also investigated. Four texture parameters were then used to obtain a reference set for normal gastrocnemius muscle. The four parameters were tested to ensure that there was no effect from the varying depth or size of ROI. These parameters were then tested against abnormal muscle. The texture parameters AR model and gradient were found to be the most sensitive parameters for differentiating healthy muscle from injured muscle and may be used as a tool to monitor the healing process.


A 21-year-old woman who for more than one year had had epigastric pain which was unrelated to food and radiated belt-like, was found to have a marked increase in gamma-GT, slightly elevated phosphatase activity, and increased erythrocyte sedimentation rate. The diagnosis of choledochal cyst, type Ia, was confirmed by sonography, endoscopic retrograde pancreatography and intravenous cholangiography. A choledochocystojejunostomy with a Y-Roux anastomosis was constructed to stop the cholestasis and prevent complications. The patient became symptom-free after the operation.


In this work human action recognition problem was discussed in video sequences. Solution of the problem was studied in three stages. Firstly, points of interest were detected with preproccesing and these points which are called cuboids were declared in small windows, then feature extraction was performed and finally, human action is decided by using classification. Features extraction is not only performed in the spatial domain but also along the cuboid video, that is in the time domain. K-nn(nearest neighbor) algorithm was used as a classifier. Furthermore, algorithm was run on the Weizmann database and results were presented. In addition to the traditional human action studies, different databases were evaluated in this work, preprocessing and feature extraction parameter optimization was also performed. The results show that performance is increased by 6-11%.


Random quantum circuits are commonly viewed as hard to simulate classically. In some regimes this has been formally conjectured, and there had been no evidence against the more general possibility that for circuits with uniformly random gates, approximate simulation of typical instances is almost as hard as exact simulation. We prove that this is not the case by exhibiting a shallow circuit family with uniformly random gates that cannot be efficiently classically simulated near-exactly under standard hardness assumptions, but can be simulated approximately for all but a superpolynomially small fraction of circuit instances in time linear in the number of qubits and gates. We furthermore conjecture that sufficiently shallow random circuits are efficiently simulable more generally. To this end, we propose and analyze two simulation algorithms. Implementing one of our algorithms numerically, we give strong evidence that it is efficient both asymptotically and, in some cases, in practice. To argue analytically for efficiency, we reduce the simulation of 2D shallow random circuits to the simulation of a form of 1D dynamics consisting of alternating rounds of random local unitaries and weak measurements -- a type of process that has generally been observed to undergo a phase transition from an efficient-to-simulate regime to an inefficient-to-simulate regime as measurement strength is varied. Using a mapping from quantum circuits to statistical mechanical models, we give evidence that a similar computational phase transition occurs for our algorithms as parameters of the circuit architecture like the local Hilbert space dimension and circuit depth are varied.


This study investigated the foraging behaviour, diving behaviour, movements and diet of lactating southern sea lions in the Falkland Islands. They appeared to be primarily nocturnal, benthic foragers hunting at depths ranging from the surf line down to 250 m, and from just off their breeding sites out to 45 km offshore. Occasional longer trips may extend foraging ranges to over 150 km from breeding sites. Attendance patterns suggest that Falklands' sea lions do not haulout simply to feed their pups. Other factors such as predation and thermoregulation may cause them to come ashore. When at sea they travelled at approximately 1 m s −1 , slower than previous studies of otariids indicated. Absence from the breeding site did not imply continuous foraging; all study animals used remote haulout sites away from their pups. Repeated use of the same areas and the short duration of foraging trips suggest that they were able to catch enough food within a fairly small foraging range. Data on diet support the suggestion that lactating sea lions are mainly benthic foragers. They take a wide range of prey species. The most common cephalopods were Loligo gahi , similar in size to those taken by the fishery. There is therefore potential for competition between the sea lion population and the Loligo trawl fishery. There was considerable overlap between the diet of sea lions and those of Gentoo and Magellanic penguins, which suggests that sea lions may compete with both species.


We investigate the relation between audit committee (AC, hereafter) quality indices derived from a principal component analysis (PCA) and firm value using a sample of 12,301 firms over the period 2002 to 2012. We also examine the usefulness of the indices in predicting the quality of a firm's internal controls, financial reporting, and audit quality. We report a significant positive (negative) relation between 'high' ('low') AC quality firms and future firm value, measured as industry-adjusted Tobin's q, supporting the view that AC characteristics have a significant impact on firm value. We show that low AC quality firms are significantly more likely to have internal control concerns disclosed by predecessor auditors, including accounting standard issues, financial restatements, audit opinion concerns, and deficiencies that undermine internal control effectiveness. We also show that low AC quality firms are more likely to manage earnings, be external auditor dependent with respect to non-audit tax services, and switch to a lower quality auditor. Further, they are also more likely to receive an audit report containing additional explanatory notes, consistent with a higher likelihood of future financial misstatements. Conversely, high AC quality firms are less likely to have accounting issues, dismiss an auditor after disagreements, have adverse restatements, and receive an audit report containing additional explanatory notes. Taken together, our findings support the view that the AC plays an important role in monitoring the financial reporting process. The results are robust to several econometric concerns primarily related to endogeneity, and to controls that capture broader firm-level governance characteristics, suggesting that AC quality has incremental value in driving better financial reporting, and internal control outcomes and, more importantly, firm value.


OBJECTIVE
To investigate the feasibility of the bipaddled split pectoralis major myocutaneous flap for immediate reconstruction of oral mucosal defects and neck defects after resection of recurrent oral cancer.

METHODS
Six patients with oral mucosal defects combined with neck defects after recurrent oral cancer resection were treated with bipaddled split pectoralis major myocutaneous flap between September 2013 and September 2014. There were 5 males and 1 female with an average age of 54.7 years (range, 45-62 years), including 4 cases of recurrent tongue cancer, 1 case of recurrent mandibular gingival cancer, and 1 case of mouth floor carcinoma. All patients underwent local recurrence at 8 to 14 months after first operation, with no distant metastasis. The defects of the intraoral mucosa was 4.0 cm x 2.5 cm to 6.5 cm x 3.5 cm and the defect of the neck skin was 5.5 cm x 3.5 cm to 7.5 cm x 5.0 cm. The pectoralis major myocutaneous flaps (14.0 cm x 3.5 cm to 17.0 cm x 5.5 cm) were incised at the level of the 3rd to the 4th rib, and then split down along the muscle fiber till about 2 cm away from the thoracoacromial vessels, forming 2 independent skin paddles with 1-2 branch vessels to the pedicles of the distal ones. The distal skin paddles were used for oral reconstruction while the proximal paddles for repair of neck defects. The chest donor sites were sutured directly.

RESULTS
Cervical haematoma and infection happened in 1 patient respectively after operation, and were cured after symptomatic treatment. All 6 split pectoralis major myocutaneous flaps with 12 skin paddles completely survived. All patients were followed up 6 to 18 months (mean, 11 months). One patient died of pulmonary metastasis at 8 months after operation and the other 5 survived without relapse or metastasis during follow-up. The intraoral paddles showed good shape with satisfactory speech function and swallowing recovery. The paddles also healed perfectly on the neck with flat outlooks, and all patients obtained full appearance and free movement of the neck. No fistula formed on the submandibular region and neck.

CONCLUSION
The bipaddled split pectoralis major myocutaneous flap can complete simultaneous immediate reconstruction of oral mucosal defect and neck defect. It is very useful in the treatment of recurrent oral cancer.


Climate change may significantly affect the hydrological cycle and water resource management, especially in arid and semi‐arid regions. In this paper, output from the Providing Regional Climates for Impacts Studies (PRECIS) regional climate model were used in conjunction with the Soil and Water Assessment Tool (SWAT) to analyse the effects of climate change on streamflow of the Xiying and Zamu rivers in the Shiyang River basin, an important arid region in northwest China. After SWAT model calibration and validation, streamflow in the Shiyang River Basin was simulated using the PRECIS climate model data for greenhouse gas emission scenarios A2 (high emission rate) and B2 (low emission rate) developed by Intergovernmental Panel on Climate Change. Monthly streamflow and hydrological extremes were compared for present‐day years (1961–1990), the 2020s (2011–2040), 2050s (2041–2070) and 2080s (2071–2100). The results show that mean monthly streamflow in Shiyang River Basin generally increased in the 2020s, 2050s and 2080s between 0.7–6.1% at the Zamu gauging station and 0.1–4.8% at the Xiying gauging station. The monthly minimum streamflow increased persistently, but the maximum monthly streamflows increased in the 2020s and slightly decreased in the 2050s and 2080s. This study provides valuable information for guiding future water resource management in the Shiyang River Basin and other arid and semi‐arid regions in China. Copyright © 2011 John Wiley & Sons, Ltd.


We have fabricated a Josephson junction, with an approximately symmetrical gap structure which consists of a Ta/W counter electrode, a Ta/Nb base electrode and an AlOx -Al barrier for operation as a superconducting X-ray detector at 0.3 K. A Ta layer is selected due to its long lifetime of quasiparticles and high X-ray absorption efficiency. The W layer is selected as a buffer layer for a body centered cubic Ta counter electrode, and the Nb layer is chosen for a body centered cubic Ta base electrode The Al layer acts as an overlayer for fabricating the AlOx barrier. A fabricated junction shows a gap voltage of 1.3 mV, a sharp transition width of less than 50 µ V, and a small subgap leakage current of 1.5 µ A.


In the evolutionary battle between viruses and their hosts, viruses have armed themselves with weapons to defeat the host's attacks on infected cells. Various proteins encoded in the adenovirus (Ad) E3 transcription unit protect cells from killing mediated by cytotoxic T cells and death-inducing cytokines such as tumor necrosis factor (TNF), Fas ligand, and TNF-related apoptosis-inducing ligand (TRAIL). The viral protein E3-gp19 K blocks MHC class-I–restricted antigen presentation, which diminishes killing by cytotoxic T cells. The receptor internalization and degradation (RID) complex (formerly E3-10.4 K/14.5 K) stimulates the clearance from the cell surface and subsequent degradation of the receptors for Fas ligand and TRAIL, thereby preventing the action of these important immune mediators. RID also downmodulates the epidermal growth factor receptor (EGFR), although what role, if any, this function has in immune regulation is uncertain. In addition, RID antagonizes TNF-mediated apoptosis and inflammation through a mechanism that does not primarily involve receptor downregulation. E3-6.7 K functions together with RID in downregulating some TRAIL receptors and may block apoptosis independently of other E3 proteins. Furthermore, E3-14.7 K functions as a general inhibitor of TNF-mediated apoptosis and blocks TRAIL-induced apoptosis. Finally, after expending great effort to maintain cell viability during the early part of the virus replication cycle, Ads lyse the cell to allow efficient virus release and dissemination. To perform this task subgroup C Ads synthesize a protein late in infection named ADP (formerly E3-11.6 K) that is required for efficient virus release. This review focuses on recent experiments aimed at discovering the mechanism of action of these critically important viral proteins.


Summary
Twenty-six cities, towns and villages located in various parts of the northern half of Venezuela were visited and inspections made to determine the extent to which the breeding of the yellow fever mosquito, Aedes aegypti, was occurring. Observations were also made at each place on the system of water supply and on other conditions having potential influence on the breeding and distribution of this species. In practically all the places visited, the system of water supply was found to be of such a nature as to necessitate the use of numerous containers for water storage in the houses, thus providing conditions favorable for breeding of domestic mosquitoes in the habitations. Fifteen of the cities and towns had a piped water supply—at least the better class houses had this convenience—but in only one town, San Cristobal, was the supply sufficient to provide running water in the houses at all hours of the day and night. The other 11 towns and villages depended for their supply on stored rain water, wells, and nearby rivers. In 14 of the places visited, water was observed being sold in the streets by venders.
In the 26 places visited, more than 3506 houses were inspected and 10,229 water containers were examined. No Aedes aegypti breeding was found in 3 of the towns, Calabozo, Ortiz and San Cristobal. The other 23 places were all positive. In these 23 positive towns the house visits totaled 3255 and breeding was found in 1550, giving an average house percentage of 47.61.
The water containers examined in the 23 towns numbered 9616 and consisted of the following vessels: 2725 tinajas, 2053 ollas, 1822 barrels, 1083 pilas, 824 filter stones, 288 tanks, 23 ornamental fountains, and 798 miscellaneous containers. Of these vessels, mosquito breeding was found in 2752, or 28.61 per cent. The positive containers included 1020 tinajas, 990 barrels, 278 ollas, 232 pilas, 95 filter stones, 70 tanks, 5 ornamental fountains, and 62 miscellaneous vessels.


In Mali, despite the existence of a national vaccination policy, coverage of neonatal tetanus remains low. According to the Demographic and Health Survey (DHS) IV Mali, the rate of births protected against neonatal tetanus is 56%.
The objective of this study was to investigate the status of tetanus toxoid (TT) in women of reproductive age (WRA) in the municipality V of Bamako District.
The study was conducted in Mali in the municipality V of the Bamako District. This was a cross-sectional study conducted from July to October 2006. The target population was composed of women of reproductive age and health care providers. A total of 262 people, including 200 women of childbearing age and 62 health care providers were interviewed.
The age group 14-23 years accounted for 39% of WRA. Among the WRA, 27.4% did not know that tetanus vaccination is to prevent maternal and neonatal tetanus. Most of WRA, or 61.8%, thought that a single dose of TT was enough to be protected. Among WRA surveyed, 76.2% were vaccinated where 66.7% had received between 2 and 10 doses of TT. Women who received no dose of TT were nulliparous and primiparous. The main reasons given by women who had not received vaccination were lack of knowledge (47.6%), lack of time (14.3%) and neglect (23.8%). The health personnel interviewed spoke of running out of TT stocks less than a week after receiving new orders, in 7/11 health centers. Strengthening Behaviour Change Communication (BCC) for tetanus vaccination and immunization schedule compliance will increase tetanus vaccination coverage. To avoid stockouts, we recommend a regular and sufficient reorder of TT in health centers.


We herein report a 73-year-old Japanese woman with metastatic thymic carcinoma who developed diffuse alveolar hemorrhage (DAH) during irinotecan chemotherapy. She presented with a mild fever and exertional dyspnea after the second cycle of weekly irinotecan monotherapy. Chest images showed diffuse ground-glass opacities. The diagnosis of DAH was based on the findings of the bronchoalveolar lavage fluid, which was bloody and contained hemosiderin-laden macrophages. The discontinuation of irinotecan and introduction of oral prednisolone improved her symptoms and chest abnormal shadows. This is the first case of DAH caused by irinotecan.


This paper promotes the use of some little-used but most valuable theorems that are available to students in introductory network analysis: the voltage and current shifting theorems; the voltage and current source theorems; the reduction theorem; and the substitution theorem. Examples illustrate how these theorems can be used to solve for one or more variables in the many networks that contain dependent as well as independent sources. Network simplification techniques are maximized and the use of equations is minimized. A more extensive use of the duality concept is also recommended.


As a country that will experience shortages of fossil fuels in the not too distant future, India will need to develop renewables, mainly solar and nuclear power. In the coming decades, however, coal will remain the major source of power. Reducing energy requirements by pushing demand side management is a high-priority option for India. From the viewpoints of both climate change and energy security, these are India's imperatives.


Accessibility is an important factor of competitiveness among particular cities and regions and, consequently, improved transportation infrastructure can bring important impulses for regional development. Therefore, construction of new motorways, highways and speed railways is believed to help significantly in economic revitalisation of problem regions. The presented model shows the current as well as future time accessibility of centres of regions as well as of local labour systems.


Warfarin remains widely used by patients with cardiovascular diseases[.Due to high interindividual variability, the anticoagulant activity of warfarin has to be monitored using the international normalized ratio (INR).The most widely recommended approach for evaluating the quality and safety of anticoagulation is to estimate the percentage of time in therapeutic range (TTR). It was a single center, cross-sectional observational study that was conducted at cardiology department at Benha University Hospital. This study was designed to: Study the INR values in patients on VKAs in the selected area., Calculation of the time in the therapeutic range (TTR) when is possible according to the number of INR/Patient., Find out which patient characteristics that are associated with good INR control. Patients were subdivided into two sub groups; sub group I : patients with TTR ≥ 65% , sub group II : patients with TTR < 65% .The study was designed to screen not less than 2000 INR laboratory tests from these patients. Mean TTR was 60.27%+_24.48% for the Rosendaal method. After multivariate adjustment,variables associated with good anticoagulation control were university studies (OR: 1.99, 95% CI: 1.08-3.64), chronic hepatic disease (OR: 8.15, 95% CI: 1.57-42.24), low comorbidity expressed as Charlson index(OR: 0.87, 95% CI: 0.76-0.99) , no previous cardiac disease (OR: 0.64, 95% CI: 0.41-0.98), lower risk of bleeding assessed as hypertension, abnormal enal/liver function, stroke, bleeding history or predisposition, rlabile international normalized ratio, elderly age, and use of drugs or alcohol { HAS-BLED} (OR: 0.81, 95% CI: 0.69-0.95), and lower heart rate OR: 0.99, 95% CI: 0.98-0.99). Our study shows a rate of inadequate control with AVKs of 54%, and 46% of the patients spent more than half the time outside the therapeutic range. .In our study, having a university degree was associated with adequate anticoagulation control.We believe that higher education helps patients to understand the importance of anticoagulant treatment adherence.


The daylighting control system has to be applied to prevent the excessive incident daylight and reduce energy use. As the one of the most useful daylighting control systems, the blind system is simple and easy to install on the window for small office buildings. This study aims to evaluate the summer energy performance of small office buildings by venetian blinds and energy saving strategy of ministry of knowledge economy in korea. For the study, the simulations have been executed on blind installation conditions and lighting control methods. As results, the energy loads cut down 22 to 25(%) by using blind energy. Also, the efficient shows high on EMS system and low on 45° slat angles. Also, using energy saving strategy can reduce about 13(%) energy load.


Changing climate can impact erosion directly by increasing or decreasing the rainfall depth and intensity and indirectly by influencing the vegetative cover on landscapes. Stochastic climate models are increasingly being used to allow the assessment of erosion to be done using ensemble statistics. Precipitation is mostly widely represented by first determining the state of the day is wet or dry using discrete transitional probabilities and then, for a wet day, determining the precipitation depth. The parameters for stochastic models are based on the statistical analysis of observed data for the current conditions. Simple methods to modify these stochastic parameters under different climate scenarios are desired to easily simulate their impact on erosion. Modifying parameters for precipitation depth needs to be considered carefully because changes in depth can be achieved by varying the statistics of daily precipitation, by changing the number of wet days, or by a combination of these statistics. A framework for modifying the precipitation depth for new climate conditions is developed in the study. In addition to the stochastic climate parameters related to the moments of probability density functions and transitional probabilities under the current conditions, the proposed framework requires the user to specify the fractional changes in the total precipitation depth and the mean daily precipitation depth. Relationships are developed to determine indirectly the proper number of wet days from transitional probabilities for a first-order Markov chain. These relationships are dependent on a user-specified parameter of the ratio of the mean number of wet-wet day sequences of the current and new climate conditions. The sequence of wet-wet days is important in modeling soil erosion. The framework is applied to 80 years of precipitation data for Stillwater, OK. The implications of assuming no change in the wet-wet-day ratio with new climate conditions is compared to the results obtained assuming a ratio equal to the fractional change in the mean number of wet days. If the new climate condition corresponds to an increase in the number of wet days, the assumption of an unchanged ration corresponds to new storm patterns that develop more often on dry days and dissipate more rapidly on wet days. The opposite trend occurs if the new climate condition corresponds to a decrease in the number of dry day. Under this scenario, storm patterns tend to dissipate more slowly resulting, on average, in more frequent consecutive days with precipitation. A wet-wet day ratio equal to the fractional change in the mean number of wet days corresponds to no change between the current and new climate conditions of the transitional probability of wet-given- wet-day. This result suggests that the persistence of storm systems do not change under the new climate conditions. The proposed framework is useful and easy to implement in stochastic climate models.


Web caching technology has been widely used to improve the performance of the Web infrastructure and reduce user-perceived network latencies. Proxy caching is a major Web caching technique that attempts to serve user Web requests from one or a network of proxies located between the end user and Web servers hosting the original copies of the requested objects. This paper surveys the main technical aspects of proxy caching and discusses recent developments in proxy caching research including caching the "uncacheable" and multimedia streaming objects, and various adaptive and integrated caching approaches.


We recently reported three periods when single-pulse transcranial magnetic stimulation (TMS) of the occipital pole impaired performance on a forced-choice visual letter-identification task. TMS-induced suppression during these periods is best explained by a blink-associated covering of the pupils and by a direct interference with letter-processing neural activity. We now report TMS-induced suppression at times that seem too late for the suppression to be explained by the first mechanism and too early for the suppression to be explained by the second mechanism. The most likely explanation is a blink-associated interference with letter-processing neural activity.


Abstract Background Effective antiretroviral therapy has increased survival in persons with HIV (PWH). Over 45% of PWH are now over 50 years old, and comorbidities of aging are becoming more prevalent. The objective of this study was to evaluate hospitalization rates and causes for hospitalization among PWH in longitudinal HIV care by age. Methods Hospitalization rates and diagnoses were determined in PWH receiving longitudinal care at 13 sites in the HIV Research Network between 2014 and 2015. Using AHRQ Clinical Classification Software, we divided inpatient ICD9 discharge diagnoses into diagnostic categories. Multivariate negative binomial regression was performed to assess for factors associated with overall hospitalization and for each diagnostic category. Results The sample included 20,608 patients, 73% male, 46% black, 21% Hispanic, 47% MSM, and 12% IDU. Median age was 48 yo [range 18–89] of which 32% were 50–59 yo, 12% were ≥ 60 yo. 75% had CD4 ≥ 350, 81% had HIV-1 RNA < 50 copies. 20% had private insurance, 36% Medicaid, 10% Medicare, and 5% were uninsured. All cause hospitalization rate for 2014–2015 was 201/1000 person-years (PY). Non-AIDS defining infection (non-ADI) was the leading cause for admission (47/1,000 PY), followed by cardiovascular disease (CVD) (22/1,000 PY), psychiatric (14/1,000 PY), endocrine (14/1,000 PY) and ADI (13/1,000 PY). In multivariate analysis, the incidence rate ratio (IRR) for all-cause hospitalization increased by age group (18–29 yo reference): 30–39 yo IRR 1.05 (95% CI 0.88, 1.26), 40–49 yo IRR 1.28 (1.08, 1.51), 50–59 yo IRR 1.43 (1.22, 1.69), and 60 yo or greater IRR 1.97 (1.64, 2.37). Hospitalization rates increased significantly by age group for CV, GU, pulmonary, endocrine, and oncology diagnostic categories. Rates did not differ by age for non-ADI infection, GI and mental health diagnostic categories. Conclusion The hospitalization rates for noncommunicable diseases (NCDs) increase as PWH age. There is an increase CV hospitalizations among older PWH. ADI accounted for fewer hospitalizations than many chronic diseases. Our results suggest that HIV experts, primary care providers and other specialists may need to work together to optimize the care of older PWH. Disclosures A. E. Nijhawan, Gilead: Consultant, Research support.


The metabolic syndrome, a cluster of metabolic disorders often associated with visceral obesity, increases cardiovascular mortality and morbidity. As the body's largest endocrine organ, adipose tissue not only stores excess body energy, but also secretes a variety of bioactive adipocytokines. Obese patients, particularly those with visceral fat accumulation, have reduced plasma levels of adiponectin, the most abundant and adipose-specific adipocytokine. Although the association of adiponectin with several diseases remains controversial, many clinical studies have demonstrated that low plasma concentrations of adiponectin (hypoadiponectinaemia) associate closely with obesity-related diseases, including atherosclerotic cardiovascular diseases, Type II diabetes mellitus, hypertension and dyslipidaemia. Accumulating experimental evidence indicates that adiponectin possesses anti-atherogenic, anti-inflammatory and anti-diabetic properties and may also participate importantly in the mechanism of metabolic syndrome and other diseases. Despite these associations, further clinical and experimental investigations will be needed to illuminate the in vivo pathophysiological significance of this protein. Although evaluation of adiponectin as a novel therapy will ultimately require clinical intervention studies, this mediator may represent a novel target for the prevention and treatment of visceral obesity metabolic syndrome.


The objective of this work is the mathematical modelling and the numerical simulation of the stationary, laminar, and natural convection, in a confined square cavity (H = L) filled with two fluids (a mixture of nanoparticles of aluminum oxide and Al2O3 water) in one partition and pure water in the other partition. A porous conductive wall of thickness w (w = L/e) and thermal conductivity Keff constitutes the exchange surface between these two partitions. The fluid movement is modeled by the Navier-Stokes equations in the two partitions, while the porous medium is modelled by the Darcy–Brinkman equation. Comsol Multiphysics software is used to solve the system of differential equations that is based on the finite element method. The results are discussed with particular attention to the mean and local Nusselt number (Nu), streamlines and isotherms. A parametric study for Rayleigh number Ra (102 to 106), volume fraction j (0% to 10%), and Darcy number Da (10-7 to 10-2) is performed. The obtained findings show that the increase in Ra, Da, and j intensifies the flow and improves the thermal exchange on the cold wall. For Da £ 10-5, Nu remains practically low and the natural convection is being dominated by conduction. For Da > 10-5, an increase in Nu is observed and the flows tend towards a purely convective situation. Furthermore, an increase in the heat transfer coefficients is observed with the raise of the porous layer permeability, volume fraction and Rayleigh number.


Optical Coherence Tomography (OCT) is an in vivo imaging technique which is able to perform tomographic or crosssectional images of biological tissues. It's main field of application lies in ophthalmology for acquiring 3D volumes of the retina. Thereby unique information about macular diseases such as diabetic retinopathy, or age related macular degeneration can be obtained. However, image contrast may be rather poor in conventional OCT imaging which can be overcome using polarization sensitive OCT (PS-OCT). Another limitation of state of the art is the limited transverse resolution of OCT instruments. The resolution can be improved using adaptive optics. In this thesis an existing adaptive optics-scanning laser ophthalmoscope (AO-SLO) in combination with a time domain OCT (TD-OCT) was upgraded by an additional polarization sensitive channel in order to provide PS-OCT images with cellular resolution. PS-OCT improves the image contrast. Thereby additional information of the retina can be gathered, because several retinal structures (e.g. retinal pigment epithelium) change the polarization state of the light which can be detected using PS-OCT. Furthermore a dynamic focus scheme for achieving isotropic resolution through the whole volume OCT scan was calibrated. To improve the signal-to-noise ratio, the system was partially further developed. The new instrument was tested on technical samples as well as for in vivo retinal imaging. Representative images recorded in healthy volunteers are presented.