Active cathode material and graphite anode material are routinely mixed with conductor and binder to improve the electrical conductivity and mechanical stability of electrodes. Despite its benefits, this carbon binder domain (CBD) impedes ionic transport and reduces the active surface area, thus impacting the battery performance. We consider a composite spherical particle, whose active-material core is coated with CBD, and its homogeneous counterpart, for which we derived equivalent electrical conductivity, ionic diffusivity, and reaction parameters in the Butler-Volmer equation. These equivalent characteristics are defined to ensure that the same mass and charge enter the composite and homogenized spheres. They are expressed in terms of the volume fraction of the active material and transport properties of the active material and CBD. In general, the equivalent effective diffusion coefficient and reaction parameters are time-dependent and exhibit two-stage behavior characterized by the reaction delay time. At later times, these characteristics are time-independent and given explicitly by closed-form formulae. The simplicity of these expressions facilitates their use in single- and multi-particle representations of Li-ion and Li-metal batteries.


Oxygen uptake (VO2) kinetics provide information about the ability to respond to the increased physical load during a constant work rate test (CWRT). Box-Jenkins transfer function (BJ-TF) models can extract kinetic features from the phase II VO2 response during a CWRT, without being affected by unwanted noise contributions (e.g., phase I contribution or measurement noise). CWRT data of 18 COPD patients were used to compare model fits and kinetic feature values between BJ-TF models and three typically applied exponential modelling methods. Autocorrelation tests and normalised root-mean-squared error values (BJ-TF: 2.8 ± 1.3%; exponential methods A, B and C: 10.5 ± 5.8%, 11.3 ± 5.2% and 12.1 ± 7.0%; p < 0.05) showed that BJ-TF models, in contrast to exponential models, could account for the most important noise contributions. This led to more reliable kinetic feature values compared to methods A and B (e.g., mean response time (MRT), BJ-TF: 74 ± 20 s; methods A-B: 100 ± 56 s–88 ± 52 s; p < 0.05). Only exponential modelling method C provided kinetic feature values comparable to BJ-TF features values (e.g., MRT: 75 ± 20 s). Based on theoretical considerations, we recommend using BJ-TF models, rather than exponential models, for reliable determinations of VO2 kinetics.


We propose a consistent and locally efficient method of estimating the model parameters of a logistic mixed effect model with random slopes. Our approach relaxes two typical assumptions: the random effects being normally distributed, and the covariates and random effects being independent of each other. Adhering to these assumptions is particularly difficult in health studies where, in many cases, we have limited resources to design experiments and gather data in long‐term studies, while new findings from other fields might emerge, suggesting the violation of such assumptions. So it is crucial to have an estimator that is robust to such violations; then we could make better use of current data harvested using various valuable resources. Our method generalizes the framework presented in Garcia & Ma (2016) which also deals with a logistic mixed effect model but only considers a random intercept. A simulation study reveals that our proposed estimator remains consistent even when the independence and normality assumptions are violated. This contrasts favourably with the traditional maximum likelihood estimator which is likely to be inconsistent when there is dependence between the covariates and random effects. Application of this work to a study of Huntington's disease reveals that disease diagnosis can be enhanced using assessments of cognitive performance. The Canadian Journal of Statistics 47: 140–156; 2019 © 2019 Statistical Society of Canada


Hydrogen sulfide (H2S) is previously described as a potentially lethal toxic gas. However, this gasotransmitter is also endogenously generated by the actions of cystathionine-β-synthase (CBS), cystathionine-γ-lyase (CSE) and 3-mercaptopyruvate sulfurtransferase (3-MST) in mammalian systems, thus belonging to the family of gasotransmitters after nitric oxide (NO) and carbon monoxide (CO). The physiological or pathological significance of H2S has been extensively expanded for decades. Growing evidence has revealed that H2S exerts cytoprotective functions in the cardiovascular, nervous and gastrointestinal systems by modulating numerous signaling pathways. With the continuous advancement of microarray and next-generation sequencing technologies, noncoding RNAs (ncRNAs) have gained recognition as key players in human health and diseases due to their considerable potential as predictive biomarkers and therapeutic targets. Coincidentally, H2S and ncRNAs are not independent regulators but interact with each other during the development and progression of human diseases. Specifically, ncRNAs might serve as downstream mediators of H2S or act on H2S-generating enzymes to govern endogenous H2S production. The purpose of this review is to summarize interactive regulatory roles of H2S and ncRNAs in the initiation and development of various diseases, and explore their potential health and therapeutic benefits. This review will also highlight the importance of crosstalk between H2S and ncRNAs in disease therapy.


ABSTRACT The "Improving Prosecution" Working Group developed two of the top ten recommendations approved by the experts at The National Policy Summit on Elder Abuse. These recommendations were: (1) improving the legal landscape by strengthening elder abuse laws and (2) increasing awareness within the justice system. At the Summit, the working group members focused on the historical response of criminal justice and allied first responders to elder abuse. While acknowledging the many accomplishments that preceded the Summit, working group members recognized that the response had been inconsistent, sporadic, and limited. Significant barriers (the lack of training, resources, forensic expertise, and awareness of promising practices) hindered development of effective responses. The working group members recommended new directions and approaches. This article traces the historical criminal justice response to elder abuse and describes the recommendations of the working group, before discussing some of the perti...


Radix Pseudostellariae is used as a tonic drug in traditional Chinese medicine with immunomodulating and anti-fatigue activities, and the polysaccharide is considered as the main active component. The purpose of this study is to examine the effect of the polysaccharide isolated from Radix Pseudostellariae (PRP) on mouse chronic fatigue syndrome (CFS) induced by intraperitoneal injection of polyriboinosinic:polyribocytidylic acid (poly I:C), a double-stranded synthetic RNA. It has shown that the fatigue symptom of mice lasted at least 1 week as evaluated by forced swimming time. PRP (100, 200, 400 mg kg−1), orally administered 3 days before poly I:C injection, showed dose-dependent anti-fatigue effects. In addition, poly I:C led to evident alternations in neuroendocrine and immune systems of mice, such as reduced spontaneous activity and learning ability, declined serum level of corticosterone, increased weight indexes and T lymphocyte numbers in thymuses and spleens, and increased CD4+/CD8+ ratio but decreased proliferation ability of T lymphocytes in spleens. PRP alleviated the abnormalities caused by poly I:C, and restored the function of hosts to normal conditions. The findings suggest that PRP is beneficial to CFS, and the underlying mechanisms of action involve neuroendocrine and immune systems.


Antimicrobial peptides (AMP) produced throughout our body are important effectors in the defense barrier of innate immunity. Here, we have analyzed antimicrobial activity and polypeptide composition of meconium versus neonatal feces to address the development of antimicrobial defense of the neonatal gut. Extracts of meconium exhibited antimicrobial activity against Bacillus megaterium, Escherichia coli, and group B streptococci (GBS) but not against the yeast Candida albicans. Extracts of neonatal feces were found to possess low activity against E. coli, GBS, and C. albicans. However, the anti-B. megaterium activity was higher in the fecal extracts than in meconium. All activities were reduced or abolished when salt was added to the antimicrobial assay. The AMP cathelicidin LL-37, α-defensin HNP-1-2, α-defensin HD 5, and lysozyme were identified in both meconium and fecal extracts. In addition, HNP-3 and a fragment of azurocidin were found in meconium, whereas the holoprotein azurocidin was detected in feces. In meconium, histones H2A and H4 were isolated and identified by their antimicrobial activity. Notably, LL-37 and lysozyme were found at significantly higher levels in feces than in meconium. Our findings reveal that meconium and feces contain AMP, acting in the defense of the neonatal gut, and may be implicated in the control of the initial colonization.


The aim of the paper is to discuss once more the controversial ending of Huckleberry Finn from the perspective afforded by comparative literature and myth criticism. Huck Finn has been related to the myth of the American Adam, but also to the picaresque hero and to the quixotic figure. The paper claims that the myth of the American Adam as formulated in Huckleberry Finn results from a creative and ironic crossing of the picaresque and quixotic myths. Huck's Adamic nature is defined by a blending of both picaresque and quixotic qualities and in relation to picaros and Quixotes presented by Twain in the novel. The ending plays a very important part in establishing Huck's compound mythic identity.


(57) ABSTRACT To generate dynamic relationship-based content personalized for members of a Social networking system, at least one action of one or more members of the Social networking system is associated with relationship data for the one or more mem bers to produce consolidated data. One or more elements associated with the consolidated data is identified and used to aggregate the consolidated data. Further exemplary methods comprise weighting by affinity the aggregated consolidated data to generate dynamic relationship-based content person alized for the members of the web-based social network.


In some gas turbine aeroengines, the HP compressor is driven by the H.P. turbine through a conical shaft or drive cone. This drive cone is enclosed by a stationary surface that forms the supporting material for the combustion chambers. Air used to cool the turbine blades is directed into the space around the drive cone, and a major concern to an engine designer is the temperature rise in this air due to frictional dissipation and heat transfer. This paper presents results from a combined experimental and CFD investigation into the flow within an engine representative HP compressor drive cone cavity. The experimental results show similarities in flow structure to that found in classic rotor-stator systems. Both 2-D and 3-D CFD simulations were carried out using the FLUENT/UNS code. The 3-D model which included the actual compressor blade tip clearance gave the best agreement with the experimental data. However, the computational resource required to run the 3-D model limits its practical use. The 2-D CFD model, however, was found to give good agreement with experiment, providing care was exercised in selecting an appropriate value of initial tangential velocity.


HgCl2 is known to be a renal toxin, but its mechanisms of toxicity are not well understood. The cell line LLC-PK1 was used as a model for renal proximal tubule cells, and the effects of different concentrations of HgCl2 were studied. Apoptosis in response to 35 microM HgCl2 was confirmed by observation of morphological features characteristic of apoptotic cells as well as cleavage of chromosomal DNA into fragments of multiples of 200 base pairs. Ten percent of LLC-PK1 cells in a monolayer underwent apoptosis. These cells detached from the culture flask before apoptosis. Measurement of transepithelial resistance (TER) was used as a functional assay of junctional complex integrity in a novel approach to characterize preapoptotic events in this cell line. Monolayers of LLC-PK1 cells that contained apoptotic cells showed a transient decrease in TER followed by a recovery of TER to the initial levels. The decrease in TER was accompanied by a loss of hemicysts within the monolayer. These data indicate a temporary loss of junctional complexes within the monolayer during apoptosis. One hundred micromolar HgCl2 caused all cells to become necrotic within 3 hr. HgCl2 (10 microM) caused some changes in cell morphology, but no cell death.


For the past 12 years peripheral iridectomy has been used as the initial surgical procedure after an acute attack of angle-closure glaucoma. The operation has been performed 2 to 5 days after the pressure has been controlled medically and has been followed routinely by prophylactic peripheral iridectomy in the fellow eye. Peripheral iridectomy for primary acute angle-closure glaucoma controlled the condition without any need for further medical or surgical therapy in 72% of cases. Careful and frequent follow-up within the first 4 postoperative months is essential to prevent further field loss, which can occur very rapidly if the pressure is not adequately controlled. If the pressure remains uncontrolled, further surgery should not be delayed. It was impossible to decide which patients would eventually need trabeculectomy when they first attended in the acute attack. Peripheral iridectomy as a prophylactic procedure was entirely effective in preventing an acute angle-closure attack in the fellow eye.


Background: Upper extremity replantation is a procedure that has revolutionized hand surgery. Since its introduction, a rapid evolution has occurred with a shifting focus from implant survival to optimization of functional outcomes and surgical efficiency. In this review, the current concepts surrounding the indications for replantation, variations in surgical technique, the factors affecting outcomes, and future directions of the specialty are analyzed. Methods: A literature review was performed of all recent articles pertaining to digit, hand, and upper extremity replantation surgery. Particular emphasis was placed on comparative studies and recent meta-analyses. Results: The indications and contraindications for replantation surgery are largely unchanged, with mechanism of injury remaining one of the most important determinants of implant survival. With advances in surgical technique, improved outcomes have been observed with avulsion injuries. Distal tip replantations appear to be more common with improved microsurgical techniques, and for these distal injuries, digital nerve and vein repair may not be necessary. Cold ischemia time for a digit amputation should not preclude transfer to a replantation facility or significantly affect the decision to perform a replantation. However, transferring physicians should thoroughly review the options with patients to prevent unnecessary transfers, which is an area where telemedicine may be useful. Conclusion: This review provides an update on the current concepts of the practice of replantation and the treatment and management of patients with upper extremity amputations.


Nine pigeons were trained to discriminate a moving stimulus from a stationary stimulus. In one experiment, the stimulus was a rotating disc with radial stripes. In a second experiment, the stimulus was a vertically moving film strip with horizontal bars. Several psychophysical procedures were used to determine the minimal detectable velocity of movement. The detection thresholds for most of the pigeons fell in the range of 4.4 to 6.5 millimeters per second, corresponding to a retinal velocity of 4.1 to 6.01 degrees per second. A signal detection analysis of the psychophysical data indicated systematic changes in response bias that were related to the ordinal position of the stimulus velocity in the sequence.


The three-dimensional solution structure of the MTX2 toxin (65 amino acids and 4 disulfides) from the green mamba venom (Dendroaspis angusticeps), a toxin that activates the pharmacological M1 muscarinic acetylcholine receptors, has been determined by nuclear magnetic resonance and molecular modeling. Seventeen structures were calculated from 810 distance and 68 dihedral angle restraints using DIANA and X-PLOR. The average rms deviation between the 17 refined structures and the energy-minimized average structure is 0.95 A for the backbone atoms. The overall folding of MTX2 consists of three loops stabilized by the four disulfides and forming a two- and a three-stranded beta-sheet. This structure appears to be very similar to that of other snake toxins, such as neurotoxins, fasciculins, and cardiotoxins, that also possess the same three-finger fold. For instance, the RMSd for the backbone atoms between MTX2 and the curaremimetic toxin alpha (from Naja nigricollis), the acetylcholinesterase inhibitor fasciculin 1 (from Dendroaspis angusticeps), and the cardiotoxic toxin gamma (from Naja nigricollis) are 1.86, 1.87, and 2.04 A, respectively. Local differences are observed between this toxin and the other structurally related toxins. Some of these differences could be relevant for the functional specificity of MTX2. In particular, this toxin presents a large twist at the tip of loop II due to a bulge (V31, T32; N35) that accommodates an inserted amino acid in the loop. This spatial arrangement brings the side chain of K34 in the beta-turn of the loop to be aligned with the beta-sheet. Hypotheses about a possible functional role of this lysine are described. Other characteristics in the side-chain distribution that could be related to the MTX2 function are presented.


The University of Wisconsin (UW) Melt Profiler was operated under convection and conduction heating modes for evaluating the melt/flow properties of cheese. Five processed cheeses, each with a different solid fat index (SFI = 1+, 5−, 5+, 6− and 8+), were tested. In general, the higher the SFI of the cheese, the lower the time and temperature at the softening point. Similar trends were also observed between the cheese SFI values and the time and temperature at the rapid flow point. As conduction heating is more effective than convection heating, the heating method affected the cheese melt/flow parameters remarkably. Furthermore, TSP and TRF tended to be higher when the cheeses were tested at higher temperatures.


I reviewed the literature on epidemiology of Stroke in Blacks in Africa. Stroke, said to be rare in Black Africans some four decades ago, has become increasingly common now accounting for 4% to 9% of deaths and 6.5% to 41% of neurological admissions in hospital populations. In community-based studies, it is the third or fourth commonest non-infective neurological disease, after headache, epilepsy and diseases of peripheral nerves. In both hospitals and communities, males are more afflicted than females. The age specific incidence rates are similar to those found in Caucasians and Japanese. Occlusive stroke is the commonest type accounting for about 60%, followed by cerebral haemorrhage (20%) subarachnoid haemorrhage (10%). The major risk factor is hypertension which is present in 80% or more in patients with cerebral haemorrhage and subarachnoid haemorrhage, and in 60% in those with occlusive stroke. Other risk factors are age, sickle cell disease, diabetes mellitus, non-ischaemic heart disease (including cardiomyopathies, infective endocarditis, atrial fibrillation mitral valve prolapse) infections, arteritis, smoking, alcohol consumption and cocaine use (in the young people), Transient ischaemic attracts are relatively uncommon reflecting the rarity of large vessel atherosclerotic disease. Case fatality rate is higher than in the developed countries. About 15% of young people (below age of 40 years) with stroke have no identifiable risk factor. Studies are needed on the effectiveness of


Background: Gastroesophageal reflux disease pathogenesis may be associated with disturbances of the autonomic nervous system. Methods:  One hundred five participants aged 35-45 years of either sex, which include Gastroesophageal reflux disease patients, thirty five each (who presented typical symptom of Gastroesophageal reflux disease with reflux esophagitis (ERD) and without reflux esophagitis (NERD)) and thirty five age and sex matched control subjects, were enrolled in the study. Autonomic function test was assessed using Sustained Handgrip test. Results: In the present study, no significant difference was observed in age, height, weight, body mass index, resting systolic blood pressure and diastolic blood pressure between the study groups. The mean difference of diastolic blood pressure (mmHg) response to Sustained Handgrip test between ERD and NERD; ERD and Control; NERD and Control was statistically highly significant (p=0.001; p<0.001; p=0.029, respectively), predicting reduced sympathetic activity in gastroesophageal reflux disease, more in patients with reflux esophagitis (ERD). Conclusions:  Reduced sympathetic activity can cause impairment of lower esophageal sphincter function, particularly of the neural mechanisms related to control of transient lower esophageal sphincter relaxation.  It might increase number and time duration of transient lower esophageal sphincter relaxations resulting in pathological enhancement of GERD.


QUIC protocol is considered an experimental environment and a straight forward evolution of the TCP protocol. Applications created on top of QUIC demonstrate being more efficient than the regular HTTPS stack. Computational offload to kernel space is used as performance optimization for modern applications and brings with it a series of architectural and algorithmic challenges. This work presents eQUIC Gateway, a kernel space module that filter packets based on real time information exchanged with a user space QUIC application. Throughout kernel offload technique for filtering packets, eQUIC Gateway increased the packets throughput in 30.9%, reduced 65 % of the average HTTPS request duration under attack and reduced by 26.4% the CPU time consumed for filtering packets. The source code of eQUIC Gateway is public available on Github.


The CMS muon system has played a key role for many physics results obtained from the LHC Run-1 and Run-2 data. During the Long Shutdown (2013–2014), as well as during the last year-end technical stop (2015–2016), significant consolidation and upgrades have been carried out on the muon detectors and on the L1 muon trigger. The algorithms for muon reconstruction and identification have also been improved for both the High-Level Trigger and the offline reconstruction. Results of the performance of muon detectors, reconstruction and trigger, obtained using data collected at 13 TeV centre-of-mass energy during the 2015 and 2016 LHC runs, will be presented. Comparison of simulation with experimental data will also be discussed where relevant. The system's state of the art performance will be shown, and the improvements foreseen to achieve excellent overall quality of muon reconstruction in CMS, in the conditions expected during the high-luminosity phase of Run-2, will be described.


Laser irradiation after the immediate application of dentin bonding systems (DBSs) and prior to their polymerization has been proposed to increase bond strength. The objective of this study was to evaluate the effect of diode laser irradiation (λ = 970 nm) on simplified DBSs through microtensile bond strength tests. Forty healthy human molars were randomly distributed among four groups (n = 10) according to DBSs used [Adper™ SingleBond 2 (SB) and Adper™ EasyOne (EO)], and the respective groups were irradiated with a diode laser (SB-L and EO-L). After bonding procedures and composite resin build-ups, teeth were stored in deionized water for 7 days and then sectioned to obtain stick-shaped specimens (1.0 mm2). The microtensile test was performed at 0.5 mm/min, yielding bond strength values in MPa, which were evaluated by two-way ANOVA followed by Tukey's test (p < 0.05) for individual comparisons. For both adhesive systems, diode laser irradiation promoted significant increases in bond strength values (SB: 33.49 ± 6.77; SB-L: 43.69 ± 8.15; EO: 19.67 ± 5.86; EO-L: 29.87 ± 6.98). These results suggest that diode laser irradiation is a promising technique for achieving better performance of adhesive systems on dentin.


European migration law combines equal treatment within Europe and unequal treatment at the borders, while local migration policy aims at social inclusion, acceptance of diversity and equality. This paradox sets a challenge for the implementation of a local anti-discrimination policy. Good governance and policy must be based on solid knowledge about the phenomena to which they relate. Action to implement migration policy at local level has to start from Fundamental Human Rights. This requires focus on the importance and the power of language.


We consider an exhaustive polling system with three nodes in its transient regime under a switching rule of generalized greedy type. We show that, for the system with Poisson arrivals and service times with finite second moment, the sequence of nodes visited by the server is eventually periodic almost surely. To do this, we construct a dynamical system, the triangle process, which we show has eventually periodic trajectories for almost all sets of parameters and in this case we show that the stochastic trajectories follow the deterministic ones a.s. We also show there are infinitely many sets of parameters where the triangle process has aperiodic trajectories and in such cases trajectories of the stochastic model are aperiodic with positive probability.


In this letter we develop an expression for the approximate throughput guarantee violation probability (TGVP) for users in time-slotted networks for any scheduling algorithm with a given mean and variance of the bit-rate in a time-slot, and a given distribution for the number of time-slots allocated within a time-window. Based on this general result, we evaluate closed-form expressions for the TGVPs for four well-known scheduling algorithms. Through simulations we also show that our TGVP approximation is tight for a realistic network with moving users with correlated channels and realistic throughput guarantees.


YNST (Yunnan Solar telescope) is a large solar instrument with a pure aperture of 980mm. It was designed for obtaining high-precision measurement for the solar magnetic field and atmospheric dynamic process. YNST is being installed at the Fuxian Lake in Yunnan, China. The solar observation tower includes two vertical multi-wavelength spectrographs and one Fabry-Perot interferometer system working in the 0.3 - 2.5 micron spectral range. The two spectrographs will supply high-resolution spectral data with short exposure time and a large field of view (180 '' x 180 ''), as well as the ability to work in polarized light.


Abstract Stommel's two-box model of thermohaline circulation is generalized to incorporate 1) either mixed or Newtonian thermal and saline boundary conditions; 2) temperature-dependent evaporation, including a simple coupled air-sea model; and 3) a nonlinear flow law for meridional overturning. The authors prove that under steady forcing, the generalized model cannot exhibit self-driven oscillations. If the saline adjustment time is larger than the thermal, then 1) there is one and only one, stable "saline" equilibrium state corresponding to evaporation-driven sinking and 2) "thermal" equilibrium states corresponding to sinking in cooling zones may or may not exist. If they do, they come in pairs, one saddle and one stable node or spiral. A nonlinear "wiggly" flow law may lead to more than one such pair.


Nigeria today faces serious challenge in providing adequate energy to meet the needs of her citizenry. Efforts are currently geared towards generation of more energy to ease the problem. While these efforts are commendable, it is equally desirable to explore ways to minimize consumption of generated energy. The objective of this work is to investigate the effect of building orientation on energy demand in buildings. This paper considered the use of standard design considerations, fundamental cooling load equations and the guidelines stipulated by the American Society of Heating, Cooling and Air conditioning Engineers (ASHRAE). The study takes the designs of three buildings within the University of Ibadan, Nigeria into consideration with the view to harness the energy saving potentials through building orientation and selection of efficient cooling equipment. The results obtained were 155.34, 224.75, 86.35 kW and 163.60, 232.04 and 90.64 kW for the three lecture envelopes including the Faculty of Science, CBN and the Department of Chemistry lecture theatres using the North-South and East-West building orientations respectively. Increase in energy demand of 7.96, 7.29 and 4.29 kW was thus obtained with the East-West building orientation over North-South. Energy efficiency is thus guaranteed with North-South building orientation.


Six cases of mechanical lameness involving the coxofemoral joint are presented. All dogs had a history of chronic rear leg pain and lameness, and decreased range of motion of the hip. On physical examination, ventral subluxation of the coxofemoral joint during extension was present in three dogs. A radiographic diagnosis of subluxation was made in five dogs. In each dog, surgical exploration of the area caudal to the coxofemoral joint revealed a fibrous mass between the lesser or third trochanters and the ischium, diagnosed as a nonneoplastic fibrous reaction by microscopic examination. The clinical, radiographic, and histopathologic signs were similar to previously described cases of myositis ossificans. Five dogs returned to normal function after excision of the soft tissue mass, and one dog was normal when lost to follow-up 4 weeks postoperatively.


Premedication is an old idea. Claude Bernard suggested using morphine before anesthesia to facilitate induction. Misconceptions are prevalent concerning premedication. Often it is ordered empirically without rational basis. This exhibit indicates accepted uses and common misconceptions. Why Give Premedication? Preanesthetic medication is necessary (1) for psychic sedation primarily, (2) to minimize secretions, (3) to fortify impotent anesthetics, and (4) as prophylaxis for suppression of vagal and other autonomic reflex activity. Summary Premedication is part of the anesthetic. The desired goal is tranquility and amnesia without loss of consciousness. The narcotics combined with belladonna alkaloids still remain the most reliable and versatile agents for premedication. What Are the Criteria for Selection of Premedication? Premedication is part of the anesthetic. Drugs and methods must be individualized for a particular patient and technique of anesthesia. The anesthetist is best qualified to prescribe it. It should be his prerogative to select it. What Drugs


A Case of Spontaneous Resolution of Systolic Anterior Motion after Mitral Repair Susumu Isoda, Norihisa Karube, Akira Sakamoto and Tamitaro Soma (Department of Cardiovascular Surgery, Saiseikai Yokohama-Shi-Nanbu Hospital, Yokohama, Japan) A 70-year-old patient underwent modified maze procedure and mitral repair including quadrangular resection, annular placation (Reed procedure), and flexible ring annuloplasty with Cosgrove ring. Systolic anterior motion (SAM) of the anterior mitral leaflet and mild mitral regurgitation was observed on weaning from cardiopulmonary bypass. The patient was medically treated, and postoperative echocardiography revealed disappearance of the SAM 11 days after surgery. In addition to the surgical condition of rather excessive annular plication and small ring, transient conditions including inotropic support, insufficient volume under diastolic dysfunction of left ventricle, and loss of atrial contraction were thought to be the causes of SAM. Jpn. J. Cardiovasc. Surg. 33: 171-174 (2004)


Differential diagnosis of urticarial skin lesions not representing classic urticaria remains a challenge. Long-lasting nonpruritic urticarial plaques and the histopathologic finding of a dense infiltrate with neutrophil granulocytes are indicative for a rare entity within a group of diseases termed neutrophilic dermatoses. Here, we report a case of neutrophilic urticarial dermatosis characterized by nonpruritic urticarial skin lesions, histopathologic changes resembling Sweet syndrome, and simultaneous Still syndrome. After treatment with conventional immunosuppressives including systemic corticosteroids without disease control, the patient responded to anakinra therapy within days achieving complete remission of skin lesions and systemic symptoms including fever and high C-reactive protein.


Tremendous advances in tissue engineering and regenerative medicine have revealed the potential of fabricating biomaterials to solve the dilemma of bone and articular defects by promoting osteochondral and cartilage regeneration. Three-dimensional (3D) bioprinting is an innovative fabrication technology to precisely distribute the cell-laden bioink for the construction of artificial tissues, demonstrating great prospect in bone and joint construction areas. With well controllable printability, biocompatibility, biodegradability, and mechanical properties, hydrogels have been emerging as an attractive 3D bioprinting material, which provides a favorable biomimetic microenvironment for cell adhesion, orientation, migration, proliferation, and differentiation. Stem cell-based therapy has been known as a promising approach in regenerative medicine; however, limitations arise from the uncontrollable proliferation, migration, and differentiation of the stem cells and fortunately could be improved after stem cells were encapsulated in the hydrogel. In this review, our focus was centered on the characterization and application of stem cell-laden hydrogel-based 3D bioprinting for bone and cartilage tissue engineering. We not only highlighted the effect of various kinds of hydrogels, stem cells, inorganic particles, and growth factors on chondrogenesis and osteogenesis but also outlined the relationship between biophysical properties like biocompatibility, biodegradability, osteoinductivity, and the regeneration of bone and cartilage. This study was invented to discuss the challenge we have been encountering, the recent progress we have achieved, and the future perspective we have proposed for in this field.


Starting from the COMET methodology by Bosselut et al. (2019), generating commonsense knowledge directly from pre-trained language models has recently received significant attention. Surprisingly, up to now no materialized resource of commonsense knowledge generated this way is publicly available. This paper fills this gap, and uses the materialized resources to perform a detailed analysis of the potential of this approach in terms of precision and recall. Furthermore, we identify common problem cases, and outline use cases enabled by materialized resources. We posit that the availability of these resources is important for the advancement of the field, as it enables an off-the-shelf-use of the resulting knowledge, as well as further analyses on its strengths and weaknesses.


Twelve expressed sequence tags-derived markers were isolated from Plasmopara halstedii (Oomycetes), the causal agent of sunflower downy mildew. A total of 25 single nucleotide polymorphisms and five indels were detected by single-strand conformation polymorphism analysis and developed for high-throughput genotyping of 32 isolates. There was a high level of genetic diversity (HE = 0.484). Observed heterozygosity ranged from 0 to 0.143 indicating that P. halstedii is probably a selfing species. These markers were also useful in detecting significant genetic variations among French populations (FST = 0.193) and between French and Russian populations (FST = 0.23). Cross-amplification tests on three closely related species indicated that no loci amplified in other Oomycete species.


The electronic contributions to the binding energy between a pair of hydrogen atoms and the interaction of hydrogen with transition-metal impurities are estimated in the tight-binding approximation. The role of the band and bound states on the electronic structure of the impurity problem and the pair interactions is examined. The appearance of a bound state below the conduction band contributes noticeably to the chemical interactions. The binding energy between two hydrogen atoms is found to be attractive for the first nearest neighbours. The interaction between hydrogen and transition-metal impurities to the left of Pd in the periodic table is also calculated. In addition to the above, pair interactions between '4d'-type impurities have been estimated.


Inducible transcription systems play a crucial role in a wide array of synthetic biology circuits. However, the majority of inducible promoters are constructed from a limited set of tried-and-true promoter parts, which are susceptible to common shortcomings such as high basal expression levels (i.e., leakiness). To expand the toolbox for regulated mammalian gene expression and facilitate the construction of mammalian genetic circuits with precise functionality, we quantitatively characterized a panel of eight core promoters, including sequences with mammalian, viral, and synthetic origins. We demonstrate that this selection of core promoters can provide a wide range of basal gene expression levels and achieve a gradient of fold-inductions spanning 2 orders of magnitude. Furthermore, commonly used parts such as minimal CMV and minimal SV40 promoters were shown to achieve robust gene expression upon induction, but also suffer from high levels of leakiness. In contrast, a synthetic promoter, YB_TATA, was shown to combine low basal expression with high transcription rate in the induced state to achieve significantly higher fold-induction ratios compared to all other promoters tested. These behaviors remain consistent when the promoters are coupled to different genetic outputs and different response elements, as well as across different host-cell types and DNA copy numbers. We apply this quantitative understanding of core promoter properties to the successful engineering of human T cells that respond to antigen stimulation via chimeric antigen receptor signaling specifically under hypoxic environments. Results presented in this study can facilitate the design and calibration of future mammalian synthetic biology systems capable of precisely programmed functionality.


The economic crisis which started in 2008 has demonstrated more clearly the importance of conjuncture aspects for organizational results evidencing associated opportunities and vulnerabilities. In such a context, if on one hand innovation is affected by investment reduction by most enterprises, on the other it has shown to be one of the "antidotes" against the crisis and appears as fertile soil for investments, in the organizational as well as in the territorial context. Enterprises and countries which maintained or even raised efforts toward innovation have demonstrated a higher resilience in times of difficulty. This study aims at identifying opportunities and threats to the innovation performance of firms by means of the study of the crisis effects upon external facilitators and barriers. Besides the literature review, case studies developed in Portuguese and Brazilian enterprises are used for the analysis of the practical effects of the identified aspects in two distinct realities in what concerns the economic crisis. The results show that although Portugal has suffered the crisis effects, in a general way, more than Brazil, when we look to innovation performance, Portugal has shown better results than Brazil during and after the crisis. This study contributes to enterprise and academic purposes since it classifies factors which influence innovation positive or negatively in times of crisis.


Physicians working under capitated arrangements must provide quality care and make money, i.e., manage the underwriting risk. Sometimes those ends can seem to be contradictory. To use capitation as a tool to provide cost-effective and quality health care, it behooves the physician to know what forces are at work that influence the results of this capitated environment. Several of those areas are under control of the physician directly and others are not. The physician must know what he or she can control and what cannot be controlled.


This paper presents new approach in the edge detection of 3D images (for nonphotorealistic rendering). This new approach uses curvature estimations with lighting effect on triangle mesh as a new factor in edge detection process. New algorithm to detect edges on 3D curved surface with results is presented. In the proposed technique, the curved surface is generated by using Bezier curves and those generated curves are connected together using a special fashion to generate triangle mesh. Depending on those generated curves, the direction of surface becomes defined. The curvature is then calculated at defined points on each curve. The estimated curvature and lighting effect determine if there is edge can be detected or not. The size of the step of jumping between two defined areas determines the accuracy of detecting edge. The algorithm is tested on curved-surface which on it the edges are hardly to detect.


Arguments against the legitimacy of judicial review are still widely discussed despite the spreading of this legal practice on a world-wide scale. This paper concentrates on one of the most sophisticated of these normative arguments, that is, the one proposed by Jeremy Waldron and based on the idea of disagreement. After having reconstructed Waldron's main points, the paper focuses on some limits which affect his argument. Three aspects are taken into account: the flawed distinction between input and output reasons, the problem of regress and the reductive conception of equality proposed by Waldron.


DNA methylation (DNAm) is an essential mechanism governing normal development in humans. Although most DNAm patterns in blood cells are established in utero, the genes associated with immune function undergo postnatal DNAm modifications, and the characterization of this subset of genes is incomplete. Accordingly, we used available longitudinal DNAm datasets from a large birth cohort in the U.S. to further identify postnatal DNAm variation in peripheral leukocytes from 105 children (n = 105) between birth and the first two years of life, as determined by postnatal changes in β values (with the percentage of methylation ranging from 0 to 1.0 at individual CpG sites). Our study is an extension of a previous analysis performed by our group and identified that: (1) as previously described, DNAm patterns at most CpG sites were established before birth and only a small group of genes underwent DNAm modifications postnatally, (2) this subset includes multiple immune genes critical for lymphocyte development, and (3) several members of the tumor necrosis factor receptor and cytokine superfamilies with essential roles in immune cell activation, survival, and lymphoid tissue development were among those with a larger postnatal variation. This study describes the precise epigenetic DNA methylation marks in important immune genes that change postnatally and raises relevant questions about the role of DNAm during postnatal immune development in early childhood.


OBJECTIVE
To evaluate the effect of bronchial artery embolization (BAE) with polyvinyl alcohol (PVA) foam and gelatinum sponge (GS) for serious hemoptysis.

METHOD
Of 46 patients with severe hemoptysis, BAE with only GS was performed in 21 cases and with both PVA and GS in 25 cases.

RESULT
The total efficacy rate of BAE was 91.3%; and comparable between PVA+GS and GS groups (92.0%; vs 90.5%;, P>0.05). The total recurrence rate after BAE was 26.2%;, but lower in PVA+GS group than in GS group (11.3%; vs 42.1%;, P<0.05). No serious complications occurred in these patients after BAE.

CONCLUSION
BAE is effective and safe for management of serious hemoptysis, and treatment with PVA+GS may effectively lower the recurrence rate.


To stabilize a conventional quadrotor, simplified equivalent vehicles (e.g., autonomous car) are developed to test the designed controller. Based on that, various controllers based on feedback linearization have been developed. With the recently developed concept of tilt-rotor, there lacks the simplified/equivalent model, however. Indeed, the tilt structure is relatively unusual in vehicles. In this research, we put forward a unique fictional vehicle with tilt structure, which is to help evaluate the property of the tilt-structure-aimed controllers. One phenomenon (state drift) in controlling an over-actuated tilt structure by feedback linearization is presented subsequently. State drift can be easily neglected and is not paid attention to in the current researches in tilt-rotor controllers' design so far. We report this phenomenon and provide a potential approach to avoid this behavior.


Multi-carrier cooperative relay-based wireless communication is of particular interest in future wireless networks. In this paper we present resource allocation algorithm in which sub-carrier pairing is of particular interest along with fairness constraint in multi-user networks. An optimization of sub-carrier pair selection is formulated through capacity maximization problem. Sub-carrier pairing is applied in both two-hop Amplify & Forward (AF) and Decode & Forward (DF) cooperative multi-user networks. We develop a less complex centralized scheme for joint Sub-carrier pairing and allocation along with relay selection. The computational complexity of the proposed algorithms has been analyzed and performance is compared with Exhaustive Search Algorithm.


Chitosan is known for its absorption and adhesion property and it is a non-toxic biodegradable hetero polymer. It has a strong affinity for water and high degree of solubility in acidic medium. In addition, chitosan hydrogels showed low mechanical strength and minimum ability to control the delivery of encapsulated compounds. And hence, in this investigation a set of compounds cross linked with Chitosan was screened for anticancer agent using computational technique (molecular docking)
against NOS enzyme (PDB ID: 4NOS). The result was interesting as majority of the compounds screened turned up with favorable molecular interaction and binding affinity as evidenced from the docking score. Furthermore the molecular interaction analysis represents the cross linked compounds possessed heavy molecular interaction at the active site residue of the enzyme. Thus, Chitosan cross linked compounds target the specific active site residue and hence can be used in future for drug delivery.


Total, ouabain insensitive and ouabain sensitive Na+ and K+ adenosine triphosphatase activity in the erythrocyte membrane of protein-calorie malnourished children with marasmus and kwashiorkor was compared with the enzyme activity in apparently healthy children (normals). Na+ and K+ contents of erythrocyte and plasma were also determined in these patients. Specific activity (units per milligram of membrane protein) of ouabain sensitive Na+ and K+ adenosine triphosphatase was significantly higher in erythrocyte membrane preparations from children with kwashiorkor but not from children with marasmus. After 4 to 5 weeks of treatment with diets sufficient in protein and calories the specific activity of the enzyme was lower as compared to that on admission. Erythrocyte and plasma Na+ content (microgram/10(6) cells and microgram per milliliter of plasma) in children with kwashiorkor were not different from those in normal children, however, there was reduction in K+ content of erythrocytes and plasma of these children. After treatment, erythrocyte Na+ and K+ and plasma K+ in children with kwashiorkor increased significantly. In marasmic children erythrocyte Na+ was higher as compared to normal but there were no differences in K+ content of either eyrthrocytes or plasma in these children.


A plethora of scholars argue that that feminism is tailor-made to serve a particular group of people and it does not address the need of all women. As a term conceptualized and adopted by white American women, feminism entails an agenda designed to meet the needs and demands of that particular group. For this reason, it is plausible for white women to identify with feminism and feminist movement. Placing all women's history under white women's history, thereby giving the latter a definite position, is problematic. Thus, various definitions, including womanism, have been coined to best suit the needs of different racial groups, black women in particular. Alice Walker (1983) in her acclaimed volume of essays "In search of our mother's garden" though using the term womanism interchangeably, argues that a "womanist" was "a black feminist or feminist of color". Most African American women note little difference between the two since both support a common agenda of black women's self definition and self-determination.This paper presents and attests to a view that while feminism and womanism are western-oriented, there is a feminism and womanism intelligible in an African context.Keywords: Africana; feminism; womanism; women; sexual equality; stiwanism; taxonomy


A proton exchange membrane (PEM) fuel cells (FCs) with ultracapacitor (UC) and battery (BT) hybrid system has fast transient response compare to stand alone FCs. This hybrid system is promising candidates for environmentally friendly alternative energy sources. An energy management system design and control strategy was introduced in this study. The energy management strategy FC/UC/BT hybrid system model has been developed and the control strategy was programmed in the LabVIEWTM environment and implemented using National Instrument (NI) devices. The energy management strategy is able to manage the energy flow between the main power source (FCs) and auxiliary sources (UC and BT). To control the hybrid system and achieved proper performance, a controller circuit was developed with the three energy sources aligned in parallel to deliver the requested power. The developed model demonstrates the proportion power from the FC, UC and BT under various load demand. Experimental results demonstrate that FC/UC/BT hybrid system operated automatically with the varying load condition. The experimental results are presented; showing that the proposed strategy utilized the characteristic of both energy storage devices thus satisfies the load requirement.


Three languages play an important role in the province of Fryslân: Frisian as the minority language spoken by a majority of the population, Dutch as the dominant language in society, and English as an increasingly important additional language. The position of Frisian as a language for teaching is marginal at all levels of education. Although it is an obligatory language for all primary schools, there is only a small percentage of schools that use Frisian as a medium of instruction. Even when attitudes toward Frisian seem positive, English and in particular Dutch are perceived as more important languages to learn. A promising experiment with trilingual education has shown the possibilities for using three languages as languages of instruction. Multilingualism in the curriculum is an important challenge for education in Fryslân.


[1] We observed the Lunar Crater Observation and Sensing Satellite (LCROSS) lunar impact on 9 October 2009 using three telescope and instrument combinations in southern New Mexico: the Agile camera with a V filter on the Astrophysical Research Consortium 3.5 m telescope at Apache Point Observatory (APO), a StellaCam video camera with an R filter on the New Mexico State University (NMSU) 1 m telescope at APO, and a Goodrich near-IR (J and H band) video camera on the NMSU 0.6 m telescope at Tortugas Mountain Observatory. The three data sets were analyzed to search for evidence of the debris plume that rose above the Cabeus crater shortly after the LCROSS impact. Although we saw no evidence of the plume in any of our data sets, we constrained its surface brightness through analysis of our photometrically calibrated data. The minimum surface brightness that we could have detected in our Agile data was 9.69 magnitudes arc sec−2, which is 177 times fainter than the brightest part of the foreground ridge of Cabeus. In our near-IR data, our minimum detectable surface brightness was 8.58 magnitudes arc sec−2, which is 370 times fainter than the brightest part of the foreground ridge in the J and H bands. The debris plume was detected by the LCROSS shepherding spacecraft and the Diviner radiometer on the Lunar Reconnaissance Orbiter. Given the plume radiance observed by LCROSS, we cannot distinguish between a conical or cylindrical plume geometry because when seen from Earth, both are below our detection thresholds.


The competition of surface and subsurface crack initiation induced failure is critical to understand very high cycle fatigue(VHCF) behavior, which necessitates the elucidation of the underlying mechanisms for the transition of crack initiation from surface to interior defects. Crack initiation potential in materials containing defects is investigated numerically by focusing on defect types, size, shape, location, and residual stress influences. Results show that the crack initiation potency is higher in case of serious property mismatching between matrix and defects, and higher strength materials are more sensitive to soft inclusions(elastic modulus lower than the matrix). The stress localization around inclusions are correlated to interior crack initiation mechanisms in the VHCF regime such as inclusion-matrix debonding at soft inclusions and inclusion-cracking for hard inclusions(elastic modulus higher than the matrix). It is easier to emanate cracks from the subsurface pores with the depth 0.7 times as large as their diameter. There exists an inclusion size independent region for crack incubation, outside which crack initiation will transfer from the subsurface soft inclusion to the interior larger one. As for elliptical inclusions, reducing the short-axis length can decrease the crack nucleation potential and promote the interior crack formation, whereas the long-axis length controls the site of peak stress concentration. The compressive residual stress at surface is helpful to shift crack initiation from surface to interior inclusions. Some relaxation of residual stress can not change the inherent crack initiation from interior inclusions in the VHCF regime. The work reveals the crack initiation potential and the transition among various defects under the influences of both intrinsic and extrinsic factors in the VHCF regime, and is helpful to understand the failure mechanism of materials containing defects under long-term cyclic loadings.


In this study, we undertook a narrative analysis of participants' long-term lived experience of eating disorders and specialist service provision. Eight participants were recruited with service experience across five National Health Service (NHS) Trusts in the United Kingdom. All participants had a minimum of 10 years self-reported experience living with an eating disorder. The data are presented across different temporal stages that demonstrate the development of participants' self-construct in relation to their first contact with specialist services, what had happened in their lives for this to become necessary, and their current relationships with services, before exploring what participants need from services to help them feel heard going forward. Findings suggest that current methods of service delivery result in delayed and inappropriate supports and a consequent "battling" against professionals, which can provide an obstacle to compassionate and collaborative working and promote "revolving door" experiences.


OBJECTIVE: To describe the role of hydroxyurea in the treatment of HIV-1. DATA SOURCES: Published clinical studies using hydroxyurea in HIV treatment were accessed through MEDLINE (January 1994–March 1999) and conference abstracts. All relevant studies were evaluated. DATA SYNTHESIS: Adherence, expense, and resistance limit the pharmacotherapeutic options in the management of patients with HIV. Hydroxyurea may be an alternative to conventional HIV treatments. CONCLUSIONS: Several potential advantages of adding hydroxyurea to antiretroviral treatment regimens include the drug's well-documented toxicity, convenient dosing, good tolerability and low cost, and its unique mechanism of action. Hydroxyurea may have synergistic effects that prove promising in initial and salvage therapy antiretroviral regimens. Larger, well-controlled clinical studies are needed to adequately define the role of hydroxyurea in the treatment of HIV.


Objective: To check whether nurse's work overload influences prenatal care provided to pregnant women according to both point of views. Methods: Descriptive and qualitative study conducted in 2010 in Guarapuava/PR with 10 low-risk pregnant women and 10 nurses in charge of 5 basic health care units. Interviews were carried out using a semi-structured questionnaire containing the characterization of the sample and questions on prenatal care received and provided. Data underwent content analysis. Results: Nurses are in the age group between 25 and 47 years have 3-21-year experience after graduation and the time spent at the job ranged from 6 months to 7 years. Pregnant women were between 21-30 years old single multipara and have been attending the unit for more than one year. Nurses report work overload that negatively affects the prenatal care provided to pregnant women and the number of activities carried out exceed the time they have to perform them. Pregnant women presented different opinions and it became evident that the care could be improved and that the short time spent on the consultations interferes in the quality. Conclusion: For the nurse the work overload influences the quality of care provided to pregnant women and pregnant women notice that the poor quality of care provided by this professional is associated with the large number of activities they need to perform.


In this paper, we analyse the discretization of the generalized radon transform/amplitude versus scattering angles (GRT/AVA) migration - inversion formula by means of quasi-Monte Carlo methods. These methods are efficient, in the sense that they require sparsely sampled measurements only, and accurate, which we have shown by theory and examples. Another feature of Monte Carlo methods is their ability to suppress effectively coherent noise associated with undesired wave phenomena in the inversion procedure. As examples, we carried out the associated integrations over and , and consistently found that quasi-random sequences achieve a prescribed accuracy with significantly fewer nodes.


Background. Effective patient–doctor communication is a key component of patient-centred care, which is one of the six pillars of quality healthcare delivery. Structured and effective communication skills training for healthcare providers is the need of hour in medical education. We assessed the efficacy of role play and simulation in developing communication skills. Methods. As a key component of an acute critical care course (ACCC), communication skills are taught using role play models and simulation. Live feedback is critical in learning during this course as per the principles of adult learning (andragogy). Quantitative and qualitative data were collected to assess the efficacy of ACCC. Results. The 19th ACCC was introduced to interns at the All India Institute of Medical Sciences, New Delhi in December 2018. The teaching methodology and objective-oriented structured training in ACCC were much appreciated for training in human factors with emphasis on communication. A positive response was obtained from the candidates 3 weeks after they completed the course to assess whether interns are able to make use of this training in their day-to-day clinical practice amounting to a reliable evidence level of Kirkpatrick's 'return of investment'. Conclusion. The use of 'role play' to teach communication skills is effective and superior to lecture-based teaching. Further structured and interactive programmes in communication skills training will improve patient care, relatives' satisfaction and the image of medical profession.


Saponin rich fraction of Chlorophytum borivilianum was investigated for transdermal enhancer activity by using human cadaver skin in vitro with pramipexol as the model drug. Moreover, FT-IR studies were conducted to understand to possible enhancement mechanism. Results shows significantly increased flux of the drug compared to control (p<0.05). Similarly permeability coefficient (Kp), cumulative amount release (Q24) and enhancement ratio (ER) shown significant increase over control sample. FT-IR studies reveal that Chlorophytum borivilianum reduces peak area by 89.00 % for symmetric and asymmetric stretching peaks. In addition significantly reduces percentage of secondary structures of keratin at amide I band. These results indicate that C. borivilianum enhances transdermal permeation of pramipexol by biphasic mechanism involving partial extraction of stratum corneum (SC) lipid and interaction with SC keratin.


model by making government draw a part the surplus2 of the M sector (the profit income) in the form of import tariff revenue. This facilitates government investment and capital formation and consequent growth. But if one observes the experience during the last 45 years of protectionist policies, it appears that a major part of surplus for government investment appears to have come mostly from the unorganised manufacturing and agricultural sectors which employ a major section of the poor, instead of the protected sector Major part of government expenditure is drawn from its revenue through highly regressive indirect taxes and deficit financing. Government investment through deficit financing, if it causes inflation, makes the poor take the major part of the burden. Therefore, the burden of government expenditure might have been borne mostly by the poor but not by the organised manufacturing sector. The overvalued exchange rate suppressed agricultural prices and also other exportable goods' prices which implies that these sectors subsidised the urban consumption. In other words, agricultural sector and government expenditure made feasible by indirect taxes and deficit financing might have kept subsidising the organised manufacturing sector.


The safety barrier used for the impact tests described in this report is different in design from barriers at present in use on roads in the United Kingdom. It consists of one metre high sheet metal bins, 3.2 m long overall, height 1.2 m, jointed end to end resting on hard level ground and filled with sand. Although originally designed to contain cars, North American tests of this Canadian barrier have indicated a relatively high containment capacity. Four tests were carried out in the UK in order to examine the containment limit of the barrier when impacted by British vehicles. These tests showed that the barrier satisfactorily contained and redirected: (a) a small saloon car weighing 0.76 tonne travelling at 110 km/hr (69 mph) and at 20 degrees; (b) a coach weighing 8.5 tonne travelling at 74.5 km/hr (47 mph) and at 15 degrees. The barrier contained, but did not satisfactorily redirect, a coach weighing 8.5 tonne travelling at 77 km/hr (48 mph) and at 20 degrees. The fourth test used a 16 tonne heavy goods vehicle impacting at 82 km/hr (51 mph) and at 15 degrees. This impact resulted in collapse of the barrier section, release of bin lids and sand, and the vehicle rolled over and came to rest across the barrier. Containment and redirection of the vehicle were partially achieved. (a)


The multidrug-resistant yeast Candida auris is associated with invasive infections in critically ill patients and has been isolated in different countries worldwide. Ease of spread, prolonged persistence in the environment and antifungal drug resistance pose a significant concern for the prevention of transmission and management of patients with C. auris infections. Early and correct identification of patients colonized with C. auris is critical in containing its spread. However, this may be complicated by C. auris strains being misidentified as other phylogenetically related pathogens. In this review, we offer a brief overview highlighting some of the critical aspects of sample collection, laboratory culture-dependent and independent identification and the susceptibility profile of C. auris.


Verbal aspect in past tense expression has often been identified as a difficult area for students learning Spanish, and other Romance languages, as a second language (Blyth, 1997; Dansereau, 1987; Frantzen, 1995; Westfall & Foerster, 1996). Not only does Spanish operate within an aspectual system that is typologically different from that of English (Comrie, 1976; Whitley, 2002), but the Spanish perfect (present perfect, he comido) and perfective (preterit, comí) morphological forms are also experiencing change in progress in that the present perfect appears to be replacing the preterit in at least some dialects of the Spanish-speaking world (Holmes & Balukas, 2011; Howe, 2006, 2013; Schwenter, 1994; Schwenter & Torres Cacoullos, 2008). At a bare minimum, the Spanish aspectual system consists of a perfective verb form, traditionally expressed using the preterit (Pret) (yo comí), and an imperfect verb form, expressed by the imperfect (Imp) (yo comía). At least in Peninsular Spanish, as the studies cited above indicate, the present perfect verb form also enters into a variable perfective system. English, on the other hand, has a simple past (I ate) and a past progressive (I was eating). These two aspectual systems allow speakers of their respective languages to express past time in quite different ways (Comrie, 1976). The English simple past can correspond to either Pret or Imp in Spanish while the past progressive corresponds to Imp (Slabakova & Montrul, 2003). Given the differences between the aspectual systems of English and Spanish as well as the variation students most certainly hear in the input they receive, it is not surprising that this system is a difficult one to acquire. The current study seeks to examine the constraints that govern the selection of past tense morphology in the interlanguage of 30 high school students participating in an intensive summer study abroad program in Valencia, Spain as well as the constraints that govern the morphological choices of members of the students' host families, a group of native speakers (NS) that represent a partial measure of the input to which learners are exposed while abroad.


Hypoxia is a hallmark of tumor. Based on this feature, a hypoxia-responsive drug delivery system combined with tumor-targeting was developed. HA-NI conjugates were prepared by grafting the carboxyl group of hyaluronic acid (HA) with an amine group of nitroimidazole (NI) derivative in the presence of 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC) and N -hydroxysuccinimide (NHS). The structure of HA-NI conjugates was confirmed by FT-IR and 1 H NMR, the degree of substitution (DS) of NI derivative was also calculated based on 1 H NMR. Amphiphilic HA-NI conjugates could self-assemble into micelles by ultrasonic method. The size and morphology of micelles were characterized by dynamic light scattering (DLS), atomic force microscope (AFM) and transmission electron microscopy (TEM), the stability of micelles was also investigated by DLS. It was found the size of micelles was in the range of 80 ~ 220 nm while the DS decreased from 6.5% to 3.6%. Doxorubicin (DOX) was encapsulated in micelles, and DOX-loaded micelles had smaller sizes compared with blank micelles. Drug-loading (DL) and entrapment efficiency (EE) were obtained by UV-Vis analysis and increased with the increasing DS. Under hypoxic condition, micelles became bigger and size distribution of micelles became wider, it was clear to observe the destruction of micelles by AFM and TEM. UV spectrum revealed the characteristic peak belonging to NI at 325 nm disappeared and Zeta potential increased from - 30.6 ± 0.4 mV to - 24.9 ± 0.5 mV 6 h later. In vitro drug release studies demonstrated that DOX was released from HA-NI micelles in a hypoxia-dependent manner: micelles were sufficient-ly stable at normoxic condition while accomplished a rapid drug release under hypoxic condition.


As an important part of a smart city, intelligent transport can effectively reduce energy consumption and environmental pollution. Traffic flow forecasting provides a reliable traffic dispatch basis for intelligent transport, and most of the existing prediction methods only predict a single saturation or speed and do not use the saturation and speed in a unified way. This paper proposes a new traffic flow prediction method based on RNN-GCN and BRB. First, the belief rule base (BRB) is used for data fusion to obtain new traffic flow data, then the recurrent neural network (RNN) and graph convolution neural network (GCN) model is used to obtain the time correlation of the traffic data, and finally, the traffic flow is predicted by the topology graph. The experimental results show that the method has a better performance than ARIMA, LSTM, and GCN.


This paper presents, in 2 parts, a control law for a low frequency active suspension system. The first part, talks about the problematics, the strategy and the modelling. The control part and the results of the simulations are presented in the second part. More precisely, after the presentation of the problematics, the strategy which allows to get around the conflict of the passive suspensions is exposed in this first paper. Then, the hydropneumatic suspension which allows the implementation of this strategy is presented. It is composed of one hydractive part and one low frequency active part. Finally the validation and synthesis models are developed; their exploitation is made in the second paper.Copyright © 2009 by ASME


An interstadial deposit of mud and peat corresponding to the Danish and Dutch so called Brorup-interstadial has been investigated. A first series characterised by Betula nana and non arboreous vegetation as well as a second series of closed forests have been described. Birch, later on pine and spruce were the constituents of the forests. The conception of the vegetation derived from pollenanalytical investigation shows a considerable influence of the local vegetation on the fen with Betula nana and Pinus montana var. uncinata, to which particular attention has been paid.


Resistive random access memory (RRAM) utilizes the resistive switching behavior to store information. Compared to charge-based memory devices, the merits of RRAM devices include multi-bit capability, smaller cell size, and energy per bit (~fJ/bit). In this chapter, we review different perovskite material-based resistive random access memories (RRAMs). We first introduce the history of RRAM development and operational mechanism of conduction, followed by a review of two types of materials with perovskite crystal structure. One is conventional perovskite oxides (PCMO, a-LCMO, etc.), and the other is perovskite halides (organic-inor-ganic hybrid perovskites and inorganic perovskites) that have recently emerged as novel materials in optoelectronic fields. Our goal is to give a comprehensive review of perovskite-based RRAM materials that can be used for neuromorphic computing and to help further ongoing development in the field.


Estimation of input energy using approximate methods has been always a considerable research topic of energy based seismic design. Therefore several approaches have been proposed by many researchers to estimate the energy input to SDOF systems in the last decades. The characteristic period is the key parameter of most of these approaches and it is defined as the period at which the peak value of the input energy occurs. In this study an equation is proposed for estimating the characteristic period considering an extensive earthquake ground motion database which includes a total of 268 far‐field records, two horizontal components from 134 recording stations located on both soft and firm soil sites. For this purpose statistical regression analyses are performed to develop an equation in terms of a number of structural parameters, and it is found that the developed equation yields satisfactory results comparing the characteristic periods calculated from time history analyses of SDOF systems.


OBJECTIVE—Birth weight has been associated with the risk of type 2 diabetes in several studies. We investigated whether prenatal influences on birth weight (gestational age, parity, preeclampsia, prepregnancy BMI, smoking during pregnancy, and socioeconomic position [SEP]) were associated with glucose metabolism in midlife and the role of birth weight for gestational age (BGA) and adult adiposity in mediating these associations. RESEARCH DESIGN AND METHODS—Data from 7,518 participants of the 1958 British Birth Cohort with information on A1C at age 45 years were analyzed. Associations between prenatal exposures and A1C ≥6% were examined using a series of logistic regression models. The basic model consisted of all prenatal factors (except parity) adjusted for sex and family history of type 2 diabetes. Further adjustments included BGA only, concurrent adiposity only (BMI and waist circumference), and BGA plus adiposity. RESULTS—In the basic model, preeclampsia (odds ratio 1.78 [95% CI 1.14–2.80]), prepregnancy BMI ≥25 kg/m2 (1.90 [1.45–2.47]), maternal smoking (1.33 [1.04–1.71]), and manual SEP (1.87 [1.36–2.58]) were independently associated with A1C at 45 years of age. Adjustment for BGA had little impact on the prenatal factors/A1C associations, whereas adjustment for adult adiposity at 45 years substantially reduced associations for prepregnancy BMI, smoking during pregnancy, and SEP. CONCLUSIONS—Prenatal exposures were related to blood glucose levels in mid-adulthood. Associations for several prenatal factors were largely mediated through adult adiposity but surprisingly not through birth weight. Prenatal exposures are likely to have the strongest effect on glucose metabolism indirectly through their influence on adiposity.


Genetic data are increasingly being applied to re-evaluate past taxonomic hypotheses and better understand the evolutionary patterns and connectivity among regional populations of cosmopolitan species. This is of particular importance for heavily exploited, commercially important species. The phylogenetic structure of the Yellowtail Jack, Seriola lalandi Valenciennes, 1833, was investigated using genetic data from 42 individuals collected from California, the Pacific coast of Baja California (Mexico), the Gulf of California (Mexico), New Zealand, Japan, South Africa, and Chile. An analysis using S. dumerili as an outgroup and combining the sequences of two mitochondrial genes (CR and COI) and four nuclear genes (RAG2, EHHADH, UBE3A, MLL) was used to determine the level of genetic divergence among samples from different geographic regions. Bayesian and Maximum Likelihood analyses utilizing combined mitochondrial gene (mtDNA) or nuclear gene (nucDNA) data supported the existence of multiple regionally restricted clades with mtDNA analysis identifying four major clades and nucDNA supporting three. Both mtDNA and nucDNA trees were very similar in topology, which was reflected in the combined total evidence phylogram. These clades were highly supported with Bayesian posterior and bootstrap probabilities ranging from 90 to 100 percent for the three major clades that were recovered in both mtDNA and nucDNA trees. These clades represent regionally specific specimens collected from the 1) Northeast Pacific, 2) Northwest Pacific, and 3) Southern Hemisphere. Morphometric analysis (MDS and ANOSIM) of available meristic data on the number of soft dorsal-fin rays, anal-fin rays, and total number of gill rakers separated specimens among the three regions identified by genetic analysis (P  =  0.05). Based on the phylogenetic structure within this taxonomic unit as evidenced by genetic data and significant meristic differences among these regional lineages, we conclude that three cryptic species currently bear the name Seriola lalandi Valenciennes, 1833. We propose the resurrection of two currently available names based on nomenclatural priority. The Northwest Pacific species name should revert to Seriola aureovittata Temminck and Schlegel (1845) (type locality Japan), and the Northeast Pacific species to Seriola dorsalis Gill (1863) (type locality Cabo San Lucas, Mexico). Seriola lalandi Valenciennes, 1833 (type locality Brazil) should apply only to the species in the Southern Hemisphere.


Increasing real estate and other infrastructure costs have resulted in the trend of co-working offices where users pay as they use for individual desks. Co-working offices that provide personalized comfort need to address users with potentially widely varying thermal comfort preferences. Providing personalized comfort in cabins separated by physical partitions with neighboring thermal zones or open-plan offices with a single actuator has received attention in the literature. In this article, the problem of minimizing user discomfort in open-plan co-working offices with multiple actuators while being cognizant of the energy consumed is considered. Specifically, the decision problems of assigning users to desks based on their thermal preferences and jointly controlling the multiple actuators are addressed. The non-linearities in the underlying thermodynamic constraints and the seating decision together make the problem computationally hard. A two-step heuristic that addresses these issues is presented. First, using a model that accounts for spatio-temporal thermodynamics, a one-time assignment of users to desks is performed that reduces the thermal resistance faced by the HVAC systems to provide the preferred comfort levels. Next, the setpoints are decided for all actuators to jointly minimize user discomfort by optimization and model-predictive control. Further, scalability is addressed by clustering user preferences and the associated HVAC actuators' setpoints for the cases where a large number of actuators may be present in the room.


The objective of this research is to determine the competitiveness level of the manufacturing small and medium-sized enterprises (smes) of Baja California and to identify which areas within them affect this competitiveness. The methodology used is descriptive, correlational, and cross-sectional; the systemic competitiveness model is developed at the micro level, and a measurement instrument with 64 questions is used on 195 companies in the state; in addition, traditional multiple linear regressions are performed to test the hypotheses. One of the findings is that the smes in the state have a medium-low competitiveness level and do not show any relationship between the size of the companies and their competitiveness; however, the production-operations area prove to be more important for their competitiveness level. Although the measurement instrument that is used has no proportionality at the municipality and subsector level, it does allow us to approach the internal operation of the smes.


The significance of developing community GIS (Geographic Information System) is put forward and a brief introduction which is related to the characters of COM (Component Object Model) is given. The key technology of database design under the component technology is researched. The function of the system, the design and realization of the model are introduced.


Abstract Education of medical students requires teaching students how to navigate in the broad field of medical research. The objective of this article is to provide an overview about medical research and to show how to denote a medical study in a concise fashion. Medical research can be classified into categories according to the object of investigation. Examples for medical research categories are therapeutic, diagnostic and prognostic studies, epidemiological studies, animal and in vitro studies etc. Each research category uses a specific set of study types with names such as cross-sectional study, case-control study etc. The article describes the principles of the study types. Together, research category and study type briefly describe the design of a medical study.


Are workers in China underpaid? And if so, what may be the reasons and by how much? We address these questions empirically by deploying a heteroscedastic stochastic frontier model, using nationally representative household surveys of the period of 2003–2008. We estimate that labour underpayment is approximately 43.7% in this period of assessment, a significantly higher figure than the estimates for Western economies. Underpayment in this period takes a U-shape relationship. Determinants of underpayment were proposed by seven hypotheses and confirmed by bootstrap method, except age discrimination. Test results show that intergenerational effects are the most salient factor for underpayment. At the same time, we construct an index to measure the wage distortion in the labour market. Our findings indicate a general trend in which underpayment is increasing and differs between workers of different demographic characteristics and across regions. Our study contributes to the field by applying three models to capture the differing levels of influence of a range of factors on underpayment in the Chinese labour market.


The prediction of the flow in a gas turbine exhaust diffuser of a combined cycle power plant is particularly difficult as maximum performance is obtained with highly loaded diffusers, which operate close to boundary layer separation. CFD (computational fluid dynamics) simulations then need to cope with complex phenomena such as smooth wall separation, recirculation, reattachment, blockage and free shear layer mixing. Recent studies based on the RANS (Reynolds-Averaged-Navier-Stokes) approach demonstrate the challenge for two-equation turbulence models to predict separation and mixing of the flow correctly in such highly loaded diffusers and identify that more accurate methods are needed. Hence, the application of a hybrid Scale-Adaptive Simulation (SAS) is investigated and the CFD results are compared with experimental results from an in-house test rig.In the present study the flow in a model exhaust diffuser (for heavy-duty gas turbine diffuser applications typical Reynolds number 1.5×106 and inlet Mach number 0.6) is examined with unsteady RANS (URANS) simulations with the SST (Shear Stress Transport) model as well as a hybrid Scale-Adaptive Simulation (SAS) model. The SAS model switches from URANS to a mode similar to a Large Eddy Simulation (LES) in unsteady flow regions to resolve various scales of detached eddies. The current study shows that with the SST model similar results are obtained with RANS and URANS simulations, whereas the more complex SAS model leads to a much better resolution of the unsteady fluctuations. However, the time-averaged results of the SAS calculations overpredict the blockage of the separation and hub wake. This results in an underprediction of the pressure recovery and the mixing of the flow compared to the simpler two-equation models and also compared to experimental results.Copyright © 2013 by Siemens Energy, Inc.


Introduction: Ischaemic Heart Diseases are becoming progressively commoner in the younger persons of third and fourth decade. A massive rise in the levels of SGOT, LDH, CPK, during myocardial infarction suggest large infarct with poor prognosis. Earlier and rapid fall in the pseudocholinesterase level may have a poor prognosis. Aims and objectives: To Study incidence, levels and patterns of Pseudocholinesterase Activity In Acute Myocardial Infarction. Material and Methods: 75 subjects were included in the study. 25 cases were controls and 50 cases were patients of Acute Myocardial Infarction admitted within 48 hours of onset of Acute Chest Pain in Intensive Coronary Care Unit of Department of Medicine. Out of 50, 44 were confirmed (34 complicated and 10 uncomplicated) and 6 were provisional cases. Subjects were studied for incidence, levels and pattern of pseudochlinesterase activity and data collected were analysed statistically. Results and observations: 1).The normal value of pseudocholinesterase activity ranged from 138.74 to 302.70 μmol/ml (mean value of 192.78 ± 46.64). 2). All 44 (100%) confirmed cases and 4 (66.66%) out of 6 provisional cases of acute myocardial infarction had significant fall in the values of pseudocholinesterase activity at one or other time during the study period. 3). Levels of pseudocholinesterase started falling after 12 hours of chest pain in all 44 confirmed cases and 4 provisional cases. Lowest values were seen in 22 (59.46%) out of 37 cases on 1st day, 17 (39. 53%) out of 43 cases on 2nd day and 5 (11.9%) cases on 3rd day. Levels started rising thereafter and minimum normal values were attained on 7th day. Mean lowest value was 80.50 ± 34.59. 4). Mean lowest value in complicated group was 73.94 ±34.07 while in uncomplicated group it was 96.99 ± 16.53 (P< .01). Lowest values in complicated and uncomplicated groups were seen on 1st and 2nd day respectively. 5). The mean value in complicated group (73.94 ± 34.07, 77.97 ± 20.00 and 92.48 + 20.88 on 1st, 2nd and 3rd day respectively) was much lower than uncomplicated group (104.28 ± 26.18, 96.99 ± 16.53 and 120.21 ± 22.97 on, 1st, 2nd and 3rd day respectively) following myocardial infarction (P < .00l). 6). 3 (75%) out of 4 cases who expired had lowest value of pseudocholinesterase activity on the day of death. Conclusion: In myocardial infarction, earlier and rapid fall in the pseudocholinesterase level may have a poor prognosis, a persistent low level in patients having complication may be a grave prognostic sign.


The observation of the electronic Raman scattering in n-Ga1-xAlxAs (x > 0.45) is reported and the charge state of DX centers in III-V alloy semiconductors is discussed. The result shows clearly that the electronic Raman scattering in n-Ga1-xAlxAs of indirect band-gap and the persistent photoconductivity in n-Ga1-xAlxAs of direct band-gap are equivalent to each other. Both of them originate from the optical induced metastable state of donors in n-Ga1-xAlxAs (x > 0.22) at low temperatures. At higher temperatures, this hydrogen-like level is depopulated to the benefit of a stable DX-like deep state.


Finance being an important function of business, is very crucial to meet various financing and investment activities in it. The wide scope of financial management should be considered to include three major finance functions like investment decisions, financing decisions and dividend decisions respectively. In all organizations financial management system involves a sound judgment, combines with a logical approach to decision making. Different alternatives having different implications are available to a business enterprise in the process of decision making. Gulati Institute of Finance and Taxation is an organization that is specialized in research, training, consultancy and provision of fiscal and social policy inputs to the Government of Kerala and the South Indian states in general. Financial management system in GIFT will not only determine the performance of the GIFT but will contribute much towards the transparency and accuracy of the institute. So its the need of the hour to evaluate the performance of Computerized Accounting System especially its reliability and consistency part considering its use by the various stakeholders. An effective financial reporting system in any organization requires a well designed defect free system along with the trained staff and sound accounting and information system. The study in this organization was conducted to analyse the effectiveness of financial management practices followed in GIFT and based on the analysis and discussion of the data evaluated, to give appropriate suggestions to GIFT for the betterment of financial management practices. The study is descriptive and analytical in nature and it is a fact finding study. The data used for Analysis is the Audited Financial Statements of GIFT for the financial years 2012-13 to 2015-16. The present work entitled "An Evaluation of Financial Management System in Gulati Institute of Finance and Taxation, Thiruvananathapuram was conducted for a period of 2 months. The study was organized mainly to study the Financial Management System of the organization. The data for the study were collected through secondary sources. With the help of several tools the data were easily interpreted. The objectives of the study have been accomplished with the help of primary data collected from the administrative of the GIFT.


Abstract Cucumber plants (Cucumis sativus L.) were grown under controlled conditions and fumigated with either O3, diluted automobile exhaust or a combination of both. The ratio of variable to maximum chlorophyll fluorescence (Fv/Fm) was estimated as a measure of PSII activity Activities of the enzymes catalase, glutathione reductase and guaiacol-dependent peroxidase and contents of the antioxidants ascorbate and glutathione were assayed as potential indicators of oxidative stress. The behavior of catalase and of PSII are of particular diagnostic interest because they require continuous repair in light. Exposures of up to 13 days to moderate concentrations of the pollutant gases alone did not induce striking changes in any of the activities that were assayed. A lso when the plants were subjected to an additional stress treatment by exposing them to 4 short cold treatments (2h each at 0 - 4 °C in light on days 12-15 after sowing) which induced marked declines of the Fv/Fm ratio, the chlorophyll content and the catalase activity, these cold-induced symptoms of photodamage were not significantly enhanced by the fumigation treatments. However, increases of the activities of glutathione reductase and peroxidase observed during a period of recovery following the cold-exposures were markedly higher in O3-fumigated plants, as compared to plants grown in filtered air or fumigated with car exhaust alone. The results emphasize that effects of moderate pollutant exposures may be latent or delayed over long time periods and that defence responses can be enhanced when plants are exposed to additional, naturally occurring stress situations.


We study linear perturbations about non rotating black hole solutions in scalar-tensor theories, more specifically Horndeski theories. We consider two particular theories that admit known hairy black hole solutions. The first one, Einstein-scalar-Gauss-Bonnet theory, contains a Gauss-Bonnet term coupled to a scalar field, and its black hole solution is given as a perturbative expansion in a small parameter that measures the deviation from general relativity. The second one, known as 4-dimensional-Einstein-Gauss-Bonnet theory, can be seen as a compactification of higher-dimensional Lovelock theories and admits an exact black hole solution. We study both axial and polar perturbations about these solutions and write their equations of motion as a first-order (radial) system of differential equations, which enables us to study the asymptotic behaviours of the perturbations at infinity and at the horizon following an algorithm we developed recently. For the axial perturbations, we also obtain effective Schrödinger-like equations with explicit expressions for the potentials and the propagation speeds. We see that while the Einstein-scalar-Gauss-Bonnet solution has well-behaved perturbations, the solution of the 4-dimensional-Einstein-Gauss-Bonnet theory exhibits unusual asymptotic behaviour of its perturbations near its horizon and at infinity, which makes the definition of ingoing and outgoing modes impossible. This indicates that the dynamics of these perturbations strongly differs from the general relativity case and seems pathological.


Vehicle crashworthiness simulation is the main component of the virtual auto-body design. One developing commercial vehicle was simulated on crashworthiness by the non-linear finite element method. The bumper crashworthiness at the speed of 8 km/h was analyzed and valuated. On the other hand, the deformation of the auto-body, the movement of the steering wheel and the dynamic responses of the occupant at the initial velocity of 50 km/h were studied. The results appear that the design of the vehicle could be improved on structure and material. Finally, the frontal longitudinal beam, the main energy-absorbing part of the auto-body, was optimized on structure. Simulation results also show that applying new material, such as high strength steel, and new manufacture techniques, such as tailor-welded blanks could improve the crashworthiness of the vehicle greatly.


Dirty air and poor access to healthcare threatens the lives of billions of people in low-income regions of the world. We investigated whether upper-airway hydration might alter two-phase flow in the airways on normal tidal breathing and be a useful, safe, easily distributed non-drug intervention for limiting risks of COVID-19. In observational human volunteer studies involving 464 human subjects in Marburg, Germany (357 normal subjects), Boston, US (20 healthy subjects), and Bangalore, India (87 subjects recently tested positive for COVID-19), we find that respiratory droplet generation increases by up to 4 orders of magnitude with up to 1% total body mass dehydration (n=20), and in dehydration-associated states of advanced age (n=357), elevated BMI-age (n=148), and SARS-CoV-2 infection (n=87). Hydration of the nose, larynx and trachea in a protocol of exercise-induced dehydration by the nasal inhalation of calcium-rich hypertonic salt droplets of mean diameter 8-12 μm diminished respiratory droplet numbers and increased oxygenation relative to a non-treatment control (P<0.05). In a randomized double-blinded nasal-saline control study, thrice-a-day delivery of the calcium-rich hypertonic salts (active) over three days suppressed respiratory droplet generation by 51% +/- 11% and increased oxygen saturation by 48.08% ± 9.61% (P<0.001) in COVID-19 positive subjects (n=20), while no changes in exhaled aerosol (P=0.235) or oxygen saturation (P=0.533) were observed in the nasal-saline control group (n=20). In the active group 47% of patients discharged with no self-reported symptoms while all of the subjects in the nasal saline group discharged with lingering symptoms. Hydration of the upper airways appears promising as a non-drug approach for reducing risks of lower respiratory-tract infections such as COVID-19.


Background: Although the aging process and features of chronic obstructive pulmonary disease (COPD) have several similarities, the relationship between aging and COPD pathogenesis remains incompletely understood. The klotho gene was found to be related to premature aging and emphysematous changes in an animal model. We investigated whether klotho gene polymorphisms are related to COPD susceptibility and emphysema severity. Methods: A total of 219 COPD subjects from the Korean Obstructive Lung Disease Cohort and 305 control subjects were genotyped for two single nucleotide polymorphisms (SNPs) of the klotho gene associated with coronary artery disease. Logistic regression was performed to determine the association of these SNPs with COPD susceptibility and linear regression was performed to investigate their association with emphysema severity in COPD subjects. Results: The mean age of the COPD subjects was 66 years and their mean FEV1 was 1.46 L. There were no associations between either SNP or COPD susceptibility (p=0.6 and 0.2, respectively) and there were no associations with emphysema severity. Conclusion: Genetic polymorphisms of the klotho gene were not associated with COPD in a Korean population.