We develop a contingency view of process management's influence on both technological innovation and organizational adaptation. We argue that while process management activities are beneficial for organizations in stable contexts, they are fundamentally inconsistent with all but incremental innovation and change. But dynamic capabilities are rooted in both exploitative and exploratory activities. We argue that process management activities must be buffered from exploratory activities and that ambidextrous organizational forms provide the complex contexts for these inconsistent activities to coexist.


Excited states have been identified in the very neutron-deficient N = Z + 3 nucleus 111 Xe for the first time, using the 58 Ni( 58 Ni, α n) heavy-ion fusion-evaporation reaction. Gamma-ray transitions have been unambiguously assigned to 111 Xe by correlation with the characteristic 111 Xe → 107 Te → 103 Sn α -decay chain using the method of recoil-decay tagging. Inspection of γγ coincidence data has shown that five of the transitions form a rotational-like sequence. Excitation-energy systematics suggest that the sequence could be the favored signature partner of a band built on an h 11 / 2 neutron. Aligned angular momenta of states in the band have been compared to analogous bands in neighboring xenon isotopes. The aligned angular momenta for the 111 Xe band are constant over the range of observed rotational frequencies, suggesting that the first π ( h 11 / 2 ) 2 alignment is either delayed or absent. It is speculated that the alignment of h 11 / 2 protons in the presence of neutrons in near-identical h 11 / 2 orbitals may be affected by neutron-proton interactions, or by the onset of octupole correlations.


In a medium containing glucose, the yeast Torulopsis gropengiesseri converts long-chain methyl-branched alkanes into glycolipids by one or more of three metabolic pathways, namely, (i) alkane → alkan-1-ol → alkanoic acid →ω- and/or ω-1-hydroxyalkanoic acid → glycolipid, (ii) alkane → alkan-1-ol → glycolipid, and (iii) alkane → alkan-1-ol →ω- and/or ω-1-hydroxyalkan-1-ol → glycolipid. Pathways (ii) and (iii) are important for the metabolism of alkan-1-ols whose dehydrogenation to alkanoic acids is inhibited by one or more methyl substituents close to the primary alcohol group. Initial oxidation of 2,2-dimethylhexadecane occurs exclusively at the less hindered terminal position which is the predominant site of the initial oxidation of 2-methyl-hexadecane. Alkanoic acids and alkan-1-ols which have methyl substituents close to the functional group give ω- and ω-1-hydroxy-derivatives; alkanoic acids and alkan-1-ols which have methyl substituents at the ω-1-position give ω-hydroxy-derivatives.


Options for the surgical closure of large symptomatic perforations are limited and consist of an open or closed approach using skin or mucosal flaps, with or without different grafts. The aim of this study is to review our experience in treating large nasal perforations using a closed approach with endoscopic assistance, undertaking a 3-layer reconstruction of the septum. We reviewed 14 consecutive patients with large (2–4 cm) nasal septal perforations, who were treated using an endonasal/endoscope-assisted approach. In these cases, the mucosal defect was reconstructed through a horizontal advancement of the bipedicled mucoperichondrial flaps and sutured using absorbable sutures. The cartilagineous defect was consistently reconstructed using autogenous auricular conchal grafts. Pre- and postoperative nasal symptom scores were used for the study; a decline in the number of Nasal Obstruction Symptom Evaluation Scale symptoms were recorded in 12 of 14 patients (85.7%), and visual analogue scale scores for crusting, bleeding, nasal discharge, whistling, headache, nasal pain, snoring, olfactory loss, and overall discomfort levels also decreased. It was concluded that bipedicled mucoperichondrial flaps with the insertion of auricular cartilage for a 3-layer septal reconstruction seem to give reasonably good results. The use of nasal endoscopy is an endonasal approach, which offers superior precision in all surgical steps and provides a way to obtain excellent closure of the perforation without external incisions.


Military emergency medical care in support of mission personnel in operational areas serves as a vital element of peace support operations, as it ensures the maintenance of the human resources deployed in mission areas. Although the South African National Defence Force is facing significant financial constraints, it is becoming increasingly mobile, as South Africa continues to pledge military and diplomatic assistance in the African continent to maintain peace and stability, promote development and provide security. Consequently, when deployed abroad, military emergency care providers face unique challenges.  The aim of this paper is to describe the lived experiences of Gauteng-based emergency care providers in delivering emergency medical care amid resource constraints during external deployment. The descriptions were extracted from a larger study titled "exploring lived experiences of Gauteng-based military pre-hospital emergency care providers during external deployment". The research was conducted using a qualitative, exploratory research design and was guided by a phenomenological approach.  The findings indicate that Gauteng-based military emergency care providers often did not have enough equipment or appropriate transportation to perform their duties during external deployment. As a result, they are hindered from providing quality care to ill and injured patients.


In time harmonic analysis, media composed of sub-wavelength metallic or dielectric inclusions are described by complex and dispersive effective constitutive parameters. A study of such parameters based on the conservation law of energy and causality is presented. We derive a set of general constraints on the real and imaginary parts of the constitutive parameters for lossy and lossless media in terms of electric and magnetic loss tangents. It is shown that a passive medium can indeed have a negative imaginary part of either the permeability or permittivity over a range of frequencies. These findings are consistent with the principles of causality and energy conservation.


The purpose of this Capstone project is to compare the effectiveness of augmented reality (AR) supports and visual supports on the accuracy and independent completion of vocational tasks for transition-aged students with autism and/or intellectual and developmental disabilities. At the time of submission of the paper, data collection will still be in progress and only a preliminary analysis of collected data will be available. Due to complications imposed by the COVID-19 pandemic, one 20-year-old student with autism participated in this study. The participant was taught two vocational/daily living skills (i.e., folding clothes and washing dishes). For one skill, the participant was instructed using visual, picture supports. For the second skill, the participant was instructed using augmented reality, video supports. The baseline phase utilized a multiple-opportunity method, and instructional supports were not provided to the participant for any of the intervention tasks. Baseline data were conducted in both the intervention setting with intervention materials as well as in the generalization setting with generalization materials. Upon completion of the baseline phase, a pre-intervention phase was initiated to instruct the participant in using the low-tech and high-tech supports using a comparable skill (i.e., stuffing a folder) to the selected intervention skills (i.e., folding clothes and washing dishes). The study utilized an alternating treatment design when the intervention was implemented. The effectiveness of the intervention was measured by evaluating data on the percentage of steps with independent responding and the percentage of steps with prompts to use technology as well as the comparison between the low-tech, visual supports and the high-tech, augmented reality supports. Although results are preliminary at this time, the implications of this study are promising in the field of special education and promoting independence among individuals with autism and other developmental disabilities. The preliminary results of this study do imply that further research would be beneficial in strengthening this study.


This third edition of a trusted resource brings together the latest literature across multiple fields to facilitate the understanding and prevention of falls in older adults. Thoroughly revised by a multidisciplinary team of authors, it features a new three-part structure covering epidemiology and risk factors for falls, strategies for prevention and implications for practice. The book reviews and incorporates new research in an additional thirteen chapters covering the biomechanics of balance and falling, fall risk screening and assessment with new technologies, volitional and reactive step training, cognitive-motor interventions, fall injury prevention, promoting uptake and adherence to fall prevention programs and translating fall prevention research into practice. This edition is an invaluable update for clinicians, physiotherapists, occupational therapists, nurses, researchers, and all those working in community, hospital and residential or rehabilitation aged care settings.


The edible fruit of Phyllanthus emblica (known as amla and Indian gooseberry) is widely used in Eastern traditional medicinal systems for a variety of ailments. Our group has previously reported that an amla juice powder shows neuroprotective effects in several in vitro and in vivo assay models but its chemical constituents and their neuroprotective activity remain unknown. Therefore, we conducted a phytochemical investigation of amla juice powder and evaluated the antioxidant and neuroprotective effects of the isolates. Ten phenolics (1–10), including gallic acid (1), five gallic acid derivatives (2–6), ellagic acid (7), and three ellagic acid derivatives (8–10), were isolated and identified with compounds 8–10 being reported from amla for the first time. All of the isolates showed antioxidant effects in the DPPH assay with IC50 values ranging from 6-158.9 μM superior to the synthetic commercial antioxidant, butylated hydroxytoluene (IC50 = 371.4 μM). In addition, compound 8 reduced β-amyloid-induced neurotoxicity in a transgenic Caenorhabditis elegans model by increasing their survival rate by 28.3% compared to the control group. This study adds to the growing body of evidence supporting the potential health benefits of amla and supports the functional food and nutraceutical applications of amla juice powder.


In the light of recent difficulties in observing vortices in quenches of liquid helium 4 to its superfluid state we re-examine the Zurek scenario for their production. We argue that experiments in helium 4 are unlikely to produce true vortices in the numbers originally anticipated, if at all, because of the wide Ginzberg regime and the slowness of the mechanical quenches. On the other hand, the observed production of unambiguous vortices in neutron-bombarded helium 3, with its narrow Ginzberg regime, and fast quenches, is to be expected.


O- and B-type (OB-type) pulsating stars are important objects for studying the structure and evolution of massive stars through asteroseismology. A large amount of data from various sky surveys provides an unprecedented opportunity to search for and study this kind of variable star. We identify 155 OB-type pulsating stars or candidates, including 38 Oe/Be stars or candidates, from the data observed by TESS, LAMOST, and Gaia, which are almost new. Among the 155 objects, 87 samples are identified as slowly pulsating B (SPB) stars including 37 objects with pure low-frequency and 50 objects with both low- and high-frequency pulsation, and 14 samples are identified as β Cephei pulsating variable (BCEP) stars with both low- and high-frequency pulsation. An H-R diagram shows that these SPB and BCEP stars are mainly located in their instability regions and in the evolutionary stage of the main sequence with mass ranges of 2.5–20 M ⊙ and 7–20 M ⊙, respectively. Two special objects show Fourier spectra similar to BCEP stars but with different positions in H-R, period–temperature (P-T), and period–luminosity (P-L) diagrams. Meanwhile, 52 other targets are identified as candidates of OB-type pulsating stars. We also derive the preliminary results of the P-L relation for SPB and BCEP stars, respectively. This work also indicates that in addition to the H-R diagram, the P-T and P-L diagrams are also very useful for the classification of SPB and BCEP stars. Further detailed analysis of these objects can dramatically increase our understanding of the theories of evolution and structure for massive OB-type pulsating stars.


Skin, muscle, and rectal temperatures, and O2 consumption of Eskimos and Caucasians have been compared during an acute cold exposure involving immersion of one hand and forearm in a 5 C water bath. The Eskimos consumed less O2, maintained their rectal temperatures at a higher level, and gave up less heat from the muscles of the limbs. Though the Eskimos had significantly more adipose tissue, average skin temperatures were the same in the two groups. The pattern of temperatures noted now and the previously observed higher blood flow in the hand and forearm of Eskimos point to increased cooling of arterial blood by returning venous blood in the extremities with resultant preservation of heat in the body core.

Submitted on August 6, 1962


BACKGROUND AND AIMS
The role of hepcidin in inflammatory bowel disease (IBD) children with anemia is poorly understood. However, it has been shown that vitamin D suppresses hepcidin expression. We aimed to assess serum hepcidin levels and the effect of vitamin D treatment on those levels in newly diagnosed IBD pediatric patients.

METHODS
Eighty-five children were prospectively recruited in the Dana-Dwek Children's Hospital (40 newly diagnosed IBD, 45 healthy controls, 47% female, mean age 13.5±3.4 years). Blood samples for interleukin 6 (IL-6), C-reactive protein (CRP), hepcidin, iron parameters, and 25-hydroxyvitamin D (25-(OH)-D) levels were obtained at baseline. Patients with mild-to-moderate signs and symptoms of IBD were treated with 4000 units of vitamin D daily for two weeks, after which the blood tests were repeated.

RESULTS
Basal hepcidin, IL-6, CRP, and platelets counts were significantly higher, and hemoglobin, serum iron, and transferrin levels were significantly lower in the IBD children compared to controls (p < 0.001). Eighteen patients completed two-week treatment with vitamin D. Following treatment, serum 25-(OH)-D concentrations increased by 40% (from 22.5 to 32.5 ng/ml), and serum hepcidin, CRP, and ferritin levels decreased by 81%, 81%, and 40% (from 33.9 ng/ml to 6.7 ng/ml, from 23.9 mg/l to 4.7 mg/l, and from 27 ng/ml to 16 ng/ml, respectively) (p≤0.001).

CONCLUSION
Serum hepcidin levels were significantly higher in IBD pediatric patients compared to controls. Following vitamin D treatment serum hepcidin concentration decreased significantly. These findings suggest a potential role for vitamin D in treating anemia in IBD children.


We introduce a new agnostic clustering model, \emph{minimax correlation clustering}, and a rounding algorithm tailored to the needs of this model. Given a graph whose edges are labeled with $+$ or $-$, we wish to partition the graph into clusters while trying to avoid errors: $+$ edges between clusters or $-$ edges within clusters. Unlike classical correlation clustering, which seeks to minimize the total number of errors, minimax clustering instead seeks to minimize the number of errors at the \emph{worst vertex}, that is, at the vertex with the greatest number of incident errors. This minimax objective function may be seen as a way to enforce individual-level quality of partition constraints for vertices in a graph. We study this problem on complete graphs and complete bipartite graphs, proving that the problem is NP-hard on these graph classes and giving polynomial-time constant-factor approximation algorithms. The approximation algorithms rely on LP relaxation and rounding procedures. We also discuss the broader applicability of our rounding algorithm to other (nonlinear) objective functions for correlation clustering.


Terahertz (THz) radiation, often referred to the frequency range from 0.1 to 10 THz, is the focus of an active and fast growing research community. However, this frequency range located in the electromagnetic spectrum between the microwave band and infrared band, was known as the "THz-gap" until the late 1980's. A lack of available coherent sources and detectors rendered this frequency range inaccessible. The breakthrough was achieved with the generation of THz-radiation by means of femtosecond laser pulses in the visible or nearinfrared range. The generation is usually achieved by either photo-conductive antennas or nonlinear crystals: while a biased photo-conductive antenna emits THz-radiation due to a time dependent photo-current induced by a femtosecond laser pulse, a nonlinear crystal hit by a femtosecond pulse generates a THz-pulse by difference frequency generation. Further development of THz-detectors and THz-sources like the introduction of a quantum cascade laser suitable for Terahertz frequencies provided the access to a vast variety of THz applications. In the past two decades a Terahertz technology in various fields like information and communications technology, biology and medical sciences, non-destructive evaluation and homeland security were established. Moreover, Terahertz radiation is suitable to study fundamental processes present in this frequency range like e.g. phonon excitation as well as inter-band transitions in condensed matter and rotational transitions of molecules in gases.


COVID-19 pandemic has resulted in important consequences for healthcare workers, such as long shifts, staying away from family members due to the risk of illness, and working under intense stress. Outbreaks are considered as traumatic factors like other natural disasters and are expected to cause trauma-related disorders. In this study, it was aimed to determine the acute stress levels and stress responses of both the community sample and healthcare workers via using the National Stressful Events Survey Acute Stress Disorder Short Scale (NSESSS). A total of 1027 volunteers, including 387 healthcare workers and 640 non-healthcare workers, participated in the study. The NSESSS levels of non-healthcare workers were significantly higher than healthcare worker, females compared to males, and singles than married ones. As the thought that work justice was provided in healthcare workers increased, NSESSS levels decreased. As the difficulty of finding protective equipment in healthcare workers decreased, NSESSS levels decreased. Nurses' ages, time spent on duty, and NSESSS levels were significantly higher than physicians and other healthcare workers. In the pandemic period, it can be a guide in determining the risk factors and risk groups in terms of acute stress, taking preventive mental health measures, and providing early intervention.


According to wind resource data in different parts, the characteristic wind speeds of wind turbine were calculated. From low cost considerations, the characteristic wind speeds of wind turbine were optimized, the diameters of wind wheel were shortened and the difficulty of technology was reduced, in order to design the wind turbine. Finally the thesis contrasted and validated by Experimental analysis and simulation. The results showed that: power output of the new airfoil wind turbine is improved by the characteristic wind speed of optimized design, and in four different actual wind farm wind turbine generating capacity per unit area increased by 28.4% than the conventional airfoil wind turbine.


Development of facile routes to the fabrication of thin film substrates with tunable surface enhanced Raman scattering (SERS) efficiency and identification of the optimal conditions for maximizing the enhancement factor (EF) are significant in terms of both fundamental and application aspects of SERS. In the present work, polymer thin films with embedded bimetallic nanoparticles of Ag-Au are fabricated by a simple two-stage protocol. Ag nanoparticles are formed in the first stage, by the in situ reduction of silver nitrate by the poly(vinyl alcohol) (PVA) film through mild thermal annealing, without any additional reducing agent. In the second stage, aqueous solutions of chloroauric acid spread on the Ag-PVA thin film under ambient conditions, lead to the galvanic displacement of Ag by Au in situ inside the film, and the formation of Ag-Au particles. Evolution of the morphology of the bimetallic nanoparticles into hollow cage structures and the distribution of Au on the nanoparticles are revealed through electron microscopy and energy dispersive X-ray spectroscopy. The localized surface plasmon resonance (LSPR) extinction of the nanocomposite thin film evolves with the Ag-Au composition; theoretical simulation of the extinction spectra provides insight into the observed trends. The Ag-Au-PVA thin films are found to be efficient substrates for SERS. The EF follows the variation of the LSPR extinction vis-à-vis the excitation laser wavelength, but with an offset, and the maximum SERS effect is obtained at very low Au content; experiments with Rhodamine 6G showed EFs on the order of 10(8) and a limit of detection of 0.6 pmol. The present study describes a facile and simple fabrication of a nanocomposite thin film that can be conveniently deployed in SERS investigations, and the utility of the bimetallic system to tune and maximize the EF.


Background: Intraoperative nerve blocks have shown promise in managing pain after nasal surgery. The purpose of this systematic review and meta-analysis was to analyze existing level I and II evidence on intraoperative nerve blocks in nasal surgery to optimize postoperative recovery. Methods: The primary outcome of this systematic review and meta-analysis was postoperative pain scores; secondary outcomes included perioperative opioid requirements, patient satisfaction scores, and time to first analgesic requirement. PubMed, Embase, and MEDLINE databases were searched, and two independent reviewers conducted article screening. Methodological quality assessment of studies utilized the Jadad instrument, and interrater reliability was assessed using Cohen kappa. An inverse-variance, fixed-effects model was used for meta-analysis with Cohen d used to normalize effect size between studies. I2 and Q statistics were used to assess interstudy variability. Results: Four studies were included for meta-analysis, totaling 265 randomized patients. The nerve blocks assessed included infraorbital nerve, sphenopalatine ganglion, external nasal nerve, central facial nerve blocks, and total nerve blocks. All demonstrated significantly reduced postoperative pain compared with controls, with a large effect size (P < 0.001). Opioid requirements were lower in the nerve block groups (P < 0.001), and patient satisfaction scores were higher (P < 0.001). Supplemental meta-analyses showed a longer time to first analgesic requirement for patients who received a nerve block (P < 0.001). Conclusions: These findings support the efficacy of nerve blocks in providing postoperative pain relief and enhancing patient satisfaction with pain management. Perioperative nerve blocks, in combination with general anesthesia, should be considered for postoperative pain control.


We propose a technique for data detection in a two-dimensional page-access optical memory. The technique combines sequence detection by the use of the Viterbi algorithm with decision feedback to improve the bit-error-rate performance in a system corrupted by intersymbol interference. It has an advantage in that it can be operated on a row-by-row basis as data are output from the optical detector. Use of the proposed scheme might ease the design tolerances of the optical components or permit the use of large data pages.


Brief Overview of Demographics and Risk Factors: There are more than 760 federally and state-recognized American Indians/Alaska Natives (AI/ANs) tribes in the US.1 Of those AI/ANs responding to the 2010 Census, 41% lived in the West and the majority (78%) lived in urban and rural areas or in states that do not have a federal Reservation.2 AI/ANs have daily behaviors and co-morbidities that increase their risks for cancer. They are more likely to be obese, use commercial tobacco, and have diabetes or high blood pressure. They also have long experienced lower health status in comparison with other US populations. AI/ANs born in 2011 have a lower life expectancy than all US populations (72.6 years vs. 77.8 years).2 Their poverty level is nearly twice that of the overall US population; only half as many having health insurance. When compared to other populations, AI/ANs are more likely to have a lower socioeconomic status and live in poverty, leading to less access to cancer prevention and screening services. Additionally, 20% of AI/ANs have not completed high school as opposed to only 8% of non-Hispanic Whites. Not completing high school has been associated with unhealthy and risk taking behaviors.3 The Indian Health Service (IHS) reported that cancer screening rates for AI/ANs were significantly lower in comparison to the overall US population with only 59% receiving cervical screening, 45% breast screening and 33% receiving colorectal screening, leading to increased risk of late diagnosis and decreased survival from cancer.2 Excerpts from "Native American Cancer Education for Survivors" (NACES): Native American Cancer Education for Survivors" (NACES) is the largest AI cancer survivorship database, education and support program in the US, with almost 900 survivors. NACES is a cancer education intervention designed to improve the Quality of Life (QOL) of cancer survivors by increasing knowledge and informed choice using innovative, tailored, web-based technology. The website includes a QOL survey, culturally appropriate and scientifically accurate content based on the Medicine Wheel (physical, mental-emotional, social and spiritual health), video excerpts from almost 90 AI survivors, sample questions to ask providers, and other interactive information. It is organized as a QOL Tree with information written at reading grade levels 5-7, and is based on AI survivors sharing their cancer-related stories throughout the education materials. Native Patient Navigators (NPNs) assist cancer survivors to effectively use the website and complete a QOL survey. This survey was adapted and culturally tailored from Ferrell9s QOL survey initiated at the City of Hope. In 2013, 75 items, mostly NIH PROMIS® items, were added. As of September 2014, 890 AI cancer survivors completed the survey. Findings include: Most (n=710; 79.8%) are female, 46% have high school or less education, more than half (54.6%) are full-bloods, and almost half (47.6%) were diagnosed with cancer prior to age 50. About 1/3 (35.7%) travel 200 or more miles one way to access cancer care and because of rural road conditions and other geographic issues, almost half (48.1%) travel more than 2 hours one way to access such care. More than 1/3 (37.4%) had difficulties getting into cancer treatment. These data differ greatly from NCI published findings of older age at diagnosis, living within a reasonable distance from cancer care services and access to treatment.4 5 Affordable Care Act (ACA): IHS offers basic clinic services until there is a cancer diagnosis. Then patients are referred through Contract Health Services (CHS) out of the IHS system to private health providers. When there are not enough CHS funds available in a contract year, patients cannot be referred until the next year begins. The current system typically results in people returning to their home reservation for 3-6 months to re-establish "residency", then they are placed on the CHS priority / waiting list to be referred elsewhere for cancer care. This means that AIs must return to the reservation to seek care. However, the ACA, should eliminate such obstacles to accessing timely cancer services. Those AIs who have health insurance receive care in sites determined by their healthcare plans. Those without health insurance and not living near an IHS clinic access health care the same as others in poverty, often not receiving healthcare until an emergency. For many reasons, few receive health care at public institutions. Contrary to popular belief, AIs living in urban areas do not have easier access to healthcare services in comparison to Reservation-based AIs. While almost 2/3 of AIs live in urban areas, only 2% of the total IHS budget is allocated to urban AI clinics, affecting access to cancer screening and early detection programs. Those who seek public screening services often experience fragmented care due to lack of a primary care provider, delayed or lost results reporting or insufficient or delayed follow-up care of suspicious findings. Because the ACA allows AIs the option for exemption from obtaining health insurance, many will rely solely on care through IHS. However, due to major reductions in the IHS budget, tribes and Indian organizations are referring AIs for private insurance through the ACA to assure that they receive healthcare. Because private health insurance is not the norm for AIs, many are unfamiliar with how to use it and are unclear how to access health services such as routine cancer screenings. Access to Technology: In 2012, NACR and its collaborators (Muscogee (Creek) Nation, Rapid City Regional Hospital9s Walking Forward Program, Intertribal Council of Michigan) had their Native Patient Navigators (NPNs) administer a short survey on access to and use of technology to AIs (n= 306). Two thirds of respondents were female, 64% were between 31 and 64 years of age and 68.9% had less than a college education. About 2/3 had positive responses to the use of cell phones, with 76% having a cell phone, 66.6% currently using text messaging and 74.8% willing to receive and respond to about 4-6 health-related texts per day. Many of the elders used Facebook to stay in contact with their grandchildren. Cell phone towers on Reservations are increasing; in 2014, 85% of Reservations have cell phone coverage. Although the majority of AIs now have cell phones, many do not know how to use common features. The need for "cultural" Native Patient Navigators: AIs experience barriers to accessing health care due to socioeconomic and cultural issues as well as historical trauma, even when it is second and third generation.6 7 NPNs help patients understand healthcare information by translating it into terms that are more comfortable and easily understood. They know how to address historical issues unique to tribal members, varying communication patterns and spirituality practices that may impact contemporary medical practices. They provide support and referrals to education programs, resources and cancer screenings and improve and enhance AI patient outcomes through recognizing and integrating culture in overall healthcare. References: 1 US Census Bureau, (2012). The American Indian and Alaska Native Population: 2010 (based on the 2010 Census Redistricting Data (Public Law 94-171) Summary File). In: Commerce USDo, editor. Washington, DC. 2 Indian Health Service DHHS. (2012). Indian Health Service. IHS Fact Sheets. In: http://www.ihs.gov/publicaffairs/ihsbrochure/disparities.asp. 3 DHHS, Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report, CDC Health Disparities and Inequalities Report—United States, 2013, Supplement, volume 62, number 3, November 22, 2013, page 9 4 Howlader N, Noone A, Krapcho M, Neyman N, Aminou R, Waldron W, et al. (eds). SEER Cancer Statistics Review, 1975–2009 (Vintage 2009 Populations), National Cancer Institute; Bethesda, MD, http://seer.cancer.gov/csr/1975_2009_pops09/, based on November 2011 SEER data submission, posted to the SEER web site, April 2012. 5 de Moor JS, Mariotto AB, Parry C, Alfano CM, Padgett L, Kent EE, Forsythe L, Scoppa S, Hachey M, and Rowland JH. Cancer Survivors in the United States: Prevalence across the Survivorship Trajectory and Implications for Care. Cancer Epidemiol Biomarkers Prev. 2013 Apr;22(4):561-70. 6 Harjo, Lisa, Burhansstipanov, Linda, Lindstrom, Denise, Rationale for "Cultural" Native Patient Navigators in Indian Country. Journal of Cancer Education. (online June 2014, in print summer 2014) Doi 10.1007/s13187-014-0684-0 7 Cutler M (n.d.) Multigenerational trauma: behavior patterns in cultures. Retrieved from http://edweb.boisestate.edu/instituteforthestudyofaddiction/pp/Historical_Trauma_and_Grief.ppt on July 2014 Citation Format: Linda Burhansstipanov, Linda U. Krebs, Lisa D. Harjo. Challenges in addressing cancer health disparities in Native American communities. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr IA10.


The assumption of no unmeasured confounders is a critical but unverifiable assumption required for causal inference yet quantitative sensitivity analyses to assess robustness of real-world evidence remains underutilized. The lack of use is likely in part due to complexity of implementation and often specific and restrictive data requirements required for application of each method. With the advent of sensitivity analyses methods that are broadly applicable in that they do not require identification of a specific unmeasured confounder, along with publicly available code for implementation, roadblocks toward broader use are decreasing. To spur greater application, here we present a best practice guidance to address the potential for unmeasured confounding at both the design and analysis stages, including a set of framing questions and an analytic toolbox for researchers. The questions at the design stage guide the research through steps evaluating the potential robustness of the design while encouraging gathering of additional data to reduce uncertainty due to potential confounding. At the analysis stage, the questions guide researchers to quantifying the robustness of the observed result and providing researchers with a clearer indication of the robustness of their conclusions. We demonstrate the application of the guidance using simulated data based on a real-world fibromyalgia study, applying multiple methods from our analytic toolbox for illustration purposes.


Abstract Long noncoding RNAs (lncRNAs) mediate important epigenetic regulation in a wide range of biological processes. However, the effect of all dysregulated lncRNAs in myocardial infarction (MI) is not clear. Whole transcriptome sequencing analysis was used to characterize the dynamic changes in lncRNA and mRNA expression. A gene network was constructed, and genes were classified into different modules using WGCNA. In addition, for all dysregulated lncRNAs, gene ontology analysis and cis-regulatory analysis were applied. The results demonstrated that a large number of the differentially co-expressed genes were primarily linked to the immune system process, inflammatory response, and innate immune response. The functional pathway analysis of the MEblue module included immune system process and apoptosis, and MEbrown included the T-cell receptor signal pathway by WGCNA. In addition, through cis-acting analysis of lncRNA regulation, the cis-regulated mRNAs were mainly enriched in immune system processes, innate immune responses, and VEGF signal pathways. We found that lncRNA regulation of mRNAs plays an important role in immune and inflammatory pathways. Our study provides a foundation to further understand the role and potential mechanism of dysregulated lncRNAs in the regulation of MI, in which many of them could be potential targets for MI.


Background Residual risk of relapse remains a substantial concern for breast cancer patients as greater than half of recurrences occur beyond the initial 5y of tamoxifen therapy. First generation multigene signatures provide further prognostic information to standard clinical and pathological factors, however, their utility is strongest for predicting early relapse (≤5y post-diagnosis), and they have limited prognostic value for late metastatic risk. Breast Cancer Index (BCI), a continuous risk index based on the combination of HOXB13:IL17BR (H:I) and the molecular grade index (MGI), estimates the individual risk of recurrence in ER+, LN- breast cancer patients. In this study, the prognostic performance of BCI for predicting early versus late relapse (≤5y vs >5y post-diagnosis) was examined. Methods: Gene expression profiling was performed on RNA extracted from FFPE tumor samples from untreated, postmenopausal, ER+ early stage breast cancer patients in the randomized Stockholm Trial. RT-PCR assay, pre-defined BCI score, H:I and MGI cut-points, and risk group categorization were done as previously described (Jerevall et al., Br J Cancer 2011). Association of gene expression data with the clinical endpoint of time to distant metastasis was assessed by Kaplan-Meier analysis using the log rank test; time-varying coefficient Cox proportional models were used to estimate the time-dependent hazard ratios (HRs). Results: Analyses included 274 ER+, LN- patients (51% PR+, 87% HER2−, 63% grade 2, 17.7 y median follow-up) who did not receive adjuvant tamoxifen treatment. BCI was significantly associated with 10-year distant metastasis-free survival, with probabilities of 91% (86-96%), 82% (74-91%), and 65% (52-80%) for the low, intermediate, and high-risk BCI groups, respectively (HR high versus low-risk group = 4.31; 95%CI, 2.23−8.33; P=0.00001). Risk stratification for the first 5-y post-diagnosis using time-varying coefficient Cox models showed both MGI and BCI were significantly prognostic with HRs of 6.13 (95% CI: 2.11−17.8; P=0.0009) and 5.77 (95% CI: 2.16−15.39; P=0.0005). For prediction of late relapse in the subset of patients that remained distant metastasis-free for at least 5-y (N=221), MGI decreased in prognostic utility (HR 1.65, 0.76−3.56; P=0.2), consistent with other proliferation-based gene signatures. In comparison, both H:I and BCI were significantly associated with risk of late relapse [HRs 2.89 (1.31−6.36; P=0.009); 3.31(1.3−8.39); P=0.012]. Conclusions: This post-hoc analysis of a randomized clinical trial cohort demonstrates the prognostic utility of BCI to predict disease outcome for both early and late risk of relapse in untreated patients with early stage breast cancer. Given the significant need for predictors of late risk, the stability of BCI prognostic performance may have important implications for the type and duration of treatment for hormone-responsive breast cancer. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-12-12.


Hemoglobin Bethesda is a /3 chain variant of human hemoglobin in which histidine is substituted for tyrosine at position 145. From chemical and crystallographic studies, it has been postulated that the tyrosine normally found at this position is critical for the maintaince of a normal deoxy structure. Kinetic studies of the carbon monoxide and Rbutyl isocyanide binding reactions show that deoxyhemoglobin Bethesda in low ionic strength buffers at pH 7.0 exhibits noncooperative, chain-like behavior. Under the same conditions, the Soret absorption spectrum of deoxyhemoglobin Bethesda is more like that of the isolated a~ and fl chains than that of the normal deoxyhemoglobin tetramer. In addition, reversible dissociation of deoxyhemoglobin Bethesda can be demonstrated by ultracentrifugation experiments. All of these results suggest that at neutral pH deoxyhemoglobin Bethesda exists in a conformation analogous to that postulated for liganded hemoglobin A. However, in the presence of inositol hexaphosphate, more normal, cooperative kinetic behavior is observed, subunit dissociation is reduced, and the absorption spectrum in the Soret region is found to be virtually identical with that of deoxyhemoglobin A. Thus, the substitution of histidine for tyrosine 145 /3 drastically alters the ability of hemoglobin to form a normal deoxy structure. Studies of the dissociation of oxygen and n-butyl isocyanide from saturated hemoglobin Bethesda indicate, however, that this mutation does not alter the intrinsic reactivities of the (Y and (3 heme sites within the liganded conformation. Rather, this amino acid substitution appears to inhibit the quatemary change to the deoxy conformation in such a manner that only on the addition of organic phosphates is behavior observed which resembles that of normal deoxyhemoglobin A.


OBJECTIVE: To compare biometric measures of pelvic floor function obtained using three-dimensional (3D) ultrasound and magnetic resonance imaging (MRI) in a group of nulliparous asymptomatic young women. METHODS: Twenty-seven asymptomatic nulliparous volunteers were assessed prospectively, using translabial 3D ultrasound and multiplanar 3D MRI. Levator hiatal dimensions were measured in the axial plane in both modalities. All participants were imaged supine, after voiding with data acquired at rest, on maximum Valsalva and maximum pelvic floor contraction. Interobserver variability was determined for both methods. Normally distributed continuous ultrasound data were compared with equivalent MRI parameters, and intraclass correlation coefficients were used to estimate correlation between the two methods. Bland-Altman analysis was also used to estimate agreement between methods. RESULTS: Interobserver repeatability was fair to excellent for all parameters measured with both methods. Moderate-to-substantial agreement between methods was shown for all tested parameters (intraclass correlation coefficients 0.587–0.783). There was a systematic but nonsignificant difference between methods, in that measurements on Valsalva tended to be larger for MRI, and the poorest agreement (intraclass correlation coefficient 0.587) was found for hiatal area on Valsalva. CONCLUSION: Agreement between the two methods was moderate to substantial for all parameters except for hiatal area on Valsalva. Magnetic resonance imaging yielded higher area measurements on Valsalva, which may indicate difficulties in identifying the plane of minimal dimensions due to poorer temporal resolution compared with ultrasound imaging. LEVEL OF EVIDENCE: II


The diets of four introduced Poeciliidae, Gambusia affinis holbrooki, Xiphophorus helleri, X. maculatus and Poecilia reticulata, were studied in subtropical streams, southeastern Queensland, Australia. The prey of greatest importance in G. affinis diets was usual]y of terrestrial origin, i.e. ants and adult nematoceran Diptera, but aquatic Hemiptera and other aquatic taxa were also important in some habitats. G. affinis ate invertebrate prey that were small relative to body size and mouth gape (mean prey width 0.3 x mouth gape, mean prey length 1.28 x mouth gape) and relative to the sfze range of prey present (mean prey ingested = 0.597 x mean length and 0.702 x mean width of availability prey in the environment equal to or smaller than the largest prey eaten). Some aquatic taxa (e.g., immature Trichoptera and Ephemeroptera, Oligochaeta, Crustacea and Mollusca) of the preferred size range which were abundant in the streams were eaten infrequently. X. helleri was omnivorous, consuming aquatic plant tissue, filamentous and other algae and aquatic and terrestrial invertebrates. X. maculatus consumed Crustacea and aquatic and terrestrial insects, with dominance of the atyid shrimp, Caridina. P. reticulata had a more diverse diet composed largely of terrestrial insects, particularly ants; chironomid larvae were the dominant aquatic taxon eaten. The four species of poeciliids had significantly different mean diet composition. The implications of poeciliid feeding for sympatric endemic fishes are briefly discussed.


Methanocellales represents a new order of methanogens, which is widespread in environments and plays specifically the important role in methane emissions from paddy fields. To gain more insights into Methanocellales, comparative genomic studies were performed among three Methanocellales strains through the same annotation pipeline. Genetic relationships among strains revealed by genome alignment, pan-genome reconstruction and comparison of amino average identity suggest that they should be classified in different genera. In addition, multiple copies of cell cycle regulator proteins were identified for the first time in Archaea. Core metabolisms were reconstructed, predicting certain unique and novel features for Methanocellales, including a set of methanogenesis genes potentially organized toward specialization in utilizing low concentrations of H2, a new route of disulfide reduction catalysed by a disulfide-reducing hydrogenase (Drh) complex phylogenetically related to sulfate-reducing prokaryotes, an oxidative tricarboxylic acid (TCA) cycle, a sophisticated nitrogen uptake and regulation system as well as a versatile sulfur utilization system. These core metabolisms are largely conserved among the three strains, but differences in gene copy number and metabolic diversity are evident. The present study thus adds new dimensions to the unique ecophysiology of Methanocellales and offers a road map for further experimental characterization of this methanogen lineage.


This paper discussed an analysis of correspondence especially about the kinds of error made by the staff in replying to emails from the customer. All the data were mostly analyzed based on the theory applied by Dulay, Heidi C, and Marina Burt in their book entitled Language Two (1982) and it was also supported by other theories. They were Error Analysis and Interlanguage written by S. P. Corder (1981), Error Analysis Perspective on Second Language Acquisition written by Richard (1974) and beside the other references about, several supporting references that were considered relevant to the topic were also used in this paper. In conducting this research, the library research was applied and there were three steps for the methodology. They were data collection, data analysis, and data source. The information for this paper came from emails written by Ayuna Silver employees. The data was then gathered by reading carefully and then classified based on the types of errors according to the theory used in this qualitative paper. Based on the findings of the study, it can be concluded that Ayuna Silver's staff made some mistakes, and the factor that caused the errors. There were omissions, additions, misformations, and misordering errors. Overgeneralization, incomplete application of rules, ignorance of rule restrictions, and false concept hypothesized were the factors that caused errors.
Keywords: syntax, error analysis, e-mail


The reliability characterization of a high performance 32nm SOI CMOS technology featuring gate first High-K Metal Gate and embedded High-K Metal Fill DRAM is presented. This technology features high performance 0.9V thin dielectric devices and 1.5V thick dielectric I/O devices. Included are results of Hot Carrier, Bias Temperature, Planar and Trench Node TDDB, Gate to Contact, silicon eFUSE, SER, SRAM and Logic circuit reliability evaluations.


We report on a multiband variability and correlation study of the TeV blazar Mrk 421 during an exceptional flaring activity observed from 2013 April 11 to 19. The study uses, among others, data from GLAST-AGILE Support Program (GASP) of the Whole Earth Blazar Telescope (WEBT), Swift, Nuclear Spectroscopic Telescope Array (NuSTAR), Fermi Large Area Telescope, Very Energetic Radiation Imaging Telescope Array System (VERITAS), and Major Atmospheric Gamma Imaging Cherenkov (MAGIC). The large blazar activity and the 43 hr of simultaneous NuSTAR and MAGIC/VERITAS observations permitted variability studies on 15 minute time bins over three X-ray bands (3–7 keV, 7–30 keV, and 30–80 keV) and three very-high-energy (VHE; >0.1 TeV) gamma-ray bands (0.2–0.4 TeV, 0.4–0.8 TeV, and >0.8 TeV). We detected substantial flux variations on multi-hour and sub-hour timescales in all of the X-ray and VHE gamma-ray bands. The characteristics of the sub-hour flux variations are essentially energy independent, while the multi-hour flux variations can have a strong dependence on the energy of the X-rays and the VHE gamma-rays. The three VHE bands and the three X-ray bands are positively correlated with no time lag, but the strength and characteristics of the correlation change substantially over time and across energy bands. Our findings favor multi-zone scenarios for explaining the achromatic/chromatic variability of the fast/slow components of the light curves, as well as the changes in the flux–flux correlation on day-long timescales. We interpret these results within a magnetic reconnection scenario, where the multi-hour flux variations are dominated by the combined emission from various plasmoids of different sizes and velocities, while the sub-hour flux variations are dominated by the emission from a single small plasmoid moving across the magnetic reconnection layer.


Background and aims Children diagnosed with Down syndrome have a distinctive predisposition to develop acute myeloblastic leukaemia of Down syndrome (ML-DS). This disease is preceded by a transient neonatal preleukemic state known as transient myeloproliferative disorder (TMD) which can be clinically obvious or silent. This condition is considered to be a paradox in oncology because it regresses spontaneously three months after birth, with a 5 year survival rate of approximately 80%. Methods We report a case of a 3 year old girl with Down syndrome who was monitored in our clinic since she was one month old. Results The patient was born with a Down phenotype from a dizygotic twin pregnancy, with a healthy brother. At the age of 8 days she started to present pallor and splenomegaly. Leukocytosis and thrombocytopenia were present and the May-Grunwald-Giemsa stained smears revealed 78% blasts, the aspect suggesting an acute congenital leukaemia, probably megakarioblastic. The immunophenotyping confirmed this diagnosis. The patient was diagnosed with TMD and achieved spontaneous complete remission at the age of 8 weeks and was periodically monitored in our department. At the age of 3 years she was admitted to our hospital with bleeding gums, petechiae and splenomegaly. The peripheral blood count revealed 70% blasts, anaemia and thrombocytopenia. The bone marrow aspirate concluded that it was an acute mixed phenotype, myeloid and B-lymphoblastic leukaemia. The patient started therapy with the AML-BFM 2004 protocol, achieving complete remission after the first block of chemotherapy. ConclutionS It is estimated that 20%–30% of the neonates with TMD will eventually develop ML-DS. The blasts are similar to those in TMD, with a megakarioblastic morphology. However, in our case, the blasts first had the typical morphology, but when the patient developed ML-DS blasts had both myeloblastic and lymphoblastic characteristics. TMD and ML-DS have distinctive features which make it an exceptional in vitro model for myeloid leukemogenesis.


An innovative time-dependent magnetically actuated mixing process based on magnetic nanoparticles (MNPs) for enhancing the mixing performance of a microfluidic system is presented in this paper. Finite-element technique that combines time-dependent magnetic field with mass transfer of species is employed for quantifying the effect of convection, diffusion, and magnetic field on the mixing performance. It is shown that it is possible to generate periodic magnetic forces that can make the MNPs oscillate in different directions. This oscillation of MNPs causes agitation in the surrounding fluid thus improving the mixing in the microfluidic system. Effects of MNP size, inlet velocity of the fluid entering the system, and switching frequency of magnetic field are investigated. Mixing efficiency analysis result shows that in order to have an effective MNP-based mixing, an optimum switching frequency is required that not only depends on applied magnetic field but also on convective flow velocity, channel's dimension, and nanoparticle size. It is also observed that if the switching frequency is much higher or lower than the optimum switching frequency, then MNPs add limited disturbance to the fluid flow and do not significantly enhances the mixing. Moreover, the optimum switching frequency and the inlet flow velocity is also scalable. Furthermore, when MNP actuated mixing is compared with passive mixing strategies, it is found to be more efficient. The simulation performed in this paper using the multiphysics model provides an excellent estimate of the potential to use time-dependent magnetic actuation technique for efficiently mixing or tagging MNPs with target biomolecules on-chip for further analysis. The model will also be very useful in investigating a wide range of design parameters for designing and fabricating efficient integrated lab-on-a-chip devices for point-of-care applications.


The development of high-performance photosensitizers is the top priority in photodynamic therapy (PDT). Iridium complexes are widely used because of their many advantages such as high photostability, long T1 lifetime, high yield of singlet oxygen generation, and so on. Halogen-bridged binuclear complexes are often used as intermediates in the synthesis of photosensitizers but ignored in PDT applications. Here we found that halogen-bridged binuclear iridium complexes showed excellent performance in 1O2 generation. It was also confirmed that these complexes kill tumor cells by inducing apoptosis. Through molecular design and modification, we studied the effect of the bridging halogen atoms and intracellular localization on the performance of PDT. The results show that replacing the bridging halogen with heavier atoms and targeting the complex in mitochondria can effectively enhance the efficiency of PDT. Among them, the bromine bridged binuclear iridium complex located in mitochondria reported in this paper can achieve an IC50 value of 75 nM for MCF-7 cells. This work also provides inspiration for the exploration of complex-based photosensitizers.


The scientific objectives and performance characteristics of a new astronomy mission referred to as the far ultraviolet spectroscopic explorer, or FUSE are being defined by team involving people experienced in instrumentation, observations, and theory in order to develop. mission and instrumental requirements that best meet the scientific needs. The team is intended to have a lifetime of about one year, ending with the submission of a report to NASA which could be used as the basis for an engineering design study. The principal objective of FUSE is to obtain astronomical spectra at wavelengths shorter than is possible with the Space Telescope.


The static structure functions of liquid gallium obtained from high resolution time-of-flight measurements in the temperature range 17-70°C are reported. A well-separated double structure in the static structure factor is observed first time. It is concluded that S(Q) is a superposition of two structure functions in the investigated temperature range. The presence of the β phase structure in the liquid-state could explain the strange crystallization of gallium.


The subject of determining the proper profile to use with either the wheel or rail has long been a discussion of controversy. Practices have evolved and become common in monitoring the rail profile and keeping in conformance with researched profiles that offer maximum rail life. However, with the wheel, preventative measures to maintain the accepted profile have not been widely adopted. Railroad companies and Loram Maintenance of Way have joined forces to develop an "Automatic Wheel Inspection System" (AWIS). This paper demonstrates the benefits of monitoring as well as profiling wheels in order to extend their useful life.


Investigates the performance of blind signal "COPY" algorithms which use fourth order cumulants to estimate the steering vectors. The steering vectors are then used to form a linear combiner, to produce estimates of the signals. The authors derive an asymptotic expression for the upper bound on the quality of the estimated signal in terms of the output signal-to-interference ratio. Some insight into the achievable performance of such algorithms is obtained by numerical evaluation of the bound for two test cases of interest.<<ETX>>


The goal of this study is to analyze the behavior of costs in institutions administered by the Secretary of State for Health of Santa Catarina, according to the several categories of hospitals. This is a descriptive research, conducted based on secondary data. The approach used on the issue is predominantly quantitative, with technical, bibliographical and documentary procedures. The data from 2007 and 2008 were obtained directly from the costs system of the hospitals in the research and they were statistically treated by analyzing the correlation of four distinct groups of medical specialties: General Hospitals, General Hospitals with Maternity Units, Maternity Units, and Hospitals with Other Specialties. The data for the number of treatment were correlated, first individually with the various types of costs at each hospital, where a negative correlation was found in most cases. Later, in general, the analysis of correlation of the total number of treatment in hospitals versus their total costs resulted in positive values for all tests done. As a result of these analyses, it can be inferred that there are similarities in the behavior of costs for different hospital categories. However, it is assertive that there is a variation in hospital costs with the increase or reduction in the number of treatments, only when all hospitals are analyzed jointly. Nonetheless, when analyzed individually, the different hospitals are independent from their costs related to the number of treatments.


Apoptosis is a physiological cell death process essential for development, tissue homeostasis, and for immune defense of multicellular animals. Inhibitors of apoptosis proteins (IAPs) regulate apoptosis in response to various cellular assaults. Using both genetic and pharmacological approaches we demonstrate here that the IAPs not only support opportunistic survival of intracellular human pathogens like Chlamydia pneumoniae but also control plasticity of iNOS+ M1 macrophage during the course of infection and render them refractory for immune stimulation. Treatment of Th1 primed macrophages with birinapant (IAP-specific antagonist) inhibited NO generation and relevant proteins involved in innate immune signaling. Accordingly, birinapant promoted hypoxia, angiogenesis, and tumor-induced M2 polarization of iNOS+ M1 macrophages. Interestingly, birinapant-driven changes in immune signaling were accompanied with changes in the expression of various proteins involved in the metabolism, and thus revealing the new role of IAPs in immune metabolic reprogramming in committed macrophages. Taken together, our study reveals the significance of IAP targeting approaches (Smac mimetic compounds) for the management of infectious and inflammatory diseases relying on macrophage plasticity.


Abstract A structural equation model was used for verification with chronic schistosomiasis to investigate the coagulation–anticoagulation system imbalance and to deduce the mechanism of D-dimer (D-D) level elevation in patients with advanced schistosome hepatic disease. We detected the plasma levels of tissue-type fiber plasminogen activator (tPA), urokinase type plasminogen activator (uPA), plasmin-antiplasmin complex (PAP), plasminogen (PLG), antithrombin (AT), plasminogen activator inhibitor 1 (PAI1), D-D, factor VIII: C (FVIII:C), antithrombin-III (AT-III), PLG, protein S (PS), and protein C (PC) in the healthy people as control (69), patients with chronic schistosomiasis (150) or advanced chronic schistosomiasis (90). FVIII, PAP, D-D, tPA, and uPA plasma levels were significantly higher in the chronic group than in the control group and were also significantly higher in the advanced group. However, AT-III, PC, PS, AT, PLG, and PAI1 plasma levels in the advanced and chronic groups were significantly lower than those in the control group. With progression of disease in patients with schistosomiasis japonica, a hypercoagulable state is induced by the coagulation–anticoagulation imbalance, eventually leading to patients with high levels of D-D. Furthermore, we established a structural equation model path of a "chronic schistosomiasis disease stage–(coagulation–anticoagulation–fibrinolysis)–D-D." By using analysis of moment structures (AMOS), it was shown that the chronic schistosomiasis stage was positively related to factor VIII and had negative correlation with AT-III; a good positive correlation with PAP, tPA, and uPA; and a good negative correlation with PLG and PAI1. In addition, our results show that the path coefficient of anticoagulation–fibrinolysis system to the chronic stage of schistosomiasis or D-D levels was significantly higher than that of the coagulation system. In conclusion, the coagulation and fibrinolysis imbalance in patients with chronic schistosomiasis, especially with advanced schistosomiasis, is due to the progression of disease stages.


Carbon nanotubes (CNTs) have attracted remarkable attention as reinforcement for composites owing to their outstanding properties. CNT/Cu nanocomposites were fabricated by mixing the nano-sized Cu powders with multi-wall carbon nanotubes and followed by the spark plasma sintering process. The CNT/Cu nanocomposite fabricated from nano-sized Cu powders shows more homogeneous distribution of CNTs in matrix compared to that fabricated from macro-sized Cu powders. The hardness of CNT/Cu nanocomposite fabricated from nano-sized Cu powders increases with increasing the volume fraction of CNTs, while the hardness of that fabricated from macro-sized Cu powders decreases with the addition of CNTs.


We report here the identification and characterization of pgm, a gene in Escherichia coli that encodes the enzyme phosphoglucomutase, specifically required for the catalysis of the interconversion of glucose 1-phosphate and glucose 6-phosphate. The predicted amino acid sequence of the pgm gene is highly conserved in E. coli, Acetobacter xylinum, Saccharomyces cerevisiae, rabbits, and humans. pgm deletion mutant strains are deficient in phosphoglucomutase activity.


Loss of motoneurons results in a decrease in force production by skeletal muscles and paralysis. Although it has been shown that missing motoneurons of rats can be replaced by embryonic homotopic neurons, attempts to guide their axons to their target muscles that have lost their innervation have been unsuccessful. In this study attempts were made to guide axons from grafted embryonic motoneurons to their target via a reimplanted ventral root. Adult hosts that received an embryonic graft prelabelled with 5‐bromo‐2′‐deoxyuridine had their L4 ventral root avulsed and reimplanted into the spinal cord. Three to six months later, neurons that had their axons in the L4 ventral ramus were retrogradely labelled with fast blue and diamidino yellow. In five animals that had received an embryonic graft 116 ± 16 cells were retrogradely labelled, and of these at least 15% were of graft origin, since they were positive for 5‐bromo‐2′‐deoxyuridine. In five animals that had their L4 ventral root reimplanted but did not receive a graft, only 12 ± 1.3 cells were retrogradely labelled. However, meaningful functional recovery could be achieved only if the regenerating axons of embryonic motoneurons found in the L4 ventral ramus were able to reverse the loss of force of muscles that had lost their innervation. This study shows that axons of embryonic motoneurons grafted into an adult rat spinal cord, as well as some axons of host origin, can be guided to denervated hindlimb muscles via reimplanted lumbar ventral roots. In normal rats ∼30 motor axons innervated the extensor digitorurn longus and 60 innervated the tibialis anterior via the L4 ventral root. In rats that did not receive a graft only 3.7 ± 1.2 axons reached the extensor digitorum longus and 3.5 ± 0.4 reached the tibialis anterior muscle via the implanted L4 ventral root. In animals that had an embryonic graft, 7.6 ± 0.5 axons innervated the extensor digitorum longus and 8.5 ± 0.5 reached the tibialis anterior muscle via the implanted root. In rats without a transplant the maximum tetanic tension elicited by stimulating the implanted L4 root was 16 ± 7 g for the extensor digitorum longus and 53 ± 36 g for the tibialis anterior muscle, whereas the corresponding muscles in animals that had an embryonic graft developed 82 ± 16 and 281 ± 95 g respectively. Thus it appears that the grafted motoneurons contributed to the innervation and functional recovery of the denervated muscles.


The dairy industries are characterized by a high demand for electricity, and energy for heating and cooling, necessary for obtaining a finished quality product. The scope of this study is to evaluate the technical and economic feasibility of a proposed intervention in the integration of a cogeneration and trigeneration system fueled with natural gas in an existing factory service, located in the north of Italy. The proposed intervention is analyzed in order to allow for the reduction of the overall energy demand of primary energy optimizing the activity management cost. The energy demand of this activity is analyzed below. The design choice are made in terms of energy production and distribution, as well as the economic and financial assessments related to the energy integration of either the cogeneration system or by tri-generation.


Realization of efficient deep-blue anthracene-based emitters with superior film-forming and charge transport properties is challenging. A series of non-symmetric 9,10-diphenylanthracenes (DPA) with phenyl and pentyl moieties at the 2nd position and alkyl groups at para positions of the 9,10-phenyls were synthesized and investigated. The non-symmetric substitution at the 2nd position enabled to improve film forming properties as compared to those of the unsubstituted DPA and resulted in glass transition temperatures of up to 92 °C. Small-sized and poorly conjugated substituents allowed to preserve emission in the deep blue range (<450 nm). Substitution at the 2nd position enabled to achieve high fluorescence quantum yields (up to 0.7 in solution, and up to 0.9 in the polymer host), although it caused an up to 10-fold increase in the intersystem crossing rate as compared to that of the unsubstituted DPA. Further optimization of the film forming properties achieved by varying the length of the alkyl groups attached at the 9,10-phenyls enabled to attain very high hole drift mobilities (∼5 × 10(-3)-1 × 10(-2) cm(2) V(-1) s(-1)) in the solution-processed amorphous films of the DPA compounds.


In an earlier paper1 the authors reported the results of a study of the methods of artificial respiration when conscious subjects were used. In that study three methods of artificial respiration were investigated: namely, the Schafer prone-pressure method, the modified prone-pressure method, in which the hands were rolled or snapped off the subject's back, and the pole-top method.2 A total of 15 men was tested, and the volume of air moved by the three methods of artificial respiration was measured. All of these men were conscious, and the results indicated that all the methods were adequate, with the pole-top method in the lead. Although all of the subjects were intelligent and presumably capable of completely relaxed passivity, such results are always open to the criticism that the subject may have co-operated, perhaps unintentionally.


Muramyl peptides have been shown to exert several biological activities including potentiation of humoral and cell‐mediated immunity and stimulation of natural resistance. The mode of action of muramyl peptides has not been elucidated fully and the immunological activities of some derivatives have been associated with toxic effects, including pyrogenicity and inflammatory reactions. Nevertheless, the impact of muramyl peptides on mitochondrial respiration has never been addressed. In this study, the in vitro effects of muramyl peptides on rat liver mitochondria were examined. Toxic muramyl peptides induced a significant decrease in respiratory control ratio versus non‐toxic analogues. These results were confirmed by in vivo studies in mice and were extended to mitochondria isolated from spleens. Our data address, for the first time, the effect of muramyl peptides on mitochondrial bioenergetics. Further studies are required to reveal the mechanism of mitochondrial toxicity in relation to the damaging effects of toxic muramyl peptides.


The mechanical properties of materials are highly sensitive to the content of impurities and point defects due to their interaction with plastic deformation carriers - dislocations. This opens up the possibility to some extent control the mechanical properties of materials through alloying and creating solid solutions. In a number of crystalline materials, in addition to the well-known solid-solution strengthening in the region of a low concentration of solution atoms, the opposite behavior is also observed - an increase of plasticity, or softening. In the present work, the mechanism of competition of these effects is revealed and it is shown how the boundary of behavior change can be used to estimate the microscopic parameters of materials. The theory predicts trends in the dependence of plasticity on the concentration of alloying elements, stress, temperature, strain rate, and a number of material parameters.


The case law under the Charter on the use of EU fundamental rights to scrutinize national measures represents a continuation of the earlier jurisprudence. The wording of Article 51(1) Charter of Fundamental Rights has not resulted in a general rollback of EU fundamental rights. However, the Charter has focused attention on the issue, has resulted in important new guidance and some streamlining of the case law, and will make it hard for the Court to push the jurisprudence further. The normative justification for the Wachauf type cases can be readily found and has been convincingly articulated by the Court. This does not mean that it will be easy to decide whether the connection between the EU rules and the national measure is sufficient to count as implementation, but the Court has helpfully distilled factors to be taken into account. By contrast, the normative justification for ERT type cases is more difficult to establish. This case law represents a far-going interference with national legal systems. The standard explanation, that since derogations are creatures of Union law, EU fundamental rights must apply, fails to convince. The Court is expressing its distrust of national systems of fundamental rights protection. Unfortunately the distrust may be warranted, and the political system of the EU may not be well equipped to correct matters. The case law can be defended as a judicial remedy for the failure of the political, but needs to be applied with care.


This paper addresses the use of adaptive sliding mode control for the servo actuator system with friction. The adaptive sliding mode control has several advantages over traditional sliding mode control method. Firstly, the magnitude of control effort is reduced to the minimal admissible level defined by the conditions for the sliding mode to exist. Secondly, the upper bounds of uncertainties are not required to be known in advance. Therefore, adaptive sliding mode control method can be effectively implemented. The numerical simulation via MATLAB 2014a for servo actuator system with friction is investigated to confirm the effectiveness of the proposed robust adaptive sliding mode control scheme. The results clarify, after comparing it with the results obtained by using classical sliding mode control, that the control efforts are reduced and the chattering amplitude is attenuated with preserving main features of the classical sliding mode control.


With the continuous and aggressive competition in advertising businesses, uncontrollably desires have emerged to identify and classify consumers. It is proven that companies must have a clear definition of its target market. Based on this we have seen different ways to identify, analyze, and track consumers, either voluntarily or without their consent. Browser fingerprinting techniques have evolved from being privacy-friendly to privacy intrusive to serve these demands. This also has pushed privacy concerned people to save no effort to advance countermeasures. In this paper we introduce different browser fingerprinting techniques and their relevant technologies in the wild. It additionally elaborates widely known countermeasures.


The article aims to highlight one of the highest environmental issues, caused by pollution with persistent organic pollutants (POPs) such as polychlorinated biphenyls (PCBs). This form of environmental pollution with a negative impact on human health would not be possible without the use of high voltage industrial electrical equipment with dielectric fluids infested with various PCB isomers. In order to carry out the experimental program, samples of dielectric fluids both from Romania and Indonesia were investigated. The PCBs-containing samples were characterized using GC-ECD technique, employing an Agilent 7890 gas chromatograph equipped with a 15 mCi 63Ni µECD detector. PCBs concentrations were calculated using the standard calibration method based on the internal standard according to the corresponding normative documents. Ongoing work is carried out to adapt the technique for the analysis of PCBs in soils contaminated with oil products.


Contamination of distilled water with free and bound amino acids and with microbes has been overlooked in most laboratories. Unless special precautions are taken, distilled water will be contaminated with air borne microbes, probably psuedomonads, which multiply in water of conductivity quality. Amino acids and proteins that may be found in the water therefore presumably are derived from these airborne organisms. Chemical reagents such as hydrochloric acid and ammonium hydroxide solutions, which have water as an integral part, also have been found to be contaminated with amino acids. This paper deals with the extent of such contamination and describes means to provide water and hydrochloric acid (6 mol/liter) that would be suitable for determination of amino acids in concentrations of 10-9 mol/liter or less in materials of biological interest as well as rocks, lunar soil, meteorites, etc.


Slow diffusion reactions of the pentaphosphaferrocene [Cp*Fe(η(5)-P(5))] (Cp*=η(5)-C(5)Me(5) (1)) with CuX (X=Cl, Br, I) in different stoichiometric ratios and solvent mixtures result in the formation of one- and two-dimensional polymeric compounds 2-6 with molecular formula [{Cu(μ-X)}{Cp*Fe(μ(3),η(5):η(1):η(1)-P(5))}](n) (X=Cl (2a), I (2'c)), [{Cu(μ-I)}{Cp*Fe(μ(3),η(5):η(1):η(1)-P(5))}](n) (3), [{CuX}{Cp*Fe(μ(4),η(5):η(1):η(1):η(1)-P(5))}](n) (X=Cl (4a), Br (4b), I (4c), Br (4'b), I (4'c)), [{Cu(3)(μ-I)(2)(μ(3)-I)}{Cp*Fe(μ(5),η(5):η(1):η(1):η(1):η(1)-P(5))}](n) (5) and [{Cu(4)(μ-X)(4)(CH(3)CN)}{Cp*Fe(μ(7),η(5):η(2):η(1):η(1):η(1):η(1):η(1)-P(5))}](n) (X=Cl (6a), Br (6b)), respectively. The polymeric compounds have been characterised by single-crystal X-ray diffraction analyses and, for selected examples, by magic angle spinning (MAS) NMR spectroscopy. The solid-state structures demonstrate the versatile coordination modes of the cyclo-P(5) ligand of 1, extending from two to five coordinating phosphorus atoms in either σ or σ-and-π fashion. In compounds 2a, 2'c and 3, two phosphorus atoms of 1 coordinate to copper atoms in a 1,2 coordination mode (2a, 2'c) and an unprecedented 1,3 coordination mode (3) to form one-dimensional polymers. Compounds 4a-c, 4'b, 4'c and 5 represent two-dimensional coordination polymers. In compounds 4, three phosphorus atoms coordinate to copper atoms in a 1,2,4 coordination mode, whereas in 5 the cyclo-P(5) ligand binds in an unprecedented 1,2,3,4 coordination mode. The crystal structures of 6a,b display a tilted tube, in which all P atoms of the cyclo-P(5) ligand are coordinated to copper atoms in σ- and π-bonding modes.


Kinetic methods for analytical applications can be divided into noncatalytic and catalytic methods. Enzyme kinetic determinations are a special type of catalytic methods. Enzymatic reactions are used analytically to determine enzyme activities – for instance in the diagnosis of diseases, substrate concentrations in food industry or medicine and concentrations of effectors – for example in trace analysis. Due to the high selectivity of enzymatic analysis the importance of this method in various fields is growing rapidly. The widest use is observed in clinical chemistry and in food chemistry.

This article can only give a general survey of the great potential of enzymatic analysis, with references to more detailed literature.

Enzymatic reactions are characterized by some special features, explained after the introduction. The theoretical background for kinetic determination is the comprehension of the principles on enzymatic kinetics. In section 3 the simplest mechanism, outlined by Michaelis and Menten and several transformations of this equation will be described. In this section two kinetic parameters, enzyme activity and the Michaelis constant, will be introduced. Section 4 deals with substances, so called effectors, influencing the rate of an enzymatic reaction. Simple mechanisms of these effectors will be shown. The different methods for determination of substrates, enzymes and effectors, illustrated by many examples, are represented in section 5. While substrate concentrations can be determined using both ways, equilibrium or kinetic methods, the determination of enzymes and effectors can only be performed by kinetic approaches. In the last two sections the application of immobilized enzymes in flow systems and biosensor development will be shown.


Quantifying game and training demands in basketball allows to determine player's readiness and optimizes preparation to perform and reduce injury risks. Available research is using tracking technology to perform general descriptions of the game activities at professional levels, but somehow, is not exploring the possibilities of gathering data from new variables that can contribute with complementary information for the coaching staffs. The aim of this study was to identify changes in locomotor ratio, at higher and lower speeds, during the game quarters from elite under-18 basketball teams. Ninety-four male players participated in the study (age: 17.4 ± 0.74 years; height: 199.0 ± 0.1 cm; body mass: 87.1 ± 13.1 kg) from different playing positions, Guards (n = 35), Forwards (n = 42), and Centers (n = 17). Data were gathered from an international tournament and players' movements were measured using a portable ultra-wide band position-tracking system (WIMU PRO®, Realtrack Systems, Almeria, Spain). The following variables were measured: (1) relative distance in different speed zones: walking (<6.0 km·h−1), jogging (6.0–12.0 km·h−1), running (12.1–18.0 km·h−1), high-intensity running (18.1–24.0 km·h−1), and sprinting (>24.1 km·h−1); and (2) player load, vector magnitude expressed as the square root of the sum of the squared instantaneous rates of change in acceleration in each of the three planes divided by 100. Afterward, these variables were used to calculate players' locomotor ratio (player load per meter covered) at higher (running, high-intensity running, and sprinting) and lower speeds (walking and jogging). Results from the locomotor ratio at both lower and higher speeds presented a significant effect for the quarter (F = 7.3, p < 0.001 and F = 7.1, p < 0.001, respectively) and player position (F = 3.1, p = 0.04, F = 9.2, p < 0.001, respectively). There was an increase in the locomotor ratio from game quarter (Q) Q1 to Q4 at lower speeds, but contrary trends at higher speeds, i.e., the values have decreased from Q1 to Q4. Also, forwards and centers of the best teams presented lower values at higher speeds. Altogether, the findings may be used by coaching staffs as a first baseline to elaborate normative behavior models from the players' performance and also to induce variability and adaptation in specific practice planning.


Background and objective Hypertension is a major risk factor of cardiovascular and cerebrovascular diseases, but range of subjects whose blood pressure are just lower than the cut point of hypertension has been an area of widespread concern. The concept of prehypertension which was proposed by JNC 7 in 2003 was changed into high-normal blood pressure by ESH/ESC. Previous studies have showed that in high normal blood pressure subjects, there is already the decrease of endothelial dysfunction which play a crucial role in the occurrence and development of hypertension, and even in the occurrence and development of cardiovascular diseases. Furthermore, optimal, normal and high-normal blood pressure may progress to hypertension over time, but the risk is quite different. Therefore it is significant to detect arteriosclerosis and vascular dysfunction at an early stage. However, there are few data about the evaluation of arteriosclerosis in high-normal blood pressure population. As a newly-developed technology, AI has been applied in a many large-scale clinical studies. At present, there is no report about detection of arterial elasticity with AI among high-normal blood pressure population. In this study, radial AI was measured to evaluate the damage of the high-normal blood pressure population and provide evidence of early intervention. Methods Thousand four hundred and fourteen subjects were recruited. Individuals with serious arrhythmia, heart failure, diabetes and other serious disease were excluded. The subjects were divided into normal blood pressure, high-normal blood pressure and hypertension group. Radial AI was measured by HEM 9000AI. Venous blood took to evaluate biochemical indicator. Statistical process and analysis were performed using SPSS 11.5 and EXCEL 2003. Results (1) rAI75 of female is higher than male for any decade of age. Regardless of male or female, rAI75 increases with age, but it tends to plateau after 65 years old in males. (2) After adjusting for other factors, there are still significant differences of rAI75 in three groups. rAI75 were 73.97±11.89, 76.21±12.18, 81.41±11.27 in normal group, high-normal blood pressure and hypertension group respectively. By comparing between the two groups, rAI75 in high-normal blood pressure group is significantly higher than that in normal blood pressure. (3) rAI75 is related to age, height, gender, DBP and heart beat rate. (4) Age, gender, height, DBP and heart beat rate are major influence factor of rAI75. Conclusion (1) rAI75 is increased among normal blood pressure, high-normal blood pressure and hypertension subjects. People with high-normal blood pressure already have early damage of artery. (2) AI can be used as a mean of screening the early damage of artery. It can be used to evaluate the risk factor in subjects with high-risk of cardiovascular events, and even in subjects with high-normal blood pressure with comparatively low-risk. (3) People with high-normal blood pressure will need early intervention to prevent cardiovascular events.


In the North-Western part of Europe, ASTRON is building the world-largest largest low-frequency radio telescope. The telescope is based on phased array principles and is known as the LOw Frequency ARray (LOFAR). LOFAR is optimized for detecting astronomical signals in the 30-80 MHz and 120-240 MHz frequency windows. Since this part of the spectrum is in extensive use by others, special care must be taken in the selection of possible out-station sites for LOFAR. RFI measurements were made to be sure that the radio spectrum at the potential out-station locations is suitable for LOFAR operations. An assessment procedure is presented here and specific issues are discussed, such as the impact of Digital Video Broadcast, and wind turbines. The results of the RFI observations has generated a list of specifications for (international) LOFAR out-stations.


While substantial efforts have been made to optimize and standardize fecal metabolomics for studies in adults, the development of a standard protocol to analyze infant feces is, however, still lagging behind. Here, we present the development of a hands-on and robust protocol for proton 1H NMR spectroscopy of infant feces. The influence of extraction solvent, dilution ratio, homogenization method, filtration, and duration of centrifugation on the biochemical composition of infant feces was carefully evaluated using visual inspection of 1H NMR spectra in combination with multivariate statistical modeling. The optimal metabolomics protocol was subsequently applied on feces from seven infants collected at 8 weeks, 4, and 9 months of age. Interindividual variation was exceeding the variation induced by different fecal sample preparation methods, except for filtration. We recommend extracting fecal samples using water with a dilution ratio of 1:5 feces-to-water to homogenize using bead beating and to remove particulates using centrifugation. Samples collected from infants aged 8 weeks and 4 months showed elevated concentrations of milk oligosaccharide derivatives and lactic acid, whereas short-chain fatty acids (SCFAs) and branched-chain amino acids (BCAAs) were higher in the 9 month samples. The established protocol enables hands-on and robust analyses of the infant gut metabolome. The wide-ranging application of this protocol will facilitate interlaboratory comparison of infants' metabolic profiles and finally aid in a better understanding of infant gut health.


In a multi-project contract environment with a single agent who is subject to limited liability, the optimality of performance bundling across all projects is well established: The agent should be rewarded only if all projects are successful. In this paper, we study performance bundling across multiple competitions between two (possibly asymmetric) players. We find that in addition to a beneficial cost-saving effect that diminishes with asymmetry across players, performance bundling causes a counterproductive unbalancing effect, which intensifies with this asymmetry. Thus, performance bundling is desirable only if the players are sufficiently symmetric. Otherwise, a set of independent contests is optimal.


Microplankton species composition analysis was performed according to the Utermohl (1958) inverted microscope method. Samples for the identification and enumeration of larger phytoplankton cells (>5µm), were preserved in alkaline Lugols solution. The following groups: Diatoms, Dinoflagellates and Coccolithophores were determined at species level when possible, or at higher taxonomic levels.


The first credible descriptions of congenital muscular dystrophy (CMD) were made at the beginning of this century but the individuality of this condition had difficulty to be accepted because its distinction from other types of childhood neuromuscular disorders was far from clear. The reports of different clinico-pathological phenotypes of CMD and recently of immunocytochemical and molecular genetic studies allowed the precise definition of specific entities within the group of CMD. Here we present the historical background of CMD, its vicissitudes and the main steps leading to the individualisation of the merosin-deficient CMD to which the author has contributed. Mention is also made to major achievements in the characterisation of other types of CMD, namely the Fukuyama CMD, the muscle-eye-brain disease and a peculiar form of CMD with the rigidity of the spine. Animal models of merosin-deficient congenital muscular dystrophy were identified and their current study may lead to a better understanding of the pathogenesis of the human disease and to therapeutic strategies.


Solar-driven photocatalytic conversion of CO2 to renewable fuels represents an appealing approach to remedy environmental damage and address the energy crisis. Recently, the photocatalytic conversion efficiency has been improved with the implantation of cocatalysts into semiconductor photocatalysts. However, catalytic activity and selectivity are often limited by the uncontrollable charge trapping and surface reactivity behaviors of cocatalysts. Herein, for the first time, we reveal that engineering the crystallinity of cocatalysts offers an efficient route to tune both the interfacial charge kinetics and surface reaction dynamics. With Pd nanosheets as model cocatalysts, the influence of the degree of crystallinity of Pd on the photocatalytic performance is systematically investigated. When integrated with CdS quantum dots, it is found that high-crystallinity Pd with prefect lattice periodicity and fewer bulk and interfacial defects is conducive to the electron transfer from CdS to Pd, which thus yields more effective inhibition of H2 evolution on the CdS surface and achieves the highest selectivity of 100% for CO2 reduction. In contrast, low-crystallinity Pd provides large numbers of surface unsaturated atoms and defects as highly active sites for highly efficient CO2-to-CO/CH4 conversion. The combination of experimental analysis with theory simulation suggests that the amorphous Pd outperforms the high-crystallinity one in the adsorption and activation of CO2 molecules. As a result, the CdS–Pd sample with the largest percentage of amorphous domains of Pd achieves the highest CO and CH4 evolution rates, 10.3 and 5.9 times higher than those of pristine CdS, respectively. This work opens a new avenue to tune the photocatalytic activity and selectivity in solar driven CO2 conversion through regulating the crystallinity of cocatalysts.


Much of the emergency pressures faced by acute trusts result from patients with acute exacerbations of chronic illness. Progress can be made if greater emphasis is placed on managing the patient and their disease throughout the life-cycle. A new model of care was developed termed 'comprehensive care co-ordination'. The pilots suggest this model of care for the chronic illness could be rolled out quickly.


The ability to rapidly acquire synchronized phasor measurements from around a power system opens up new possibilities for power system protection and control. In this paper, the authors develop a novel class of fuzzy hyperrectangular composite neural networks which utilize synchronized phasor measurements to provide fast transient stability swings prediction for use with high-speed control. Primary features of the method include constructing a fuzzy neural network for all fault locations, using a short window of realistic-precision post-fault phasor measurements for the prediction, and testing robustness to variations in the operating point. From simulation tests on a sample power system, it reveals that the proposed tool can yield a highly successful prediction rate in real-time.


We consider massive multiple-input multiple-output (MIMO) systems in the presence of Cauchy noise. First, we focus on the channel estimation problem. In the standard massive MIMO setup, the users transmit orthonormal pilots during the training phase and the received signal at the base station is projected onto each pilot. This processing is optimum when the noise is Gaussian. We show that this processing is not optimal when the noise is Cauchy and as a remedy propose a channel estimation technique that operates on the raw received signal. Second, we derive uplink-downlink achievable rates in the presence of Cauchy noise for perfect and imperfect channel state information. Finally, we derive log-likelihood ratio expressions for soft bit detection for both uplink and downlink, and simulate coded bit-error-rate curves. In addition to this, we derive and compare the symbol detectors in the presence of both Gaussian and Cauchy noises. An important observation is that the detector constructed for Cauchy noise performs well with both Gaussian and Cauchy noises; on the other hand, the detector for Gaussian noise works poorly in the presence of Cauchy noise. That is, the Cauchy detector is robust against heavy-tailed noise, whereas the Gaussian detector is not.


This paper re-examines the export-led growth hypothesis using provincial data. Unlike other studies that concentrate on country-level data, this study investigates the validity of the hypothesis for four largest provinces in Korea: Seoul, Kyunggee, Kyungnam, and Pusan. The causal implication of the export-led growth hypothesis is generally supported for all provinces in the sample. The framework of analysis is two- and four-variable autoregressive models that include provincial exports, provincial output, terms of trade, and national output shocks. Granger causal orderings from exports to output growth are generally supported in bivariate causal models. In multivariate models, variance decompositions and impulse response functions further indicate that export growth has a significant impact on output growth for all provinces although a feedback effect from output to export growth appears in Seoul and the Kyungnam province.


This paper studies checkpointing strategies for parallel applications subject to failures. The optimal strategy to minimize total execution time, or makespan, is well known when failure IATs obey an Exponential distribution, but it is unknown for non-memoryless failure distributions. We explain why the latter fact is misunderstood in recent literature. We propose a general strategy that maximizes the expected efficiency until the next failure, and we show that this strategy achieves an asymptotically optimal makespan, thereby establishing the first optimality result for arbitrary failure distributions. Through extensive simulations, we show that the new strategy is always at least as good as the Young/Daly strategy for various failure distributions. For distributions with a high infant mortality (such as LogNormal with shape parameter k = 2.51 or Weibull with shape parameter 0.5), the execution time is divided by a factor 1.9 on average, and up to a factor 4.2 for recently deployed platforms.


Background:
In the region of Maastricht, The Netherlands, a disease management programme (DMP) for patients with diabetes mellitus was implemented. The programme aims to improve quality of care within existing budgets. To achieve this, diabetes nurse specialists (DNSs) were given a central role within a multidisciplinary team of care providers. This study describes the cost-effectiveness of this approach. -
Aim:
To measure the incremental cost-effectiveness of a diabetes DMP, with a central role for the diabetes nurse specialist, in comparison to usual diabetes care. -
Methods:
Within the DMP, patients with low, medium and high complexities of care are cared for by general practitioners, DNSs and endocrinologists, respectively. The DNSs independently treat patients assigned to them and pay special attention to extensive self-management education. A quasi-experimental trial with two-year follow-up (n = 473) was undertaken to measure the cost-effectiveness of the DMP compared with usual care. -
Results:
A total of 23% of patients were assigned to the GP, 66% to the DNS and 10% to the endocrinologist. Statistical significant improvements in glycaemic control, health-related quality of life, compliance and most aspects of self-care behaviour were found. No statistically significant changes were found concerning total costs of care. All improvements were greatest in patients assigned to DNS. -
Conclusion:
A DMP in which DNSs play a central role is associated with improved quality of care within existing budgets. Patients assigned to DNS benefit most, indicating that the central role of DNS in the diabetes DMP is one of its critical success factors.


The operational stability of perovskite solar cells (PSCs) remains a limiting factor in their commercial implementation. We studied the long-term outdoor stability of ITO/SnO2/Cs0.05((CH3NH3)0.15(CH-(NH2)2)0.85)0.95PbI2.55Br0.45/spiro-OMeTAD/Au cells, as well as the dynamics of their degradation, under simulated sunlight indoors and their recovery in the dark. The extent of overall degradation was found to depend on processes occurring both under illumination and in the dark, i.e., during the daytime and nighttime, with the dynamics varying with cell aging. Full recovery of efficiency in the dark was observed for cells at early degradation stages. Further cell degradation resulted in recovery times much longer than one night, appearing as irreversible degradation under real operational conditions. At later degradation stages, very different dynamics were observed: short-circuit current density and fill factor exhibited a pronounced drop upon light turn-off but strong improvement under subsequent illumination. The interplay of reversible and irreversible degradation processes with different recovery dynamics was demonstrated to result in changes in the cell's diurnal PCE dependence during its operational lifespan under real sunlight conditions.


This study aimed to evaluate early childhood children in early childhood education. To reach the goals we had the collaboration of ten mothers and babies living in the city of Santa Maria / RS. For its realization, we use cross-sectional survey with descriptive approach of quantitative and qualitative nature. The methodological instrument used was a questionnaire seeking to collect personal information from the mother and baby, as well as reviews of the reflexes of babies. The evaluations took place in the first and sixth month. Data were analyzed using descriptive statistics (mean and standard deviation percentage). Of the ten assessments carried out, three had some type of change. Of these changes, one that inspired more attention is the reflection tonic, because that appears around the 3rd month being inhibited at 6 months, if it occurs can not change some tasks like rolling stand, coordination of eyes and hands and some movements spinning. We trust that to attend kindergarten babies are stimulated as they often mothers for lack of information does not have the perception that the growth and development of babies are late.