BackgroundMass effects of haematoma, neuroinflammation, oxidative stress, and neuronal apoptosis are the major causes of poor prognosis of intracerebral haemorrhage (ICH). Our previous study suggests that biocompatible iron sulphide nanoparticles possess peroxidase-like activity and can release hydrogen polysulfanes, which may inhibit brain injury. The purpose of this study was to investigate the neuroprotective efficacy of diallyl disulfide (DADS)-nFeS in mice after ICH and preliminarily illustrate the potential mechanism. MethodsAdult male C57BL/6 mice (n = 176) were injected with bacterial collagenase in the striatum. In the first part, DADS-nFeS at different doses (25, 50, or 100 mg/kg) was intragastrically administered 2 h, 26 h, and 50 h before ICH. In the second and third parts, DADS-nFeS (50 mg/kg) was administered 2 h, 26 h, and 50 h before and after the induction of ICH in the pre-treatment group and post-treatment group, respectively. H&E staining was performed to detect drug toxicity. Haematoma volume measurement, Fluoro-Jade C (F-JC) staining, Nissl staining, immunofluorescence staining, western blotting, terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL) staining, malondialdehyde (MDA) and superoxide dismutase (SOD) assays, and neurobehavioural tests were performed. ResultsAll three doses of DADS-nFeS had neuroprotective effects, and 50 mg/kg resulted in the best outcome. DADS-nFeS reduced the haematoma volume and MDA content, inhibited the activation of microglia and astrocytes, progressive neuronal degeneration, and apoptosis, increased SOD activity and neuronal survival, and improved both short-term and long-term neurological functions in perihaematomal areas after ICH. Moreover, DADS-nFeS was associated with the downregulation of Iba-1, GFAP, TNF-α, IL-1β, 4-hydroxynonenal (4-HNE), and Bax/Bcl-2 levels in perihaematomal areas after ICH. Finally, post-treatment with DADS-nFeS had a better effect than pre-treatment with DADS-nFeS. ConclusionsOur study indicated that gavage administration of DADS-nFeS decreased the haematoma volume, suppressed neuroinflammation, oxidative stress, and neuronal apoptosis, and improved short- and long-term neurological functions, which was, at least in part, realized by inhibiting the activation of microglia and astrocytes, enhancing local SOD activity, and decreasing the recruitment of reactive oxygen species. Therefore, DADS-nFeS may serve as a potential therapeutic strategy via the diet against central nervous system diseases.


This article is intended to explain the notion of "mathematical axioms" presented in Kant's Critique of Pure Reason.This notion is developed mainly within the framework of a justification of the thesis of the methodological dualism of the rational sciences (mathematics and metaphysics). We argue that there are significant differences between the critical notion of mathematical axioms, the pre-critical developments and the Wolffian definitions. The notion of "axiom" that Kant intends to take from mathematical procedures is inscribed in his peculiar way of thinking this science. This paper studies the considerations of (i) Wolff's mathematical texts, (ii) the pre-critical texts and (iii) the Critique of Pure Reason, and mentions the differences between them in the conclusion.


Salinity energy generation (SEG) studies have only been done under isothermal conditions at ambient temperature. The production of salinity energy can be improved under non-isothermal conditions, albeit preserving the energy efficiency. In the current study, the effects of gradients of temperature and concentration on the salinity energy generation process were examined simultaneously. Based on the temperature-dependent properties resulting from both temperature and concentration gradients, a numerical study was carried out to determine the maximum efficiency of salinity energy generation in funnel-shaped soft nanochannels. It was presumed that a dense layer of negative charge, called a polyelectrolyte layer (PEL), is coated on the walls of the nanochannels. Co-current and counter-current modes were used to obtain temperature and concentration gradients. Under steady-state conditions, the Poisson-Nernst-Planck, Stokes-Brinkman, and energy equations were numerically solved using equivalent approaches. The results revealed that by increasing the temperature and concentration ratios in both co-current and counter-current modes of operation, the salinity energy generation increased appreciably. The salinity energy generation increased from 30 to 80 pW upon increasing the temperature ratio from 1 to 8 at a constant concentration ratio of 1000 in counter-current mode. As verified from this analysis, low-grade heat sources (<100 °C) provide considerable energy conversion in PEL grafted nanofluidic confinement when placed between electrolyte solutions of different temperatures.


Background: Oxidative stress and inflammation may be involved in the development and progression of mood disorders, including bipolar disorder. Currently, there is a scarcity of useful treatment options for bipolar depressive episodes, especially compared with the efficacy of treatment for acute mania. N-Acetylcysteine (NAC) has been explored for psychiatric disorders for some time given its antioxidant and anti-inflammatory properties. The current trial aims at testing the clinical effects of adjunctive NAC treatment (compared to placebo) for bipolar depression. We will also explore the biological effects of NAC in this context. We hypothesize that adjunctive NAC treatment will reduce symptoms of depression, which will be reflected by changes in selected markers of oxidative stress. Methods and analysis: In the study, we will include adults diagnosed with bipolar disorder, in a currently depressive episode. Participants will undertake a 20-week, adjunctive, randomized, double-blinded, parallel group placebo-controlled trial comparing 3 grams of adjunctive NAC daily with placebo. The primary outcome is the mean change over time from baseline to end of study on the Montgomery–Asberg Depression Rating Scale (MADRS). Among the secondary outcomes are mean changes from baseline to end of study on the Bech-Rafaelsen Melancholia Scale (MES), the Young Mania Rating Scale (YMRS), the WHO-Five Well-being Index (WHO-5), the Global Assessment of Functioning scale (GAF-F), the Global Assessment of Symptoms scale (GAF-S) and the Clinical Global Impression-Severity scale (CGI-S). The potential effects on oxidative stress by NAC treatment will be measured through urine and blood samples. DNA will be examined for potential polymorphisms related to oxidative defences. Trial registration: Registered at The European Clinical Trials Database, ClinicalTrials.gov: NCT02294591 and The Danish Data Protection Agency: 2008-58-0035.


Valproic acid has been used in the treatment of migraine headache for nearly 20 years. During this period of use several additional delivery modes have been developed to either improve tolerability or patient compliance with the divalproex sodium formulation and the extended-release formulation of divalproex sodium. Additionally, an intravenous formulation has become available which permits rapid achievement of therapeutic levels of the drug. There have been a number of reports on the use of valproic acid in migraine and other headache disorders, suggesting it to be an efficacious treatment. This paper reviews the results of the published reports of valproic acid in migraine and other headache disorders, including open-label studies, comparator trials, and double-blind, placebo-controlled trials. These studies have been conducted with the various formulations of valproic acid that have been on the market. The papers utilized in this study were obtained though Medline searches on valproic acid and divalproex sodium coupled with the various headache disorders. Additionally, the CD-ROM of past issues of Headache and Cephalalgia was reviewed for similar keywords. Lastly, the indices of the journal Headache Quarterly were reviewed for additional articles on valproic acid and divalproex sodium. Valproic acid in its various formulations has been demonstrated to be an efficacious and well-tolerated agent for the preventive treatment of migraine, chronic daily headache, and cluster headache. Additionally, it has been demonstrated to be efficacious and well tolerated in treating acute migraine attacks when given as an intravenous solution.


BACKGROUND
Over the past decade, the use of drug metabolism and pharmacokinetic (DMPK) parameters to optimize selection of candidates for drug development has become one of the primary focuses of research organizations involved in new drug discovery.

OBJECTIVE
This review will focus on the feasibility of predicting human absorption using data from a cultured Caco-2 cell system and non-clinical animals.

METHODS
In-house Caco-2 permeability data were compared with human absorption data from the literature. Animal absorption data obtained from current literature were also compared with human data.

RESULTS/CONCLUSION
Using a combination of rapid in-vivo and in-vitro DMPK screens on a large array of compounds during the lead optimization process has resulted in the streamlined development of compounds that have acceptable DMPK properties. Since it is well recognized that human intestinal absorption cannot be precisely predicted by a single screening assay, it is important to utilize various in-vitro and in-vivo non-clinical studies during lead optimization in drug discovery.


Aims and objectives: the study was undertaken with an objective to study the spectrum of thyroid dysfunction in elderly and to correlate clinical symptoms with abnormal thyroid function. Methods: a total of 100 subjects aged more than 60 years, admitted to General Medicine IPD of MVJMC & RH who were suspected to be suffering from thyroid disorders or subjects with vague symptoms like generalized weakness, easy fatigability, lethargy, disinterest in daily activities, to be suspicious of thyroid disorder, were subjected to detailed clinical examination & thyroid function testing by biochemical means. Those who were found to have altered thyroid functions, thyroid antibody (TPO) test were done. When thyroid nodule was present, further relevant investigations like USG/FNAC neck was performed to make appropriate diagnosis. Results: a total of 100 patients were included in the study. Thyroid disorders were present in 25%. Overt hypothyroidism in 11%, subclinical hypothyroidism in 9% cases, hyperthyroidism in 2% and subclinical hyperthyroidism in 3% patients was noted. In this study 38 patients were males and 62 were females. Females (18%) had high incidence of thyroid disorders than males (7%). As the age advanced the incidence of thyroid dysfunction increased which was statistically significant. Overt hypothyroidism was more common among elderly (11%). Classical clinical features of hypothyroidism and hyperthyroidism were present in 9 and 2 patients respectively. All patients with hypothyroidism had positive TPO AB. Patients with thyroid dysfunction have higher values of TGs, T. Chol and LDL which was found to be statistically significant (p value


Background
Respiratory diphtheria is a potentially fatal toxin-mediated disease that is rare among highly vaccinated populations. Cutaneous infections with toxigenic Corynebacterium diphtheriae are most commonly linked to travel to an endemic region. Corynebacterium ulcerans has emerged as a predominant, locally acquired cause of respiratory and cutaneous diphtheria in Western Europe. Recently, public health agencies from several highly vaccinated regions expanded their guidelines to investigate toxigenic cutaneous diphtheria regardless of travel history. With relatively unknown epidemiology of C diphtheriae in North America, and increasing diphtheria toxin testing over the last decade, this change could lead to substantial increases in public health investigations with unclear benefits.

Methods
This study examined the diagnostic and public health benefits of toxigenic cutaneous diphtheria investigations in the highly vaccinated population of Alberta, Canada, where travel history is not required for cutaneous diphtheria investigations. All C diphtheriae isolates collected between 2010 and 2019 were reviewed for specimen source, toxigenicity, biovar, and associated clinical and public health data.

Results
Of these, 5% of C diphtheriae isolates were toxigenic and 82% were isolated from cutaneous sites. Three cases of toxigenic cutaneous disease were identified, none from patients with recent travel. Contact tracing identified asymptomatic C diphtheriae colonization among 0%-26% of close contacts, with identical isolate profiles among colonized contacts and primary cases.

Conclusions
Cutaneous diphtheria in nonendemic regions warrants public health investigation regardless of travel history and overall vaccination levels. This study underscores the importance of including C ulcerans in public health guidelines to assess the overall prevalence and epidemiology of toxigenic corynebacteria.


Abstract In plants, N‐acylethanolamines (NAEs) are most abundant in desiccated seeds and their levels decline during germination and early seedling establishment. However, endogenous NAE levels rise in seedlings when ABA or environmental stress is applied, and this results in an inhibition of further seedling development. When the most abundant, polyunsaturated NAEs of linoleic acid (18:2) and linolenic acid (18:3) were exogenously applied, seedling development was affected in an organ‐specific manner. NAE 18:2 primarily affected primary root elongation and NAE 18:3 primarily affected cotyledon greening and expansion and overall seedling growth. The molecular components and signaling mechanisms involved in this pathway are not well understood. In addition, the bifurcating nature of this pathway provides a unique system in which to study the spatial aspects and interaction of these lipid‐specific and organ‐targeted signaling pathways. Using whole transcriptome sequencing (RNA‐seq) and differential expression analysis, we identified early (1–3 hr) transcriptional changes induced by the exogenous treatment of NAE 18:2 and NAE 18:3 in cotyledons, roots, and seedlings. These two treatments led to a significant enrichment in ABA‐response and chitin‐response genes in organs where the treatments led to changes in development. In Arabidopsis seedlings, NAE 18:2 treatment led to the repression of genes involved in cell wall biogenesis and organization in roots and seedlings. In addition, cotyledons, roots, and seedlings treated with NAE 18:3 also showed a decrease in transcripts that encode proteins involved in growth processes. NAE 18:3 also led to changes in the abundance of transcripts involved in the modulation of chlorophyll biosynthesis and catabolism in cotyledons. Overall, NAE 18:2 and NAE 18:3 treatment led to lipid‐type and organ‐specific gene expression changes that include overlapping and non‐overlapping gene sets. These data will provide future, rich opportunities to examine the genetic pathways involved in transducing early signals into downstream physiological changes in seedling growth.


This thesis presents a novel algorithm to iteratively compute camera paths of long image sequences. Scale Invariant Features are first extracted from the ordered set of images. These images are then matched pair-wise sequentially and correspondences are computed. An initial geometric path is found after by applying a bundle adjustment algorithm on these correspondences. Distances between cameras are computed from this initial estimation. The iteration process starts by grouping nearby cameras and then bundle adjusting the groups, and ends by merging the groups. This process is repeated until the reprojection errors fall into the preset tolerance. The key point in this algorithm is to take advantage of loopbacks in the image sequences. We have obtained excellent results for two camera paths, namely the spiral path and the snake like path. Our algorithm achieves both precise and stable results.


She walks in beauty, like the night Of cloudless climes and starry skies; And all that's best of dark and bright Meet in her aspect and her eyes: Thus mellowed to that tender light 5 Which heaven to gaudy day denies. One shade the more, one ray the less, Had half impaired the nameless grace Which waves in every raven tress, Or softly lightens o'er her face; 10 Where thoughts serenely sweet express How pure, how dear their dwelling place.


We suggest using Fully Homomorphic Encryption (FHE) to be used, not only to keep the privacy of information but also, to verify computations with no additional significant overhead, using only part of the variables length for verification. This method supports the addition of encrypted values as well as multiplication of encrypted values by the addition of their logarithmic representations and is based on a separation between hardware functionalities. The computer/server performs blackbox additions and is based on the separation of server/device/hardware, such as the enclave, that may deal with additions of logarithmic values and exponentiation. The main idea is to restrict the computer operations and to use part of the variable for computation verification (computation fingerprints) and the other for the actual calculation. The verification part holds the FHE value, of which the calculated result is known (either due to computing locally once or from previously verified computations) and will be checked against the returned FHE value. We prove that a server with bit computation granularity can return consistent encrypted wrong results even when the public key is not provided. For the case of computer word granularity the verification and the actual calculation parts are separated, the verification part (the consecutive bits from the LSB to the MSB of the variables) is fixed across all input vectors. We also consider the case of Single Instruction Multiple Data (SIMD) where the computation fingerprints index in the input vectors is fixed across all vectors.


Releaser pheromones have direct behavioural effects to arrest, attract or disperse insects, whereas interactions within groups of social insects are often influenced by primer pheromones. The behaviour of insects displaying intermediate levels of sociality is largely unexplored in this context. In the present study, both the gregariousness and arrestment (settling near the odour source) of bed bugs Cimex lectularius L. (Hemiptera: Cimicidae) in response to conspecific exuvial extracts are described. Adult males are arrested on filter papers with extracts derived from exuviae of fifth‐instar nymphs. Adult females and nymphs display no significant evidence for such behaviour. Adults of both sexes show no preference for extracts of male versus female fifth‐instar exuviae. Arrestment of adult males does not occur on papers treated with fourth‐instar exuvial extracts. Because the insects are assayed behaviourally in groups, an index is calculated describing how far bugs are away from being located independently of one another, as a measure of gregariousness. Adult males have lower values for this index (i.e. locations are closer to independence). Adult females, nymph cohorts and mixed age groups all have higher values for this index, which tend to increase over time. Females exhibit a clear increasing dose‐dependent relationship for this index. It is concluded that the extracts of fifth‐instar nymphal exuvia arrest males on refuges that possess the odour source. However, gregariousness is induced in females, without evidence of a tendency to assemble near the odour source.


: Mentoring relationships are fraught with obstacles for both mentor and mentee. Despite challenges, these relationships provide assistance and guidance in ways not possible through other means. After the establishment of a theoretical framework for mentoring, the principles of community based participatory research(CBPR) are applied to a cross-cultural mentoring program between students at the University of Nebraska-Lincoln (UNL) and students at North Star High School in Lincoln, Nebraska in an attempt to qualitatively analyze the program's benefits.


CONTEXT
N-methyl carbamate insecticides are widely used in homes, gardens and agriculture. They share the capacity to inhibit cholinesterase enzymes with organophosphates and therefore share similar symptomatology during acute and chronic exposures. One of the serious effects of organophosphate and carbamate intoxication is the development of acute pancreatitis and subsequent intrapancreatic fluid formation.

CASE REPORT
An 18-year old Caucasian man was admitted to our Intensive Care Unit with cholinergic crisis symptomatology, after the ingestion of an unknown amount of a carbamate insecticide (methomyl). Pseudocholinesterase levels were 2 kU/L on the day of admission (reference range: 5.4-13.2 kU/L). Two days after admission, an abdominal CT scan revealed blurring of the peripancreatic fat planes, inflammation and swelling of the pancreas, and a substantial amount of ascitic fluid in the left anterior pararenal space and pelvis. Paracentesis and analysis of the ascitic fluid demonstrated findings diagnostic of pancreatic ascites. There had been no other evident predisposing factors for acute pancreatitis, other than methomyl intoxication. Eleven days after admission, pseudocholinesterase levels returned to normal, while a new abdominal CT scan revealed the formation of intrapancreatic fluid collection. The patient was discharged in good physical condition two weeks after admission. A follow up abdominal CT scan performed one month later showed a significant reduction in the size of the intrapancreatic fluid.

DISCUSSION
Acute pancreatitis is not uncommon after organophosphate intoxication and carbamates share the same risk as organophosphorus pesticides. The development of acute pancreatitis and subsequent intrapancreatic fluid collection after methomyl intoxication has not previously been reported. This is the first case reported of acute pancreatitis and pancreatic ascite formation after anticholinesterase insecticide ingestion.


This paper is devoted to the question of optimal portfolio construction for equity factor investing. The first part of the paper focusses on how to make sure that a given equity portfolio has the targeted factor exposures, even before imposing any constraints. We show that such portfolios can be derived from mean-variance optimization using stock expected returns as inputs provided these are built in a robust way from information about the factors. We propose a framework to build those robust stock expected returns and show that the targeted factor exposures are retained by the portfolios both before and after applying realistic constraints, e.g. long-only. Other more simplistic approaches fail. In the second part of the paper we illustrate the application of the framework to a practical case where the objectives are, first, to decide about the risk budget allocation to factors in some pragmatic way; and second, to construct a long-only constrained portfolio that retains the targeted exposures to four factors from well-known asset pricing equity models, namely High-minus-Low (HML), Robust-minus-Weak (RMW), Conservative-minus-Aggressive (CMA) and Momentum (MOM).


Chronic renal failure (CRF) results in profound lipid disorders, which stem largely from dysregulation of high-density lipoprotein (HDL) and triglyceride-rich lipoprotein metabolism. Specifically, maturation of HDL is impaired and its composition is altered in CRF. In addition, clearance of triglyceride-rich lipoproteins and their atherogenic remnants is impaired, their composition is altered, and their plasma concentrations are elevated in CRF. Impaired maturation of HDL in CRF is primarily due to downregulation of lecithin-cholesterol acyltransferase (LCAT) and, to a lesser extent, increased plasma cholesteryl ester transfer protein (CETP). Triglyceride enrichment of HDL in CRF is primarily due to hepatic lipase deficiency and elevated CETP activity. The CRF-induced hypertriglyceridemia, abnormal composition, and impaired clearance of triglyceride-rich lipoproteins and their remnants are primarily due to downregulation of lipoprotein lipase, hepatic lipase, and the very-low-density lipoprotein receptor, as well as, upregulation of hepatic acyl-CoA cholesterol acyltransferase (ACAT). In addition, impaired HDL metabolism contributes to the disturbances of triglyceride-rich lipoprotein metabolism. These abnormalities are compounded by downregulation of apolipoproteins apoA-I, apoA-II, and apoC-II in CRF. Together, these abnormalities may contribute to the risk of arteriosclerotic cardiovascular disease and may adversely affect progression of renal disease and energy metabolism in CRF.


The fifth plenary meeting of the Secretary of Energy Advisory Board (SEAB) was held in Washington on July 10. Opening comments by Admiral James Watkins, Secretary of the Department of Energy, provided insights into his vision of the agency's future direction.

These are exciting times, Watkins said, declaring that the "evil empire has disappeared." He hailed Boris Yeltsin's recent declaration to Congress that communism is dead. Watkins spoke of the opportunities of the "new world order," but also said that DOE is facing a management challenge of great proportions.


The Authors' reply: It is interesting to hear of the occurrence of somewhat similar relationships, between acid and basic rocks, in what appears to be a more deep-seated environment. There seems to be a considerable measure of agreement between the authors of the contribution and ourselves. We concur in recognizing that certain phenomena have resulted from the intimate association of acid and basic magma and that basic magma has frequently chilled against acid magma. It seems to us reasonable to suppose that a chilled margin may subsequently become recrystallized, though it might be difficult to establish that this has in fact occurred.


Extreme climatic conditions and their ecological impacts are currently emerging as critical features of climate change. We studied extreme sea ice condition (ESIC) and found it impacts both life-history traits and population dynamics of an Antarctic seabird well beyond ordinary variability.

The Southern Fulmar (Fulmarus glacialoides) is an ice-dependent seabird, and individuals forage near the ice edge. During an extreme unfavorable year (when sea ice area is reduced and distance between ice edge and colony is high), observed foraging trips were greater in distance and duration. As a result, adults brought less food to their chicks, which fledged in the poorest body condition. During such unfavorable years, breeding success was extremely low and population growth rate (λ) was greatly reduced. The opposite pattern occurred during extreme favorable years.

Previous breeding status had a strong influence on life-history traits and population dynamics, and their responses to extreme conditions. Successful breeders had a higher chance of breeding and raising their chick successfully during the following breeding season as compared to other breeding stages, regardless of environmental conditions. Consequently, they coped better with unfavorable ESIC. The effect of change in successful breeder vital rates on λ was greater than for other stages' vital rates, except for pre-breeder recruitment probabilities, which most affected λ.

For environments characterized by ordinary sea ice conditions, interindividual differences were more likely to persist over the life of individuals and randomness in individual pathways was low, suggesting individual heterogeneity in vital rates arising from innate or acquired phenotypic traits. Additionally, unfavorable ESIC tended to exacerbate individual differences in intrinsic quality, expressed through differences in reproductive status.

We discuss the strong effects of ESIC on Southern Fulmar life-history traits in an evolutionary context. ESICs strongly affect fitness components and act as potentially important agents of natural selection of life histories related to intrinsic quality and intermittent breeding. In addition, recruitment is a highly plastic trait that, if heritable, could have a critical role in evolution of life histories. Finally, we find that changes in the frequency of extreme events may strongly impact persistence of Southern Fulmar populations.


Although electronic tools such as handheld computers have become increasingly common throughout society, implementation of such tools to improve skills in individuals with intellectual and developmental disabilities has lagged in the professional literature. However, the use of visual scripts for individuals with disabilities, particularly those with autism spectrum disorders, has been demonstrated to be effective, though frequently in static formats. Thus, this study involved the implementation of an alternating-treatment design to investigate the effects of tablet computer-based visual scripts on vocabulary use in three 8- to 14-year-old children with autism. Results indicated that all the participants showed increased use of verbs or nouns with the treatment materials, all the participants required less invasive prompts as the project progressed, and one participant had mixed results in the spontaneous use of nouns, increasing in their use in treatment and nontreatment conditions.


1. Experimental determinations of the hydrostatic pressure in the pseudocoel of living Ascaris lumbricoides were made by a direct method, using a glass helix pressure gauge and by an indirect method using an indentation gauge, both of which are described. 2. The mean value of this pressure was 70 mm. Hg (95 cm. of water), and showed wide and often rhythmical variations from 16 mm. to as high as 225 mm. Hg. Observations on the behaviour of artificially distended worms and of the tension developed by the muscles confirm these results. 3. The mechanical structure of the cuticle, with its inextensible spiral fibrils, forming a basketwork at an angle of 75° to the longitudinal axis, provides for an anisometric expansion and contraction under the action of the longitudinal muscles which is closely in accordance with the observed changes in volume and length. 4. A discussion of the significance of this mechanism and of the high internal pressure suggests that the great similarity of form among nematodes is determined to a considerable extent by mechanical factors.


Abstract Hepatitis C virus (HCV) causes chronic infection in approximately two-thirds of cases, leading to chronic hepatitis, liver cirrhosis, liver disease, liver failure, and hepatocellular carcinoma in a substantial proportion of the 170 million HCV-infected individuals worldwide. It is generally accepted that the cellular immune response plays the most important role in determining the outcome of HCV infection. First, vigorous, multispecific and sustained CD4+ and CD8+ T-cell responses are associated with viral clearance. Second, depletion studies in chimpanzees, the only other host of HCV besides humans, have shown that both CD4+ and CD8+ T-cells are required for virus elimination. Third, the host's human leukocyte antigen alleles, which restrict the repertoire of CD4+ and CD8+ T-cell responses, influence the outcome of infection. Of note, protective immunity has been demonstrated in population-based studies, as well as in experimentally infected chimpanzees. Thus, a detailed understanding of the mechanisms contributing to the failure of the antiviral immune response should allow successful development of prophylactic and therapeutic vaccination strategies.


This paper addresses why technological progress occurred off-and-on in Imperial China but came to a standstill at around the time of the European Renaissance, leading to the decline of Imperial China. We suggest that the threat of war could have induced innovative activities as well as the accumulation of public capital, which led to the development of a modern sector in Imperial China. Using numerical simulation, we find a stagnated equilibrium in an agrarian economy under low threats of war and another with a high level of technological knowledge, public capital and a vibrant modern sector under strong threats. Long periods of peace would have the opposite effect. Some supportive historical evidence from urbanization is provided.


A problem common to university faculty and students is an implicit sense of inadequacy regarding institutional hierarchies and disciplinary boundaries. Through a focus on multidisciplinarity, learning communities enable members to navigate multiple points of view within, between, and beyond apparent institutional boundaries. After having led a workshop that placed participants in the positions of both students and faculty members negotiating multidisciplinarity through learning communities, we conclude that learning communities' methodological leveling of traditional hierarchies implicit in higher education leads to a sense of belonging that enables students and faculty to take risks essential for authentic learning. Anxiety over participation in academic discussions both inside and outside the classroom, and from within and beyond one's disciplinary expertise, thus becomes productive rather than debilitating.


ABSTRACT This research effort empirically tests three factors hypothesized to affect Indonesian millennials' predisposition to engage in ecotourism experiences, namely universalism value, horizontal collectivism and user generated content (UGC). Indonesia is generally considered a collectivist (as opposed to individualistic) society, yet there is variance in both universalism value and horizontal collectivism. Two studies were conducted, one at 'soft', and another at 'hard' ecotourism sites. Findings showed that universalism value is positively related to ecotourism predisposition. UGC has a marginal moderating effect on the universalism → ecotourism predisposition. Horizontal collectivism also has a marginal moderating effect on the universalism → ecotourism predisposition in soft ecotourism but has significant effect in hard ecotourism. Both have direct effects on ecotourism predispositions. Managers must recognize that millennials can be segmented based on both universalism value and horizontal collectivism; and that to appeal to those with higher levels on these value dimensions UGC should be encouraged.


Neonatal haemochromatosis is a disorder which affects foetuses and newborns. It is characterized by hepatocellular insufficiency, often appearing on the first day of life in the form of coagulopathy, hypoalbuminemia, hypoglycemia and jaundice. While spontaneous recovery has been reported, most of these infants die, and the diagnosis was previously often made during autopsy. With the help of MRI and salivary gland biopsies, plus increasing awareness of this disorder, the diagnosis is now often made quite early, and successful liver transplantations have been reported. Recently, there have also been encouraging preliminary reports of successful intervention with antioxidant and chelation pharmacotherapy, using a combination of selenium, vitamin E, N-acetylcysteine, deferoxamine, and prostaglandin E. We describe two patients with neonatal haemochromatosis who were both treated with this new "cocktail", one of whom died at five days of age, while the other survived, but needed a liver transplant at 2 1/2 months of age. The pathology of this condition is characterized by hepatic cirrhosis with giant cell transformation, and by siderosis of extrahepatic tissues. The prognosis is poor, and our experience with antioxidant treatment has been disappointing. Liver transplantation is a therapeutic option, but its use is limited by the scarcity of donor organs and the small size of many of the patients.


The tailored synthesis of graft copolymers from acrylic and methacrylic monomers can be accomplished solely through photoiniferter reversible addition-fragmentation chain transfer (RAFT) polymerization. Samples with poly[oligo(ethylene glycol) methacrylate] (POEGMA) backbones synthesized under green light irradiation and poly(N-isopropylacrylamide) (PNIPAM) side chains growing under blue light irradiation are presented. As monitored by temperature-dependent dynamic light scattering (DLS) measurements and temperature-variable nuclear magnetic resonance (NMR) spectroscopy, the architecture of the graft copolymers allows unique two-step lower critical solution temperature (LCST) transitions in aqueous solutions. Meanwhile, different end-groups introduced by the corresponding RAFT agents affect the detailed thermoresponsive behavior remarkably. This RAFT strategy shows more advantages when the multiple trithiocarbonate groups are converted into thiol reactive pyridyl disulfide (PDS) groups via a facile post-polymerization modification. The PDS-terminated graft copolymer can then be regarded as a usable precursor for various applications, such as thermoresponsive hydrogels.


This study presents a techno-economic assessment of slow pyrolysis of pine sawdust continued by ex-situ catalytic upgrading. The overall process consists of six sections: feed drying, pyrolysis, vapor filtration, ex-situ catalytic upgrading, vapor quenching, and combustion of permanent gas. In the process simulation, biomass is objected to slow pyrolysis at 450oC in an electrically-heated screw reactor and pyrolysis vapors is upgraded in fixed catalytic bed reactor at 425 oC (using HZSM-5). The model is then used to investigate effects of feed moisture variation and type of heating source in pyrolysis unit, i.e. thermal vs. electrical heating, to oil energy efficiency. According to the simulation model, the endothermic pyrolysis step requires 1.46 MJ/kg dry-feed. On the other hand, exsitu upgrading is slightly exothermic and releases 50kJ/kg dry-feed. Overall, the conversion of biomass to bio-oil demonstrates a mass efficiency of 19.65%wt and an energy efficiency of 29.10%. The energy efficiency raises to 32.81% if direct thermal source is applied instead of electrical heating. The bio-oil energy efficiency increases by 1.38% if the moisture content of the biomass decreases by 10%wt. In average, bio-oil and char production in exsitu catalytic upgrading generates profit 1.47 SEK/kg dry-feed. The uncertainty of bio-oil price causes the highest profit variation.


Eight multi-drug resistant mutants (4.94%) were found in 162 clinical isolates of P. aeruginosa after exposure to norfloxacin at different concentrations (1/4, 1/2, 1, 2 and 4 MICs) and were investigated for the mechanisms of drug resistance. All the mutants were eight-times more resistant to norfloxacin than the respective parents, and showed the cross-resistance to the other fluoroquinolones. However, these mutants differed in the drug-resistant patterns; the 94-74 mutant was resistant to carbenicillin, ceftazidime and chloramphenicol, TA-15 mutant was resistant to imipenem, and the 93-183 was resistant to carbenicillin, ceftazidime and gentamicin. TA-16 mutant only showed a marked decrease in the bacterial uptake of norfloxacin. Profiles of the outer membrane proteins of the mutants were analyzed by SDS-PAGE method. The six mutants, except for TA-52 and 93-183 mutants, increased the intensity of bands in the 46 KD region. Three mutants (TA-15, TA-16 and 93-183) decreased the intensity of 44 KD (OMPE) and also the former two decreased the intensity of 22 KD (OMP G). The gryA mutations associated with fluoroquinolone-resistance were investigated for the eight mutants, and the 93-183 mutant showed to have the gyrA mutation caused by the alteration in the amino acid sequence of gyrA; Thr-83 (ACC) to Ile (ATC). The result of the present study indicate that multi-drug resistance of clinical isolates of P. aeruginosa develops through different types of mechanisms, and is not easily explained fully by the present results, and suggest that many factors attributed to the development of the resistances in those mutants remains to be clarified.


The scientific advancements in fish husbandry and aquarium technology
coupled with its potential in earning foreign exchange have facilitated the
growth of marine aquarium fishery sector across the globe. Nearly 2 million
people worldwide are engaged in marine aquarium keeping, either for
recreation or as a means of livelihood. However, with richmrnamental fish
reserves especially in the south-east and south-west coastal areas, India's
share is insignificant to the global export in ornamental fishery sector. In
Kerala, there are very few studies reported on the marine ornamental fish
trade and hence this study throws light on the status of ornamental fishery
trade in Kerala, including availability of resources, demand for this sector,
problems and constraints in keeping marine aquarium and suggestions for
improving this sector. The present study was conducted in three districts of
Kerala viz. Kozhikode, Emakulum and Thiruvananthapuram and two
different sets of interview schedules were employed to draw information on
the status of ornamental fishing industry in Kerala and were administered
among 60 traders and 90 hobbyists. Results show that the scope and
demand for marine aquarium trade in Kerala is very high. Furthermore, the
study portrays the demand for sustainable approach in promoting marine
ornamental fishery sector in order to provide livelihood options to the fisher
folk and to earn foreign exchange for the State.


ABSTRACT A spatiotemporal model was developed to investigate emissions of polycyclic aromatic hydrocarbons (PAHs) in Daqing, a Chinese city with large petroleum industry plants. The model was based on land-use types determined on a 10′ × 10′ grid. A geographic information system and regression analyses were used to characterise spatial and temporal variations in PAH emissions into multiple environmental media. The simulated results were validated using previously published experimental data, and the model was found to function well. PAH emissions to the atmosphere, soil, and surface water between 1998 and 2013 were estimated. The results indicated that PAH emissions to the atmosphere increased but PAH emissions to the soil and surface water decreased over the study period. PAH emissions to the atmosphere were markedly higher in winter than in summer. PAH emissions were concentrated in urban areas and areas near petroleum production plants, indicating that PAH emissions were closely related to industrial activities. The results will support research into the migration and transformation of PAHs and human health and ecological risk assessments. The results may also be useful for developing policies for controlling PAH pollution and managing risks associated with PAHs.


In a very dynamic and highly competitive business environment every company have to make sure that they have a sustainable competitive advantage. The issue about the channel of distribution has been given a very serious attention by every business. The retailer performance that failed to meet the expectation in the springbed industry was a sign that a study regarding factors affecting the retailer performance in this industry has to be analyzed, evaluated, synthesized and empirically tested. To follow up the statement, this study was conducted on 344 springbed retailers in Jakarta, Bogor, Depok, Tangerang, Bekasi as the sample. After the validity and reliability test, the collected data was analyzed using multiple regression analysis. Results of the study revealed that the relational rent do not have an effect on springbed retailer performance, but relational governance and relational embeddedness has asignificant effect on the sprinbed retailer performance. Not all business relationships need a high level of relational rent. In a weak-tied relationship, relational rent does not affect performance. The relationships between springbed producers and retailers are weak so much so that relationships with other parties are needed to gain innovative stimuli from different sources. An over-intensive relationship may reduce the ability to respond to economic and social changes, limit the focus of marketing on a small target and risk of losing contact with a new group of emerging customer. This study shows the importance of retailer's relational governance and relational embeddedness on retailer's performance.


Ethnic and racial group differences in help-seeking are a barrier to the effective and equitable delivery of mental health services. Asian American populations demonstrate relatively low levels of help-seeking. Explanations for this effect typically point to elevated levels of stigma in these populations. An alternative explanation is that low help-seeking might also reflect holding a relatively circumscribed concept of mental disorder. Individuals and groups with less inclusive concepts of disorder may be less likely to identify problems as appropriate for mental health treatment. This study aimed to test whether group differences in the breadth of the mental disorder concept account for group differences in help-seeking attitudes. A sample of 212 American participants (102 Asian Americans and 110 White Americans) were assessed on personal stigma, help-seeking attitudes, and mental disorder concept breadth. Mediation analyses examined whether stigma and concept breadth mediated group differences in attitudes. Compared to White Americans, Asian Americans reported higher levels of stigma and narrower concepts of mental disorder, both of which were associated with less positive help-seeking attitudes. Stigma and concept breadth both partially mediated the group difference in attitudes. Theoretical and practical implications for mental health promotion and culturally sensitive clinical practices are explored.


We describe the conceptual design of the camera cryostats, detectors, and detector readout electronics for the SuMIRe Prime Focus Spectrograph (PFS) being developed for the Subaru telescope. The SuMIRe PFS will consist of four identical spectrographs, each receiving 600 fibers from a 2400 fiber robotic positioner at the prime focus. Each spectrograph will have three channels covering wavelength ranges 3800 Å - 6700 Å, 6500 Å - 10000 Å, and 9700 Å - 13000 Å, with the dispersed light being imaged in each channel by a f/1.10 vacuum Schmidt camera. In the blue and red channels a pair of Hamamatsu 2K x 4K edge-buttable CCDs with 15 um pixels are used to form a 4K x 4K array. For the IR channel, the new Teledyne 4K x 4K, 15 um pixel, mercury-cadmium-telluride sensor with substrate removed for short-wavelength response and a 1.7 um cutoff will be used. Identical detector geometry and a nearly identical optical design allow for a common cryostat design with the only notable difference being the need for a cold radiation shield in the IR camera to mitigate thermal background. This paper describes the details of the cryostat design and cooling scheme, relevant thermal considerations and analysis, and discusses the detectors and detector readout electronics.


Spectrally beam-combined (SBC) laser systems, wherein multiple laser outputs are spectrally multiplexed into a single high-quality beam, are rapidly advancing the power scaling frontier for high-average-power beam-combined fiber lasers with near-perfect beam quality. We describe two- and three-channel SBC fiber lasers featuring 93% power-combining efficiency, near-diffraction-limited beam quality, average output powers in excess of 500 W, and excellent prospects for additional power scaling. To our knowledge, this level of optical performance represents the highest combination of beam quality and average power obtained so far for a beam-combined fiber laser system.


The formation of framework vacancies in Si- and Ge-based type-I clathrates is studied using density-functional theory as a function of filling the cages with K and Ba atoms. Our analysis reveals the relevance of structural disorder, geometric relaxation, and electronic saturation as well as vibrational and configurational entropy. In the Si clathrates, we find that vacancies are unstable, but very differently, in Ge clathrates, up to three vacancies per unit cell can be stabilized. This contrasting behavior is largely driven by the different energy gain on populating the electronic vacancy states, which originates from the different degree of localization of the valence orbitals of Si and Ge. This also actuates a qualitatively different atomic relaxation of the framework.


We perform next-to-leading order calculations of the single-diffractive and nondiffractive cross sections for dijet production in proton-antiproton collisions at the Tevatron. By comparing their ratio to the data published by the CDF collaboration for two different center-of-mass energies, we deduce the rapidity-gap survival probability as a function of the momentum fraction of the parton in the antiproton. Assuming Regge factorization, this probability can be interpreted as a suppression factor for the diffractive structure function measured in deep-inelastic scattering at HERA. In contrast to the observations for photoproduction, the suppression factor in proton-antiproton collisions depends on the momentum fraction of the parton in the Pomeron even at next-to-leading order.


Abstract. Local line rolling forming is a common forming approach for the complex curvature plate of ships. However, the processing mode based on artificial experience is still applied at present, because it is difficult to integrally determine relational data for the forming shape, processing path, and process parameters used to drive automation equipment. Numerical simulation is currently the major approach for generating such complex relational data. Therefore, a highly precise and effective numerical computation method becomes crucial in the development of the automated local line rolling forming system for producing complex curvature plates used in ships. In this study, a three-dimensional elastoplastic finite element method was first employed to perform numerical computations for local line rolling forming, and the corresponding deformation and strain distribution features were acquired. In addition, according to the characteristics of strain distributions, a simplified deformation simulation method, based on the deformation obtained by applying strain was presented. Compared to the results of the three-dimensional elastoplastic finite element method, this simplified deformation simulation method was verified to provide high computational accuracy, and this could result in a substantial reduction in calculation time. Thus, the application of the simplified deformation simulation method was further explored in the case of multiple rolling loading paths. Moreover, it was also utilized to calculate the local line rolling forming for the typical complex curvature plate of ships. Research findings indicated that the simplified deformation simulation method was an effective tool for rapidly obtaining relationships between the forming shape, processing path, and process parameters.


Work on building robot models to be used in designing model-based controllers is described. Various algorithms are presented estimating the kinematic, link-inertial, and load-inertial parameters. It is shown experimentally that accurate estimates can be obtained automatically using sensor data taken during movement. The algorithms have been implemented on the MIT Serial Link Direct Drive Arm.<<ETX>>


Kriging is a geostatistical analysis of the data used to estimate the value that represents a no sample point based sample point in the surrounding by considering the spatial correlation in the data. Kriging is an interpolation method that generates unbiased predictions or estimations and has a minimum error. Indicator kriging is an estimation method that does not require the assumption of normality of data and can also be used to treat data that have a significant outlier. The indicator kriging that based on the principle of ordinary kriging also called ordinary indicator kriging. In this case study conducted Morowali estimated iron content in Central Sulawesi using ordinary indicator kriging method. The data used in the form of data coordinate point and iron content. The results obtained are presented probability value locations that fall within the zone of potential and non potential with the value the error variance. Based on the analysis to obtain a plot depicting the location of the entry in the zones of potential iron mine on the abscissa coordinate (7150–7210), the ordinate (54180–54540), and the depth ranges (440–500) meters and also the coordinates of the abscissa (7710–8130), the ordinate (54800–54960), and depths ranging from (327–342) meters.


Shale wells are often shut-in after hydraulic fracturing is finished. Shut-in often lasts for an extended period in the perceived hope to improve the ultimate oil recovery. However, current literature does not show a strong consensus on whether shut-in will improve the ultimate oil recovery. Because of the delayed production, evaluating the benefits of shut-in in improving the ultimate oil recovery is crucial. Otherwise, shut-in would merely delay the production and harm the economic performance.
 This paper uses a numerical flow-geomechanical modeling approach to investigate the effect of imbibition on shut-in potentials to improve the ultimate oil recovery. This paper proposes that imbibition is one of the strongly confounding variables that cause the mixed conclusions in the related literature. The investigation methodology involves probabilistic forecasting of three reservoir realization models validated based on the same field production data. Each of the models represents different primary recovery driving mechanism, such as imbibition-dominant and compaction-dominant recovery.
 A parametric study is conducted to explore and identify the specific reservoir conditions in which shut-in tends to improve the shale oil recovery. Ten reservoir parameters which affect the imbibition strength are studied under different shut-in durations. Comparison among the three models quantitatively demonstrates that shut-in tends to improve the ultimate oil recovery only if the shale reservoir demonstrates imbibition-dominant recovery. A first-pass economic analysis also suggests that when the shale oil reservoirs demonstrate such an imbibition-dominant recovery, shut-in tends to not only improve the ultimate oil recovery, but also the NPV. A correlation among ultimate oil recovery, flowback efficiency, and NPV also shows that there is no strong relationship between flowback efficiency and ultimate oil recovery. This study is one of the first to emphasize the importance of quantifying the imbibition strength and its contribution in helping recover the shale oil for optimum flowback framework and shale well shut-in design after hydraulic fracturing.


A series of chiral N-phosphonyl protected α-alkenyl homoallylic primary amines were synthesized by asymmetric addition of allylmagnesium bromide Grignard reagent towards chiral α,β-unsaturated imines. Only 1,2-adduct was obtained for all the imines with good yields and excellent diastereoselectivities. The chiral auxiliary could be easily removed under simple conditions, giving free multiple functionalized primary amines.


The analog-versus-digital debate rages throughout industries all over the world, and cinema is no exception. The implications for professional filmmakers are often discussed, but how does the debate affect film schools? Nicholas Oughton looked into this very question in his study on the current (and future) role of celluloid in global film education.


We study the eigenstate phases of disordered spin chains with on-site finite non-Abelian symmetry. We develop a general formalism based on standard group theory to construct local spin Hamiltonians invariant under any on-site symmetry. We then specialize to the case of the simplest non-Abelian group, $S_3$, and numerically study a particular two parameter spin-1 Hamiltonian. We observe a thermal phase and a many-body localized phase with a spontaneous symmetry breaking (SSB) from $S_3$ to $\mathbb{Z}_3$ in our model Hamiltonian. We diagnose these phases using full entanglement distributions and level statistics. We also use a spin-glass diagnostic specialized to detect spontaneous breaking of the $S_3$ symmetry down to $\mathbb{Z}_3$. Our observed phases are consistent with the possibilities outlined by Potter and Vasseur [Phys. Rev. B 94, 224206 (2016)], namely thermal/ ergodic and spin-glass many-body localized (MBL) phases. We also speculate about the nature of an intermediate region between the thermal and MBL+SSB regions where full $S_3$ symmetry exists.


Taking its cues from recent scholarship on the crisis of anti-Black violence, this essay revisits a constellation of art world events related to the 1991 police beating of Rodney King: Anna Deavere Smith's 1993 performance Twilight: Los Angeles, 1992, a one-woman play about the riots sparked when King's attackers were acquitted; the 1993 Whitney Biennial, which included the amateur videotape of the beating that had featured prominently in news coverage and during the trial; and a roundtable discussion about the Biennial that appeared in the journal October. Using the concept of the echo as a figure for a temporal "ongoingness," I argue that racial disparity exists within art historical and art critical assumptions about time. By virtue of the echoic nature of police violence against African Americans, racialized subjects often have a different relationship to past-ness than white subjects, and thus the capacity to mark events as historical is a privilege to which not all subjects have equal access. Similarly, the ability to deploy the category of the contemporary in positive ways is differentially distributed. Inspired by Darby English's suggestion that we listen for what "fights meaning" in works of contemporary art by and about African Americans, the essay harkens to the repetitions of the echo to reveal the ways in which time itself is racialized.


OBJECTIVE
The surveillance of HIV prevalence and incidence and of sexual risk behaviour among young homosexual men.

DESIGN
Cohort study, cross-sectional data presentation.

SETTING
Municipal Health Service of the City of Amsterdam, the Netherlands.

METHODS
At entry into the study participants were questioned about their sexual behaviour and blood or saliva samples were collected for laboratory determination of antibodies against HIV, hepatitis B and syphilis.

RESULTS
In June 1995-October 1996, 429 men with a mean age of 25 years were enrolled in the cohort study. Of these 22 (5%) were positive for antibodies against HIV. Based on the duration of homosexual activity of the participants the HIV incidence in this group was estimated at 1% per year. Furthermore, 10% of the participants had experienced hepatitis B infection and 1% had serological evidence of syphilis. Of those under investigation 38% had practised unprotected anogenital intercourse with steady or non-steady partners in the last six months.

CONCLUSIONS
The data suggest that HIV is spreading among young homosexual men. Given the high levels of risk behaviour continued prevention activities in this group are necessary.


Context. Simulating the propagation and predicting the arrival time of coronal mass ejections (CMEs) in the inner heliosphere with a full three-dimensional (3D) magnetohydrodynamic (MHD) propagation model requires a significant amount of computational time. For CME forecasting purposes, multiple runs may be required for different reasons such as ensemble modeling (uncertainty on input parameters) and error propagation. Moreover, higher resolution runs may be necessary, which also requires more CPU time, for example for the prediction of solar energetic particle acceleration and transport or in the framework of more in-depth studies about CME erosion and/or deformation during its evolution. Aims. In this paper we present ICARUS, a new inner heliospheric model for the simulation of a steady background solar wind and the propagation and evolution of superposed CMEs. This novel model has been implemented within the MPI-AMRVAC framework which enables the use of stretched grids and solution adaptive mesh refinement (AMR). The usefulness and efficiency (speed-up) of these advanced features are explored. In particular, we model a typical solar wind with ICARUS and then launch a simple cone CME and follow its evolution. We focus on the effect of radial grid stretching and two specific methods or criteria to trigger solution AMR on this typical simulation run. Methods. For the solar background wind simulation run, we limited the mesh refinement to the area(s) of interest, in this case a co- rotating interaction region (CIR). For the CME evolution run, on the other hand, we apply AMR where the CME is located by the use of a tracing function. As such, the grid is coarsened again after the CME has passed. Results. The implemented AMR is flexible and only refines the mesh in a particular sector of the computational domain, for example around the Earth or a single CIR, and/or for a particular feature such as CIR or CME shocks. Radial grid stretching alone yields speed-ups of up to 4 and more, depending on the resolution. Combined with solution adaptive mesh refinement, the speed-ups can be much larger depending on the complexity of the simulation (e.g., number of CIRs in the background wind, number of CMEs) and on the chosen AMR criteria, thresholds and the number of refinement levels. Conclusions. The ICARUS model implemented in the MPI-AMRVAC framework is a new inner heliospheric 3D MHD model that uses grid stretching as well as AMR techniques. The flexibility in the grid and its resolution allows an optimization of the computational time required for CME propagation simulations for both scientific and forecasting purposes.


ABSTRACT The role of policy styles in policymaking has attracted renewed scholarly interest in recent years. One of the central debates in this literature revolves around the question of how to reconcile archetype national policy styles with considerable differences in modus operandi across policy sectors. A sector-specific feature that is considered a key determinant of the manifestation of archetype national policy styles in the European Union is the degree of Europeanisation of policy sectors. This paper picks up this suggestion by addressing the question of whether and how Europeanisation affects the degree to which features of an archetype national policy style are manifest within a sector. We address this question by exploring sectoral policy styles in agricultural and food-related public health policymaking across three EU Member States: The Netherlands, the United Kingdom (England), and France. Our findings suggest that the degree of Europeanisation of a policy sector does prove an important condition that helps to understand the relationship between national and sectoral policy styles. More specifically, Europeanisation has the strongest effect when sectors face a higher adaptation pressure, i.e., when there is a larger misfit between sectoral regimes and EU-induced institutional demands. We suggest various promising avenues of future research on this relationship.


A 3D physiological articulatory model has been constructed based on volumetric MRI data obtained from a male speaker. The model is driven by muscles according to a target-dependent activation pattern. In this study, we improved dynamic characteristics of the model to produce higher sound quality for vowel sequences. Dynamic characteristics of articulatory organs were investigated using X-ray microbeam data for vowel sequences and vowel-consonant-vowel (VCV) sequences for 11 Japanese speakers. It was found that the velocity of the tongue tip is about 60% faster in transition of vowel-to-consonant than that of vowel-to-vowel, while the velocities of the tongue dorsum and jaw were independent of the sequences. Reaction time, from maximal acceleration to maximal velocity, of the articulators is about 40% shorter in vowel-to-consonant transitions than in vowel-to-vowel transitions. To apply the improved model for speech analysis, articulatory targets were estimated for the vowels in vowel sequences using AbS method, and used to generate the vocal tract shapes for vowel sequences. The vocal tract shapes and synthetic sounds were compared with speech sound and articulatory data from the target speaker. The results showed that our model demonstrates plausible dynamic characteristics of articulatory movement in producing vowel sequences. The simulation error was about 2.5% for the formants, and 0.2 cm for the observation points of the vocal tract.


Gender inequality in technological sciences is a problem, which discussed louder than ever. The number of women and men working in the technology sector still struggles to reach equality. The same applies to technological faculties of universities, as women often undertake roles, which include administrative work mostly. This case provides an analysis of the situation at the Kaunas University of Technology (KTU). In Lithuania, the distribution between men and women studying in the field of ICT is similar to the global trend. A big gap can be observed between boys and girls studying in the field of ICT and engineering. During the EQUAL-IST project implementation period, many positive structural changes implemented in the University not only in the faculty level but in the institutional level as well. The study illustrates the preparation and implementation stages of the KTU Gender Equality Plan.


BACKGROUND
Atypical renal cysts are suspicious for malignancy. It is hard in some cases to give a sharp radiological diagnosis and propose an appropriate management.

AIM
To give the histological results of the operated atypical renal cysts and to establish a correlation between the radiological findings and histological features.

METHODS
Between January 2001 and December 2012, 22 patients have been operated in our department for atypical renal cysts. There were 10 type III and 12 type IV Bosniak lesions. We have reported clinical, epidemiological and radiological findings. We have analyzed the histological results taking into consideration the radiological findings.

RESULTS
According to histological findings, 7 among the 10 type III lesions were benign (70%). However, only one case of benign tumor was noted in type IV lesions (8.3%). There was no evident correlation between tumors size and histology. With a median follow up of 48 months, three patients died because of locally advanced tumors.

CONCLUSION
Management of atypical renal cysts remains difficult. A careful computed tomography staging is essential before treatment. Type III and type IV Bosniak cysts were malign in 30% and 91% of cases, respectively. There was no correlation between tumor size and malignancy. A nephron sparing surgery should be proposed whenever possible.


ABSTRACT Hydrogen peroxide (H2O2) is a by-product of glycerol metabolism in mycoplasmas and has been shown to cause cytotoxicity for cocultured eukaryotic cells. There appears to be selective pressure for mycoplasmas to retain the genes needed for glycerol metabolism. This has generated interest and speculation as to their function during infection. However, the actual effects of glycerol metabolism and H2O2 production on virulence in vivo have never been assessed in any Mycoplasma species. To this end, we determined that the wild-type (WT) Rlow strain of the avian pathogen Mycoplasma gallisepticum is capable of producing H2O2 when grown in glycerol and is cytotoxic to eukaryotic cells in culture. Transposon mutants with mutations in the genes present in the glycerol transport and utilization pathway, namely, glpO, glpK, and glpF, were identified. All mutants assessed were incapable of producing H2O2 and were not cytotoxic when grown in glycerol. We also determined that vaccine strains ts-11 and 6/85 produce little to no H2O2 when grown in glycerol, while the naturally attenuated F strain does produce H2O2. Chickens were infected with one of two glpO mutants, a glpK mutant, Rlow, or growth medium, and tracheal mucosal thickness and lesion scores were assessed. Interestingly, all glp mutants were reproducibly virulent in the respiratory tracts of the chickens. Thus, there appears to be no link between glycerol metabolism/H2O2 production/cytotoxicity and virulence for this Mycoplasma species in its natural host. However, it is possible that glycerol metabolism is required by M. gallisepticum in a niche that we have yet to study.


Epigenetic modifications play an important role in central nervous system disorders. As a widespread posttranscriptional RNA modification, the role of the m5C modification in cerebral ischemia-reperfusion injury (IRI) remains poorly defined. Here, we successfully constructed a neuronal oxygen-glucose deprivation/reoxygenation (OGD/R) model and obtained an overview of the transcriptome-wide m5C profiles using RNA-BS-seq. We discovered that the distribution of neuronal m5C modifications was highly conserved, significantly enriched in CG-rich regions and concentrated in the mRNA translation initiation regions. After OGD/R, modification level of m5C increased, whereas the number of methylated mRNA genes decreased. The amount of overlap of m5C sites with the binding sites of most RNA-binding proteins increased significantly, except for that of the RBM3-binding protein. Moreover, hypermethylated genes in neurons were significantly enriched in pathological processes, and the hub hypermethylated genes RPL8 and RPS9 identified by the protein-protein interaction network were significantly related to cerebral injury. Furthermore, the upregulated transcripts with hypermethylated modification were enriched in the processes involved in response to stress and regulation of apoptosis, and these processes were not identified in hypomethylated transcripts. In final, we verified that OGD/R induced neuronal apoptosis in vitro using TUNEL and western blot assays. Our study identified novel m5C mRNAs associated with ischemia-reperfusion in neurons, providing valuable perspectives for future studies on the role of the RNA methylation in cerebral IRI.


Recently, the growing concern over the exhaust emissions, cooling requirements and design of exhaust system devices has led to the study of the instantaneous heat transfer rates in the straight portion of the engine exhaust port and the port itself. In this study, experimental measurements were made of the instantaneous exhaust gas temperatures and the instantaneous wall surface temperatures at four different positions in the exhaust port for a range of engine operating conditions. The calculated instantaneous heat transfer rates and the instantaneous heat transfer coefficients were found to be significantly dependent on the geometrical position in the exhaust port, the engine speed and the engine load and depicted a consistent trend in the results.


The current research investigated the role of positive psychology in contributing to the development of happiness among parents of children with autism spectrum disorder (ASD). To fulfill the main objectives, this research comprised three studies. Study I employed a qualitative design which used the hermeneutic phenomenological framework in which in-depth interviews were conducted to identify thematic dimensions to inform the development of the Happiness in Parents of Children with ASD Scale (HPCA). Study II involved a quantitative approach in which exploratory factor analysis, reliability analysis, and confirmatory factor analysis were used to develop a psychometrically sound measurement instrument– the HPCA Scale. Tests of validity via both convergent and divergent tests of validity showed that this newly developed scale is valid. Study III employed the nine-component factor structure identified for the HPCA to develop the modified positive psychology-based intervention program and test its effectiveness. The last study investigated the effectiveness of the modified positive psychology-based program via multivariate 2 x 2 mixed-repeated measures design. The results of Study I found three main themes for creating the new survey questionnaire. The results of Study II revealed the final nine-component structure of Happiness in Parents of Children with ASD Scale (HPCA). The findings in Study III indicated that seven of the nine components were significant, namely, hope in the child's independence, positive acceptance of the child's disorder, parental self-efficacy, confidence in helping child development, mind-body relaxation, contribution to society, and stress management. Promoting positive family support and resilience were not found to be significantly related to developing happiness among parents. The modified program also had an effect on decreasing depression, one of the components in the DASS-21. Further application of the program that integrates positive psychology should be considered in promoting parental happiness in other areas of child and adolescent disabilities.


Liver cancer inflicts a severe human and economic burden on patients, their families, and society. However, the costof-illness analysis of liver cancer and the patient-level data on healthcare resource use is still limited. This study aims to estimate the medical costs of liver cancer in Indonesia. A costing study using a provider perspective approach was employed. Direct medical cost data were retrieved retrospectively from medical records of 157 liver cancer patients divided into three disease categories [compensated cirrhosis (CC), decompensated cirrhosis (DC), and hepatocellular carcinoma (HCC)] from January to December 2020 from a large referral hospital in Yogyakarta, Indonesia. A bottom-up methodology based on the patient's perspective was used to calculate the cost. The estimated medical costs for the nation were obtained from the direct medical cost per patient per liver cancer stage multiplied by the number of the patients. The total direct medical cost attributable to liver cancer in 2020 was estimated to be approximately US$3.8 million. The cost of surgery was the major contributor to liver cancer treatment in every stage. The annual direct medical cost per patient increased with the severity of the disease, with the estimated cost for CC, DC, and HCC as US$20,339, $24,784, and $26,538, respectively. Liver cancer imposes a valuable burden not only on patients but also on the healthcare system. Effective interventions in the healthcare system are required to minimize the burden. However, the prevention of this disease such as healthy lifestyle changes, early screening, and vaccination would help the reduction in liver cancer incidence, reduction in mortality, and absolutely reduction in the cost of illness.


The interpretation of the content of the obligations of a State party to a human rights treaty is a critical step in working towards the implementation of the human rights guaranteed by the treaty. The last twenty years have seen significant developments in thinking about the nature of the State's obligations under human rights treaties; these have been partly the result of the extensive practice under those treaties and have contributed significantly to the elaboration of that practice. Based on a background paper prepared for an expert group meeting on the subject, this paper explores the nature, scope and content of obligations under the Convention on the Elimination of All Forms of Discrimination against Women, in particular the general obligations contained in the Convention, against the background of a decision by the treaty's monitoring body, the Committee on the Elimination of Discrimination against Women, to elaborate a general recommendation on that subject. It draws on the text of the Convention, as well as on the extensive practice under it and under other UN human rights treaties. The outcome document of the expert group meeting, and relevant material from the practice of the other treaty bodies, appear as Annexes to the paper.


If office workers lack a view to natural features outdoors, do they compensate by bringing plants and pictures of nature indoors? The authors used cross-sectional survey data from 385 Norwegian office workers to investigate whether such compensation occurs. The authors found that workers without windows had roughly five times greater odds of having brought plants into their workspaces than workers with windows, independent of age, gender, type of office, job demands, control over work, and personalization. Windowless workers also had three times greater odds of having brought pictures of nature into their workspaces. The authors consider implications of the findings for environmental design that offers contact with nature to people who spend much of their time indoors.


Two tetradentate ligands type (N2O2) and their complexes with CoII, NiII and ZnII ions were synthesized via two steps; in the first, the precursors W1 and W2 were synthesized from the reaction of  2,6-diamine pyridine or 2,4-diamine tolylene with 2,5-hexanedione respectively in a 2:1 mole ratio. In the second step the ligands [H2L1] and [H2L2] were prepared from the reaction of the two precursor's with 2-hydroxy-1-naphthaldehyde in 1:2 mole ratio. Metal complexes were synthesized by the reaction of the ligands with equivalent amounts of the metal chloride. The prepared compounds were characterized with the physiochemical and spectral techniques which confirmed tetrahedral structure around the metal ions. The antibacterial activity of the ligands and complexes were screened.


We report on a new method which allows extracting thermoelastic images by full-field method using in-plane measurement. The aim of this work is to show that it is possible to extract the in-plane thermoelastic field. Recently, a vibrometric measurement method has been developed at FEMTO-ST Institute for measuring in-plane displacement with nanometer and sub nanometer resolutions. The use of this method with thermography imaging allowed us to extract thermal expansion of micro samples heated by photothermal or thermoelectrical excitation. In this paper, we present an innovating technique to image thermoelastic field of these investigated samples. This technique is based on a CCD (charge-coupled device) camera which has been optimized for the previously presented applications.


To comply with the stringent emission norms under every driving condition, including the coldstart conditions and Real Driving Emissions (RDE) tests, accurate models that capture the spatial and temporal variation of flow distribution information in Exhaust AfterTreatment Systems (EATS) are required. This study is aimed at characterizing and quantifying flow distribution in EATS under transient conditions with realistic geometry that illustrates the complex nature of the flow conditions. Catalytic converters are employed to control emissions. Space limitation in the exhaust line creates non-uniform flow in terms of flow through bends and dead volumes. This limits the performance of the EATS. The flow from the engine does not proceed uniformly to the EATS, creating flow maldistribution at the inlet of EATS. Due to the non-uniform flow, the velocity, temperature and concentrations at the exit are functions of the flow distribution at the inlet. Reactor models that predict conversion of emissions require this information for accurate prediction of conversion of emission gases at the tail pipe. To this end, transient Computational Fluid Dynamics (CFD) simulations are performed to understand the evolution of the flow profiles in the catalytic converter, both under non-reactive and reactive conditions. The flow from the engine is turbulent. Hence, Unsteady Reynolds Averaged Navier Stokes (URANS) equation is used solve for the transport equations to obtain the profiles of velocity, temperature and concentration in the catalytic converter. The turbulence closure is achieved by using κ − ω model . The catalyst is modeled as porous media. This thesis presents the results of both non-reactive and reactive simulations, to illustrate the importance of flow and temperature non-uniformity and pulsations respectively. Flow uniformity index is used to characterize the extent of variation of the flow parameters in any catalyst plane. In addition to the uniformity index, contours and histograms are employed to demonstrate the non-uniform flow field. The specification of inlet fluctuations is also required to emulate real time flow to a catalytic converter. The contours of velocity and histograms show that there is significant distribution of the flow variables at the catalyst outlet. This illustrates that a single channel model is very ideal, and it requires flow distribution information to predict tail pipe concentrations accurately. The inclusion of flow distribution information in EATS model can make the model more accurate. These models can be then used in control and monitoring of emissions from automobiles. This will take a step closer towards Zero Emissions.


PURPOSE The outcomes of patients with myeloma from developing countries are often lacking because of poor record maintenance. Publications from such settings are also limited because of the retrospective nature of the data collection. Information technology can bridge these gaps in developing countries with real-time data maintenance. We present the real-time survival data of the patients with myeloma from a tertiary care center in North India using one such indigenously built software. PATIENTS AND METHODS These are real-time data of all patients with myeloma presenting to a tertiary care center from North India. The patient characteristics (demographics, baseline disease characteristics, risk stratification, and outcomes) were recorded contemporaneously. The survival of the study population was analyzed and grouped based on various disease characteristics at diagnosis. RESULTS The median age of the study population (N = 696) was 65.9 (34.9-94.9) years with male predominance (65%). The median follow-up was 3.7 years (0-18.6 years) with the median overall survival (OS) not achieved. The OS of the study population at 1, 3, and 5 years was 94% (n = 558), 87.5% (n = 394), and 83.1% (n = 267), respectively. Most of the patients presented in advanced stages based on International Staging System (III:70%). On Kaplan-Meier analysis, the presence of weight loss (P = .01), renal dysfunction (P = .047), and anemia at diagnosis (P = .004) had a significant impact on survival. On Cox proportional model univariate analysis, the presence of renal dysfunction, anemia, and weight loss had the significant hazard ratio of 1.68 (1-2.82, P = .049), 3.18 (1.39-7.29, P = .0063), and 2.81 (1.22-6.42, P = .014), respectively, whereas on multivariate analysis of hypercalcemia, renal disease, anemia, and bone disease (CRAB) features, only anemia was found to have a significant hazard ratio of 2.56 (1.01-6.47, P = .046). CONCLUSION The real-world data show OS comparable with the published western literature. Only anemia was found to have significant impact on survival. The use of such software can aid in better data-keeping in resource-constrained settings.


It has been shown in previous research that greater longitudinal pavement marking retroreflectivity levels increase drivers' visibility and detection distance. However, increased visibility may also cause drivers to feel too comfortable during nighttime conditions and drivers may then pay less attention and/or operate at unsafe speeds. Before-and-after studies have been conducted on pavement marking improvements such as repainting stripes or changing to a more durable marking material. Studies have also used models to estimate the retroreflectivity based on the date of installment, the vehicle exposure, or assumed a linear reduction in retroreflectivity over time. Only two studies have related measured pavement marking retroreflectivity to safety performance (crash) data. This study analyzes the relationship between 3 years of pavement marking retroreflectivity data collected by the Iowa DOT on all state primary roads and corresponding crash and traffic data. This study developed a spatial-temporal database using measured retroreflectivity data to account for the deterioration of pavement markings over time along with a statewide crash data to attempt to quantify a relationship. Three different sets of data were analyzed: the complete database, two-lane roads, and records with low retroreflectivity values (≤ 200 mcd/m/lx) only. The distributions and models of the entire database and the two-lane records did not show that poor pavement marking retroreflectivity correlating to a higher crash probability. When looking at records with low retroreflectivity values only, a statistically significant relationship was determined. However, the correlation was so small it does not have practical significance.


Abstract Background: The temporal relationship of cognitive deficit and functional impairment in Alzheimer's disease (AD) is not well characterized. Recent analyses suggest cognitive decline predicts subsequent functional decline throughout AD progression. Objective: To better understand the relationship between cognitive and functional decline in mild AD using autoregressive cross-lagged (ARCL) panel analyses in several clinical trials. Methods: Data included placebo patients with mild AD pooled from two multicenter, double-blind, Phase 3 solanezumab (EXPEDITION/2) or semagacestat (IDENTITY/2) studies, and from AD patients participating in the Alzheimer's Disease Neuroimaging Initiative (ADNI). Cognitive and functional outcomes were assessed using AD Assessment Scale-Cognitive subscale (ADAS-Cog), AD Cooperative Study-Activities of Daily Living instrumental subscale (ADCS-iADL), or Functional Activities Questionnaire (FAQ), respectively. ARCL panel analyses evaluated relationships between cognitive and functional impairment over time. Results: In EXPEDITION, ARCL panel analyses demonstrated cognitive scores significantly predicted future functional impairment at 5 of 6 time points, while functional scores predicted subsequent cognitive scores in only 1 of 6 time points. Data from IDENTITY and ADNI programs yielded consistent results whereby cognition predicted subsequent function, but not vice-versa. Conclusions: Analyses from three databases indicated cognitive decline precedes and predicts subsequent functional decline in mild AD dementia, consistent with previously proposed hypotheses, and corroborate recent publications using similar methodologies. Cognitive impairment may be used as a predictor of future functional impairment in mild AD dementia and can be considered a critical target for prevention strategies to limit future functional decline in the dementia process.


Security at major locations of economic or political importance is a key concern around the world, particularly given the threat of terrorism. Limited security resources prevent full security coverage at all times, which allows adversaries to observe and exploit patterns in selective patrolling or monitoring, e.g. they can plan an attack avoiding existing patrols. Hence, randomized patrolling or monitoring is important, but randomization must provide distinct weights to different actions based on their complex costs and benefits. To this end, this demonstration showcases a promising transition of the latest in multi-agent algorithms into a deployed application. In particular, it exhibits a software assistant agent called ARMOR (Assistant for Randomized Monitoring over Routes) that casts this patrolling/monitoring problem as a Bayesian Stackelberg game, allowing the agent to appropriately weight the different actions in randomization, as well as uncertainty over adversary types. ARMOR combines two key features: (i) It uses the fastest known solver for Bayesian Stackelberg games called DOBSS, where the dominant mixed strategies enable randomization; (ii) Its mixed-initiative based interface allows users to occasionally adjust or override the automated schedule based on their local constraints. ARMOR has been successfully deployed since August 2007 at the Los Angeles International Airport (LAX) to randomize checkpoints on the roadways entering the airport and canine patrol routes within the airport terminals.


This study aims to investigate the role of wind speed and wind direction in ventilation condition and pollutants concentration in street canyons with different aspect ratios through using ENVI-met software in a quantitative and experimental way. The results demonstrate how the combination of different wind variables (direction & speed) with different aspect ratios of canyons, can alter the ventilation condition, flow pattern and also pollutant concentration inside the urban street canyons. The result of simulations in some sections of Valiasr and Taleqani streets considering three different ratio of height to width proportion (0.3, 0.65 and 1.5) for the canyons, and two minimum and maximum threshold values for wind speed (1 m/s and 2.5 m/s) in west and south west direction, showed that increasing the wind speed to all directions (in this case west and south west) in a canyon with different aspect ratios (in this study 0.3, 0.65 and 1.5) can improve ventilation condition inside the canyon and reduce pollutants concentration within it. When the wind direction is perpendicular to the canyon, by increase of aspect ratio, the pollutant concentration will significantly increase inside the canyon, whereas the parallel wind direction in the same test shows opposite results. The findings of this study as well as subsequent findings resulted from combination of different concerned variables, as a general framework can help urban designers and planners to decide on the geometry and direction of street canyons.


Scade is a domain-specific synchronous functional language used to implement safety-critical real-time software for more than twenty years. Two main approaches have been considered for its semantics: (i) an indirect collapsing semantics based on a source-to-source translation of high-level constructs into a data-flow core language whose semantics is precisely specified and is the entry for code generation; a relational synchronous semantics, akin to Esterel, that applies directly to the source. It defines what is a valid synchronous reaction but hides, on purpose, if a semantics exists, is unique and can be computed; hence, it is not executable. This paper presents, for the first time, an executable, state-based semantics for a language that has the key constructs of Scade all together, in particular the arbitrary combination of data-flow equations and hierarchical state machines. It can apply directly to the source language before static checks and compilation steps. It is constructive in the sense that the language in which the semantics is defined is a statically typed functional language with call-by-value and strong normalization, e.g., it is expressible in a proof-assistant where all functions terminate. It leads to a reference, purely functional, interpreter. This semantics is modular and can account for possible errors, allowing to establish what property is ensured by each static verification performed by the compiler. It also clarifies how causality is treated in Scade compared with Esterel. This semantics can serve as an oracle for compiler testing and validation; to prototype novel language constructs before they are implemented, to execute possibly unfinished models or that are correct but rejected by the compiler; to prove the correctness of compilation steps. The semantics given in the paper is implemented as an interpreter in a purely functional style, in OCaml.


Objectives. We determined the prevalence of patients at risk for obstructive sleep apnea (OSA) with uncontrolled type 2 diabetes mellitus (T2DM) at the out-patient department (OPD) of the University of the Philippines-Philippine General Hospital (UP-PGH) from December 1, 2018 - February 28, 2019. We described the demographic characteristics of patients with uncontrolled T2DM and compared them with high and low OSA risk, its association, and correlation with the quality of sleep.
Methods. This is a prospective cross-sectional study among uncontrolled T2DM. The questionnaires were Berlin Questionnaire (screen OSA-HR) and Epworth Sleepiness Score (level of sleepiness). Clinicodemographic profile and significant laboratory data were obtained. Descriptive statistics utilized. Chi-square test was used to compare categorical variables between patients with high vs low OSA risk and to determine if an association exists between OSA-HR and sleep quality.
Results. A total of 240 participants, 88 males and 151 females, were included in the study. The overall prevalence of OSA-HR among patients with uncontrolled type 2DM is 58.33%. The majority of the OSA–HR patients (105 /140) was 46 years old and above. There is a significant association of tonsillar grade, Mallampati score, BMI, HbA1c, hypercholesterolonemia, and Epworth sleepiness on OSA High risk. There is also a substantial association with age, BMI, Mallampati score, tonsillar grade, hypertension, asthma, HbA1c, and hypercholesterelonemia on the level of sleepiness of OSA-HR.
Conclusion. There is a high prevalence of high OSA-risk among patients with uncontrolled DM. Factors associated with high OSA-risk among uncontrolled diabetes mellitus include HbA1c, dyslipidemia, BMI, Mallampati score, tonsillar grade, and Epworth score.


Objectives To report the outcomes of surgical treatment of calf intramuscular venous malformations (IMVMs) on pain, functional limitation, and quality of life. Methods We retrospectively reviewed 57 consecutive patients who had surgery for IMVM of the posterior compartment of the leg between 2010 and 2015. Treatments were all done at a single institution. Results Patients presented with pain (52), muscle contracture (14), or pulmonary embolism (4). Muscle involvement included the soleus muscle (n = 28, 49%), the gastrocnemius muscle (n = 25, 43%), and deep muscles (n = 4, 7%). Complete excision was possible in 52 patients (91%) and partial excision in 5 (9%). Thirty-five of 46 patients who had an MRI follow-up at six months had no residual venous malformation. At the final follow-up (mean 39 months), 32 of 40 patients seen had no residual pain and 37 had no residual functional impairment. Conclusion In cases where IMVM is located in one muscle in the leg, we demonstrated that surgery yielded improvement in pain, function, and quality of life.


Background: The benefits of breastfeeding are well established in the literature. Barriers related to breastfeeding, such as maternal obesity, are also cited in the literature. Worldwide obesity rates in women of reproductive age are rising at an alarming pace. Previous research has attempted to study the relationship between maternal body mass index (BMI) and its effect on breastfeeding outcomes, but it is not clear what the role of maternal BMI category has on breastfeeding outcomes. Objectives: The objective of this review is to examine whether and how maternal BMI affects maternal breastfeeding outcomes such as intention, initiation, duration, and exclusivity. Methods: A systemic literature search through PubMed and Cumulative Index to Nursing and Allied Health Literature was conducted between January and May 2020, by using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 23 relevant articles were retrieved. Results: Of the 23 studies that assessed the relationship between maternal BMI and breastfeeding intention and other outcomes, only 4 found no differences in breastfeeding outcomes across BMI categories. Higher than normal maternal prepregnancy BMI has been found to be associated with poorer breastfeeding outcomes. Overweight and obese women are less likely to intend to breastfeed and initiate breastfeeding. They also have shorter breastfeeding durations and are less likely to exclusively breastfeed for any period compared with normal weight women. Conclusions: Breastfeeding rates across all BMI categories do not meet the recommended guidelines established by the World Health Organization and other public health agencies, and overweight and obese women have poorer breastfeeding outcomes. Overweight and obese women need additional support to initiate breastfeeding, and to breastfeed longer and exclusively. Targeted and well-designed interventions should be implemented early in the perinatal period to support this vulnerable population.


CASE
A 32-year-old male right-hand dominant school-bus driver with facioscapulohumeral dystrophy (FSHD) was referred to an upper limb specialist for consideration for scapulothoracic fusion (STF) because of limited upper limb function and cosmetic issues. Staged bilateral STFs were performed with seven high-strength suture tapes tensioned to secure a standard tubular plate in situ.

CONCLUSION
STF may be a desirable treatment option for patients with FSHD. The use of high-strength suture tapes in cases of STF allows for secure fixation of the scapulothoracic joint. This potentially confers a reduction in operative time while ensuring adequate tensioned fixation and minimizing the risk of iatrogenic pneumothorax.